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TRAUMA- AND STRESSOR-RELATED DISORDERS

Forensic Psychology, Master of Science in Psychology, Walden University

COURSE-Abnormal Behavior

Dr. Tilbrook

September 18, 2023

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TRAUMA- AND STRESSOR-RELATED DISORDERS

My general thoughts as a paraprofessional student, everyone and I mean everyone has

something going on mentally. Whether it be stress, depression or just overall anxiety, worries

about life and how things may or may not end up. Keeping the door open for healthy, reflective

dialog is the key for understanding any disorder. Every disorder has its criteria, just like a fruit

some are bumpy, while others are smooth.

The one difference in understanding the fruit is getting to the true core of its chemical

makeup and how it is created and how it manages to survive and make it to the shelf. The same

goes for humans who suffer with personality disorders, and childhood trauma, the light at the

end of the tunnel isn't as far aways as we think. Further, more understanding should be the

strategy at the end of the day.

PTSD Post traumatic stress disorder

Post traumatic stress disorder (PTSD) is a mental health illness that many suffer from.

Some people experience this due to a traumatic event, car accident, domestic abuse and most

commonly those who have served in the military. The best way to describe it is those who suffer

with the condition experience flash backs and have nightmares and anxiety.

The things they think about tend to be uncontrollable, as if the event is taking over their

mind day in and day out. They may feel they are reliving the incident repeatedly, even if it was

years ago. The recall images, thoughts, sounds, smells. Some even experience trembling, nausea,

the symptoms may vary from person to person.

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They may suffer with acute, chronic, or later onset of symptoms. There is treatment, self-

help groups but seeing licensed professional is the best course of action. CBT (cognitive

behavior therapy), psychotherapy tends to be the most common, and many receive impressive

results. Treatments may include medication like serotonin inhibitors and serotonin-

norepinephrine, antidepressants.

DSM-5 Criteria

PTSD is common and sometimes addressed properly to get a proper diagnosis (17-40)

Several traumatic situations happening regularly can show comorbid SMI. Many times, these

types of events for example: head on collision, time as a service man and play a big part

impairing the performance of someone and the emotions they have daily.

In a UK prison sample, PTSD was shown in ranges 0.1 to 27% traumatic situation with a

high rate (17), another UK study with men, found no diagnosis of PTSD, yet many had

traumatic situations during their lifetime. In a forensic setting 41% suggested, ongoing impact of

traumatic related mental illnesses in forensics. Some research discussed the development of

trauma and violent behavior.

Examining traumatic experiences in forensics, rates have been higher than those in

general population versus, non-forensic psychiatric mental patients affected by SMI.analazing 20

plus forensic hospital patients. It was noted that ALL people have at least one traumatic

experience. The study showed traumatic situations, about personality disorders of offenders, few

of these studies showed lifetime trauma with people with personality disorders, (Batle et al 21)
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reports of childhood trauma in more than 60% of patients, the limits on this were miniscule and

was limited data due to sample size. The second limitation is to report patients' confidentiality.

The last limitation not considered was trauma to patients securely hospitalized in

psychiatric/non psychiatric setting. These things too can affect involuntary admission, forced

medication and physical restraining for safety or otherwise. (47,48). In conclusion, in forensic

settings, to consider relationships, traumatic lifetime experiences- personality disorders are the

hardest to diagnose. The lack of evidence in treatments and intervention before trauma can

reduce violence.

Forensic Psychology Aspects

Signmund Freud in his early work focused on traumatic shock and turning away from

things that did not cause pleasure and the impulse of judgement. This focus was on patients who

had endured in their lifetime, some workplace, loss of family members assault and in combat.

Despite his efforts, in the history of similar reactions have suffered and ridiculously hard

to treat. In pharmacology, natural cures are St. john's wort, chamomile tea which is supposed to

help with sleep, relaxation and valerian root designed to work with gamma aminobutyric acid

(GABA) in the brain to produce a calming effect like chamomile.

Decades later in research completed on PTSD, suicide rates and impairment to service

men with that diagnosis. Most of these were funded by the government and federal agencies to

understand the depts of the brain and its working with concentration on stress, hypothalamic-
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pituitary system. Keeping this type of mental illness untreated, can lead to suicide, and

completing suicide and other psychosis

STEP Care treatment

StepCare screens patients for symptoms, 9 item questionnaire & anxiety disorders. The

top disability cause in the world, especially with Covid –19 anxiety, depression has been

associated with reduced quality of life. With covid 19 causing so many barriers that prevented

people from having in person interaction, mental health has slowed, but expected to increase

with more digital increase in mental health.

The PHQ-9is used to check suicidal thoughts, harming self these can be mild to severe.

The STEP program gives patients a possibility to take part in the program by accepting or

declining on a tablet. This is voluntary, based on the patient's answers would find the next streps

forward in demographic information.

Step care is recommended in clinical settings; it is also used to evaluate various

conditions Richards D. A. et al. Delivering stepped care: an analysis of implementation in

routine practice. Implement Sci. 7 (2012).

Screening & Prevention, diagnostics

Exploring attacks of September 11, 2001, the developments of PTSD criteria have

changed over time. PTSD by the American Psychiatric Association (APA) a mental health
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disorder in the 1980s (APA, 1980) This mental disorder. Was. Clear. Suffield in terms of. Civil

war. catastrophic events, railway incidents. Many were classified as being overly emotional,

(Birmes et al., 2003 other also mentioned “soldier’s heart,” and muscle weakness and was

believed to be a result as being home sick and not acclimating to the military lifestyle.

Symptoms of included tremors, memory loss, and not being able concentration—these

symptoms associated with PTSD. Research after Vietnam War, termed combat fatigue after this

term became in more discussion and many service persons began suffering, discussing mental

issues coming from their occupation (IOM, 2008a) Since the 1980s there has been a criterion for

those suffering with mental illness to name a few: Psychological distress when exposed to

traumatic reminders, Detachment from others and Hypervigilance. Persons can be diagnosed as

Acute, Chronic or late onset.

Men experience PTSD traumatic events more than women, traumatic situations can differ

by types by male and female (Tolin and Foa, 2006) Also more persons of color have elevated

risks of traumatic experiences (Noris, 1992; Roberts et al., 2011) trauma types, the severity of

the event.
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References

American Psychiatric Association. (2022). Trauma- and Stressor-Related Disorders. In

Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.)

Bianchini V, Paoletti G, Ortenzi R, Lagrotteria B, Roncone R, Cofini V, Nicolò G. The

Prevalence of PTSD in a Forensic Psychiatric Setting: The Impact of Traumatic Lifetime
Experiences. Front Psychiatry. 2022 Apr 27;13:843730. doi: 10.3389/fpsyt.2022.843730. PMID:
35573371; PMCID: PMC9091818.

Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress

Disorder; Institute of Medicine. Treatment for Posttraumatic Stress Disorder in Military and
Veteran Populations: Initial Assessment. Washington (DC): National Academies Press (US);
2012 Jul 13. 2, History, Diagnostic Criteria, and Epidemiology. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK201095/

Ho FY, Yeung WF, Ng TH, Chan CS. The Efficacy and Cost-Effectiveness of Stepped Care
Prevention and Treatment for Depressive and/or Anxiety Disorders: A Systematic Review and
Meta-Analysis. Sci Rep. 2016 Jul 5;6:29281. doi: 10.1038/srep29281. PMID: 27377429;
PMCID: PMC4932532.

Pai A, Suris AM, North CS. Posttraumatic Stress Disorder in the DSM-5: Controversy, Change,
and Conceptual Considerations. Behav Sci (Basel). 2017 Feb 13;7(1):7. doi:
10.3390/bs7010007. PMID: 28208816; PMCID: PMC5371751.

Schrader C, Ross A. A Review of PTSD and Current Treatment Strategies. Mo Med. 2021 Nov-
Dec;118(6):546-551. PMID: 34924624; PMCID: PMC8672952.

Whitton AE, Hardy R, Cope K, Gieng C, Gow L, MacKinnon A, Gale N, O'Moore K, Anderson
J, Proudfoot J, Cockayne N, O'Dea B, Christensen H, Newby JM. Mental Health Screening in
General Practices as a Means for Enhancing Uptake of Digital Mental Health Interventions:
Observational Cohort Study. J Med Internet Res. 2021 Sep 16;23(9):e28369. doi:
10.2196/28369. PMID: 34528896; PMCID: PMC8485187.