Post -Traumatic Stress Disorder (PTSD)

Post -Traumatic Stress Disorder (PTSD)(6 Hours/CEU’s)

© 2009 by Aspira Continuing Education. All rights reserved. No part of this material
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electronic without written permission of Aspira Continuing Education
Course Objectives: This course is designed to help you:
1. Define PTSD
2. Learn the historical framework related to the clinical development of
PTSD as a diagnosis
3. Identify corresponding symptoms and behaviors
4. Apply widely accepted assessment techniques and tools
5. Apply widely accepted treatment techniques and tools
6. Identify risk factors
7. Identify anniversary reactions and provide treatment when indicated
8. Identify and access resources
Table of Contents:
1. History
2. Facts and Statistics
3. Symptoms and Behaviors
4. Diagnosis and Assessment
5. Treatment
6. Risk and Protective Factors
7. Trauma Anniversary Reactions
8. Resources
9. References

1. History
Battle-associated stress has been a part of human history since the 6th
century BC. Symptoms resembling PTSD have also been recognized in
combat veterans of many military conflicts throughout time. The more
contemporary conceptualization of PTSD dates from the 1970s due to the
problems that were still being experienced by Vietnam veterans. One of the
first descriptions of PTSD was provided by the Greek historian Herodotus.
In 490 BCE he described, during the Battle of Marathon, an Athenian soldier
who suffered no injury from war but became permanently blind after
witnessing the death of a fellow soldier (Bremner, Eds., Posttraumatic Stress
Disorder. A Comprehensive Text. Boston: Allyn).
The term post-traumatic stress disorder or PTSD was first used in the mid
1970s. Early in 1978, the term was used in a working group finding
presented to the Committee of Reactive Disorders. The term was formally
recognized in 1980. In the DSM-IV, which is considered authoritative, the
spelling "posttraumatic stress disorder" is used. Elsewhere, "posttraumatic"
is often rendered as two words including "post-traumatic stress disorder" or
"post traumatic stress disorder", especially in less formal writing on the
subject. The diagnosis was removed from the DSM-II, which resulted in the
inability of Vietnam veterans to receive benefits for this condition. In part
through the efforts of anti Vietnam war activists and the anti war group
Vietnam Veterans Against the War who worked with them and coined the
term post-Vietnam Syndrome, the condition was added to the DSM-III as
posttraumatic stress disorder (Bremner, Eds., Posttraumatic Stress Disorder.
A Comprehensive Text. Boston: Allyn).
In the United States, the provision of compensation to veterans for PTSD is
under review by the Department of Veterans Affairs (VA). The review was
begun in 2005 after the VA had noted a 30% increase in PTSD claims in
recent years. The VA began the review because of budget concerns and
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apparent inconsistencies in the awarding of compensation by different rating
offices. This produced opposition from veterans' rights groups, and to some
highly-publicized suicides by veterans who feared losing their benefits,
which in some cases constituted their only income. In response, on
November 10, 2005, the Secretary of Veterans Affairs announced that "the
Department of Veterans Affairs (VA) will not review the files of 72,000
veterans currently receiving disability compensation for post-traumatic stress
disorder..."
The diagnosis of PTSD has been a subject of some controversy due to
uncertainties in objectively diagnosing PTSD in those who may have been
exposed to trauma, and due to this diagnosis' association with some
incidence of compensation-seeking behavior. The social stigma of PTSD
may result in under-representation of the disorder in military personnel,
emergency service workers and in societies where the specific traumacausing
event is stigmatized (Bremner, Eds., Posttraumatic Stress Disorder.
A Comprehensive Text. Boston: Allyn).

Many US veterans returning home from Iraq and Afghanistan report
significant physical, emotional and relational disruptions due to trauma. In
response, the United States Marine Corps has instituted programs to assist
them in re-adjusting to civilian life. Similarly, Walter Reed Army Institute of
Research (WRAIR) developed the Battlemind Program to assist service
members avoid or manage PTSD. In the UK there has been some
controversy that National Health Service is dumping veterans on service
charities like Combat Stress. The inclusion of PTSD as a psychiatric
disorder in the DSM-III (American Psychiatric Association, 1980) was
propelled by the significant number of Vietnam combat veterans who
demonstrated similar symptoms (Bremner, Eds., Posttraumatic Stress
Disorder. A Comprehensive Text. Boston: Allyn).