Tuesday, February 5, 2013

RETURNING SOLDIERS WITH PTSD



RETURNING SOLDIERS WITH PTSD 
Introduction
Gibbons, Hickling and Watts (2012) posit that post-traumatic stress disorder has remained a common problem among soldiers returning from deployment. Interest in this area came on the increase since the start of the 1980s. Since then, various researchers have studied different aspects of the disorder. Scientific literature is at present huge, challenging ready mastery, and even the finest; most determined works of research are unavoidably synoptic. A number of studies have been done in this area, but with development, various controversies have emerged. Nevertheless, this field has remained a significant one as cases of post-traumatic disorder increase among veterans. Psychiatrists have in the past suggested that stressing or traumatizing events could cause severe stress symptoms even in previously well adjusted persons. Among soldiers returning from deployment, interest in the disorder has increased as more and more cases are being reported. Stress among returning soldiers is a lot and so is the prevalence of post-traumatic stress disorder
Research question: what are the economic effects of post-traumatic stress disorder on returning soldiers?
Hypothesis: there are far reaching effects of post-traumatic stress disorder among returning soldiers, not only on the individuals, but on the society in general.
Literature review
Post-traumatic stress disorder originates from exposure to events that cause psychological trauma. PTSD is an emotional disorder that is grouped among anxiety disorders. Zeber et al (2010) suggests that individuals with the disorder re-experience the traumatic events and may respond by avoiding places, people, or anything else reminds them of the events. Avoidance and hyperarousal are widespread symptoms of post-traumatic stress disorder. While the symptoms of post-traumatic stress disorder have been presented since people began to experience traumatic situations, it has been categorized as a disorder only in the 80s. However, it has been known by other terminologies before the coining of the term post-traumatic stress disorder, even at the time of the American Civil War. According to Polusny, et al (2011), soldiers were said to suffer from “soldier's heart” during the American Civil War. Even at the time of the First World War, soldiers were seen to suffer symptoms that were consistent with the disorder. The soldiers were said to have “combat fatigue.” “Gross stress reaction” was the term that was used for PTSD during the Second World War. The term “post-Vietnam syndrome” was developed during the Vietnam War in reference to the symptoms that were consistent with the disorder. It was after the Vietnam War that the term post-traumatic disorder was used (Nidiffer and Leach, 2010).
It is estimated that 7% to 8% of people in the United States are likely to suffer from the disorder at one point in their lifetime. While there are other traumatic events that cause the disorder, the highest percentage of those suffering from the disorder are returning soldiers. Research results reveal that there are higher rates of the disorder among groups like the African Americans, Hispanics and Native Americans than among Caucasians in the United States. According to Nidiffer and Leach (2010) differences in post-traumatic stress have been related to factors like higher rates of dissociation following the traumatizing experience (peritraumatic). This is possibly because of the disadvantages that are associated with these populations such as lack of social support, the tendency for self-blame and the dissimilarities in expressing stress. Among combat populations, a variety of differences have come up as a result of increased exposure to traumatic situations. Particularly, among the minority populations, exposure to combat operations at an early age is one of the factors that lead to increased prevalence of the disorder.
Many cases of post-traumatic stress disorder among soldiers returning from various wars or battles. In fact, post-traumatic stress disorder traditionally emanates from interpretation of the impact of combat on soldiers. Prevalence of Post-traumatic stress disorder among Vietnam, Persian Gulf and Iraq war veterans have been investigated. The National Vietnam Veterans Readjustment Study (NVVRS), a research commissioned by the United States government provided data on emotional and mental effects among the soldiers involved in the Vietnam War. Among the returning soldiers from the Vietnam War, 15 percent of men and 9 percent of women were affected by posttraumatic stress disorder. After the war, approximately 30 percent of male soldiers and 27 percent of female soldiers had the disorder at some point in their life. The rates of those who were involved in the war, was found to be higher than the rate in the control group (Price, 2007).
Regardless the fact that the Persian Gulf War did not last for a long time, its effect was not less traumatic than in other wars. Soldiers returning from the battle have reported cases of emotional and mental health issues. Studies looking at the psychological effects of soldiers from the war have shown that rates of posttraumatic stress disorder from the war ranged from 9% to 24%. Iraq war is another war whose soldiers have been investigated for post-traumatic stress disorder. A research investigating four United States combat infantry units consisting of 3 Army and 1 Marine who was deployed in Afghanistan and Iraq shown high rates of post-traumatic stress disorder (Tull, 2009). Most of the soldiers were exposed to some kind of traumatic, combat-related experiences. Approximately 92% of the soldiers were exposed to attacks and ambush, 94.5% to coming across dead colleagues, 95% to being shot at, and 86.5% to knowing a combatant who was seriously injured or killed. After the war, 12.5% suffered post-traumatic stress disorder (Price, 2007).
Even if not all the soldiers who have gone through traumatic events suffer post-traumatic stress disorder, there are physical and emotional effects of going through such experiences. Studies have shown that returning soldiers have showed that soldiers who have gone through very stressing events sometimes tend to have smaller hippocampus (an area of the brain that influence memory) than those who have not gone through stressing events. Such studies are particularly important in the efforts to understand the effects of post-traumatic stress disorder among returning soldiers.  Whether or not a returning soldier developed post-traumatic stress disorder, there are very high chances of using substance. Most of the soldiers use substance as a means of coping (Gibbons, Hickling and Watts, 2012)
Research has revealed that post-traumatic stress disorder has far-reaching effects on the returning soldier, their families and the society in general. People suffering from the disorder are at a higher risk of developing other physical and psychological problems. Research on the medical burden resulting from post-traumatic stress disorder has revealed that there is a considerable medical burden resulting from the disorder. The review of the literature on the issues has revealed that post-traumatic stress disorder and depression are associated with higher health care use among returning soldiers. It has been showed that between 23 and 40 percent of returning soldiers sought medical care for mental health problems. However, there is need for further research in providing a clearer picture of the mental health burden associated with post-traumatic stress disorder. It is also suggested that that the medical burden will continue to increase for returning soldiers with post-traumatic stress disorder, depression and substance use (Gibbons, Hickling and Watts, 2012)
Majority of the returning soldiers from the Iraq and Afghanistan wars have undergone great emotional, physical and relational problems. Most of them have suffered long after the war and the traumatic experience. This resulted in the United States Marine Corps coming up with various programs to help returning soldiers in coping with life after deployment and to be able to continue serving the nation. Coping with life after deployment is not very easy as relationships with partners and other family members are also affected. Although there is lack of substantial research to show the prevalence of family-related problems due to post-traumatic stress disorder, few of the investigated cases have revealed that the problem exist. Families of soldiers are affected by post-traumatic stress disorder are affected by the problem. Such families are likely to face relationship issues, partner violence, and child abuse among other domestic problems. Additionally, the families of the soldiers are already affected by their deployment, which makes the impact of substance abuse among their spouses, father and mothers even worse. Psychological effects affect the families besides the direct effect of abuse from the affected soldier (Harrison, Satterwhite and Ruday, 2010).
The economic impact of post-traumatic stress disorder among returning soldiers is a serious issue. Majority of returning soldiers seek treatment of symptoms related to post-traumatic stress disorder. As of 2005, over 200,000 returning soldiers were receiving disability compensation due to post-traumatic stress disorder. This was estimated to cost the country over $4.3 billion. This was an 80% increase in the figure of returning soldiers receiving the disability benefits for the disorder and a 149% increase in the cost of disability benefits from the 2000 data (Harrison, Satterwhite and Ruday, 2010). Post-traumatic stress disorder depression, anxiety disorder and other related psychological issues have caused much spending in the military budget. The government is said to spend a lot in terms of treatment for the military personnel diagnosed with post-traumatic stress disorder. Per capita spending for mental health in the United States was considerably stable between the years 1996 and 2000. However, there has been an increase in the per capita spending on mental health treatment on military personnel between the years 2000 and 2006. This increase was from $104.25 to $148.56. This has been attributed, a higher percentage, on treatment of post-traumatic stress disorder and other related health issues.  
Research has also been carried out to assess the treatment capability of the current health care system and approximated the cost of offering quality health care for returning soldiers. The research showed that there is a major problem in terms of mental health of the returning soldiers. However, there have been efforts in addressing the health problems for the military veterans. The United States has invested in programs for helping soldiers suffering from post-traumatic stress disorder. The returning soldiers suffering from post-traumatic stress disorder and trauma can access help from centers such as VA hospital or Vet Center. Such soldiers get treatment for the disorder as well as counseling to the soldiers and their families. In addition, every military department has programs for its members that help in counseling members in order to relieve the posttraumatic stress disorder symptoms (Harrison, Satterwhite and Ruday, 2010).
Experiment
To test the hypothesis for this research, the researcher will carry out a face-to-face interview with two soldiers who have been deployed in war and two who have never been deployed. Questionnaires will also be developed and given out to ten soldiers, five who have been deployed and five who have not been deployed. The main focus of the questions in the questionnaires and those used in the interviews will be on the effects of post-traumatic stress disorder on the returning soldiers. During the interview, the interviewee will seek to identify those returning soldiers who have been diagnosed with symptoms related to post-traumatic stress disorder. Most of the data for the research will be obtained from primary literature on research carried out by the government and individuals into the effects of post-traumatic stress disorder on returning soldiers.
Discussion and conclusion
It has emerged from the research they post-traumatic stress disorder is a serious issue among soldier returning from combat operations. The disorder is caused by exposure to traumatic events or experiences during the operation. A majority of soldiers involved in war suffer various symptoms related to post-traumatic disorder. From research it has been revealed that soldiers returning from war or battle tend to have higher rates of post-traumatic stress disorder than those who are not deployed, the control group, in various studies. This has been suggested to be because of the exposure to events such as discovering bodies of dead colleagues, being shot at, attacks and ambush, and knowing a person who has been seriously injured or killed. Due to the stressful events, the soldiers from war suffer a lot of stress that culminate in post-traumatic stress disorder.
Post-traumatic stress disorder is a reality among returning soldiers having detrimental effects on the soldiers, their families and the society in general. The problem has been shown to be accompanied with other medical issues such as depression and substance use. The problem of posttraumatic stress disorder does not only affect the soldier, but also his or her family. The state has been using a lot of money in terms of compensation cost for the veterans with post-traumatic stress disorder. There has been an increase in the number of soldiers receiving treatment and receiving disability compensation as a result of the disorder. Results from this research are significant in informing policies directed at helping returning soldier with symptoms of post-traumatic stress disorder.
More research is needed to develop measures to address the problem of post-traumatic stress disorder. Research is required to help inform more effective prevention policies and refining the current ones. It is also very important for policy makers in the area to develop policies aimed at addressing the problem. Development in prevention strategies is one of the ways of achieving a considerable solution towards this end. This is possible by researching on risk factors related to the disorder. This is also possible by developing programs to counsel the soldiers before and after deployment. Additionally, treatment and rehabilitation for returning soldiers will go a long way in addressing the issue. Researchers should continue developing models that help policy makers in the military in making informed decisions in the implementation of effective interventions.



References:
Gibbons, S. W., Hickling, E. J., & Watts, D. (2012). Combat stressors and post-traumatic
stress in deployed military healthcare professionals: an integrative review. Journal of Advanced Nursing, 68(1), 3-21
Harrison, J. P., Satterwhite, L. F., & Ruday, J. (2010). The Financial Impact of Post
Traumatic Stress Disorder on Returning US Military Personnel. Journal of Health Care Finance, 36(4), 65-74.
Nidiffer, F., & Leach, S. (2010). To Hell and Back: Evolution of Combat-Related Post
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Polusny, M., Erbes, C., Murdoch, M., Arbisi, P., Thuras, P., & Rath, M. (2011). Prospective
Risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq. Psychological Medicine, 41(4), 687-698.
Price, Jennifer L.   Findings from the National Vietnam Veterans' Readjustment Study –
Factsheet. National Center for PTSD. United States Department of Veterans Affairs
Tull, Matthew. Rates of PTSD in Veterans, 2009. Viewed on May 9, 2012 from            http://ptsd.about.com/od/prevalence/a/MilitaryPTSD.htm
Zeber, J. E., Noel, P. H., Pugh, M., Copeland, L. A., & Parchman, M. L. (2010). Family
perceptions of post-deployment healthcare needs of Iraq/Afghanistan military personnel. Mental Health in Family Medicine, 7(3), 135-143.