Post traumatic stress disorder (PTsd) in war veterans Timothy demason and christian edinger

Videos of PTSD YouTube: http://www.youtube.com/watch?v=azWNpCap_Ww CBS NEWS: http://www.cbsnews.com/news/the-war-within-treating-ptsd/

Etiology: Biological Factors Noradrenaline Stathmin GRP (gastrin-releasing peptide) Hyperresponsive Amygdala and Prefrontal Cortex Shin et al. (2001)

Etiology: Cognitive Factors Appraisal Lower Intelligence McNally and Shin (1995)

Etiology: Sociocultural Factors Discrimination Oppression Roysircar (2000) Societal Expectations

symptoms Re-experiencing Avoidance Hyper arousal

Prevalence 2-17% point prevalence of combat related PTSD in US military veterans

Cultural Factors 3% Prevalence rate Around 0-3% Globally

Gender Variations Higher in women than men

Treatment Approaches Other Medication Psychotherapy Cognitive Therapy (CT) Cognitive Behavioral Therapy, Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT) Eye Movement Desensitization and Reprocessing (EMDR) Stress Inoculation Training Interpersonal Psychotherapy (IPT) Group Therapy Family Therapy Psychodynamic Therapy Medication Other Exercise and other physical activities

Relationship between etiology and therapeutic approach Disclaimer: No 1 treatment works for everyone Identifying a specific cause is reductionist Can one truly treat symptoms when the “causes” are unknown Primary therapeutic approach aimed to reduce greatest risk factor Culture affects beliefs about causes and treatments Gender Desire to locate causes is a highly western phenomenon Eclectic approach works well

Relationship between etiology and therapeutic approach Cont’d Low levels of Serotonin are present in PTSD victims Use of SSRIs to help Serotonin stay in the synapse longer would be one way etiology would cause a therapeutic approach Low education about PTSD and an inability to cope with the traumatic event Use of Prolonged Exposure (PE) to educate patient and then enhance their ability to face the traumatic event so that they can move on with daily life Low levels of cortisol are also present Glucocorticoid provides a dose of corticosterone to boost cortisol levles and has worked in rats There are many different relationships that exist and since PTSD is complex and relatively new. Researchers have not found an optimal treatment for PTSD, AND SYMPTOMS ARE WHAT ARE ULTIMTELY REDUCED RATHER THAN THE MENTAL ILLNES ITSELF

PTSD Cognitive factor: Coping ability (Foa & Kozak, 1986) Pathophysiology Neuroendocrinology Over-reactive adrenaline response Hypocortisolism High norepinephrine Neuroanatomy HPA Axis Hippocampus and flashbacks = suppression (Skelton et al., 2011) (Heim, Elhert, and Hellhammer, 2000) Cognitive factor: Coping ability (Foa & Kozak, 1986) Traumatic event PTSD Biological Factor: Genetic Predisposition (True et al., 1993) Sociocultural factors: Societal expectations (Nayback, 2008)