Running head: POSTTRAUMATIC STRESS DISORDER

Posttraumatic Stress Disorder: History, Prevalence, and Treatment

Abstract

POSTTRAUMATIC STRESS DISORDER

Posttraumatic stress disorder is a condition that develops when someone has been severely
traumatized and as a result, shows several symptoms of anxiety and depression and is not
functioning properly. It is triggered by an actual or threatened situation involving death, severe
injury, or some form of sexual abuse. The disorder must also develop as a result of having direct
exposure to the event, realizing that the traumatic event occurred to someone in the immediate
family or a close friend, or by being repeatedly exposed to the variables surrounding the
traumatic event. The symptoms that can be observed in individuals who struggle with PTSD
include recurring, distressing memories, repetitive nightmares, as well as triggered reactions that
cause the individual to feel as if the traumatic event is currently taking place. They may also
experience psychological distress and want to avoid any thoughts, feelings, and/or memories that
remind them of the traumatic event. Higher percentages of the disease are seen in war veterans,
substance abusers, and sexual abuse victims. However, even though PTSD is a prevalent issue in
the United States today, there are different treatments/interventions that can be used to help those
who suffer from it.

Keywords: posttraumatic stress disorder, PTSD, traumatic, sexual abuse, psychological distress,
treatments/interventions

Posttraumatic Stress Disorder: History, Prevalence, and Treatment

POSTTRAUMATIC STRESS DISORDER

Posttraumatic stress disorder is a stress disorder that can develop as a result of

experiencing a severe trauma such as witnessed or threatened death, sexual assault, or crucial
injury. It can last for years and cause psychological distress that will occur when one is exposed
to any internal or external cues that reminds them of the traumatic event. It can also develop as a
result of a personal experience or realizing that something traumatic happened to a family
member or friend. Additionally, without treatment, a dissociative or repressive state will occur
and cause great strife for the individual struggling with the disorder. This paper will: (1) briefly
explain what posttraumatic stress disorder is, (2) provide a historical background of the disorder,
(3) discuss its prevalence within the United States today, (4) offer some research concerning the
different treatment and intervention options for the disorder, (5) and give a critical analysis of the
subject.
A Brief Description of Posttraumatic Stress Disorder
According to Kanel (2014), posttraumatic stress disorder (PTSD) is a broad category
that applies to people who have been severely traumatized at one or more times in their lives; at
present, they are not functioning effectively because they have not integrated the trauma and laid
it to rest (p. 154). The DSM-V fact sheet on PTSD (2013) goes into more specific detail by
stating that the disorder is triggered by an exposure to actual or threatened death, serious injury
or sexual violation (p. 1). However, the exposure must come as a result of directly experiencing
the traumatic event, witnessing the traumatic event, learning that the traumatic event was
experienced by a family member or a close friend, or by experiencing repeated exposure to the
details of the traumatic event. Additionally, individuals who suffer from PTSD show symptoms
of recurrent, uncontrolled, and intrusive distressing memories, recurring painful dreams, as well
as dissociative reactions in which the individual feels as if the traumatic event is taking place.

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People with PTSD may also suffer from extreme psychological distress when exposed to internal
or external triggers that mirror the traumatic event and have a desire to avoid any thoughts,
feelings, or memories that remind them of the event.
Historical Content of PTSD
Prior to the last century, few breakthroughs were made regarding PTSD within the United
States. However, when the Vietnam War concluded, thousands of soldiers returned to the states
in need of emotional help. In addition to the correlation discovered between military experience
and PTSD, a similar correlation was seen between PTSD and substance use disorders (SUDS).
An identical interrelationship was also found between PTSD and sexual abuse. This led
psychologists to search for ways to better understand PTSD and its symptoms.
Military Service and PTSD
As previously stated, military service can increase ones chances of developing PTSD.
Additionally, because of the nature of the Vietnam War and the antipathetic feelings that most
Americans share towards it, the soldiers who served in Vietnam may be even more predisposed
to developing the disorder. Because of this, Lund (1984) documented a study that was conducted
in order to help Vietnam veterans. The study involved using the Guttman scaling technique to
construct a measure of trauma in the Vietnam War that overcomes some of the problems of
previous scales (p. 1323). From these results, a Combat Exposure Scale was created using
questions that soldiers were asked about their traumatic experiences in Vietnam and how those
experiences related to their PTSD symptoms. As a result, Lund (1984) discovered that the
Combat Exposure Scale could accurately identify those veterans objectively diagnosed as
having PTSD and also could predict the intensity of the subjective report of PTSD symptoms
better than indices of previous life adjustment (p. 1327).

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PTSD and SUDs

According to Brady (2004), there are three different hypotheses that attempt to explain
the relationship between PTSD and SUDs. The first, is known as the self-medication
hypothesis (p. 207). When it comes to PTSD, many people have triggers that cause them to
experience severe stress. Because of this, one of the symptoms of the disorder is the repression of
painful memories that are associated with the traumatic event that placed an individual in a
clinically stressful state. As a result, some PTSD patients resort to drastic measures such as
substance abuse to ensure that they avoid any thought or cue that reminds them of the traumatic
event. Bradys second hypothesis (2004), is known as the high-risk hypothesis (p. 207). This
hypothesis claims that people with SUDs and high-risk lifestyles are more likely to experience
trauma; therefore, they are more likely to develop PTSD. The third hypothesis was titled the
susceptibility hypothesis which states that substance use increases an individuals susceptibility
to developing PTSD following a trauma (p. 207). Overall, 36%-50% of individuals who seek
treatment for SUDs meet the criteria for PTSD (p. 206).
PTSD and Sexual Abuse
Due to the fact that not much is known about how PTSD manifests itself in the early
years of life, many recent studies have centered on children and adolescents. More specifically,
children and adolescents who have experienced severe trauma like sexual abuse. As a result,
Hillary and Schare (1993) have proposed that sexual abuse, particularly in the form of incest
yield a psychological pattern of symptoms that may result in PTSD (p. 161). One such study
that was conducted regarding this subject area was documented by Hillary and Schare (1993).
The study attempted to investigate PTSD in adolescents through the use of standard objective
measures comparable to those used to assess PTSD in adult populations (p. 162). The

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experiment yielded several conclusions that symptoms of PTSD can be found in adolescents who
were the victims of sexual abuse.
Prevalence
PTSD is still prevalent in the world today. However, for the sake of research and time, the
author is only going to focus on the prevalence of PTSD within the United States. According to
the U.S. Department of Veteran Affairs website (2014), about ten women out of every onehundred women will develop PTSD during their lifetimes as will four men out of every onehundred men. Adding the numbers together, that means that about seven or eight people out of
every one-hundred will develop PTSD at some point. On a yearly average, that percentage equals
about 5.2 million adults (see pp. 4-6). Additionally, the chances of developing PTSD can increase
if an individual has had any military service, has experienced the sudden death of a loved one,
struggles with an SUD, or has been sexually abused at a young age; these are only a few of the
characteristics that raise the odds of developing this particular stress disorder.
Treatments and Interventions
Most stress disorders do not last for more than a few months. However, PTSD symptoms
can become habits where the individual learns to survive using defense mechanisms like
dissociation or repression. When someone completely represses or cuts away from anything that
connects them to the traumatic event though, they are building a storehouse of pain. If these
repressed memories are not dealt with, many negative consequences will develop. Therefore, in
order to prevent any dissociative behavior from developing and to help people heal from their
pain, PTSD must be carefully treated. A few different treatment methods are provided in the
following subsections.
SITCAP

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One PTSD treatment model is known as SITCAP, which stands for Structured Sensory
Intervention for Children, Adults, and Parents. This model was created by the National Institute
for Trauma and Loss in Children (TLC) in Michigan. According to Kuban and Steele (2011), the
premise of this treatment model is that traumatic memories are experienced at a sensory level
and must be reactivated in a safe environment in order to be tolerated and managed with a sense
of power and a feeling of safety (p. 42). SITCAP treatment includes different drawing tasks and
questionnaires that target the specific emotions that are expressed when one experiences a
traumatic event. The interventions place the traumatic sensory experiences in a mental
framework in order to provide structure, a sense of control, and safety. The cognitive framework
then helps turn the traumatic event into a story which can be used to help the individual think
differently about their PTSD experience. According to Kuban and Steele (2011), the ultimate
goal of SITCAP is to enable the individual to reframe their traumatic experiences so that the
damaging memories become a resource for resilience versus a trigger for terror (p. 43).
Regarding the programs effectiveness, it has been noted that this intervention program reduces
trauma reactions. In fact, the most severe victims saw the greatest positive effect, contrary to
the myth that little can be done to help those exposed to multiple traumas (p. 43).
FOCUS
Interventions for mental illnesses are different from interventions for distress. The most
successful models that are used for helping stressed individuals are models that empathize
prevention. This is where the Institute of Medicine comes into play. According to Cozza,
Haskins, and Lerner (2013), the Institute of Medicine outlined a set of activities that promote and
sustain health. Those activities place prevention strategies along a spectrum of intensity:
universal (helpful to all), selective (useful to those at higher risk), and indicated (targeted to those

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who exhibit symptoms of a behavior (p. 4). One such intervention program that utilizes this
type of structure is called FOCUS, which stands for Families Overcoming Under Stress. It was
designed to help children and families contend with parental depression, a parents infection
with HIV, and military deployment (p. 5). It is primarily used by military servicemen because
deployment causes stress for both the parents and their children. However, it has also been
refined specifically or families who contend with PTSD. According to Cozza, Haskins, and
Lerner (2013), the FOCUS PTSD program follows participants for ten years to determine
whether they make a long-term difference in the lives of adults and children the stress associated
with combat deployment and its consequences (p. 5). Based on the evidence provided by this
intervention method, one could conclude that PTSD programs that incorporate family focused
approaches to the disorder are helpful and show positive results.
Critical Analysis
PTSD is a severe stress disorder that is caused by a traumatic event like death, critical
injury, or sexual violations. However, it can also develop if such a traumatic event were to
happen to someone that an individual is close to, instead of having the event occur to the
individual him/herself. As a result of the traumatic event, external and internal triggers now
accompany the event and cause the individual suffering from the disorder psychological unrest.
The severity of the unrest can cause the patient to slip into a dissociative or repressive state in
which they attempt to forget all of the sensory feelings and thoughts related to the traumatic
event. The chances of developing PTSD are higher for individuals who have served in the
military, struggled with substance abuse, or been sexually abused. It is so prevalent in the United
States, that over 5 million people develop it every year. However, there are different types of
treatment and intervention methods that treat it such as SITCAP and FOCUS which are designed

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to help those who struggle with PTSD by reframing their perspective of the traumatic event in a
safe environment in order to change their fear into a more positive and controlled set of thinking.
Based on the research conducted on PTSD, one could conclude that it is a prevalent. One could
also argue that more information about PTSD should be made available to the general
population. Therefore, it is in this authors opinion that individuals who struggle with PTSD be
uplifted and supported. Otherwise, healing will never occur and those individuals will continue
to struggle with their negative emotions.
Conclusion
PTSD is a stress disorder that is caused by a severe traumatic event such as sudden death,
critical injury, or sexual assault. It can develop regardless of whether the traumatic event
happened to the individual personally or if it happened to someone close to that individual. The
disorder also causes individuals to associate painful feelings with any internal or external triggers
that reminds them of the event. Additionally, psychological distress can result from it and cause
individuals to dissociate or repress all of the senses that relate to the traumatic event. Also, those
who have served in the military, have had a history of substance use disorders, and/or have been
sexually assaulted have a higher risk of developing PTSD. On average, a little over 5 million
people in the United States develop the disorder every year. However, there are different
treatments/interventions that exist to help those who struggle with the disorder such as the
Families Overcoming Under Stress (FOCUS) intervention model and the Structured Sensory
Intervention for Children, Adults, and Parents (SITCAP) model.
References
Brady, K. F. (2004). Substance abuse and posttraumatic stress disorder. Current Directions In
Psychological Science (Wiley-Blackwell), 13(5), 206-209.

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Cozza, C. J., Haskins, R., & Lerner, R. M. (2013). Keeping the promise: Maintaining the health
of military and veteran families and children. Future Of Children, 1-6.
Hillary, B. E., & Schare, M. L. (1993). Sexually and physically abused adolescents: An empirical
search for PTSD. Journal Of Clinical Psychology, 49(2), 161-165.
Kanel, K. (2014). A guide to crisis intervention (5th Ed.). Stamford, CT: Cengage Learning.
Kuban, C., & Steele, W. (2011). Restoring safety and hope: From victim to survivor. Reclaiming
Children & Youth, 20(1), 41-44.
Lund, M. A. (1984). The combat exposure scale: A systematic assessment of trauma in the
vietnam war. Journal Of Clinical Psychology, 40(6), 1323-1328.
PTSD Fact Sheet. (2013). Retrieved March 6, 2015, from
http://www.dsm5.org/Documents/PTSD Fact Sheet.pdf
PTSD: National Center for PTSD. (2014, November 10). Retrieved March 6, 2015, from
http://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp