Post-Traumatic Stress Disorder: Potential Issues and Treatment Implications Regarding the Counseling

“During some period of their lives, approximately 7.8% of Americans will experience post-traumatic stress disorder, with women (10.4%) twice as likely as men (5%) to develop the condition (Peirce, Burke, Stoller, Neufeld, & Brooner, 2009).” Post-traumatic stress disorder (PTSD) is a malady that may develop after contact, by experiencing or witnessing a frightening or possibly life-threatening event. The individual, who has been exposed to either death, threatened death, concrete or susceptible serious injury, or actual or threatened sexual violence must have experienced one of four stressors (American Psychiatric Association, 2013). The first stressor, in-person witnessing, may be illustrated by the occurrence of a daughter watching her mother die in the hospital or, even quickly, in a car accident. Subsequently comes a stressor that may have occurred indirectly, such as an individual learning that his close friend or relative was exposed to trauma, either violent or accidental (American Psychiatric Association, 2013). The third stressor, repeated or extreme indirect exposure, may occur in social workers or police officers that have been repetitively illustrated details of child abuse, as well as first responders who have gathered body parts on various occasions (American Psychiatric Association, 2013). Finally, the final stressor, direct exposure, could be symbolized through the example of a wife who has been psychologically or physically abused by a violent husband. This presentation will display a concise description of the diagnostic criteria, treatment implications, and issues that a counselor might address when assisting a client who is or has suffered from PTSD, as a result of domestic violence.

Every year, 5.2 million people, or 3.6% of adults between the ages of 18 and 54, experience PTSD (What is PTSD, 2007). This exemplifies only a slight share of individuals who have faced a minimum of one traumatic occurrence, as 60.7% of males and 51.2% of females have reported at least one of these incidents (What is PTSD, 2007). PTSD has been suggested to generally result in men as an aftermath of experiencing rape, childhood neglect or physical abuse, or combat exposure. Meanwhile, the disorder typically occurs in women who have suffered through sexual molestation, rape, physical attack, childhood physical abuse, or the threat of weaponry (What is PTSD, 2007). Countless individuals, who undergo traumatic events, struggle amending and coping for a period of time, but that does not suggest that they have post-traumatic stress disorder; with the proper self-care and time, many tend to adjust. However, if the symptoms become worrisome, last over a month, cause substantial symptom-related suffering, and impede effective functionality, the individual may be suffering from PTSD. The uproar must not be caused by substance abuse, medication, or another illness.

According to the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 2013), the traumatic events that potentially cause PTSD must meet particular conditions and symptoms from each of four symptom clusters; one symptom is required from each condition. The first condition involves intrusion; Symptoms related to this condition may be exist through nightmares, flashbacks, penetrating or extended stress after reminders of the event, obvious physiologic reactivity after contact with trauma-related spurs, or chronic, uncontrolled, and disturbing memories (American Psychiatric Association, 2013). The second condition related to PTSD is avoidance, in which the person affected dodges trauma-related thoughts or feelings or trauma-related outside reminders, such as certain individuals, locations, items, circumstances, actions, or discussions (American Psychiatric Association, 2013). The next condition involves negative adjustments in cognitions or mood, in which the individual must experience two of the following symptoms: Losing interest in activities that used to matter to him or her, the inability to remember important details of the event, obstinate undesirable trauma-related emotions (e.g., fear, anger, guilt, or disgrace), tenacious and inaccurate negative beliefs and expectancies about oneself or the world (e.g., “This world is cruel and unfair”, “I ruin everything”), persistent wrongful blame on self or others for causing the incident, a sense of isolation from others, or the habitual incapacity to feel positive emotions (American Psychiatric Association, 2013). Patients, diagnosed with PTSD, must also experience at least two of the following symptoms, regarding the alterations in arousal and reactivity condition; These symptoms include short-tempered or hostile behavior, hyper-vigilance, irresponsible or self-destructive comportment, amplified startle reaction, trouble falling or staying asleep, and difficulties concentrating (American Psychiatric Association, 2013).

Counselors who treat individuals undergoing post-traumatic stress disorder might address all of the above symptoms. Numerous patients may even display dissociative symptoms, in which they experience depersonalization and feel as though they are outside spectators, utterly disconnected from themselves or derealization, in which they feel that things, or rather the situation, is not real (American Psychiatric Association, 2013). It is also very common for other conditions, such as anxiety, depression (50% of women with PTSD), physical symptoms, or substance abuse, to occur due to the PTSD. Counselors might need to address issues (e.g., divorce, separation, unemployment, or spouse abuse) that tend to run alongside PTSD, with their patients (What is PTSD, 2007). While symptoms may occur immediately, full diagnosis is not proposed until at least six months after the traumatic incident(s) (American Psychiatric Association, 2013); Therefore, seeking beneficial treatment after PTSD indications unravel can be vital to decrease symptoms and mend function.

As a counselor generally begins treating a patient with PTSD by conducting a thorough evaluation and then creating a treatment plan that meets the distinct requirements of the affected individual. One of the key treatments recommended to these individuals is psychotherapy, which primarily involves talking alone with a mental health professional or in groups (Post-Traumatic Stress Disorder, 2014). Psychologists and counselors may teach the individual to deal with memories, recaps, responses, and feelings, associated to the traumatic events, without becoming flabbergasted or disoriented. Support from family and friends can also be a crucial part of therapy. It seems useful for a professional to educate survivors and their families about the issues frequently linked to PTSD, how individuals develop the disorder, and how it affects survivors and the close people in their lives. Other sorts of therapies, which may help a victim of domestic violence suffering from PTSD, are family therapy, medications, prescribed by doctors and psychiatrists, and exposure therapy, in which patients are safely exposed to the trauma they encountered and learn to confront and control their fear (Post-Traumatic Stress Disorder, 2014).

Grounded on these factors, additional scholarly articles, based on the effects of PTSD in women who have suffered from domestic violence, have been reviewed. After a study, based on the effect of cognitive-behavioral therapy on PTSD, Iverson, Gradus, Resick, Suvak, Smith, and Monson (2011) suggested that, during treatment of female survivors of interpersonal violence, decreases in PTSD and in depressive symptoms were connected to a reduced chance of intimate partner violence (IPV) victimization. Najdowski & Ullman (2009) proposed that maladaptive coping moderately arbitrated the outcomes of other distresses, self-blame, and observed power over recuperation on PTSD indications and self-rated healing; Greater maladaptive coping was linked to amplified PTSD symptoms and lower self-rated healing. A separate research study implied that embarrassment, guilt-related anguish, and guilt-related perceptions exhibited noteworthy connections to PTSD (Beck, McNiff, Clapp, Olsen, Avery, & Hagewood, 2011). “In the context of psychological abuse, elevated stages of both emotional/verbal abuse and dominance/isolation interacted with extreme heights of shame in their involvement with PTSD (Beck et al., 2011).” Studies directed by Klump (2006) and Becker, Stuewig, and McCloskey (2010) evaluated physical, emotional, intensified physical, and sexual abuse, in order to support the hypothesis that IPV and history of childhood abuse (e.g., physical abuse, sexual abuse, and witnessing domestic violence) impact self-reports of PTSD symptoms; Adult IPV types and childhood victimization types each displayed an independent relationship with PTSD symptoms. The final article, by Woods (2005), adheres to my interest, due to my experience working on various psychological evaluations and forensic reports for women who have suffered from domestic violence. This article, which embraces the majority of the information presented in this report, begs for future research, or more specifically, longitudinal and intervention research, which should integrate a series of psychosocial and physiologic health outcomes in the 51.2% of women suffering from PTSD, due to traumatic life-changing events.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Beck, G., McNiff, J., Clapp, J., Olsen, S., Avery, M., & Hagewood, J. (2011). Exploring Negative Emotion in Women Experiencing Intimate Partner Violence: Shame, Guilt, and PTSD. Behavior Therapy, 42(4), 740-750. Retrieved from http://eric.ed.gov/?q=ptsd in women&id=EJ945213

Becker, K., Stuewig, J., & McCloskey, L. (2010). Traumatic Stress Symptoms of Women Exposed to Different Forms of Childhood Victimization and Intimate Partner Violence. Journal of Interpersonal Violence, 25(9), 1699-1715. Retrieved from http://eric.ed.gov/?q=ptsd in victims of domestic violence&id=EJ893456

Iverson, K., Gradus, J., Resick, P., Suvak, M., Smith, K., & Monson, C. (2011). Cognitive-Behavioral Therapy for PTSD and Depression Symptoms Reduces Risk for Future Intimate Partner Violence among Interpersonal Trauma Survivors. Journal of Consulting and Clinical Psychology, 79(2), 193-202. Retrieved from http://eric.ed.gov/?q=ptsd after domestic violence&id=EJ933768

Klump, M. (2006). Posttraumatic Stress Disorder and Sexual Assault in Women. Journal of College Student Psychotherapy, 21(2), 67-83. Retrieved from http://eric.ed.gov/?q=ptsd in women&id=EJ838102

Najdowski, C., & Ullman, S. (2009). PTSD Symptoms and Self-Rated Recovery among Adult Sexual Assault Survivors: The Effects of Traumatic Life Events and Psychosocial Variables. Psychology of Women Quarterly, 33(1), 43-53. Retrieved from http://eric.ed.gov/?q=ptsd in women&id=EJ826317

Peirce, J., Burke, C., Stoller, K., Neufeld, K., & Brooner, R. (2009). Assessing Traumatic Event Exposure: Comparing the Traumatic Life Events Questionnaire to the Structured Clinical Interview for "DSM-IV" Psychological Assessment, 21(2), 210-218. Retrieved from http://eric.ed.gov/?q=ptsd in women&id=EJ842442

Post-Traumatic Stress Disorder. (2014, November 24). Psychology Today.

What is PTSD? (2007). Nebraska Department of Veterans' Affairs. Retrieved from http://www.ptsd.ne.gov/what-is-ptsd.html

Woods, S. (2005). Intimate Partner Violence and Post-Traumatic Stress Disorder Symptoms in Women: What We Know and Need to Know. Journal of Interpersonal Violence, 20(4), 394-402. Retrieved from http://eric.ed.gov/?q=ptsd in women&id=EJ690495​

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