PosttraumaticStress Disorder, commonly known as (PTSD) is diagnosed when individuals haveexperienced a traumatic event that either have negative changes to theirthoughts and mood, avoid stimuli’s that are related to the event and havere-experiences the traumatic event. These factors must occur for as long as amonth post trauma.
Some people that are diagnosed with posttraumatic stressdisorder may have the subtype such as disorientation; this includes a distortedsense of reality of their surroundings. According to the DSM-5 by Rosenburg andKossleyn (2014) that PTSD is not attributable to the physiological effects ofsubstance or another medical condition.’ Posttraumatic Stress disorder can beaffected by neurological factors e.g. neurotransmitters as well as nervoussystem reactions. Psychological factors also play a role into why individualsdevelop PTSD this is because individuals have two specific beliefs that theworld is a dangerous place and that they’re not good at controlling stress. Inaddition, social factors also play a part as to why people develop PTSD;socioeconomic factors, social support and culture are all social factors thatcan develop Posttraumatic Stress Disorder.The firstfactor that causes PTSD is the neurological factors; in the brain people whohave PTSD have an abnormal functioning of the hippocampus as well as an exposedsympathetic nervous system.
Orr et al (1993) found evidence to support thatpeople with PTSD have sympathetic nervous systems. “They assessed the heartrate, skin conductance, and left lateral frontalis electromyographic responsesof World War II (WWII) and Korean War male veterans to recollection of theircombat experiences by using a script-driven imagery technique previouslyvalidated in Vietnam veterans.” They found that those with PTSD have strongassociated cues with their trauma; such as sweating or increased heart rate. Inaddition, that skin conductors were the clearest method of distinction whenmeasuring the trauma of those with posttraumatic stress disorder and thosewithout posttraumatic stress disorder. Thus, individuals with PTSD have astronger reaction to relevant cues than people without PTSD. It has also beenfound that individuals with PTSD have to use more of their hippocampus and itmust work harder in order for it to remember information than individualswithout this disorder (Shin et al., 2004).
They explored the blood flow in thehippocampus of 16 firefighters, 8 with PTSD and 8 without, the firefighterswith PTSD had significant lower volumes in the hippocampus than those withoutPTSD. Demonstrating individuals with PTSD have to use more of their hippocampusand it needs to work harder when recalling information. In addition, McNally etal (1995) found that individuals with PTSD found it hard to recallautobiographical memories, suggested that an impaired hippocampus does impairpeoples’ memory and ability to recall information. From this we can understandthat the hippocampus is a critical part in the brain that enables our recall ofinformation (Squire and Kandel, 2000). The impaired hippocampus can help explain why one student developedPTSD, but the other didn’t as the individual who suffers from PTSD might have hadto use a larger volume of their hippocampus when recalling memories than theother, in everyday activities and their normal life before the traumaticincident the friend could have had an impaired hippocampus, so it made the friendhave a higher risk of developing Posttraumatic stress disorder than the otherwithout the impaired hippocampus. Neurotransmittersare also present with individuals who suffer with Posttraumatic StressDisorder, the most common neurotransmitters associated with PTSD arenorepinephrine and serotonin.
Research by Southwick et al (1993) found thatresponses differed from patients with PTSD than those without. He gaveparticipants a drug that rises the levels of norepinephrine in the body whenthe drug became effective he found that individuals with PTSD, 70% had a panicattack while 40% had flashbacks of their traumatic event. Those without PTSDhad small effects when the drug became effective in the body. Implying thatnorepinephrine does affect the cardiovascular system for those who suffer fromPTSD.
Similarly, research has found that serotonin is a factor that effectspatients with PTSD. Adamec et al (2008) found that individuals who have geneticalleles are at a higher risk of developing PTSD after a traumatic event. Grabeet al (2009) further supports this and found that there was a gene-environmentinteraction with an L allele which lead to frequent trauma in PTSD, more than60% of carriers of the L allele are exposed to three or more traumas whichdeveloped in PTSD as a ‘result of an interaction between genotype andexposure.’ One friend may have also developed Posttraumatic stress disorderwhile the other didn’t after the shooting as the friend could be a carrier of Lalleles of serotonin which means that he has a higher risk of developing PTSDas Grabe et al (2009) found that L alleles are exposed to three or more traumasthat later develop into Posttraumatic Stress Disorder.PsychologicalFactors also lead an individual to develop Posttraumatic stress disorder asindividuals who have psychological factors that occur before a traumatic eventhappens it will increase the chances of that individual developing PTSD. Thereare two specific beliefs that increase the vulnerability of someone developingPTSD: first, believing your unable to control stress (Heinrichs et al.
, 2005)and second, the belief that the world you live in is a dangerous place (Keane,Zimering, & Caddell 1985). They studied Vietnam veterans and concluded atwo-factor theory with individuals with PTSD. When people are exposed to a life-threateningexperience, just as Pavlov’s study with fear, we can become conditioned tostimuli’s sounds and smells. Suffers of PTSD tend to believe we live in a dangerousworld is because they have conditioned certain sounds, smells and stimuli tothat life threating experience that they encountered. There are many otherreasons why people are vulnerable to develop PTSD. For example, individuals whouse dissociate as a coping mechanism after a traumatic event. Shalev et al (1996)examined patients that were admitted to hospital and were screened for anyphysical injuries after a traumatic event.
They found that individuals who werelikely to be diagnosed with PTSD had higher levels of peritraumatic dissociationand severe depression and anxiety. After 6 months it was found that peritraumaticdissociation was the main factor above all the others that suffers of Posttraumaticstress disorder had. This psychological factor can help explain why one frienddeveloped PTSD and the second one didn’t because they had different copingmechanisms. The friend that developed PTSD after the school shooting mostpossible have used disassociating to cope and deal with the trauma whereas thefriend who didn’t develop PTSD after the school shooting could have used a differentcoping strategy such as speaking to family and friends about the incident orrevisiting the same place where the shooting happened. Furthermore,other psychological factors that can develop PTSD are already having an anxietydisorder. Copeland et al (2007) supported claim and suggested that because mostanxiety disorders involve hypervigilance this can lead to individuals react to traumaticevents negatively and ways that increase a stress disorder.
They also found by conductinga longitudinal study where they studied 1420 children ages 9, 11 and 13 thatchildren who experienced childhood traumas were more likely to develop Posttraumaticstress (PTS) symptoms. Children that experienced violent or sexual trauma hadthe strongest correlation for developing the highest number of symptoms for PTS.The friend could have developed PTSD because he could have experienced childhoodtrauma which meant that he could have developed PTS symptoms and when he gotolder and witnessed the school shooting it reinforced those symptoms and madehim develop PTSD. Classical and operant conditioning can explain how to avoidPTSD attacks. Classical conditioning is explained by a traumatic event occurringleading the traumatic stress is the unconditioned stimulus and the personsfeeling the conditioned stimuli which can then produce strong, aversive conditionedemotional responses (Keane, Zimering, & Caddell, 1985). Therefore, when theindividuals experience a similar situation to the traumatic one it induces aversivereactions which lead that individual to avoid the situation. To explain operantconditioning Jacobsen et al (2001) found that people who have PTSD have a highernumber of substance use disorder than those who experienced a trauma but didn’tdevelop PTSD. Thus, to avoid PTSD attacks you need to use negative reinforcementfor example alcohol and drugs.
The lastfactor that has an involvement with individuals developing PTSD are socialfactors. The social factors before and after a traumatic event can help usdetermine whether or not individuals will develop PTSD. In addition, socioeconomicfactors can affect an individual’s ability to cope with stressors.
Individualswith financial difficulties that have a concern of whether they can feed andhouse themselves or their family, find it more challenging to cope with atraumatic event than those with financial stability or financial fortune. Mezeyand Robbins (2001) found that when the less privileged face challenges it couldreduce emotional resources that are needed to cope with stress and traumatic eventswhich increase the risk of PTSD. This can be another explanation as to why one frienddeveloped PTSD and the other didn’t. The friend who developed PTSD could befrom a less privileged background to his friend where he is hardly eating at homedue of his family’s financial difficulties, therefore find it more difficult todeal with traumatic events as he doesn’t have strong enough emotional resourcesto help him cope with the school shooting.
Moreover, people who are deprivedsocioeconomically are more prone to experience trauma (Himle et al., 2009).Norris et al (2003) found that people who are from a disadvantaged socioeconomicallybackground are more likely to witness crimes or become a victim, as in moredeprived areas there is a higher crime percentage than rich areas. Furthermore,when individuals receive social support after a trauma have a lower risk ofdeveloping PTSD (Kaniasty & Norris 1992). This is supported by Jakupcak etal (2006) who found that military servicemen and women who had a strong socialsupport when returning home after experiencing a trauma while they were at servicewere less likely to develop PTSD.
Social support can also explain why onefriend developed PTSD and the other didn’t. The friend who developed PTSD couldbe because after the incident he didn’t have a large social support system, sohe could have felt isolated and no one wanted to speak to him or support himafter the shooting. Finally, culture can determine whether someone developsPTSD or not; their surroundings can help understand which PTS symptoms are moredominant.
Cultural styles allow teaching of coping mechanisms to what work andwhat doesn’t work. Perilla et al (2002) examined 404 residents 6 months after hurricaneAndrew and found that “ethnic groups differed strongly in the prevalence ofposttraumatic stress disorder”; Caucasian victims showed the lowest rate of 15%and Latino victims showed the highest rate of 38%. Implying that differentcultures have different coping mechanisms to trauma as there is a difference inbehaviour of ethnic groups.Neurologicalfactors, psychological factors and social factors can all explain why one frienddeveloped PTSD and the other did not. As demonstrated through research a neurologicalreason for the one who developed PTSD was that he has an L allele gene that containserotonin which increases the chances of developing PTSD.
The psychologicalexplanation could be that he already experienced a traumatic event from youngand then experienced the school shooting, or after the school shooting he copedwith this trauma by dissociating. The social explanation is that the friendsare from different socioeconomically backgrounds, the one who developed PTSD couldbe from a poorer less fortunate family. In addition, after the incident of the schoolshooting he could not have had the correct social support system around him tohelp him deal with that trauma and that his culture was different to hisfriends. Having a different culture means that each culture has different copyingmechanisms and his friend could be from a culture that has stronger copingmechanisms to deal with traumatic events than his own culture.