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A New
Environment for PTSD
Christopher A. Miller
Advanced General Psychology
Instructor: Dr. Darcel Harris
October 15, 2011
Table of Contents
        •Abstract
1       •The Current Environment


        •Deployment Tempo and Recuperation
    2



        •Military Studies and Cultural Context
    3



        •Occupationally linked Trauma
    4


        •Preparedness and Occupational Familiarity
    5



        •Combating Stigmas and Coping
    6


        •Concerns
    7   •Conclusion
Abstract
The scientific approach towards PTSD today appears to be based
around the environmental factors that make someone susceptible to
the traumatic events, or environmental conditions that cause the
systems of PTSD to exhibit in an individual. To better understand
the disorder there is a need to incorporate and expand research into
the disorder using other psychological perspectives beyond
environmental factors.

                     The Current Environment

    Research into the prevention and treatment of
     the disorder drastically favors an environmental
     approach.

    The environmental perspective is often favored
     due to the fact that the onset of the symptoms is
     triggered by extreme and sudden stimulus from
     the environment.
Deployment Tempo and
Recuperation

Environmental    deployment schedules are claimed as predictive
   Factors
                  environmental conditions

                 environmental conditions cause
                  cognitive, behavioral and physiological
Conditions        responses that can be a catalyst for psychiatric
and Stimuli
                  disorders, including PTSD

                 Reaction
                   and
                Processing                                     PTSD
                of Trauma
Military Studies and Cultural
Context

 cumulative stressors and the rates of
  recuperations are calculated as factors
  corresponding to a Poisson dose-response
  function and threshold distribution

 lag time between the onset of symptoms and
  when the individuals self-report the symptoms of
  PTSD

 lag time was independent of the amount of
  combat time limits the models analysis to two
  factors of analysis: combat stress and
  deployment tempo,
Occupationally linked
Trauma

 organizational structural differences may impact
  resilience and stress factors, combat related
  traumas are found to be more significant

 high-risk groups
Preparedness and
Occupational Familiarity



               the familiarity of an individual’s role
                during a trauma

               personal perceptions of threat to life
                during trauma

               coping advice was found to reduce
                prevalence
Combating Stigmas and
Coping

 lower IQ

 lower education levels

 marital status

 lower ranks



“conservative critics of psychotherapy have called
ptsd [sic], in part , a political artifact of the antiwar
movement, a way to portray Vietnam veterans as
psychiatric victims of an unjust war” Dworkin, R.
(2010).
Concerns
“Osuch and colleagues mention many of the
places where we need to look including:
crytoarchitectonics, neurotransmitters, and
receptors, neuropeptides, enzyme
synthesis, neurotropic factors, synaptic
proteins, signal transduction pathways, markers of
inflammation or infections as well as neuronal
regeneration and apoptosis” Friedman, M., &
Harris, W (2004).
 Conclusion
 To better understand this disorder future investigators
 need to incorporate and expand research perspectives
 using other psychological perspectives beyond external
 environmental factors.
Concerns
“Osuch and colleagues mention many of the
places where we need to look including:
crytoarchitectonics, neurotransmitters, and
receptors, neuropeptides, enzyme
synthesis, neurotropic factors, synaptic
proteins, signal transduction pathways, markers of
inflammation or infections as well as neuronal
regeneration and apoptosis” Friedman, M., &
Harris, W (2004).
 Conclusion
 To better understand this disorder future investigators
 need to incorporate and expand research perspectives
 using other psychological perspectives beyond external
 environmental factors.
References
Atkinson, M. P., Guetz, A., & Wein, L. M. (2009). A dynamic model for posttraumatic stress disorder
among U.S. troops in operation Iraqi freedom. Management Science, 55(9),                            1454-1454-
1468. Retrieved from http://search.proquest.com/docview/213269767?                     accountid=34899
Costa, D. L., & Kahn, M. E. (2010). Health, wartime stress, and unit cohesion: Evidence from
                 union army veterans*. Demography, 47(1), 45-45-66. Retrieved from http://
                 search.proquest.com/docview/222819735?accountid=34899
Dworkin, R. W. (2010). The rise of the caring industry. Policy Review, (161), 45-45-59.             Retrieved
from http://search.proquest.com/docview/609957271?accountid=34899
Friedman, M. J., & Harris, W. W. (2004). Commentary on "brain environment interactions:
                 Stress, posttraumatic stress disorder, and the need for a postmortem brain collection":
                 Toward a national PTSD brain bank. Psychiatry, 67(4), 384-384-390. Retrieved from
                 http://search.proquest.com/docview/220668332?accountid=34899
Hoge, C. W., Castro, C. A., Hotopf, M., & Fear, N. (2006). Post-traumatic stress disorder in UK
                 and US forces deployed to Iraq/Author's reply. The Lancet, 368(9538), 837-837; author
                 reply 837. Retrieved from http://search.proquest.com/docview/199058983?
                 accountid=34899
Iversen, A. C., Fear, N. T., Ehlers, A., Hacker H. J., Hull, L., Earnshaw, M., . . . .Hotopf, M.    (2008). Risk
factors for post-traumatic stress disorder among UK armed forces personnel.
                 Psychological Medicine, 38(4), 511-511-22. doi:10.1017/S0033291708002778

Marx, B. P., Doron-Lamarca, S., Proctor, S. P., & Vasterling, J. J. (2009). The influence of
                  pre-deployment neurocognitive functioning on post-deployment PTSD                 symptom
                  outcomes among Iraq-deployed army soldiers. Journal of the International
                  Neuropsychological Society : JINS, 15(6), 840-840-52. doi:10.1017/S1355617709990488
Polusny, M. A., Erbes, C. R., Murdoch, M., Arbisi, P. A., Thuras, P., & Rath, M. B. (2011).         Prospective
risk factors for new-onset post-traumatic stress disorder in national guard soldiers deployed to Iraq.
Psychological Medicine, 41(4), 687-687-698.
                  doi:10.1017/S0033291710002047
Sundin, J., Fear, N. T., Iversen, A., Rona, R. J., & Wessely, S. (2010). PTSD after deployment to
                  Iraq: Conflicting rates, conflicting claims. Psychological Medicine, 40(3), 367-367-82.
                  doi:10.1017/S0033291709990791
Wells, T. S., LeardMann, C. A., Fortuna, S. O., Smith, B., Smith, T. C., Ryan, M. A., . . . Blazer, D. (2010). A
prospective study of depression following combat deployment in support of                           the wars in
Iraq and Afghanistan. American Journal of Public Health, 100(1), 90-90-9. Retrieved from
http://search.proquest.com/docview/215085621?accountid=34899

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M7 A2 Review Paper Ppt Miller C

  • 1. A New Environment for PTSD Christopher A. Miller Advanced General Psychology Instructor: Dr. Darcel Harris October 15, 2011
  • 2. Table of Contents •Abstract 1 •The Current Environment •Deployment Tempo and Recuperation 2 •Military Studies and Cultural Context 3 •Occupationally linked Trauma 4 •Preparedness and Occupational Familiarity 5 •Combating Stigmas and Coping 6 •Concerns 7 •Conclusion
  • 3. Abstract The scientific approach towards PTSD today appears to be based around the environmental factors that make someone susceptible to the traumatic events, or environmental conditions that cause the systems of PTSD to exhibit in an individual. To better understand the disorder there is a need to incorporate and expand research into the disorder using other psychological perspectives beyond environmental factors. The Current Environment  Research into the prevention and treatment of the disorder drastically favors an environmental approach.  The environmental perspective is often favored due to the fact that the onset of the symptoms is triggered by extreme and sudden stimulus from the environment.
  • 4. Deployment Tempo and Recuperation Environmental  deployment schedules are claimed as predictive Factors environmental conditions  environmental conditions cause cognitive, behavioral and physiological Conditions responses that can be a catalyst for psychiatric and Stimuli disorders, including PTSD Reaction and Processing PTSD of Trauma
  • 5. Military Studies and Cultural Context  cumulative stressors and the rates of recuperations are calculated as factors corresponding to a Poisson dose-response function and threshold distribution  lag time between the onset of symptoms and when the individuals self-report the symptoms of PTSD  lag time was independent of the amount of combat time limits the models analysis to two factors of analysis: combat stress and deployment tempo,
  • 6. Occupationally linked Trauma  organizational structural differences may impact resilience and stress factors, combat related traumas are found to be more significant  high-risk groups
  • 7. Preparedness and Occupational Familiarity  the familiarity of an individual’s role during a trauma  personal perceptions of threat to life during trauma  coping advice was found to reduce prevalence
  • 8. Combating Stigmas and Coping  lower IQ  lower education levels  marital status  lower ranks “conservative critics of psychotherapy have called ptsd [sic], in part , a political artifact of the antiwar movement, a way to portray Vietnam veterans as psychiatric victims of an unjust war” Dworkin, R. (2010).
  • 9. Concerns “Osuch and colleagues mention many of the places where we need to look including: crytoarchitectonics, neurotransmitters, and receptors, neuropeptides, enzyme synthesis, neurotropic factors, synaptic proteins, signal transduction pathways, markers of inflammation or infections as well as neuronal regeneration and apoptosis” Friedman, M., & Harris, W (2004). Conclusion To better understand this disorder future investigators need to incorporate and expand research perspectives using other psychological perspectives beyond external environmental factors.
  • 10. Concerns “Osuch and colleagues mention many of the places where we need to look including: crytoarchitectonics, neurotransmitters, and receptors, neuropeptides, enzyme synthesis, neurotropic factors, synaptic proteins, signal transduction pathways, markers of inflammation or infections as well as neuronal regeneration and apoptosis” Friedman, M., & Harris, W (2004). Conclusion To better understand this disorder future investigators need to incorporate and expand research perspectives using other psychological perspectives beyond external environmental factors.
  • 11. References Atkinson, M. P., Guetz, A., & Wein, L. M. (2009). A dynamic model for posttraumatic stress disorder among U.S. troops in operation Iraqi freedom. Management Science, 55(9), 1454-1454- 1468. Retrieved from http://search.proquest.com/docview/213269767? accountid=34899 Costa, D. L., & Kahn, M. E. (2010). Health, wartime stress, and unit cohesion: Evidence from union army veterans*. Demography, 47(1), 45-45-66. Retrieved from http:// search.proquest.com/docview/222819735?accountid=34899 Dworkin, R. W. (2010). The rise of the caring industry. Policy Review, (161), 45-45-59. Retrieved from http://search.proquest.com/docview/609957271?accountid=34899 Friedman, M. J., & Harris, W. W. (2004). Commentary on "brain environment interactions: Stress, posttraumatic stress disorder, and the need for a postmortem brain collection": Toward a national PTSD brain bank. Psychiatry, 67(4), 384-384-390. Retrieved from http://search.proquest.com/docview/220668332?accountid=34899 Hoge, C. W., Castro, C. A., Hotopf, M., & Fear, N. (2006). Post-traumatic stress disorder in UK and US forces deployed to Iraq/Author's reply. The Lancet, 368(9538), 837-837; author reply 837. Retrieved from http://search.proquest.com/docview/199058983? accountid=34899 Iversen, A. C., Fear, N. T., Ehlers, A., Hacker H. J., Hull, L., Earnshaw, M., . . . .Hotopf, M. (2008). Risk factors for post-traumatic stress disorder among UK armed forces personnel. Psychological Medicine, 38(4), 511-511-22. doi:10.1017/S0033291708002778 Marx, B. P., Doron-Lamarca, S., Proctor, S. P., & Vasterling, J. J. (2009). The influence of pre-deployment neurocognitive functioning on post-deployment PTSD symptom outcomes among Iraq-deployed army soldiers. Journal of the International Neuropsychological Society : JINS, 15(6), 840-840-52. doi:10.1017/S1355617709990488 Polusny, M. A., Erbes, C. R., Murdoch, M., Arbisi, P. A., Thuras, P., & Rath, M. B. (2011). Prospective risk factors for new-onset post-traumatic stress disorder in national guard soldiers deployed to Iraq. Psychological Medicine, 41(4), 687-687-698. doi:10.1017/S0033291710002047 Sundin, J., Fear, N. T., Iversen, A., Rona, R. J., & Wessely, S. (2010). PTSD after deployment to Iraq: Conflicting rates, conflicting claims. Psychological Medicine, 40(3), 367-367-82. doi:10.1017/S0033291709990791 Wells, T. S., LeardMann, C. A., Fortuna, S. O., Smith, B., Smith, T. C., Ryan, M. A., . . . Blazer, D. (2010). A prospective study of depression following combat deployment in support of the wars in Iraq and Afghanistan. American Journal of Public Health, 100(1), 90-90-9. Retrieved from http://search.proquest.com/docview/215085621?accountid=34899

Notes de l'éditeur

  1. My interest in military service connected PTSD developed from being in the military and working at the Philadelphia VA Medical Center’s Behavioral Health and Social Work Services Office. The objective of this paper is partly to explore the disorder and partly identify new directions of research and exposing further potentials.
  2. The overwhelming focus is on the environmental stimuli that can trigger PTSD symptoms. Atkinson, M., Guetz, A., and Wein, L. (2009) suggests that deployment schedules are a predictive environmental condition, as well as the rate of recuperation. Similarly, environmental conditions argued by Costa, D., and Kahn, M. (2010) cause cognitive, behavioral and physiological responses from which stress hormones are released and those stress hormones can be a catalyst for psychiatric disorders, including PTSD. PTSD is approached from the view that the trauma combined with persistent environmental conditions in turn develop PTSD.
  3. Atkinson, M., Guetz, A., and Wein, L. (2009) conducted this military research study. Again with studies of this type the focus is on the environment. The exposure to stress and the frequency that stress is encountered. The exposure to stress in conjunction with a traumatic event may be a necessary condition for the onset of PTSD, but determining if these environmental influences are the only necessary condition is vital. We must first acknowledge that multiple people can be exposed to the same or nearly same environment, but they will not all result in cases of PTSD. To establish this we need to look beyond the environment.
  4. Exploring who develops PTSD and why could be more important than what environmental conditions trigger it. Adding cultural context to the debate Hoge, C., Castro, C. A., Hotopf, M., and Fear, N. (2006) begin to contrast the persistence and prevalence of cases of PTSD between U.S. and U.K. forces having fought in Iraq.While comparing the percentage rates of combat related traumas and the organizational structural differences that may impact resilience and stress factors, combat related traumas are found to be more significant.
  5. Iversen, A. C., Fear, N. T., Ehlers, A., Hacker H. J., Hull, L., Earnshaw, M., Greenberg, N., Rona R., Wessely, S. and Hotopf, M. (2008) continue the debate of the resilience and environment exploring the contrast between U.K. Military personnel mental health and non-military occupations susceptible to psychological trauma. However, the positions addressing the environment are more in moving toward the cognitive perspective addressing the thought processes.
  6. There are also problems associated with studying only the environmental factors surrounding PTSD, Particularly when studying military groups. Considerations such as lower IQ, lower education levels, marital status and lower ranks were associated with higher rates of PTSD, but these may be factors of circumstance that place these demographics in a military positions more likely to encounter combat (i.e. infantry).The ASVAB placement test may place lower IQs in higher proximity to combat thereby skewing the results of a study, but further investigation is warranted into the concept. These studies may be perpetuating or even creating inaccurate stigmas around PTSD.
  7. People in the same combat environment with a multitude of environmental similarities experience PTSD at differing rates of prevalence. Friedman, M. J., and Harris, W. W. also argue that similar methods of research, specifically work with brain banks developed for schizophrenia, Alzheimer’s disease, alcoholism, mood and a variety of other neurological disorders, which can be comorbid with PTSD, already exist even though the prevalence of PTSD is currently greater than the other disorders except for depression.
  8. People in the same combat environment with a multitude of environmental similarities experience PTSD at differing rates of prevalence. Friedman, M. J., and Harris, W. W. also argue that similar methods of research, specifically work with brain banks developed for schizophrenia, Alzheimer’s disease, alcoholism, mood and a variety of other neurological disorders, which can be comorbid with PTSD, already exist even though the prevalence of PTSD is currently greater than the other disorders except for depression.
  9. People in the same combat environment with a multitude of environmental similarities experience PTSD at differing rates of prevalence. Friedman, M. J., and Harris, W. W. also argue that similar methods of research, specifically work with brain banks developed for schizophrenia, Alzheimer’s disease, alcoholism, mood and a variety of other neurological disorders, which can be comorbid with PTSD, already exist even though the prevalence of PTSD is currently greater than the other disorders except for depression.