Tag Archives: post-traumatic stress disorder

Unlocking the brain’s response to trauma, violence

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Scott Johnson of The Oakland Tribune writes about the science of chronic trauma and puts it in the perspective of Oakland, Calif., residents who are regularly exposed to chronic levels of stress and trauma. There were 95 homicides in Oakland in 2010.

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Photo by BlatantNews.com via Flickr

Scientists are finding that trauma affects how the brain functions and, especially in children, can create long-term debilitating problems, including anti-social behavior, dissociation, emotional numbness and trouble forming social relationships.

Fortunately, scientists also are finding there are therapeutic tools that can help.

The science around chronic trauma is evolving quickly and in exciting new ways. Even as scientists discover new evidence about what is happening in the brains of chronically traumatized people, intriguing new techniques are emerging for coping with the effects.

Johnson, the Oakland Tribune‘s Violence Reporting Fellow, is blogging at OaklandEffect.com, where he has written about his own experiences and about attending the recent “Healing Moments in Trauma Treatment” conference. Johnson’s position is funded by the California Endowment and he will be with the Tribune for a year, reporting on a wide range of issues, including those related to the impacts of violence on the mental health of Oakland residents.

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

PTSD or personality disorder? It matters to soldiers

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The AP’s Anne Flaherty has put together a story that illuminates the Army’s refusal to admit that it could have misdiagnosed (and discharged) hundreds of soldiers who may have had PTSD or traumatic brain injury instead of a personality disorder. Keep in mind that a discharge for “personality disorder” means no veterans’ benefits and a lifetime of stigma. A diagnosis of PTSD or injury, on the other hand, means treatment will be covered by the government.

dentistPhoto by isafmedia via Flickr

The Army, for its part, has decided there’s nothing unusual about the following chain of events (taken from Flaherty’s story):

  1. The Army “discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.”
  2. In 2007, The Nation‘s Joshua Kors writes a cover story exposing the Army’s apparent habit of diagnosing soldiers with a personality disorder instead of considering the possibility of PTSD or traumatic brain injury.
  3. Soon after, “the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.”
  4. Sure enough, “the annual number of personality disorder cases dropped by 75 percent.”
  5. At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.
  6. Army officials “reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006” and said they “did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder.”

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

More vets come home as result of psychiatric issues

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On Shots, NPR’s Health Blog, Nadja Popovich reports on a recent Johns Hopkins study that found, more troops were evacuated from Iraq and Afghanistan in 2007 for mental health problems than for combat injuries.

The increase comes despite the military’s increased focus on combating mental health problems among American soldiers. The largest number of evacuated soldiers are still those diagnosed with “noncombat-related injuries, such as muscle and joint problems that come from carrying equipment,” but psychiatric evacuations are a growing and complex problem.

afghanistanAmerican paratroopers in Afghanistan. Photo by U.S. Army Spc. William E. Henry via Flickr

… those suffering from mental health issues had a remarkably low rate of returning to full duty. “Psychiatric conditions have the lowest return to duty rates among any diagnostic group aside from combat injuries,” (study leader Steven P. Cohen, an associate professor of anesthesiology at the Johns Hopkins School of Medicine and a colonel in the U.S. Army Reserve) wrote. “But the effects are much worse, because psychiatric conditions worsen the prognosis for all other conditions.”

“Patients with PTSD — as a rule — have multiple other complaints,” he continued. “Studies have shown that most people with persistent PTSD have ongoing musculoskeletal, neurological and constitutional complaints that are unlikely to respond to treatment.”

Related AHCJ articles

Interviewing ‘profoundly affected’ soldiers
Tips for interviewing service members returning from Iraq, the Middle East or Afghanistan

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

What happens when most of a society has PTSD?

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Writing for the Dart Center for Journalism and Trauma, Judith Matloff and Robert Nickelsberg look at the effects of decades of strife upon the disputed South Asian province of Kashmir. A third of Kashmir’s residents suffer from psychological distress (in the United States, that number is around 6 percent to 8 percent) and the region’s few psychiatrists are so overwhelmed – one small clinic saw over 100,000 visitors last year – that they can do little more than rush through minutes-long consultations and hand out prescription medication as if it were “Tootsie Rolls at Halloween.”

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Clouds gather over Kashmiri peaks, photo by Brian Guest via Flickr

Practically everything that can cause PTSD has coalesced in Kashmir — loss, fear, distrust, random violence, a sense of powerlessness. The unrelenting Indian occupation fuels despair. Stress affects nearly everyone: the men routinely frisked on the street, the women forced to beg when their husbands vanish and the children given up to orphanages. Kashmir illustrates what researchers have long suspected: that prolonged exposure to direct confrontation results in still greater anguish. People don’t get used to violence; they grow more vulnerable.

Suicides are up in the region – despite strong taboos among the Muslim populace – and the community’s psychological state deteriorates further with every passing year. “‘The accumulation of events results in higher levels of distress,’ (Kaz de Jong, a mental health advisor with MSF-Amsterdam) explains. ‘What you see in chronic conflict is that self-support mechanisms and resilience go down.’ Instead of getting stronger, the afflicted just get more desperate.”

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.