Treatment for PTSD

Cognitive-behavioral therapy (CBT) 
Cognitive-behavioral therapy for PTSD have been found to be very successful in reducing peoples' symptoms and improving their quality of life.
Some of CBT therapies  that are regularly used to treat PTSD include:
1. Exposure Therapy
2. Stress-Inoculation Training
Exposure Therapy
People with PTSD may develop fears of reminders of their traumatic event. The goal of exposure therapy is to help reduce the level of fear and anxiety connected with these reminders, thereby also reducing avoidance. This is usually done by having the client confront or be exposed to the reminders that he fears without avoiding them. This may be done by actively exposing someone to reminders (for example, showing someone a picture that reminds him of his traumatic event) or through the use of imagination.
By dealing with the fear and anxiety, the patient can learn that anxiety and fear will lessen on its own, eventually reducing the extent with which these reminders are viewed as threatening and fearful.
Stress-Inoculation Training

The basic goal of this therapy is to help the person suffering from PTSD gain confidence in his ability to cope with anxiety and fear stemming from trauma reminders. The therapist helps the patient become more aware of what things are the reminders of fear and anxiety. In addition, patients learn some of the coping skills that are useful in managing anxiety, such as muscle relaxation and deep breathing.
The therapist helps the patient learn how to detect and identify the reminders as soon as they appear so that the patient can put the newly learned coping skills into immediate action. In doing so, the patient can tackle the anxiety and stress early on before it gets out of control.

Medical or Drug Treatment

Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. No medications have been specifically designed to treat the symptoms of PTSD, although some medications commonly used to treat anxiety disorders and depression have been found to be effective in helping people manage their symptoms. Antidepressants such as Prozac and Zoloft are the medications most commonly used for PTSD. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD. Basically they just bring you to the state of mind where you are able to continue with the treatment by for example CBT. 

CBT in combination with Medications

Medications are often paired with cognitive-behavioral therapy because by using both of these the effectiveness of them is boosted. The medications are usually used to improve the physical symptoms such as hyperarousal whilst CBT is usually used to improve the psychological symptoms such as avoidance and sadness. If only medications are used, it does not cure the patient completely because he still might be suffering from some psychological problems. If only CBT is used, it might take a longer time and the symptoms of hyperarousal might never completely disappear. When are these two treatments combined, PTSD can be treated faster and in a much more effective way. 

Post Traumatic Stress Disorder (PTSD)

What is PTSD?

PTSD is an emotional illness that that is classified as an anxiety disorder and usually develops as a result of a terribly frightening, life-threatening, or otherwise highly unsafe experience such as war or any other storngly emotional event. People who suffer from PTSD re-experience the traumatic event in some way, tend to avoid places, people, or other things that remind them of the event. They are also exquisitely sensitive to normal life experiences (hyperarousal). PTSD has been recognized as a formal diagnosis since 1980. PTSD has also been called "battle fatigue" and "shell shock".

• In the past year alone the number of diagnosed cases in the military jumped 50%– and that’s just diagnosed cases.
• Studies estimate that 1 in every 5 military personnel returning from Iraq and Afghanistan has PTSD.
• 70% of adults in the U.S. have experienced some type of traumatic event at least once in their lives. That’s 223.4 million people. Up to 20% of these people go on to develop PTSD. As of today, that’s 31.3 million people who did or are struggling with PTSD.

What are the symptoms?

After many years of research, 17 PTSD symptoms have been identified. These symptoms develop following the experience of a traumatic event and are divided into three separate categories.

1. Re-experiencing symptoms

• Frequently having upsetting thoughts or memories about a traumatic event.
• Having recurrent nightmares.
• Acting or feeling as though the traumatic event were happening again, sometimes called a "flashback."
• Having strong feelings of distress when reminded of the traumatic event.
• Being physically responsive, such as experiencing a surge in your heart rate or sweating, to reminders of the traumatic event.

     2. Avoidance symptoms

• Making an effort to avoid thoughts, feelings, or conversations about the traumatic event.
• Making an effort to avoid places or people that remind you of the traumatic event.
• Having a difficult time remembering important parts of the traumatic event.
• A loss of interest in important, once positive, activities.
• Feeling distant from others.
• Experiencing difficulties having positive feelings, such as happiness or love.
• Feeling as though your life may be cut short.

     3. Hyperarousal symptoms

• Having a difficult time falling or staying asleep.
• Feeling more irritable or having outbursts of anger.
• Having difficulty concentrating.
• Feeling constantly "on guard" or like danger is lurking around every corner.
• Being "jumpy" or easily startled.

To be diagnosed with PTSD, a person does not need to have all of these symptoms. However, a person with PTSD usually has at least some of the symptoms from each category. 

What causes PTSD?

PTSD is caused by experiencing any trauma, defined as an event that is life-threatening or that severely compromises the physical or emotional well-being of an individual or causes intense fear. Such events can be for example: seeing or being victim of violence, death or serious illness of someone very close to you, war, car accidents, natural disasters (hurricanes, fires, tornadoes, etc.), robbery, shooting, seeing somebody dying in front of your eyes, etc. People can also be diagnosed with PTSD in reaction to events that may not qualify as traumatic but can be devastating life events such as divorce or unemployment.

Briefly explain how memory and emotion relate to PTSD.

Memory and emotion are closely related to PTSD because first of all, PTSD is caused by experiencing a strongly emotional traumatic event and second of all, memory is the one that is responsible for bringing back the emotional event to the mind of  person suffering from PTSD. Therefore, we can see that memory, emotion, and PTSD are all very closely related to each other. 

Flashbulb Memory - Talarico & Rubin (2003)

Procedure: The day after the terrorist attack on September 11, they gave to 52 students a questionnaire about their memory of September 11 and an ordinary event of their choosing from the preceding few days. Then they divided the participants into three groups, and had each group return for a follow-up questionnaire session after a different amount of time such as: 7 days, 42 days, and 224 days. In the follow-up session they were asked the same questions about their memories about both the ordinary event (typically this was something like a party or a sporting event) and the flashbulb memory of September 11.
Findings: The number of details remembered about September 11 and the everyday event were statistically very similar and sometimes even identical. Most memories were consistent, and over time, the number of consistent details participants were able to recall declined, but there was no difference in the decline for ordinary memories and for memories of September 11. The number of inconsistent details (e.g. "I was with Fred" changing to "I was with Mary") increased similarly for both ordinary events and September 11. However, participants were more likely to believe their memories of September 11 were accurate than their ordinary memories. They reported the ordinary memories becoming less and less vivid and reliable, even though objectively they could remember no more details about September 11.
Conclusion: The rate of forgetting of flashbulb memories is the same as the rate of forgetting of ordinary memories. Talarico & Rubin suggested that flashbulb memories and ordinary autobiographical memories differ not in their rate of forgetting, but in the confidence with which they are held, with confidence in flashbulb memories remaining high, even as the memories are forgotten. Confidence in ordinary autobiographical memories declines as the memories are forgotten.
Weakness: They only tested retention intervals of eight months or less.

Flashbulb Memory - Neisser & Harsch (1992)

Procedure: Participants were asked about the Challenger space ship one day after the disaster and 2.5 years later. They asked questions such as: where they were, what they were doing, who told them, what time it occurred etc.  

Findings: The findings showed that memories had in fact dimmed. 40% of the participants had distorted memories in the final reports they made. Interestingly participants were not aware of this fall off in performance, being highly confident in their ability to recall accurately.

Conclusion: This represents how memories have deteriorated significantly during the two and half years, suggesting that Flashbulb Memories (FBMs) are not reliable and that FBMs may be ordinary memories. The results suggest that what is different is the confidence that people have in their memories associated with significant events.

Flashbulb Memory - Brown & Kulik (1977)

Brown & Kulik (1977) described flashbulb memories, suggesting that dramatic events can imprint a powerful impression in peoples' memories, and argued that there may be some physiological process involved in encoding such a memory. Such events as the Kennedy assassination, or Princess Diana's death are examples of events which bring us flashbulb memories.
Aim: The aim of this study was to investigate whether dramatic, or personally significant events can cause "flashbulb" memories.

Procedure: Participants were asked a series of questions about their memories of ten major events, such as the assassination of President John F. Kennedy in 1963. They were asked questions such as where they were when they heard the news, what were they doing, etc. 

Findings: Memories for such events were particularly vivid, detailed and long lasting. People usually remembered where they were when they heard of the news, how they heard it, what they and others were doing at the time, and the emotional impact of the news on themselves and those around them.

Conclusion:  Dramatic events can cause a physiological imprinting of a memory of the event

Weaknesses: 1. Data collected through questionnaires, so it is impossible to verify the accuracy of memories reported

2. It could be that dramatic events are rehearsed more than usual, making memories more durable, rather than any "imprinting" process causing flashbulb memories