Posttraumatic Stress Disorder and 9-11 (cont.)
Sadly, the September 11th tragedy is only the most recent causative (precipitating) event for posttraumatic stress disorder. The scope of the PTSD problem in our society is actually substantial. For example, a current diagnosis of PTSD has been found in 15% of 500,000 men who were Vietnam veterans. Likewise, almost 18% of 10 million women who were victims of physical assault have PTSD. As a matter of fact, eight to 10% of the population will suffer from PTSD at sometime in their lives.
The consequences of PTSD for both the afflicted individual and society are significant. For example, studies have shown that patients with PTSD will have an increased number of suicides and hospitalizations. Also, patients with PTSD will have an increased frequency of alcohol abuse and drug dependency problems. In addition, we know that patients who have been victims of criminal acts subsequently have a much higher utilization of medical services in general. Most significantly, one third of PTSD patients will have related symptoms 10 years after the trauma. The majority of these people will also suffer from other psychiatric, marital, occupational, financial, and health problems.
In general, posttraumatic stress disorder can be seen as an overwhelming of the body's normal psychological defenses against stress. Thus, after the trauma, there is abnormal function (dysfunction) of the normal defense systems, which results in certain symptoms. The symptoms are produced in three different ways:
First, symptoms can be produced by re-experiencing the trauma, whereby the individual can have distressing recollections of the trauma. For example, the person may relive the experience as terrible dreams or nightmares or as daytime flashbacks of the event. Furthermore, external cues in the environment may remind the patient of the event. As a result, the psychological distress of the exposure to trauma is reactivated (brought back) by internal thoughts, memories, and even fantasies. Persons also can experience physical reactions to stress, such as sweating and rapid heart rate. (These reactions are similar to the "fight or flight" responses to emergencies described by Dr. Walter Cannon.) The patient's posttraumatic symptoms can be identical to those symptoms experienced when the actual trauma was occurring.
The second way that symptoms are produced is by persistent avoidance. The avoidance refers to the person's efforts to avoid trauma-related thoughts or feelings and activities or situations that may trigger memories of the trauma. This so-called psychogenic (emotionally caused) amnesia (loss of memory) for the event can lead to a variety of reactions. For example, the patient may develop a diminished interest in activities that used to give pleasure, detachment from other people, restricted range of feelings, and a sad affect that leads to the view that the future will be shortened.
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