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Health, Medicine, Nursing
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Veteran Affairs and PTSD (Research Paper Sample)
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This paper looks at the effects of combat conditions on war veterans, particularly with respect to post traumatic stress disorder (PTSD).
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Veteran Affairs and PTSD
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Veteran Affairs and PTSD
Introduction
Posttraumatic stress disorder, or PTSD, refers to an anxiety disorder that can develop after an individual’s exposure to traumatic events such as the threat of death, accidents, serious injury, or assault. The diagnosis of PTSD may result when a set of symptoms such as high levels of anxiety (hyperarousal), disturbing recurrence of flashbacks, and the numbing or avoidance of memories of the traumatizing event persist for extended periods, usually more than a month following the traumatic event. Because of combat conditions, war veterans are predisposed to PTSD (Kulkarni, Porter & Rauch, 2012, p. 273). A growing number of war veterans have been seeking treatment for PTSD at the Department of Veteran Affairs. PTSD is categorized as an anxiety disorder, and the attributes are not present before experience of the violently traumatic event. Characteristically, the individual with PTSD will avoid all thoughts, discussions, and emotions of the stress-causing event and may experience memory loss or amnesia. Nonetheless, the individual commonly relives the event through disturbing, recurrent flashbacks, recollections and nightmares.
Pathophysiology of PTSD
Neuroendocrinology
PTSD symptoms may come about following the experience of a traumatic incident that leads to an abnormal adrenaline response, causing profound neurological patterns in an individual’s brain that can endure long after the causal event, which causes the individual to be hyper-responsive to future terrifying or anxiety-causing situations. During the traumatic experience, increased levels of stress hormones are often secreted, which smother hypothalamic activity and may be the major factor that contributes towards PTSD development. PTSD causes certain biochemical changes in the body and brain that is different from other disorders (Beck & Sloan, 2012, p. 169). Individuals with PTSD have unceasingly low serotonin levels, which may lead to behavioral symptoms such as irritability, anxiety, aggression, ruminations, impulsivity, and suicidal tendencies. The levels of dopamine in PTSD patients can contribute to the symptoms that are characteristic of the condition. Low dopamine levels can lead to apathy, anhedonia, motor deficits, and impaired attention while increased levels may cause agitation, psychosis, and restlessness.
PTSD Among Military Veterans
The scars of warfare often take a number of forms, from the loss of limbs to illnesses due to battlefield exposure and the psychological toll of experiencing extreme traumatic events. PTSD among military veterans endures to be an important concern with projected prevalence rates of fifteen percent among Vietnam-era war veterans, between two and ten percent among the first Gulf War veterans, and between eleven and twenty-two percent among active duty troops and veterans of the incursions in Afghanistan and Iraq. These rates, together with the documented, multidimensional injury and mutilation associated with PTSD create a pressing need for the better understanding and treatment of this disorder in this population (Kulkarni, Porter & Rauch, 2012, p. 276). Two emotion-related indicators of PTSD, which are anger and dissociation, are well-known risk factors associated with the development and progress of PTSD. They are also significant problems among war veterans with PTSD.
Anger among PTSD War Veterans
Anger is often associated with a number of negative consequences such as impulsive aggression, inadequate treatment outcomes, increased aggression, as well as substance misuse. The trauma survivors who report increased heights of anger among both civilian and veteran populations are more likely to meet PTSD criteria. In addition, the level of anger among war veterans often differentiates those with and without PTSD. An increased level of anger is frequently associated with severe overall PTSD, even following the removal of stressor events. According to Orth and Wieland (2006), the intensity of the relationship between anger and PTSD is significant across trauma types, even though it is most pronounced among military war veterans.
Dissociation among PTSD War Veterans
Dissociation is defined as the difficulty in integrating feelings, thoughts, and experiences into coherent memory and consciousness. Increased symptoms of dissociation, both in the course of and after exposure to the traumatic event, are associated with higher prevalence and increased asperity of PTSD among civilian and military population. Increased dissociation levels, both during and after traumatic events, have been found to be more marked among war veterans with PTSD than those without. This has been predictive of PTSD condition even after the management of the level of combat exposure (Kulkarni, Porter & Rauch, 2012, p. 272). However, the connections between dissociation and symptoms of PTSD, which are numbing/avoidance, intrusion, and hyperarousal, are still obscured. For example, studies conducted on female war veterans who served in the Vietnam war indicate dissociation as predictive of intrusive and avoidance symptoms. Conversely, an increased dissociation level has only been related to symptoms of arousal in a section of male Australian Vietnam War veterans.
Anger and Dissociation
In combination, anger and dissociation are key factors in the development, as well as the maintenance of PTSD. Additionally, increased levels of anger and dissociation have often been associated with inferior mental health outcomes (that is, social impairment and PRSD). Dissociation and anger are complimentary manners of emotional detachment from the traumatic experience that involve problematic coping mechanism consistent with emotional avoidance (Kulkarni, Porter & Rauch, 2012, p. 272). Even though these results are undeniable and compelling, replication and extension are necessary in the understanding of the relationship between dissociation, anger, and PTSD among war veterans.
Trauma, Criminal Involvement, and Negative Affect in Afghanistan and Iraq War Veterans
War veterans who served in Afghanistan and Iraq who struggle with emotional outbursts and anger resulting from combat trauma are more likely to be apprehended for criminal misdemeanor compared to other veterans (Elbogen et al, 2012, p. 1100). Even though criminal conduct among veterans has been viewed as a growing problem, less is known regarding why some veterans are more prone to arrests than others are. Criminal behavior theories suggest that individuals who have had exposure to traumatic events and stressful environments and who report negative emotions such as irritability and anger, show elevated risks of antisocial conduct. As more psychologically-scarred soldiers returned from active duty in Afghanistan and Iraq, society’s concern for and focus on these soldiers, as well as their psychological disorders increased. With studies substantiating the validity of PTSD diagnosis and the real impact of the condition on the conduct of war veterans, greater emphasis may be accorded to the hypothesis that PTSD is a disorder that gives a basis for a mental status defense, which include insanity, self-defense, and lack of mens rea.
Management of PTSD
Psychological
Numerous variations of psychotherapy have been suggested for trauma-related complications such as PTSD. Simple counseling practices in treating PTSD include basic education about the condition, as well as providing safety and support (Benedek & Wynn, 2011, p. 36). Some psychotherapy programs th...
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