Research Paper: PTSD History Study Effects and Treatments for War Veterans

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PTSD for War Veterans and Families

SOME WOUNDS DO NOT HEAL

PTSD History, Study, Effects and Treatments for War Veterans

Post-traumatic Stress Disorder or PTSD symptoms develop in response to life-threatening trauma, typically among multiply deployed soldiers in war zones, such as Iraq and Afghanistan. Most of them are younger than 25, of lower rank, genetically predisposed and female. Broad categories of symptoms are re-experiencing distress, avoidance and hyperarousal, leading to overall personal malfunctioning and a host of interaction problems with the family and the community. Current treatments include rehab, counseling, medication and a virtual environment world approach. Until enough is known and done about PTSD, the returning war veteran and his family must suffer the condition and all its consequences.

Introduction and History

PTSD or Post-Traumatic Stress Disorder is a form of anxiety, which develops from exposure to, or an experience of, a frightening event or threatening ordeal (National

Institute of Mental Health, 2010). Such events or ordeals include violent personal assaults, disasters, accidents or military combat. PTSD is a new term but it has existed in modern medicine until the American Psychiatric Association classified it in 1980 (More Focus Media Group Inc., 2010). For centuries, people have suffered extreme stress as a result of trauma. But the ironic advancements of modern age have raised stress to a high level, which produced the disorder. Research reveals that bombings, terrorist attacks and other global tragedies conduce to the prevalence. Hence, it characteristically develops in war fighters. Persisting terrifying thoughts and memories of their war trauma recur without warning. They feel emotional numbness, fear, detachment and aggression, especially towards household members, who were once close to them (NIMH). PTSD severely affects not only the afflicted returning war veteran but also his family.

Body

High Rates

Official records in 2007 showed that PTSD cases among returning veterans from Iraq ranged from 12-20% (Roehr, 2007). Of the 1.5 million deployed by this year, more than 52,000 received treatment from the Department of Veterans Affairs. Dr. Evan Kanter informed the 135th annual meeting of the American Public Health Association that a minimum of 300,000 returning soldiers from Iraq develop PTSD. This number costs an estimate of $600 billion in health care, which costs more than the war itself at $500 billion. Dr. Kanter reported that 25% of the first returning 100,000 veterans from Iraq and Afghanistan were diagnosed at the DVA with mental conditions, the most common of which was PTSD. There was underreporting at first as the veterans did not want to delay their return. Moreover, mental health conditions like the PTSD have a delayed and insidious onset (Roehr).

The 17 official PTSD symptoms are broadly categorized into re-experiencing memories and distress, avoidance and hyperarousal (Roeh, 2007). Avoidance takes the form of withdrawal, emotional numbing, detachment, and memory gaps. Hyperarousal is expressed as irritability, anger outbursts, hypervigilance and exaggerated startle and in insomnia and poor concentration. Other features are poor occupational and social function, depression, suicidal ideation, alcohol and drug abuse, guilt, shame, inability to trust, over-controlling, few or no close relationships, extreme isolation, unemployment, divorce, domestic violence and child abuse. Returning veterans are also said to be twice as likely as the general population to die of suicide, according to official records. Dr. Kanter pointed to unprecedented multiple deployments to a combat zone as a risk factor with trauma intensity and duration as predictive factors. Those sent to war at multiple times are sicker and costlier to take care of. More than half a million of them have been deployed twice or more, according to Dr. Kanter. Recovery takes time and depends on limiting exposure to triggers, restoring balance, fulfilling physical and emotional needs and limiting alcohol and stimulants use. Dr. Kanter added that PTSD has very telling effects on families. It causes marital problems and problems on children's personality and behavior, family violence and strong likelihood of generational transmission of violence (Roehr).

Effects of Repeated Deployments

Recent surveys conducted with 2,543 National Guard members deployed to Iraq in

2008 revealed that they were thrice as likely to develop PTSD as those not previously deployed (Kline et al., 2010). Those deployed were also more likely to develop major depression and poorer physical functioning than the general population. The sampled respondents in the survey were 2,995 New Jersey National Guard members undergoing pre-deployment medical assessment for deployment to Iraq in 2008. They had significantly varied demographic and military characteristics. The deployed were older, many of them women and coming from racial or ethnic minorities, better educated and likely to be fully employed (Kline et al.).

The study found that despite comprehensive health screenings by state and federal military authorities, repeated deployments of New Jersey National Guard troops to Iraq may result in medical health impairments (Kline et al., 2010). Furthermore, the Office of the U.S. Army Surgeon General reported that multiple deployments adversely affect work performance during deployment (Kline et al.). These findings support those of the earlier study by Roehr.

Trends and Risk Factors of PTSD and Depression

Using Veterans Affairs data, this study identified these among 29,000 veterans sent to Iraq and Afghanistan and received VA healthcare upon their return between 2002 and 2008 (Seal et al., 2009). These soldiers developed the disorders after deployment to Iraq and Afghanistan 4-7 times higher than at earlier periods. They were younger than 25 years old, female and greater exposure to combat. A substantial increase in mental health diagnoses after the Iraq War and seeking VA healthcare drew apprehensions and called for early intervention to prevent the chronic disorders (Seal et al.).

The prevalence and risk for mental health conditions among Operation Iraq Freedom and Operation Enduring Freedom in Afghanistan veterans increased after the start of the Iraq War in March 2003 (Seal et al., 2009). Reasons behind were decrease in public support and lower morale among the soldiers; unexpected threats to life in the Iraq insurgency for a lack of definable "front-line;" multiple and longer deployments and increased media coverage. Those aged 16-24 and in active duty were at the highest risk for PTSD and alcohol and drug abuse. And these younger soldiers who were at the lower rank had a greater exposure to combat. As to gender, women were likelier to develop depression than men. And the lack of social support or inability to sustain a close relationship may also affect post-deployment mental health problems. Target screening and early intervention into particular subgroups can be the best prevention of chronic mental health and social and occupational disorders (Seal et al.).

Susceptibility

Genetic make-up strongly predisposes certain individuals to PTSD, anxiety and depression (Cassels, 2008). This was the finding of a unique study conducted with 12 multigenerational families by Dr. Armen Goenjian of the University of California Los Angeles Department of Psychiatry and Bio-behavioral Sciences and his team. The 200 respondents experienced the devastating and massive earthquakes in Armenia in 1988. The study found that 41% of them developed PTSD symptoms and 61% depressive symptoms due to genetic factors (Cassells).

Previous to this unique study, the known risk factors for PTSD were female gender, past history and family history of anxiety and exposure to traumatic experiences (Cassells, 2008). Early studies on twins, however, suggested a genetic link between PTSD and anxiety and PTSD and depression. But no research was undertaken to explore the connection because of the difficulty of family studies on PTSD. These studies typically involved single individuals rather than whole families on their exposure to particular traumas. Dr. Goenjian and his team overcame this difficulty. Their respondents were survivors of the earthquakes, which killed 17,000 people and destroyed more than half of the city. Information on their objective and subjective experiences was obtained from every participant. This included the destruction of their homes, deaths of relatives, the sight of dead bodies, getting injured or witnessing the injuries of others. They also expressed fears of earthquakes, getting hurt or dying and the injuries and death of others. They were parents and children, grandparents and grandchildren, siblings and other relatives of families during the quakes. The study found that the genetic makeup of the majority of them rendered them vulnerable to developing PTSD, anxiety and depressive symptoms. Moreover, the team found that the disorders develop from shared genes and not only from environmental factors, such as upbringing. Vulnerability is shared by 3 phenotypes as the more important causes of disease than environmental factors. This puts PTSD, anxiety and depression under one diagnostic category of disorders. The study can help in the identification of the specific, shared genes involved (Cassells).

The Physical and Mental Health Status of Deployed Service Members

The currently involvement of the U.S. military in massive, long-term and complex combat operations around the world requires that its deployed service members be in optimum health conditions in body and mind (Smith et al., 2004). A millennium cohort study conducted with more than 77,000 service members from 2001-2003 as part of a big longitudinal, population-based military health study provided the response to the… [END OF PREVIEW]

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