Question

Choose one of the psychological disorders discussed this week and briefly describe the criteria that qualifies it as a disorder.  What kinds of medical treatment(s) are recommended for this disorder? Discuss the cultural views of this disorder (any stigma or societal views?). Now that you have an understanding of the different theoretical perspectives, compare and contrast two different perspectives (such as psychodynamic and behaviorism) on how they would view this disorder and how it would be best treated.

Answer 1

1. Post-Traumatic Stress Disorder (PTSD) is a disorder that causes trauma to the person, whenever they try to relive it, who has had a traumatic experience in the past. They have a fight or flight reaction when they experience the same situation again, which is considered one of the ways by which the body tries to protect the person from harm. Common symptoms, according to DSM, include:

• Being jumpy, edgy, distressed, weeping fits
• Unable to sleep properly (insomnia)
• Avoidance of certain people, places, etc. that may trigger the PTSD
• Physiological reactions to events (heart racing, sweating, panic attack, uneven breathing, etc.)
• Inability to remember certain aspects or all of the traumatic event
• Irritated, depressed, aggressive and lack of concentration
• Reliving of events through nightmares, flashbacks, etc.
• Negative feelings of guilt, shame, blaming, etc.

Using the 4 D's Criteria and the symptoms of PTSD a person can be diagnosed as having PTSD. Four main criteria that are commonly used by doctors and physicians to determine if a person might have a psychological disorder are:

• Deviance - The symptoms show that the person is deviating from that of a normal behavior.
• Dysfunction - If he/she feels like it is interfering with his/her daily life (work, school, home, etc.) or that of functioning normally.
• Distress - If the person is distressed about having PTSD. Does not want to keep feeling this way. If the symptoms can be categorized into being chronic, mild, moderate or severe.
• Danger - If the person feels suicidal or has tendencies of harming someone

Then the person qualifies as having a disorder.

2. Most common treatments for PTSD includes:

• Cognitive Behavioral Therapies - It involves of learning to identify and modify or reduce the patterns negative or dysfunctional thoughts and behaviors that produce stress, anxiety and ultimately lead to trauma. It helps maintain a positive image and help reduce negative thoughts and behaviors.
• Eye-Movement Desensitizing and Reprocessing - This treatment involves reduction of stress of traumatic events using eye movements. The traumatic events are recalled to mind while paying attention to eye movements or other sounds.
• Exposure and Response Prevention - It involves prolonged exposure to the events and the response to the events are prevented. It involves making a list in ascending order of response (low to high response) as the event takes place and going through them while preventing response to each item in list one by one (next item is taken up when patient learns to control emotions on the previous item).
• Pharmacotherapy - It involves administration of medication by a doctor. Usually anti-depressants and anti-anxiety medications are provided to help with stress and depression resulting from trauma. These medications usually consist of SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors) like Sertraline (Zoloft), Paroxetine (Paxil), Fluoxetine (Prozac) and Venlafaxine (Effexor).

3. The culture vacillates between elevated ideas of hero worship and victimhood depending upon who, how, and when the person acquires PTSD. If it is due to war, or due to a heroic survival or duty accompanied with a pitiful story the person is exemplified and worshipped as a hero or a survivor. If it is due to something wrong like you left someone to die, tried to save yourself, etc. the guilt and shame that the person is experiencing will be magnified by other people and the person will be victimized and shamed. Most people do not feel like talking about it because it feels like you are 'whining' and being 'weak' not being able to deal with it. But in reality, this is a debilitating and vexing disorder which should never be underestimated and left untreated as it can lead to more mental problems and health complications in future.

4. Cognitive Perspective of PTSD suggests that the reaction to events is due to the individual perceiving a serious and immediate threat during that particular time. It suggests that the event is seen as a threat due to the a) excessive negative feelings being attached to the event and b) disturbance of memory, poor elaboration of event and strong perceptual priming. Cognitive approach sees PTSD as being associated with dysfunctional thoughts and feelings leading to dysfunctional coping strategies and defense mechanisms of the body. According to the view PTSD may be created by errors or biases in thinking (catastrophic thinking) which in turn determine our actions. A negative cognitive style with deficit for retrieving of positive memories can contribute to PTSD development and severity. So, cognitive approach believes that a person can be treated by detaching the negative feelings associated with the event. This can be done by identifying the negative and faulty thinking associated with the event and modifying it to bring in a positive thought regarding the event.

Behavioral Perspective of PTSD looks at how, what and when a person reacts to the events in question. It views PTSD as a disorder of reactivity which manifests itself as a maladaptive behavior when the individual interacts with the environment or with self. It views PTSD as a learned fear conditioning to which the body reacts to in a negative behavior. In this the event which is an unconditioned stimulus evokes negative emotions (conditioned stimulus) to which the body responds (conditioned response). The bodily response to a negative emotion is a naturally learned mechanism which every human has learned through experience and past. The cycle keeps repeating till the event gets chained with the bodily response and it becomes a learned fear conditioning. Behavioral approach to treating PTSD is that the cycle of conditioning should be broken. This approach believes that if a person is taught to not respond to the situation (event) then the person can be treated successfully. The response or behavior that manifests with interaction or reliving of the event should be prevented or reversed, thus, breaking the cycle of fear conditioning.