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Samantha Zeegers
Dr. Afshin Gharib
Intro to Psychology
4 December 2014
PTSD
Many people will experience some sort of trauma in their lifetime. This trauma could
lead to a psychological disorder called Posttraumatic Stress Disorder, or PTSD. PTSD is a
condition that occurs after harm or potential harm occurs to a person. This will cause the
person to feel stress or fear when they are no longer in danger. The most common sufferers are
military veterans. PTSD first came to public attention after the Vietnam War. As Ethan Watters
says in Crazy Like Us, the movement to recognize PTSD was a political as well as a psychological
one. Anti-war protestors encouraged the research into this disorder to help their fight against
the war. Since then PTSD has become more well-known in the psychology field, and its
symptoms and causes more developed.
Presently, scientists are looking into genes that cause fear. The National Institute of
Mental Health (NIH) speaks about a couple of studies conducted on mice to show the effect of
genes on fear. They note a protein called Slathmin, which is needed in forming fear memories.
The mice that did not have the protein were shown to have less fear and more willingness to
explore more areas. Another gene that they studied was GRP (gastrin-releasing peptide), a
signaling chemical in the brain released during emotional events (National Institute of Mental
Health). This chemical seems to control the fear response, without it fear memories may last
longer.

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Some symptoms of PTSD include distressing memories, upsetting dreams, and changes
in emotional reactions. NIH classifies all the symptoms into 3 categories; re-experiencing
symptoms, avoidance symptoms, and hyper arousal symptoms. Re-experiencing would be
flashbacks and frightening thoughts. Avoidance is when the victim stays away from reminders
of the incident and starts to feel emotionally numb. Being easily startled or feeling tense is
hyper arousal symptoms. PTSD normally occurs within 3 months of the incident. According to
NIMH, to be diagnosed with PTSD a person must have all three categories of symptoms for at
least a month.
PTSD is treated with psychotherapy and medication. Psychotherapy is where the victim
speaks with a mental health professional about the incident to help treat it. There are many
types of therapy used. Some psychiatrists use a behavioral therapy that forces the patient to
face the trauma. They do this by imagining, writing about, or visiting the site. The Mayo Clinic
describes another therapy as a type of talk therapy helps you recognize the ways of
thinking...that are keeping you stuck These two methods together have shown great
progress in PTSD patients.
A study published by Hundt, Mott, Cully, Beason-Smith, Grady, and Teng in February
2014 showed the factors involved in the utilization of psychotherapy in veterans with PTSD.
The study was conducted at a PTSD clinic in a VA Medical Center. They researchers wanted to
see if there was any reason that some veterans werent using the psychotherapy sessions at the
clinic. There were 796 patients that had been to at least one session in the past year. Out of
that population a random sample of 157 patients were selected for the study.

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The 157 patients in the study were predominately male (90%), Caucasian (62%), married
(64%), and post high school educated (59%). They were aged 24 to 80, with an average age of
46 and a standard deviation of 16. Their service areas were diverse including 51%
Iraq/Afghanistan, 41% Vietnam, and 8% Persian Gulf. Eighty-nine percent of the sample was
diagnosed with PTSD and the other eleven percent was shown with the symptoms of PTSD.
The researchers recorded multiple things of these patients. They measure how often
they came in for a basic psychotherapy session, suicidal ideation, crises, hospitalization, and
walk-in sessions. They measured the suicidal ideation by the outpatient psychiatry notes and
their most recent psychosocial assessment. To determine what they would classify as high or
low utilization of psychotherapy they noted how long a normal session would last and other
studies. The team determined that less than 4 sessions was considered low utilization and more
than 52 sessions was considered high utilization. Any patients that used an average of 4 to 52
sessions in a year were considered moderate.
Once the researchers created the groups they divided each of the patients into a
classification. Thirty nine of them were low users, ninety three were moderate users, and
twenty five were high users. Using a chi-square analysis of the patients demographics, they
were able to identify who would be the most common to utilize it least. It indicated that
younger age, lower yearly income, Iraq/Afghanistan war era, and single marital status were
related to low utilization. They also noticed that high users attended primarily group therapy,
rather than individual, whereas the opposite was true for low users (p. 738)

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There is a limit to the reliability of this study due to sample being biased to certain
groups (e.g. women). It is impossible for the researchers to fully examine the effects of all of
the variables. Also, the population only included one VA center, which can show bias based on
location and other factors.
Another study was done in London, Ontario on current and former Canadian Forces
members. The study was done by Kate St. Cyr, Alexandra McIntyre-Smith, Ateka A Contractor,
Jon D. Elhai, and J. Don Richardson. This group includes stress clinicians, and department heads
of psychology and psychiatry at multiple universities. The study looked at the correlation
between somatic symptoms and health-related quality of life (HR-QoL) in PTSD patients.
The research was done on 291 patients at the Parkwood Hospital Operation Stress Clinic
in Ontario. Each patient was given self-report questionnaires assessing the amount and severity
of their somatic complaints, depressive symptom severity, and HR-QoL. It is still unclear
whether somatic symptoms are a casual factor of PTSD or if it is the consequence of a previous
psychological trauma. This study is testing the hypothesis that it is a factor of PTSD.
The demographics of this study include ninety two percent male. The mean age of the
patients was 45 years old with a standard deviation of 15 years. The average number of years
they served in the Canadian Forces was 13.5 years and were deployed to Afghanistan. Other
places of deployment included the Balkans, Korea, and Africa.
The questionnaires showed that most commonly reported somatic complaints were
feeling tired, trouble sleeping, and pain in the arm, legs, joints, or back. It also indicated an
impaired mental and physical HR-QoL. The researchers findings suggest that the somatic

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symptoms have a significant correlation with mental and physical HR-QoL in PTSD patients. It
suggests that patients presented with PTSD symptoms should also be evaluated for somatic
symptoms.
It should be noted PTSD symptoms present differently in different cultures, countries,
and time eras. Medical records show that although PTSD has been shown in cases since before
the American Revolution it appears differently. Soldiers from different times are unconsciously
internalizing cultural expectations and then experiencing them as unavoidable and real
(Watters). This also occurs from culture to culture. Watters says that for Cambodian refugees
their PTSD was accompanied with visits from vengeful spirits and intense distress that they
had not been able to perform rituals for dead. The meaning of the event and what is socially
acceptable in the culture influences the symptoms of PTSD sufferers.
PTSD is becoming increasingly common around the world. With non-stop war, natural
disasters, and such things, there is no end in sight to this disorder. However, there are studies
constantly being done to help with the symptoms of PTSD. The world needs to invest more time
and energies into this kind of research. This disorder can become quite crippling and with the
growing number of diagnoses it is imperative that we find a way to help.

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References
Hundt, N. E., Mott, J. M., Cully, J. A., Beason-Smith, M., Grady, R. H., & Teng, E. (2014). Factors
associated with low and high use of psychotherapy in veterans with PTSD. Psychological
Trauma: Theory, Research, Practice, And Policy, 6(6), 731-738. doi:10.1037/a0036534
Post-traumatic stress disorder (PTSD). (n.d.). Retrieved from
http://www.mayoclinic.org/diseases-conditions/post-traumatic-stressdisorder/basics/treatment/con-20022540
Post-Traumatic Stress Disorder (PTSD). (n.d.). Retrieved from
http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml#part6
St. Cyr, K., McIntyre-Smith, A., Contractor, A. A., Elhai, J. D., & Richardson, J. D. (2014). Somatic
symptoms and health-related quality of life among treatment-seeking Canadian Forces
personnel with PTSD. Psychiatry Research, 218(1-2), 148-152.
doi:10.1016/j.psychres.2014.03.038
Watters, E. (2011). Crazy Like Us: The Globalization of the American Psyche. New York, NY: Free
Press.