Post-traumatic Stress Disorder

Diagnosis Some debate about the DSM-V criteria Symptoms last more than 30 days Specific stressor triggers symptoms Affective Anhedonia (unable to feel positive); emotional numbing Behavioural Hypervigilence, passivity, nightmares, flashbacks Cognitive Intrusive memories, inability to concentrate, hyperarousal Somatic Back pain, headaches, stomach aches, digestive problems Regression in development in children

Statistics US- 1-3% men and 10% women have lifetime prevalence Affects 15-24% of people exposed to traumatic events Not everyone who has a traumatic event will experience PTSD

Statistics Type of trauma is correlated to PTSD 3% of personal attacks 20% of veterans 50% of rape victims 30% of all cases are connected to the loss of a loved one

PTSD Cross Cultural Studies show similar behaviour in Australian war veterans Complicating Factors Depression Substance abuse Problems of memory and cognition Other physical and mental health issues Generally speaking PTSD impairs a person’s ability to function in social and family life

Biological Level of Analysis Possible genetic predisposition Twin studies (Hauff and Vaglum, 1994) Role of noradrenaline Emotional arousal High levels express emotions more readily than normal Geraciotti (2001) PTSD patients have higher levels Stimulating adrenal system in PTSD caused panic attacks in 70% of PTSD patients and flashbacks in 40% Control groups had no symptoms Possible increased sensitivity of noradenaline receptors in PTSD patients

Cognitive Level of Analysis Differences in processing Intrusive memories (flashbacks)- triggered by sound or smells Cue-dependent memory (Brewin et al 1996) Therapy developed by Albert Rizzo- virtual Iraq- to treat veterans- flooding and then habituation PTSD- feel a lack of control over lives and world is unpredictable Feel guilt

Personality Traits and PTSD Attribution Theory PTSD patients take personal responsibility for failures and cope with stress by focusing on the emotion rather than the problem Victims of child abuse overcome PTSD if they see that it was not their fault War vets with a purpose and commitment to the military were less likely to develop PTSD

Sociocultural Level Lots of research in this area Racism and oppression- predisposing factors Vietnam- higher PTSD in blacks and Hispanics than whites Rwanda: threat of death a strong influence on intrusive thoughts and avoidance behaviour Bosnia: 73% girls (attributed to fear of rape) and 35% boys suffer from PTSD Observation of domestic violence: may play a role in PTSD in children

Cultural Considerations Different cultures have different presenting symptoms Western world display cognitive and anxiety Eastern display somatic- body memory symptoms

Gender Considerations Longitudinal study (Brelau et al. 1991) Significant gender difference 11.3 % women compared to 6% men Women 5 times more likely to develop PTSD after a violent incident Symptom differences noted Women- numbing and avoidance, anxiety and affective disorders Men- irritability, impulsiveness, substance abuse

Gender stereotypes Lead to Girls internalizing (depression, anxiety) Boys externalizing (delinquency, aggression)

Assignment Rwandan Genocide Read the case study on page 158 and answer the questions When doing research in a country that had experienced genocide, what issues do you think psychologists would have to address when carrying out their research?