Post-Traumatic Stress Disorder (PTSD)

 

Introduction

Post-Traumatic Stress Disorder (PTSD) can be elaborated as a serious, but often a chronic situation to pronounced stressful situations. Post-Traumatic stress disorder (PTSD) has a wide range of behaviors and symptoms that are originated when one is exposed to some serious traumatic event that induces a threat to another or oneself. Some serious stressors most likely, natural disasters, combat, or related event can be the reason for exposure to Posttraumatic stress disorder (al, 2014). This broad range of PSTD symptoms is elaborated in the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) (American Psychiatric Association 1994). But the diagnosis of posttraumatic stress disorder was first introduced to the public in the Diagnostic and Statistical Manual (DSM) (American Psychiatric Association) 3^rd edition, which was published in 1980. This is a chronic impairing malfunction, which is characterized by avoidance and re-experiencing symptoms potentially. Moreover, the negative alternation associated with arousal and cognition is also a cause of PSTD. Despite its severity, the first time it catches public interest was during and after military invasions by America worldwide i.e. Iraq, Afghanistan. This disease has an alarming effect on war veterans and several studies have been done to date which is evidence of advancement in this field. Still, the hidden mechanism and specific treatment for this disease are unclear and understudied. The risks associated with PSTD are significant and equally important to individuals and nations. Due to the social, financial, and medical problems PSTD carriers, their well-wishers, and people under trauma exposure must be educated about the risks PSTD can cause.

Posttraumatic stress disorder PSTD is a widespread and enervating psychiatric syndrome. It can cause numerous functional disturbances in multiple domains. It has a complex etiology and manifestation that makes it hard to diagnose and define the conditions and symptoms.

As per DSM-IV, PSTD symptoms are subcategorized into three events: re-experiencing the trauma, numbing/ avoiding, and hyperarousal. The results of this PSTD hypothesis are validated in the DSM-IV. (BO Rothbaum, 2013). The traditional method applied in the Factor analysis of Post-traumatic stress disorder PTSD is generally identifying the symptoms of such trauma in the given cluster of a specific population. There are fewer studies done on the after-treatment symptoms and exploration of the response to these factors after treatment. Despite the less attention provided to after-treatment effects, the factor cannot be cast aside that Posttraumatic stress disorder is undertreated, underestimated, and under-recognized. To nullify the mental burden which patients bear during posttraumatic stress disorder PSTD it is mandatory to first detect the PSTD in patients bearing this mental burden.

Several decades of study and research improved our diagnosis and refined our knowledge. The latest study in this regard suggests more symptoms and broad clusters. In the latest edition of DSM-V PSTD is categorized into 4 clusters and 20 symptoms. These four clusters are: active, avoidance, bleak alterations in mood and cognition, and there are marked alterations in reactivity and arousal. It made the diagnosis easy in a way that now the diagnostic requirements are squeezed to any stressors exposure which is empowered with a minimum of one symptom of intrusion, one symptom of avoidance, at least two anti-alterations in mood and cognition symptoms, and at least two turbulence symptoms in reactivity and arousal. If this diagnosis lasts for a minimum of one month, and functional impairment is also seen then the diagnosis is confirmed. The previous studies had a thin line between anxiety disorder and PSTD but this new DSM-V shifted from the stress disorder category to a new group of stressor-related and trauma-related disorders that defines cognition alternation of post-traumatic stress disorder (al M. e., 2018). Alongside this shift, in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) the criteria of diagnosis were noticeably revised. The third amendment DSM-V makes was to emphasize empowering the typical categorical diagnosis. This needs to be done with the ratings of dimensional severity, this change needs to be implemented on all the major disorders of DSM-V. This new categorization of stress disorder and trauma-related disorders made it clear that the recognition of PSTD is different from typical anxiety disorders (al M. J., 2011). This categorization is similar to that of the World Health Organization's International Classification of Disease (ICD-10) which is to provide a diagnosis caused by a severe traumatic event that leads to the specific symptoms. This categorization of PSTD thus faced opposition also due to the possibility of an increase in the broad criteria in mixed clinical manifestations of disorder (Lori A. Zoellner Ph.D., 2011).

After the proposed new criteria Miller and his colleagues (Miller, 2013) conducted a study on a very large scale to find the Prevalence and latent structure of the proposed symptoms in national and veteran samples. It was an online study that was conducted with the help of the internet and it involved a National stressful event survey (Kilpatrick, 2013). A measurement was developed to examine the extent of exposure of traumatic effects and the intensity of the presence of DSM 5 proposed symptoms. Collaboration is made between the DSM 5 workgroup of PSTD to develop a language that translates each symptom through a specific process. This process is aimed to reflect the conceptualization of the committee for each symptom.  The survey started with 28 questions all related to the life section. They were arranged in a way to access the exposure in a class of events as per DSM 5 criteria. Any person who inhabits a criterion of an event is then examined and administrated as per prior responses.

  The severity of PTSD is strongly felt among the clinicians over the past few years, that if PTSD is not treated well in time, it may result in disturbed life patterns, depression, and mortality. Though many effective treatments are devised over a period based on the bio-psychosocial model, even then it is strongly felt among psychologists and psychiatrists that PTSD needs to be recognized more effectively. Assessing accurately posttraumatic stress disorder is the prime and foremost step in addressing the burden of mental health that patients experience. Over the period it is also realized that for self-assessment there is a need for a short version of the self-rating assessment scale.

This paper is about the development of The National Stressful Event Service Short Scale NSESSS (Post-traumatic stress disorder). The National Stressful Event Service Short Scale NSESSS (Post-traumatic stress disorder) proposed a brief self-reporting measurement scale of nine items. Moreover, the scale validation was carried out in a line on individuals exposed to trauma and strong psychometric properties and efficacy were observed. The present study and research aim to evaluate the sound psychometric properties of the NSESSS (PTSD).

 

 

 

 

 

 

 

 

 

 

 

Bibliography

al, J. W. (2014). Risk of post-traumatic stress disorder following traumatic events in a community sample. pubmed.gov.

al, M. e. (2018). Posttraumatic stress disorder: from diagnosis to prevention. Military medical research, 32.

al, M. J. (2011). Classification of trauma and stressor-related disorders in DSM-5. Wiley online library.

BO Rothbaum, D. B. (2013). A factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended‐release clinical trials. Wiley Online library.

Kilpatrick, D. (2013). National Stressful Events Survey PTSD ShortScale(NSESSS-PTSD). American psycology assosiation.

Lori A. Zoellner Ph.D., B. O. (2011). PTSD not an anxiety disorder? DSM committee proposal turns back the hands of time. Wiley online library.

Miller, M. W. (2013). The prevalance and latent structure of proposed DSM 5 posttraumatic stress disorder symptoms in US National and veteran samples. American Psycology association.