Tuesday, October 28, 2014

Criteria For Telepsychiatry For Post Traumatic Stress Disorder

By Young Lindsay


It was never a new thing, it just went under more than eighty aliases over the years. At one time it was known as nostalgia and homesickness, in another time it was referred to as shell shock and irritable heart. Yet no matter the moniker, the disorder is real, and is present in human beings who have been subjected to hurt, danger, and extreme situations.

During the 1980s, its scientific term was recognized. Now that we have a name to call the illness, the rise of modern psychology gave way to more information, leading to more interventions including telepsychiatry for post-traumatic stress disorder. In the presence of conflicts worldwide, the increase of crimes and violence, terrorism and stronger natural disasters, more trauma victims are coming forward for help, and the best thing you can do for those at risk is to notice the warning signs before it is too late.

Getting hurt firsthand is the first factor to consider if someone is at risk. Being a witness to a horrible, scary event, and living through a dangerous disaster are also part of the criteria. Having feelings of helplessness, experiencing extreme anxiety and fear, and having minimal social support after the traumatic situation will further increase the risk. Resiliency factors consist of having a coping strategy when faced with danger, being able to effectively react and respond to danger, and having enough social support.

As the psychological well being of a person is innate as much as it is environmental, genes play a crucial role in determining if an individual is at risk. Stathmin is a protein found in our genes that elicits the making of fear memories. Researchers have also found out that a version of the 5 HTTLPR gene control the production of serotonin, the hormone that fuels the fear response.

Certain brain areas are also in charge of dealing with trauma and fear. When we our afraid, our amygdala takes care of what kind of emotion, learning, and memory will be produced. Meanwhile, when it comes to judgment and resolutions, our prefrontal cortex acts as the frontier. Studying genes and the human brain is the key to unlocking the probability of PTSD before it can be developed or triggered.

Diagnosis requires one re experiencing symptom, two hyperarousal and three avoidance symptoms. Re experiencing symptoms such as nightmares, flashbacks, and scary thoughts may affect the person daily, such that it would drastically intervene in the life of the afflicted. Objects, words, and certain situations may trigger these symptoms.

Three avoidance symptoms are needed to be diagnosed. The signs include staying away from anything that reminds the individual of the experience, even to the point of losing interest in their previous hobbies. For example, traumatized rape victims may not want to have sex anymore even with their loving partner.

Two hyperarousal symptoms are necessary to complete the criteria. The victim would often develop insomnia, become easily agitated, provoked, and startled, and are listless and tense most of the time. These set of symptoms are not evoked, rather, they are consistent.

When a person has passed the criteria and has been diagnosed, CBT or cognitive behavioral therapy is often used as an intervention. Medical treatments consist of paroxetine and sertraline, the only approved drugs for PTSD. In the event that there is a known catastrophe, it is important to have the victims undergo critical incident stress debriefing as soon as possible to prevent the onset of PTSD.




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