JOHN DOE
Abstract
Posttraumatic stress disorder is a common and disabling disorder that develops as a consequence of traumatic events and is characterized by distressing re-experiencing portions of the trauma, avoidance of reminders, emotional numbing and hyper-arousal. In spite of the deleterious impact of PTSD within the U.S. military, our current understanding of the human pathophysiology governing the divergent paths associated with extreme stress response the remains unabated. Given the widespread phenomenon of ‘trauma’, it begs the question of whether or not preexisting features accompany some suffers who have developed PTSD and why others may or may not face the same effect. Much research has been conducted in this arena and it seems that no one researcher has a definitive cause, much less a standardized treatment approach for PTSD sufferers. Posttraumatic Stress Disorder Posttraumatic stress disorder (PTSD) develops as a consequence of traumatic events such as interpersonal violence, disaster, severe accidents, or other life-threatening experiences. The most common characteristics of PTSD are the re-experiencing of symptoms linked to a specific event. Patients involuntary re-experience aspects of the traumatic event in a very vivid and distressing way. This includes: flashbacks, in which the person acts or feels as if the event were recurring, nightmares, intrusive images or other sensory impressions from the event. For example, one soldier witnesses another, mortally wounded during a bombing. Consequently this survivor continues hearing the sound of the explosion and unwillingly relives the memories of the horrific encounter over and over.
Patients who suffer from PTSD display periods of both hyperarousal and numbing. Avoidance of situations, stimulus or reminders linked with the event is quite common. The patients’ emotional state can range from feelings of intense fear, anger, sadness or guilt, to shame and emotional numbness. Social and occupational functioning is often severely impaired with PTSD. These considerations present a significant burden not only to the individual but society at large (Bailey, 2013). If PTSD remains untreated, secondary problems such as depression, substance abuse, and social isolation may transpire.
Introduction
According to the DSM-IV-TR (APA, 2000), posttraumatic stress disorder is caused by situations in which a person “experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or threat to the physical integrity of self or others” which provoked a response that “involved intense fear, helplessness or horror.” While anyone in the general population has the potential to have an experience that would qualify as traumatic, the likelihood of developing PTSD increases when the traumatic event involves danger or violence from other people. Events, such as those, are likely to occur during wartime experiences (Yehuda & LeDoux, 2007). Specific to the inherent dangers found on the battlefield, the development of PTSD is a momentous risk for combat veterans. Unprecedented when compared to the civilian population.
Incidence and Exposure Since 2001, over 1.6 million U.S. troops have served in the Afghanistan or Iraqi conflicts during both Operation Enduring Freedom and Operation Iraqi Freedom (Angkaw, 2013). As of November 17, 2011, 6,320 service members were killed in Afghanistan (Operation Enduring Freedom [OEF]) and Iraq (Operation Iraqi Freedom [OIF]) (Belasco, 2011). An estimated 50,000 to 100,000 service members were known to have experienced non mortal wounds and injuries during deployment in the theater of operations for OIF/OEF. The number of those injured during military service is staggering; with an unprecedented number of injured U.S. service members returning home in contrast to previous military actions (Gibson, 2012).