DEVELOPMENTAL HAZARD PRESENTATION: PTSD IN ADULTS By: Emmanuel
Dealca Kristin Davis Kaitlyn Downing Amber Arwine Shelby
Fluegge
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DSM V & PTSD The diagnostic criteria for the manuals next
edition identify the trigger to PTSD as exposure to actual or
threatened death, serious injury or sexual violation. The exposure
must result from one or more of the following scenarios, in which
the individual: directly experiences the traumatic event witnesses
the traumatic event in person learns that the traumatic event
occurred to a close family member or close friend (with the actual
or threatened death being either violent or accidental); or
experiences first-hand repeated or extreme exposure to aversive
details of the traumatic event (not through media, pictures,
television or movies unless work-related). American Psychiatric
Association. (2013). Diagnostic and statistical manual of mental
disorders. (5th ed.). Washington, DC: Author.
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DSM V SOME NEW ADDED DIAGNOSTIC CRITERIA Draws a clearer line
when detailing what constitutes a traumatic event Sexual assault is
specifically included Recurring exposure that could apply to police
officers and first responders Language stipulating an individuals
response to the event- intense fear, helplessness, or horror
according to DSM-IV has been deleted, that criterion proved to have
no utility in predicting the onset of PTSD. DSM V pays more
attention to 4 distinct clusters: Re-experiencing, avoidance,
negative cognitions and mood, and arousal. Re-conceptualized as a
stress-response syndrome rather then an anxiety disorder American
Psychiatric Association. (2013). Diagnostic and statistical manual
of mental disorders. (5th ed.). Washington, DC: Author.
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EPIDEMIOLOGY Statistics 7 or 8 of every 100 people will have
PTSD at some point in their lives. About 5.2 million adults have
PTSD during a given year. Women more likely to develop PTSD - 10%
women 5% men will experience PTSD in their lifetime. Prevalence
6.8% of the U.S. population experiences lifetime prevalence. 3.5%
of the U.S. population experiences 12 month prevalence.
http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asphttp://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp)
http://www.nimh.nih.gov/statistics/1ad_ptsd_adult.shtml
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EPIDEMIOLOGY CONTD People with PTSD have among the highest
rates of healthcare service use. People with PTSD present with a
range of symptoms, the cause of which may be overlooked or
undiagnosed as having resulted from past trauma. The annual cost to
society of anxiety disorders is estimated to be approximately $42.3
billion. Research suggests that prolonged trauma may disrupt and
alter brain chemistry. For some people, this may lead to the
development of PTSD.
http://www.sidran.org/sub.cfm?contentID=66§ionid=4
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WHO IS MOST LIKELY TO DEVELOP PTSD? Those directly exposed to
trauma as witness or victim Those seriously hurt during the event.
Experienced lost lasting, very severe trauma. from
http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-
is-ptsd.asp)
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PTSD & THE MILITARY 11-20% of Veterans of Iraq &
Afghanistan wars. 30% of Vietnam Veterans Symptoms Re-experiencing
the trauma Avoidance and/or emotional numbness Feeling on edge or
wary of danger Disparities Those with PTSD report experiencing a
barrier to care, more so than those with other anxiety disorders.
Only half of those with PTSD receive even minimal treatment.
http://www.nimh.nih.gov/statistics/1ad_ptsd_adult.shtml
http://www.nimh.nih.gov/statistics/1ad_ptsd_adult.shtml
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PTSD & THE MILITARY
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RISK FACTORS Environmental Demographic Cognitive Biological
Genetic Halligan, S. & Yehuda, R. (2000). Risk Factors for
PTSD. The National Center for Post Traumatic Stress Disorder.
11(3). http://ncptsd.org
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ENVIRONMENTAL RISK FACTORS A history of exposure to trauma or
to chronic stress especially at an young age Prior assault Prior
trauma A history of family instability Halligan, S. & Yehuda,
R. (2000). Risk Factors for PTSD. The National Center for Post
Traumatic Stress Disorder. 11(3). http://ncptsd.org
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DEMOGRAPHIC RISK FACTORS Gender Lower level of education,
income, and being divorced or widowed. Higher risk in ethnic
minorities Halligan, S. & Yehuda, R. (2000). Risk Factors for
PTSD. The National Center for Post Traumatic Stress Disorder.
11(3). http://ncptsd.org
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COGNITIVE RISK FACTORS Lower intellectual functioning
individuals Studies show that the soldiers that entered combat
found that lower level pre-combat intelligence was associated with
increased risk of PTSD Impairments in explicit memory in high risk
groups (veterans) Halligan, S. & Yehuda, R. (2000). Risk
Factors for PTSD. The National Center for Post Traumatic Stress
Disorder. 11(3). http://ncptsd.org
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BIOLOGICAL RISK FACTORS An early exploration of biologic change
in a group is known to be at high risk of PTSD. High level of
stress within family Dissociative reactions Borderline personality
and dependent personality disorders Halligan, S. & Yehuda, R.
(2000). Risk Factors for PTSD. The National Center for Post
Traumatic Stress Disorder. 11(3). http://ncptsd.org
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GENETIC RISK FACTORS Individuals with PTSD have parents or
relatives with mood, anxiety, and substance abuse Intergenerational
effects of stress and/or trauma Family history of PTSD or
depression Halligan, S. & Yehuda, R. (2000). Risk Factors for
PTSD. The National Center for Post Traumatic Stress Disorder.
11(3). http://ncptsd.org Post Traumatic Stress Disorder. (2014).
Helpguide.org A trusted non-profit Resource.
http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_
treatment.htm
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OTHER RISK FACTORS Lack of support from family/community Lack
of coping skills Blaming the victim of the trauma Low self-esteem
Post Traumatic Stress Disorder. (2014). Helpguide.org A trusted
non-profit Resource.
http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms
_treatment.htm
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PROTECTIVE FACTORS: INTIMATE PARTNER VIOLENCE strong social
support system counseling religious belief education and income
levels current employment (Astin et al., 1993; Mertin & Mohr,
2001; O'Keefe, 1998; Saunders, 1994; Vogel & Marshall,
2001)
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PROTECTIVE FACTORS: WAR TRAUMA & TORTURE Turk Civilians
Preparedness Repeated exposure Social support OEF, & OIF era
Veterans Post-trauma social support Pre-deployment
preparation/training Study conclusion: PTSD prevention efforts
should vary by veteran experience Pre-deployment prep did not seem
sufficient Johnson, H., & Thompson, A. (2008). The development
and maintenance of post-traumatic stress disorder (PTSD) in
civilian adult survivors of war trauma and torture: A review.
Clinical Psychology Review, 28, 36-47.
doi:10.1016/j.cpr.2007.01.017 Renshaw, K. D. (2011). An integrated
model of risk and protective factors for post-deployment PTSD
symptoms in OEF/OIF era combat veterans. Journal of Affective
Disorders, 128, 321-326. doi:10.1016/j.jad.2010.07.022
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PROTECTIVE FACTORS: INJURED MILITARY PERSONNEL Morphine 243
patients who received a PTSD diagnosis- 61% treated with morphine
453 who did not receive PTSD diagnosis- 76% treated with morphine A
highly significant difference (p