Post-Traumatic+Stress+Disorder+(PTSD)

** Post-Traumatic Stress Disorder (PTSD) ** **Causes** Post-traumatic stress is an anxiety disorder that can occur after a person has been exposed to a traumatic event involving injury or death such as sexual abuse, violence, or rape. PTSD may affect a person right away or over a six month time period. It can last from 3 months to several years. The disorder can occur at any age. While the cause of PTSD is unknown, there are psychological, social, genetic, and physical factors that contribute to the diagnosis. The disorder affects the way the body handles stress in terms of stress hormones and chemicals that are responsible for transmitting information between nerves. Research has shown that extreme stress can cause major physical changes in the hippocampus and medial prefrontal cortex, two areas of the brain involved in memory and emotional response. These changes can lead to PTSD symptoms, in particular loss and distortion of memory of events surrounding the abuse, but also to ongoing problems with learning and remembering new information (Bremner, 2000).

**Sexual Ab****use & PTSD** Sexual abuse can occur between anyone (adults, teens, children) at any age. This abusive behavior is used to gain power over an individual. There are many types of sexual abuse; some include physical contact or touching offenses. For example, fondling, touching sexual organs, masturbation, vaginal or anal penetration with self or objects and intercourse itself (Boulware, 1998). Sexual abuse can lead to PTSD. According to the U.S. Department of Justice (2008), i n 2006, victims age 12 or older experienced 272,350 rapes or sexual assaults. In addition, 89% of rape or sexual assault victims in 2006 were female with31% assaulted by strangers; 44% were friends or acquaintances of their victims, and 21% were intimate partners. American Indian and Alaskan Native women are almost three times as likely to experience rape or sexual assault as white, African American, or Asian American women. Approximately 1/3 of all rape victims develop Rape-related Post-Traumatic Stress Disorder sometime during their lifetimes, and more than 11% still suffers from it (Ringel, 2008).

**Symptoms** Victims of sexual abuse that have PTSD may experience several symptoms. There are three categories that describe this process.
 * **Repeated "reliving" of the event** (flashbacks, nightmares, intrusive memories, dreams, physical situations relating to sex, panic attacks, claustrophobia)
 * **Avoidance** (emotional numbing, disconnectedness, difficulty remembering incident, lack on interest in participating in routine activities, isolation from places, people or objects that are reminders of the event, less expression of moods, feelings of failure, abnormal responses to fear, social impairment or withdrawal)
 * **Arousal** (lack of concentration, mood swings, insomnia, excess awareness)

 Individuals may also face symptoms in relation to being sexually active. PTSD can affect a person’s **sexual communication**. Some of the symptoms involve failure to become aroused, disturbing sexual thoughts/images, inappropriate sexual behavior, inability to achieve orgasms, sexual dysfunction, detachment or emotional distance while having sex, and experiencing guilt, fear, anger, and disgust when being touched or engaging in sexual intercourse. This means it may be hard for someone with PTSD to sexually communicate or be intimate with a partner after a traumatic event. A survivor may have difficulty expressing their sexual needs because they may feel they no longer have the right to pleasure and sexual attention. Therefore this lack of communication can affect sexual satisfaction. Survivors often want to feel in control and sex can be used as a way to maintain power in the relationship (Boulware, 1998).

 PTSD is also common in childhood sexual abuse. C hildren may feel nervous, fearful, and depressed due to the abuse. They communicate this by acting out the abuse through drawings, playing with others, or behavioral issues, and may lose skills they once learned such as wetting the bed. Survivors also may feel like they need to be sexual in order to be loved or to get attention. As a result, they lack self-respect and communicate this through erotic sexual behavior. While they may feel a sense of closeness to their abuser, it can also trigger negative feelings when trusting others in the future. Children also tend to blame themselves because they think they asked for it or something is wrong with them (Boulware, 1998).

**Diagnosis (acute, chronic, delayed onset)** For a clinical diagnosis of PTSD, symptoms in all three of these areas (repeated re-living of event, avoidance, arousal) must be present at the same time for a period of at least one month. The symptoms must cause significant distress in the victim’s everyday lives. <span style="font-family: 'Times New Roman',Times,serif; line-height: 26px; margin-bottom: 12pt;">PTSD is diagnosed as //acute// if the duration of the symptoms is less than three months. It is //chronic// if the duration of symptoms is three months or more. PTSD is diagnosed //with delayed onset// if the symptoms appear at least six months after the traumatic event. Symptoms of PTSD can take a long time to manifest themselves (National Center of Victim and Crime, 1992).

<span style="font-family: 'Times New Roman',Times,serif; margin-bottom: 12pt;">**Triggers** <span style="font-family: 'Times New Roman',Times,serif; line-height: 200%; margin-bottom: 0in; text-indent: 0.25in;">Certain situations cause the event of sexual abuse to be relived. Triggers may be internal or external depending on the victim.
 * <span style="font-family: 'Times New Roman',Times,serif;">Identification of the assailant
 * <span style="font-family: 'Times New Roman',Times,serif;"> Sensing (touch, scent, sound)
 * <span style="font-family: 'Times New Roman',Times,serif;"> Anniversaries of the event
 * <span style="font-family: 'Times New Roman',Times,serif;"> Holidays and other important family life event
 * <span style="font-family: 'Times New Roman',Times,serif;"> Hearings, trials, appeals and other criminal justice proceedings

<span style="font-family: 'Times New Roman',Times,serif; line-height: 26px;">People with PTSD will avoid situations that trigger memories or flashbacks of the traumatic event. If untreated, the victim's life may become dominated by attempts to avoid situations that remind him or her of the event (National Center of Victim and Crime, 1992).

<span style="font-family: 'Times New Roman',Times,serif; line-height: 200%; margin-bottom: 0in;">**Signs & Tests** <span style="font-family: 'Times New Roman',Times,serif; line-height: 200%; margin-bottom: 0in;">There are no tests that can determine if you have PTSD. The diagnosis is based on symptoms recorded by a healthcare provider who will decide whether or not the disorder exists.

<span style="font-family: 'Times New Roman',Times,serif; margin-bottom: 12pt;">**Treatment** <span style="font-family: 'Times New Roman',Times,serif; line-height: 17pt; margin-bottom: 9pt;">(Post-Traumatic Stress Disorder, 2010) <span style="display: block; line-height: 150%; margin-bottom: 9.0pt; mso-layout-grid-align: none; mso-pagination: none; text-align: center; text-autospace: none;"><span style="display: block; font-family: 'Times New Roman',Times,serif; text-align: center;">**References** <span style="font-family: 'Times New Roman',Times,serif;">American Psychiatric Association. (2002). //Diagnostic and Statistical Manual of Mental disorders -IV-R//. (4th ed.). Washington, DC. <span style="font-family: 'Times New Roman',Times,serif; letter-spacing: 2pt;">Boulware, C. (1998). //Adult Survivors of Childhood Sexual Abuse//. Retrieved from [] <span style="font-family: 'Times New Roman',Times,serif; letter-spacing: 2pt;">Bremner, J. (2000, March). //The Invisible Epidemic: Post-Traumatic Stress Disorder, Memory and the Brain//. Retrieved from [] <span style="font-family: 'Times New Roman',Times,serif;">// National Center for PTSD //. (2007, January 1). Retrieved from [] <span style="font-family: 'Times New Roman',Times,serif;">National Center for Victims of Crime & Crime Victims Research and Treatment Center. (1992). //Rape in American: A Report to the Nation.// Arlington, VA: National Center for Victims of Crime. <span style="font-family: 'Times New Roman',Times,serif;">// Post Traumatic Stress Disorder //// Research Fact Sheet //. (2010, September 7). Retrieved from [] (Image) <span style="font-family: 'Times New Roman',Times,serif;">// Post-Traumatic Stress Disorder //. (2010, February 14). Retrieved from [] <span style="font-family: 'Times New Roman',Times,serif; letter-spacing: 2pt;">Ringel, C. (2008). //Criminal Victimization//. Washington, DC: Bureau of Justice Statistics, US Department of Justice.
 * <span style="font-family: 'Times New Roman',Times,serif;">Support and love from family/friends
 * <span style="font-family: 'Times New Roman',Times,serif;">Support groups i.e. rape crisis centers (people who have had similar experiences)
 * <span style="font-family: 'Times New Roman',Times,serif;"> Recall of event (talking about it and taking control of experience)
 * <span style="font-family: 'Times New Roman',Times,serif; line-height: 22px;"> Behavioral Therapy- used to treat avoidance symptoms. This can include being exposed to the object that triggers your symptoms until you become used to it and no longer avoid it.
 * <span style="font-family: 'Times New Roman',Times,serif; line-height: 22px;"> May need to be treated for possible depression, alcohol or substance abuse, or related medical conditions before addressing symptoms of PTSD
 * <span style="font-family: 'Times New Roman',Times,serif; line-height: 22px;">Medicines that act on the nervous system can help reduce anxiety and other symptoms of PTSD. Antidepressants, including selective serotonin reuptake inhibitors (SSRIs) such as Prozac, can be effective in treating PTSD.
 * <span style="font-family: 'Times New Roman',Times,serif;">Don't downplay the abuse ("it wasn't that bad"), but also try not to have extreme fears related to the abuse ("my child will never be safe again").
 * <span style="font-family: 'Times New Roman',Times,serif; line-height: 22px;">Counseling/Therapy