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======Post Traumatic Stress Disorder====== | ======Post Traumatic Stress Disorder====== | ||
- | Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after an individual experiences or witnesses a traumatic event. From a medical and psychiatric perspective, | + | Post-traumatic stress disorder (PTSD)[(PTSD> |
+ | is a mental health condition that can develop after an individual experiences or witnesses a traumatic event. From a medical and psychiatric perspective, | ||
Symptoms of PTSD can be divided into four main categories: | Symptoms of PTSD can be divided into four main categories: | ||
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From a psychiatric perspective, | From a psychiatric perspective, | ||
+ | |||
+ | =====Diagnostic Criteria===== | ||
+ | |||
+ | [[the_diagnostic_statistical_manual_and_the_icd|The Diagnostic and Statistical Manual of Mental Disorders]], | ||
+ | |||
+ | A. Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways: | ||
+ | |||
+ | * Directly experiencing the traumatic event(s) | ||
+ | * Witnessing, in person, the event(s) as it occurred to others | ||
+ | * Learning that the traumatic event(s) occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. | ||
+ | * Repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse). | ||
+ | |||
+ | Note: Criterion A4 does not apply to exposure through electronic media, television, movies, or pictures, unless this exposure is work-related. | ||
+ | |||
+ | B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the event(s) occurred: | ||
+ | |||
+ | * Recurrent, involuntary, | ||
+ | * Recurrent distressing dreams in which the content and/or affect of the dream are related to the traumatic event(s). | ||
+ | * Dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the traumatic event(s) were recurring. Such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings. | ||
+ | * Intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event(s). | ||
+ | * Markedly diminished interest or participation in significant activities. | ||
+ | * Feelings of detachment or estrangement from others. | ||
+ | * Inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, | ||
+ | |||
+ | C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following: | ||
+ | |||
+ | * Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). | ||
+ | * Avoidance of or efforts to avoid external reminders (people, places, conversations, | ||
+ | |||
+ | D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following: | ||
+ | |||
+ | * Inability to remember an important aspect of the traumatic event(s) (typically due to dissociation). | ||
+ | * Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world (e.g., "I am bad," "No one can be trusted," | ||
+ | * Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/ | ||
+ | * Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame). | ||
+ | * Markedly diminished interest or participation in significant activities. | ||
+ | * Feelings of detachment or estrangement from others. | ||
+ | * Inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, | ||
+ | |||
+ | |||
+ | =====Shell Shock===== | ||
+ | |||
+ | "Shell shock" | ||
+ | |||
+ | <WRAP RIGHT> | ||
+ | {{youtube> | ||
+ | </ | ||
+ | |||
+ | The symptoms of shell shock were varied and included things like anxiety, depression, nightmares, flashbacks, irritability, | ||
+ | |||
+ | At the time, there was little understanding of the psychological effects of combat and many soldiers with shell shock were treated harshly, including being court-martialed, | ||
+ | |||
+ | As more and more soldiers began to experience shell shock, the British Army began to establish specialized hospitals to treat these soldiers. Medical professionals at these hospitals began to understand that shell shock was not a physical injury, but a psychological one, caused by the trauma of warfare. | ||
+ | |||
+ | During World War I, the treatment of shell shock varied widely and was often ineffective. Many soldiers with shell shock were treated harshly and were seen as malingerers or cowards. Some soldiers were court-martialed, | ||
+ | |||
+ | As the war progressed, the British Army began to establish specialized hospitals to treat soldiers with shell shock. Medical professionals at these hospitals began to understand that shell shock was not a physical injury, but a psychological one caused by the trauma of warfare. | ||
+ | |||
+ | In these hospitals, a variety of treatment methods were used, including: | ||
+ | |||
+ | * Rest and recuperation: | ||
+ | * Occupational therapy: soldiers were given tasks to complete such as woodworking or farming to keep them occupied and to aid in their recovery | ||
+ | * Psychotherapy: | ||
+ | * Electroconvulsive therapy (ECT) and Insulin shock therapy: Both were used as a last resort to treat soldiers who were unresponsive to other treatments. | ||
+ | * Morphine and other sedatives: these drugs were used to help soldiers sleep and reduce their symptoms of anxiety and depression. | ||
+ | |||
+ | It is important to note that these treatments were not always effective, and many soldiers with shell shock did not fully recover. Additionally, | ||
+ | |||
+ | After the war, the term "shell shock" fell out of use and was replaced with the term "war neurosis" | ||
+ | The understanding of PTSD has greatly developed since the first world war, and the treatments for it have improved significantly as well. | ||
+ | |||
+ | =====Vietnam War Veterans===== | ||
+ | |||
+ | During the Vietnam War, it is estimated that approximately 2.7 million American soldiers served in the conflict. After the war, a significant number of Vietnam War veterans[(Vietnam_veteran> | ||
+ | |||
+ | It is difficult to determine the exact number of Vietnam War veterans who were incarcerated after the war. The Department of Veterans Affairs (VA) has reported that as of 2016, around 30% of Vietnam War veterans were incarcerated, | ||
+ | |||
+ | One of the main reasons that many Vietnam War veterans ended up in prison was due to their struggles with PTSD and related issues such as substance abuse and homelessness. After experiencing the trauma of combat, many veterans had difficulty adjusting to civilian life and turned to drugs or alcohol to cope. This often led to addiction, which in turn led to legal problems and involvement with the criminal justice system. | ||
+ | |||
+ | Additionally, | ||
+ | |||
+ | It is worth noting that, since the Vietnam War, the US government, the Department of Veterans Affairs, and veteran organizations have increased their efforts to help veterans with their reintegration into society and to provide support for those suffering from PTSD and other mental health issues. These efforts include providing veterans with counseling, therapy, and other forms of mental health support, as well as job training and education programs. | ||
+ | |||
+ | =====Homelessness Among British Gulf War Veterans===== | ||
+ | |||
+ | The rate of homelessness among British veterans from the Gulf Wars (1990-1991 and 2003-2011) is a complex issue and there is no clear consensus on the exact numbers.[(homeless> | ||
+ | | ||
+ | |||
+ | Some estimates suggest that around 10% of the homeless population in the UK are veterans, with a proportion of those being Gulf War veterans. However, the true number is likely to be higher as many veterans who are homeless do not self-identify as such, making it difficult to get an accurate count. | ||
+ | |||
+ | There are a variety of factors that contribute to veterans experiencing homelessness, | ||
+ | |||
+ | The UK government and veterans' | ||
+ | |||
+ | It's worth noting that the UK has a duty to provide housing to its veterans who are homeless or at risk of becoming homeless under the Homelessness Reduction Act 2017. The act makes it a legal duty for local authorities to provide assistance to veterans who are homeless or at risk of becoming homeless. | ||
+ | |||
+ | =====Alcohol===== | ||
+ | |||
+ | Substance use disorder, such as alcohol use disorder, commonly co-occur with PTSD [( : | ||
+ | authors | ||
+ | title : Psychotropic drugs: fast facts (3rd ed.) | ||
+ | publisher : W. Norton & Company | ||
+ | published : 2002 | ||
+ | pages : 348 | ||
+ | isbn : 978-0-393-70301-6 | ||
+ | url : https:// | ||
+ | )] | ||
+ | . Studies have found that between 30-50% of individuals with PTSD also struggle with alcohol abuse or dependence. This is likely due to the fact that many individuals with PTSD use alcohol as a way to self-medicate and cope with the symptoms of their disorder, such as anxiety, depression, and flashbacks. However, it is important to note that alcohol use can exacerbate the symptoms of PTSD and make the disorder worse over time. | ||
+ | |||
+ | =====Complex Post Traumatic Stress Disorder (cPTSD)===== | ||
+ | |||
+ | Complex post-traumatic stress disorder (cPTSD)[(C-PTSD> | ||
+ | |||
+ | cPTSD is considered to be a " | ||
+ | |||
+ | The symptoms of cPTSD can be divided into three categories: | ||
+ | |||
+ | - Intrusive symptoms, such as flashbacks, nightmares, and dissociation | ||
+ | - Avoidance symptoms, such as emotional numbing and difficulty trusting others | ||
+ | - Negative changes in mood and cognition, such as feelings of guilt, shame, and a sense of being fundamentally flawed. | ||
+ | |||
+ | cPTSD also includes symptoms such as: | ||
+ | |||
+ | * Difficulty regulating emotions, including feeling emotionally " | ||
+ | * Difficulty with self-perception, | ||
+ | * Difficulty with relationships, | ||
+ | |||
+ | It is important to note that cPTSD is not yet recognized as a separate disorder in the Diagn and Statistical Manual of Mental Disorders (DSM-5), but is considered a " | ||
+ | |||
+ | |||
+ | |||
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