Post-traumatic stress disorder (PTSD) is a psychological injury that is often observed in veterans. According to Garrett and Hough (2018), PTSD is a prolonged reaction to a stressful event, which is often characterized by recurrent thoughts, nightmares, lack of concentration, and overreaction to environmental stimuli. PTSD may also be characterized by a struggle to find the right words, feeling frightened, and experience memory loss. Neuroanatomical studies confirmed that PTSD symptoms are caused by changes in major brain structures. For instance, language problems are caused by impairment of the prefrontal lobe, the overreaction is caused by overdrive of the amygdala, memory loss happens when the hippocampus shrinks, and fear is caused by the trauma of the medial prefrontal cortex (Garrett & Hough, 2018). Therefore, it can be stated that the majority of psychological symptoms can be explained by physiological changes.
Even though PTSD can be confirmed by changes in the brain, the condition is diagnosed using information about symptoms received from the patients or their relatives. The DSM-5 criteria include several aspects that are assessed during the diagnosis procedure. First, the evaluators need to understand if the patient was exposed to the actual threat, serious injury, or sexual violence (Center for Substance Abuse Treatment, 2014). Second, the evaluators assess the presence of intrusion symptoms (Center for Substance Abuse Treatment, 2014). Third, the patients are screened for persistent avoidance of the traumatic stimuli (Center for Substance Abuse Treatment, 2014). Fourth, the assessors search for negative alterations in cognitions and mood associated with the traumatic events (Center for Substance Abuse Treatment, 2014). Fifth, the patients need to present marked alterations in arousal and reactivity associated with the traumatic events (Center for Substance Abuse Treatment, 2014). All the changes should occur for more than one month; they should cause clinically significant distress or impairment in different areas of functioning (Center for Substance Abuse Treatment, 2014). None of the changes should occur due to substance misuse (Center for Substance Abuse Treatment, 2014). DSM-5 does not include assessments of the biological basis of PTSD.
Standard treatment techniques for PTSD are therapies that do not take into account the physiology behind the condition. PTSD is treated by family therapy or cognitive processing therapy (WebMD, n.d.). At the same time, the condition can be treated using medications and prolonged exposure therapy (WebMD, n.d.). Garrett and Hough (2018) also mention novel approaches to PTSD therapy that utilize electric impulses to erase fear caused by PTSD. In summary, it can be stated that the physiological factor of PTSD is not considered in conventional treatment methods.
Steenkamp, Litz, Hoge, and Marmar (2016) conducted a systematic review of common treatments of veterans demonstrating PTSD symptoms. The results revealed that the most common therapies are cognitive processing therapy and prolonged exposure, as 49%-70% of patients participating in the research were treated using these therapies (Steenkamp et al., 2016). The majority of patients experienced a significant improvement in PTSD symptoms after these interventions (Steenkamp et al., 2016). However, 60%-72% of patients retained their PTSD diagnosis after treatment (Steenkamp et al., 2016). Therefore, additional research is needed to develop new treatment methods that can improve the outcomes of patients with PTSD.
However, outcomes may be also be improved by early detection methods. For instance, Garrett & Hough (2018) state that hippocampal reduction is often present in PTSD patients. Therefore, groups with a high risk of PTSD, such as veterans, should be screened using computer tomography to measure hippocampal volumes. A decreased size of hippocampi could show that a person is more susceptible to developing PTSD if they were to experience an extremely stressful situation.
References
Center for Substance Abuse Treatment. (2014). DSM-5 diagnostic criteria for PTSD. Web.
Garrett, B., & Hough, G. (2018). Brain and behavior: An introduction to behavioral neuroscience (5th ed.). Los Angeles, CA: SAGE Publications, Inc.
Steenkamp, M., Litz, B., Hoge, C., & Marmar, C. (2016). Psychotherapy for military-related PTSD. JAMA, 314(5), 489. Web.
WebMD. (n.d.). What are the treatments for PTSD? Web.