Now, to reiterate my title, this is what is wrong.
Post-traumatic stress disorder PTSD is an anxiety disorder that may develop after an individual is exposed to one or more traumatic events. In order to meet criteria for a diagnosis of PTSD, in addition to being exposed to at least one potentially traumatic event as described above, an individual must react with helplessness, fear or horror either during or after the event.
Individuals with PTSD exhibit four different types of symptoms, including: Reliving or re-experiencing the event -- symptoms include nightmares, intrusive thoughts, flashbacks and psychological distress and physical reactivity in response to trauma cues.
Avoidance -- avoiding reminders of the traumatic event, including thoughts, emotions, people, places and conversations that may trigger memories of the traumatic event.
Emotional numbing -- symptoms include feeling emotionally numb or having reduced emotional experiences, detachment or estrangement from others, and being less interested in previously enjoyed activities. Arousal symptoms are very common in returning veterans, even in those who do not meet full criteria for a PTSD diagnosis.
The most frequently reported problems are increased anger or irritability and difficulty sleeping. Other arousal symptoms include constantly being on guard, having difficulty concentrating and feeling jumpy or easily startled. These symptoms cause difficulties in social relationships -- with family, dating and friendships -- and occupational functioning in work or school.
Is it common for soldiers returning from war to experience symptoms of PTSD? In addition to military personnel that meet full criteria for a PTSD diagnosis, many others display some combination of PTSD symptoms as they readjust to the challenges of civilian life after functioning under the constant life-threat they experienced during deployment.
It is common to have some PTSD symptoms at first, especially hypervigilance, insomnia and nightmares as veterans try to integrate and process their war zone experiences. These symptoms are likely to be more intense for those who have returned recently, and many of these symptoms are likely to decrease over time as they adjust to civilian life.
One way to conceptualize many of these PTSD symptoms is to think of them as part of a stress-response continuum. At one end are individuals who are burdened by stressors at home at the same time that they are reminded of traumatic events that happened in the war zone, yet are coping well with few mental health symptoms and little functional impairment.
These people are often able to reintegrate into their previous jobs with little disruption and return to their relationships, in which they can communicate about areas of difficulty.
In the middle may be those who have a variety of PTSD symptoms, yet do not evidence clinically significant impairment in functioning. At the other end of the spectrum are veterans who are plagued with a host of PTSD symptoms and have difficulty functioning in their daily lives.
Can you tell us about the research that has been done on the relationship between killing in war and PTSD?
A few studies have detailed the elements of war-zone exposure that are necessary, but not sufficient, to create risk for chronic PTSD. In one study of Vietnam veterans, King and colleagues found that instances of traditional combat e.
In another study that examined killing in the context of committing atrocities during war within a larger model, Fontana and Rosenheck found a strong relationship between killing and PTSD.
After taking killing into account, the atrocities variable no longer predicted PTSD symptoms, suggesting that killing could be the potent ingredient in predicting PTSD. Our preliminary results from a current study of Vietnam veterans have demonstrated that in addition to PTSD, killing is also associated with a number of mental health and functioning problems, even after taking exposure to general combat into account.
Finally, we are currently in the process of conducting a study about the impact of killing on veterans returning from deployments to Iraq and Afghanistan.
We are not aware of any other studies that document this relationship in newly returning veterans. Why is killing in war a potentially traumatic event that would lead to PTSD? Although soldiers are trained to kill, as cited in Soldiers of Conscience, killing is quite difficult for most individuals.
Prior to killing another enemy combatant or a civilian, there is generally some type of life threat. The circumstances of killing also generally involve either the person him or herself being injured or in danger of being killed and often others being killed. Pulling the trigger, even in self defense, is not easy and is often accompanied by a series of complex emotional reactions before and after taking a life.
While some may react in this way, others may not, which is why assessment of reactions to killing is quite important. Also, it is important to remember that just because an individual experiences killing as a traumatic event does not mean that the person will inevitability develop PTSD symptoms or a formal diagnosis of PTSD.
Killing is difficult for many soldiers who may not develop PTSD, and those issues should be evaluated separately. What are the current rates of mental health problems in soldiers returning from Iraq and Afghanistan? These rates are somewhat similar to those reported in other scientific studies.
An initial report by Hoge and colleagues indicated that 16 to 17 percent of returning Operation Iraqi Freedom OIF combat veterans and 11 percent of returning Operation Enduring Freedom OEF combat veterans met screening criteria for at least one mental health disorder.
In a more recent study, Hoge and colleagues found that the prevalence of screening positive for a mental health problem was 19 percent among service members returning from Iraq and 11 percent after returning from Afghanistan. Mental health problems are related to impairments in physical health and general functioning.ESSAYS OR COUNSELS.
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