Post Traumatic Stress Disorder (PTSD) Causes and Effects

Post Traumatic Stress Disorder (PTSD) Causes and Effects Post Traumatic Stress Disorder, also known as PTSD, is one of the most widespread, costly, and least understood of the many anxiety disorders. PTSD is a neurotic condition that is linked to stressors of traumatic events. Post Traumatic Stress Disorder is normally a delayed response to the unpleasant effects of extreme events of a catastrophic nature (Rumyantseva Stepanov, 2008). Many people with this disorder experience a strong sensation of fear and may also feel of helpless. These feelings disturb the person’s perception of their own security (Dieperink, 2005). There has been interest for more than a century in the psychological and behavioral effects of trauma. However, the empirical research in this area is only about twenty-years old (Roy-Byrne, 2002). In this paper I will review three empirically supported articles simultaneously in effort to better describe how to diagnose this disease, manage its effects, and treat the patients. Post Traumatic Stress Disorder causes clinically significant severe emotional states in social, professional, or other important aspects of life. The diagnosis of PTSD requires the occurrence of a traumatic incident, so it is reasonable to suggest that the stressor, its duration, and its meaning should have considerable influences on the occurrence and clinical features of the long-term psychopathological response. It is important to establish the ordinary clinical features and differences of Post Traumatic Stress Disorder due to the different stressors. This is vital not only in the theoretical aspects, but also in the practical aspects (Rumyantseva Stepanov, 2008). Dieperink suggests the options to treat patients with Post Traumatic Stress Disorder could include exposure therapy, group psychotherapy, inpatient therapy, and individual therapy, among other. However, not everyone with PTSD would be a candidate for exposure therapy, although it is often considered an initial treatment for people with PTSD (Dieperink, 2005). According to Roy-Byrne, studies have not looked into the possible medications outside of benzodiazepines neuroleptics. None of the prior studies examined the differences between treatments within large mental health networks (Roy-Byrne, 2002). There have been relatively well researched studies in exposure therapy a number of medications. These studies have been found to be extremely effective in the treatment patients. However, it has been difficult to find a single therapy to be consistently successful for patients with PTSD. Dieperink says that the Food and Drug Administration has only approved two medications for the treatm ent of Post Traumatic Stress Disorder: Sertraline and Paroxetine. Selective serotonin reuptake inhibitors are considered the first-line medication for the treatment of Post Traumatic Stress Disorder. To Better understand what constitutes effective treatment for patients with PTSD, one must take the first step to determine what is being done in PTSD studies at this time (Dieperink, 2005). The following is a study regarding workers in the Chernobyl disaster that were diagnosed with Post Traumatic Stress Disorder Rumyantseva and Stepanov studied the cases of a group of sixty-six patients regarding their involvement in combat actions and working in the post-Chernobyl atomic energy station clean-up. The test used several diagnostic methods including, structured clinical interviews, clinical PTSD diagnostic scales, and Gorovits scales for the self-evaluation of traumatic events. Thirty of the subjects were involved in combat actions and the other thirty-three were clean-up workers. The mean ages of the patients were 27  ± 2.8 years for the combatants and 43.7  ± 4.5 years for the clean-up workers. Combatant patients had incomplete higher education and corresponding training for military action. Most clean-up workers had higher education, though some had some mid-level specialist education. They were observed for 5 to 6 years and again 15 to 17 years after involvement in the stress situations. After 5–6 years after Chernobyl, the combatants had rare (1–2 times per month) episode s of minimal or moderate, controllable levels of distress in situations that reminded them of the event. Emphasis was placed on the features of the stress situations in both groups. Combatants had directly experienced a fear of being killed or wounded, horror of capture, torture, and humiliation. They were involved in battle and special operations and they had witnessed the deaths of many of their peers. Most combatants spent around six months in military action zones. The result was exceeded the individual’s exceeded their ability to cope. They were confronted with constant vigilance, perceptions of a hostile environment, and the need to make rapid responses to sources of threat. A completely different type of stress occurred in Chernobyl clean-up workers who had to deal with can be considered a prolonged traumatic event. The social-psychological consequences of this disaster were observed for 19 years. The catastrophe was an extraordinary event, the first of its type in hum an experience. As a result, Chronic Post Traumatic Stress Disorder was diagnosed in all the patients studied. When combatants were presented with real threats, flashbacks were seen. These flashbacks were mainly in â€Å"hypngagogic/hypnopompic states† or when they were intoxicated with alcohol. These flashbacks were of moderate intensity. Patients were able to maintain partial control of their actions by sustaining a link with the outside world. In their dreams, combatants saw many people that were unable to protect themselves, being captured, shooting, detonations, and others. They would often state that they were being surrounded and that the enemies were close. In the dreams, they would fire back with their guns but the bullets would come out of the barrel in slow motion. Also, the bullets did not fly or seem to come out of the barrel and fall. The patients considered these dreams as nightmarish. When they woke up, they struggled to get back to sleep. Many of the patients that were seeking medical help preferred to use alcohol to help them sleep. There were signs indicating difficu lties in concentrating or even maintaining minimal levels of attention in several combatants and virtually all clean-up workers. At the psychological level, most members of this group experienced increased symptoms and depression with feelings of fear, guilt, despair, impotence, hopelessness, and grief. The patients lacked trust in the help and treatment proposed for them, including psychotherapeutic treatment. They thought treatment was impossible and their condition was irreversible. Most people ultimately characterized themselves by the passive-aggressive social role of a victim. The main principle at the core of the treatment of patients with PTSD is the ability to recognize the priority of psychotherapy and the use of antidepressants with primarily anxiolytic effects and minimal side effects in small doses. Psychotherapy included a variety of psychotherapeutic approaches. Therapies used included psychological debriefing for individuals, evidence-based psychotherapy; cognitive behavioral therapy as a disclosure treatment and progressive desensitization, which must be done individually for patients of this group. There was a particular curiosity in the use of Coaxil in patients Post Traumatic Stress Disorder. It is associated with the establishment of its ability to change the neuroendocrine response to stress. It can prevent stress-induced behavioral and cognitive insufficiency in animals and corrects the responses of stress, not only weakening the stress-induced changes in the hypothalamus, but also assisting in the reversal of those changes. Preclinical and preliminary clinical data have shown evidence that Coaxil can be effective in the treatment of the specific and nonspecific symptoms of PTSD (Rumyantseva Stepanov, 2008). Post Traumatic Stress Disorder is a very complicated disease. Although scientists have come a long way in diagnosing and treating PTSD, it is clear that much more research may be needed to fully treat these patients. Post Traumatic Stress Disorder is extremely widespread and has become very expensive to treat and manage. Ideally, we should be taking steps toward relieving the experience of fear and helpless in those affected with this disorder. It is reasonable to assume that patients with PTSD can be rehabilitated and live normal lives without the stressors associated with this condition. My reaction to writing this paper is a mixed one. I was a bit overwhelmed with the notion of having to read a published article in an area that I am unfamiliar with. However, after spending some time dissecting each one, I have developed and appreciation for the well written ones. These articles are very dense in information for their size and a lot can be learned from reading them. There are others that were a bit difficult to read and left me wanting to know more information than what was given. However, I learned a great deal from this assignment. I have a new appreciation for the complexities of this disorder and I have enjoyed reading the articles. References Rumyantseva, GM Stepanov, AL (2008). Post-Traumatic Stress Disorder in Different Types of Stress (clinical features and treatment). Neuroscience and Behavioral Physiology, Vol. 38, No. 1. Dieperink, Erbes, Leskela, Kaloupek (2005). Comparison of Treatment for Post-Traumatic Stress Disorder among Three Department of Veterans Affairs Medical Centers. Military Medicine. Volume 170. Ray-Byrne, MD (2000). Post-Traumatic Stress Disorder: Diagnosis, Management and Treatment. The American Journal of Psychiatry, 159, 4.

Ted Bundy & terror

Ted Bundy was a terror for girls and women in 1970’s. He was a serial killer and a rapist who is believed to have ruthlessly murdered more than 20 girls from 1974-1979. Theodore Robert Cowell was born on November 24, 1946 to Eleanor Louise Cowell in a Vermont residential home for unwed mothers.His grandparents were introduced to him as his parents and his mother as his elder sister since she was unmarried. â€Å"Some, perhaps searching for some cause to Bundy's future actions, feel that Bundy's grandfather, Sam, may actually have fathered Ted out of an incestious relationship with Eleanor.The resulting confusion was the only known possbile truama in the young boy's life† (â€Å"Predator; Ted Bundy† BEGINNINGS). Eleanor married Johnnie Bundy on May 19, 1951 and Theodore Robert Cowell adopted Bundy as his last name. Bundy did not have any unpleasant experience in his childhood (â€Å"Predator; Ted Bundy† BEGINNINGS). By the time of his graduation Bundy had b ecome a stealer. He met his love Stephanie Brooks during his studies at the University of Washington. Even though love blossomed in their relationship it was not long that the couple broke off.â€Å"Bundy's lack of confidence and tendency toward manipulation had ruined the relationship† (â€Å"Predator; Ted Bundy† BEGINNINGS). Many of his victims are said to resemble Brooks who had a major impact on him. Bundy returned to his birthplace in 1969 and discovered the facts about his mother. He returned to the University of Washington. Another woman Liz Kendall entered his life and filled it with love. He had everything in his life by 1973- a degree in psychology, a loving partner and an impressive job with the Washington State Republican Party (â€Å"Predator; Ted Bundy† BEGINNINGS).Bundy became a brutal murderer by the end of 1973. He killed a number of girls in Washington. His first victim was 15 year old Kathy Devine. He abducted her on November 25, 1973 in a gre en pick-up and her body was recovered on December 6. Joni Lenz, his next victim, however was not killed though she suffered from brain damage and internal organ injuries. Lynda Ann Healy was abducted from her home on February 1, 1974 and never seen again. His next victims were Donna Manson, Susan Rancourt, Kathy Parks, Brenda Ball, Georgean Hawkins, Brenda Baker.All girls aged 15-19 years and Bundy followed a similar course of events in killing them- abduction and killing. Bundy carried on his inhuman routine and killed Janice Ott and Denise Naslund on July 14 at Lake Sammamish State Park. This time police could figure out a sketch and name Ted (though suspected to be unreal at first) of the criminal with the help of the people around (â€Å"Predator; Ted Bundy† SERIAL KILLER IN WASHINGTON). Bundy went to Utah after killing about 11 young girls in Washington. He carried on his fury in Utah and claimed his first victim 16 year old Nancy Wilcox on October 2, 1974.Bundy raped, h it and murdered Melissa Smith and Laurie Aimee both 17 year old teenagers later in the month. He then tried to kidnap Carol DeRonch but she was lucky to escape. He was however successful in abducting another girl, Debbie Kent, later in the day who was not lucky like DeRonch. His next victims were Caryn Campbell, Julie Cunningham, Denise Oliverson, Melanie Cooley, Lynette Culver, Susan Curtis, Shelley Robertson, Nancy Baird and Debbie Smith. Most of the girls’ bodies were not recovered and those recovered were mostly nude and severely injured (â€Å"Predator; Ted Bundy† BUNDY GOES TO UTAH).Bob Haywood, Utah Highway Patrol Officer, suspected a VW in Granger, Utah and tried to have a look into it. The driver drove the vehicle away but was caught soon by Haywood. Driver was identified as Ted Bundy and officer found several doubtful things in his car like burglary tools, a mask made of panty hose, an icepick, and handcuffs. Bundy had come under police scanner and they tried to figure out his link with the abduction of DeRonch. DeRonch could not identify Bundy but a teacher at school from where Kent disappeared identified him. He was held in relation to DeRonch attack.Deronch later identified him and he was sent to jail for 1-15 years. He was then tried for the murder of Caryn Campbell. Police found her hair in Bundy’s VW. Bundy was defending himself in the case and while on the visit to the courthouse law library on June 7, 1977 escaped jumping from a two storey window. He was arrested again after 6 days of freedom. â€Å"On December 30, 1977, he hacked his way through an old welded light fixture in his cell ceiling and crawled through to a deputies living quarters, put on some civilian clothes and walked out.He made his way to Vail, Colorado, took a bus to Denver, and boarded a plane to Chicago. † He finally fled to Florida (â€Å"Predator; Ted Bundy† ARREST†¦ AND ESCAPE). Bundy could not resist his killer temptation for lon g and attacked 4 girls on the night of January 14, 1978- Lisa Levy, Margaret Bowman, Karen Chandler, and Kathy Kleiner. Two of them were killed and other two survived. He also claimed the life of Cheryl Thomas the same night. All of the girls were ruthlessly beaten, raped and strangled. He abducted and killed another girl Kimberly Ann Leach on February 9 Feb 2008.He stole VW again to escape but was soon arrested after some struggle and attempted fleeing (â€Å"Predator; Ted Bundy† ON THE RUN IN FLORIDA). Bundy was tried for the murders in Florida and convicted on July 23. â€Å"the bite marks on Levy's buttock and Nita Neary's eyewitness identification were too much to be overcome. Five days late the penalty phase began. Character witnesses were called by both sides including Mary Louise Bundy for the defense† (â€Å"Predator; Ted Bundy† LAST DAYS). On July 31 the verdict of death sentence came Bundy’s way.The state of Florida tried Bundy for Leachâ€℠¢s murder and he was again convicted and sentenced to death. Bundy married Carol Ann Boone in the court who later gave birth to his daughter in October 1982. Bundy never admitted defeat and tried till end to escape his death sentence. Bundy’s death sentence was executed on January 24, 1989. He was electrocuted and declared dead at 7:16 am (â€Å"Predator; Ted Bundy† LAST DAYS). Fig. 1 (â€Å"Predator; Ted Bundy† LAST DAYS). Works Cited â€Å"Predator; Ted Bundy. † tedbundy. 150m. com. 22 July, 2008

Using an example of an organisation, identify how the change in legislation was implemented and evaluate the impact of this on the service delivery

Our role as social workers is one of an empowering nature; we are or should be committed to equality and re-establishing equal power bases. Promotion of independence is fundamental to our role, for this reason I have decided to look at the implementation of the Direct Payments scheme, for disabled people; brought in under the Community Care (direct Payments) Act 1996. This was brought in as legislation, because of disabled peoples pressure groups, and in order to give disabled people further ‘independence and choice' (Abbot, D (2003)) further to this the Disabled Children Act 2000 extended the access to Direct Payments to 16 – 17 year old disabled people. Within this paper I will analyse the role of social services departments for disabled people before and after the implementation. In analysis I will identify issues that have arisen from this change in relation to the organisation of social services, the social workers and service users, analysing issues of interpretation, and cultural change. The legislation empowered local authorities to set up ‘Direct Payment' Schemes for disabled people that are entitled to community care services, under the community care act but discretion was given to local authorities on how to implement it. (Community Care, (1999) sept, 8th). Because of this discretion the take up and the manner of take up to the scheme differed which resulted in very little movement for a number of years. Husler (no date given) states ‘this legislation is permissive, which means councils can not ignore it, but they have discretions on how to implement it' (Ibid). This lack of guidance to implementation led to discrepancies in the implementation of the Direct Payments scheme Prior to the implementation of the direct payments scheme, the role of social services was to assess the needs and risks of the disabled person, and through this process of assessment seek to minimise or control risk and elevate need. This was done through the provision of services directly controlled or distributed from central government of local social services departments. We see in this situation the relationship of power was one of retention by the social worker within a culture of ‘Role' and ‘task' rather than person. Although many would argue with this point and state the cultural work base of this time was one of a ‘person' culture as defined by Burnes (2000)p.164), where the service users needs and wishes are prominent with the minimisation of the structural highrachy base. Handy (1986) would disagree with this notion and further argues that western organisations work predominantly from a role or task orientated cultural work base. This is evident in many of the recently published documents on working practices and guidelines on legislation interpretation, such as the ‘Working Together Document 2000 and the Assessment Framework 2000. Further, if look back to the development of the social services and the then Charity Organisation Society (COS) founded in 1869 we see evidence of similar practice in relation to current assessment of needs. This was also done by a COS worker who made judgements based on his of her knowledge, this is clearly an earlier form of means testing (Glasby & Littlechild (2002)). From this assessment a payment was given to the person or which then was referred to as ‘relief.' This was technically abolished in 1834; it continued to be paid in practice well into the twentieth centaury, as a range of complex measures for the support of the poor as unemployment soared (Thane. P (1996). The Poor Law was finally abolished in 1948 putting an end to payments to the poor by social services departments, and replaced by a national scheme for the payment of social security benefits and the provision of welfare services to the elderly and the Disabled. This allowed the practitioner to distance themselves from cash payments and the stigma of poverty, further this led to as Becker (1993) states ‘practitioners having little poverty awareness (p93) and further viewing money problems as being the problem of other agencies (Davies & Wainwright (1997) quoted in Glasby & Littlechild p 61) This desire for the social work profession to distance it self from the nineteenth centaury roots has, resulted in the resistance to the implementation of the Direct Payment Schemes. Although the Direct Payment Scheme is very different from the early payments made by the COS and earlier forms of social services departments. This resistance has been from the shop floor social workers to MPs such as Virgina Bottomly, who wrote to the MP introducing the Private members bill prior to its introduction to legalise direct payments â€Å"Social services legislation is concerned with†¦.services and not with direct payments which is the province of the social security system† (Quoted In Hatchett W, (1991): pp 14 – 15). Governmental ideology for the implementation of the Direct Payments scheme was to reflect the principles of participation, inclusion and equality through offering choice and independence. Because of the lack of clear guidance on interpretation this agenda has been misinterpreted and further resulted in the slow take up of the scheme. Roles and procedures have changed in departments which require operational changes, and a further shift in the approach to the concept of risk and control (Dawson (2000) quoted in Carmichael & Brown (2002) p.804) The involvement in service users lives by social workers has shifted away form one of assessment and the in house provision of services, to one of assessment and the provision of monies to purpose individual care form the quasi market place. This can be tailored to meet the individual needs and life of a person, rather than the one ‘size fits all' attitude of previous service provision (Glasby & Littlechild (2002)) this is in comparison to earlier payments being made by the Independent Living Fund indirectly through third parties (Brindle, D. (2000)) further key points to the misinterpretation and slow take up of the scheme is due to the ambiguous wording of the legislations guidance the ‘willing and able criteria' (Clark & Spafford (2002)) this point argues the service users must be able to ‘choose' direct payments, problems such as ability the to choose have arisen from this guidance as well as to whom the allocation of payment should be made. Who should have control over the money? Is a question the local authorities have struggled with when assessing people with severe disabilities and people with mental incapacitates. Authorities have taken this grey area of the legislation and effectively excluded people with mental incapacities because of the legal implications which resulted in the rejecting of an application. Further to this councils have adopted a top down model in which local disability organisations are not closely enough involved within. This bureaucratic model is arguably necessary because of the complexity of the system, the workforce need clearly structured role, responsibilities and lines of command for effectiveness (Coulshed & Mullender (2001)) this is for the purposes of accountability and stability in the system (Ibid).although this can restrict professional autonomy and offer further resistance to change (Aldridge (1996) quoted in Coulshed & Mullender, p 31) With the implementation of this scheme, there was a shift away from the old system of social worker control to that of user control, which social workers saw as a danger and who have voiced concerns of â€Å"vulnerable people managing their own services and whether it is right to risk such payments' (Snell, J. (2000)). This is clear indication as Cyert & March (1963) state ‘confusion over how political constraints on policy make a rationalist approach to decision making impossible (quoted in Burnes. B (2000)) This has led to social workers becoming uncertain as to what is needed from them, because of the role and responsibility change, as well as the cultural change in the departments, which has further left social workers feeling disempowered. Power and control is reduced from the social worker, and rebalanced with the service user, social workers have seen this as a perceived loss of their identity and status. (Clark & Spafford (2002) p 252) Confusion and lack of participation in the planning stages of the delivery of services has left social workers resenting the direct payments scheme, this has further led to slow take up and slow information distribution to service users. Etienne d'Abouuville (1999) states the schemes are floundering because local authorities are using social workers to advice on direct payments, rather than Disabled peoples organisations which can provide peer support. This is further evidence in the change of role change in the role of the care manager Glasby & Littlecihild (2002) argue workload implications and the low ratio of staff is a strong and potential barrier to the independence of disabled people. Mullins (1993) comments on this and states ‘commitment and cooperation to organisational goals will depend on how these are perceived to be in their own interests'. If we look at this in the context of the social worker who has been giving advice to the service user on, employers' responsibility, obligations and legal ramifications without training and on top of their ‘normal' workload we see why social workers are feeling stressed. Further too this reluctant to work in with the scheme (Hosler (1999)). Social worker having little involvement in the change has led to this resistance; this is perpetuated with the burdening of further responsibility on the worker. Mullender and Coulshed argue ‘where structures are going through change this is adapted to more quickly where there are open lines of communication and decentralised structures. If we analyse the impact of the organisational change to the service user we see a clear recondition of the social model of disability which as Oliver argues ‘It is not people impairments which limit people's ability to participate in society and to exercise their rights, but the organisation of society it self which causes the disability† (Quoted in Stainton, T. (2002) p 752) This social model articulates not how to find a way of compensating for the natural disadvantage, but how society can accommodate a range of differences (Ibid). Service users have stated they have rights and autonomy furthering the ability to be recognised as full citizens (Stainton, T (2002)). Many disabled people prior to the introduction of the Direct Payments Scheme were given little or no choice in relation to who provided the care, and to what extent. This was reflective of the funding structures and mechanisms of the social services departments (Statinton, T (1998)), here the departments or the family would access and commission the service, which resulted on many occasions being put on a waiting list. In this analysis we see little or no choice or control on the part of the service recipient, and further if criteria for service were not met then no service was offered. This coupled with resource constraints and tightly specified service contracts can together restrict the remits and activities of services (Glendininig, C, (2000)) With the new system the service user retains overall control on who to commission to carry out the work and for what period of time, the service user defines what needs are to be met and to what extent. A shift away from the social worker led assessment. With a recondition of the Disabled person's rights the Direct Payments Scheme also brought with it the responsibility of being an employer and with that obligation to contractual agreements. This could be seen as a potential barrier, but many disabled people have commented, â€Å"All the stress is worth having control of your own care† (Clark and Spafford (2002)) In conclusion we see how the change has resulted in a cultural change within the social services departments and further a shift away from the ethos of the social worker as the expert. This is welcomed by Disability groups who have campaigned for the Direct Payments Scheme, but resented by those whose job's it has affected with added workload and change in role. Change is a natural occurrence and some would argue inevitable to human evaluation, it is about recognising where sociality shortfalls are and actively seeking to rectify them. As with a majority of pieces of legislation they are based on social justice principles, but interpretation results in oppression and discrimination

A Study On The Biology Course Essay - 720 Words

The results of the experiment vary from what is reported by previous studies (Curry, 2013, Enattah et al., 2002, Tishkoff, 2007). The experiment was conducted on students currently in the Biology 225 course in Schenectady, NY. The class was primarily composed of individuals whom are descendants of Europe. Therefore, an assumption was made that by in large, the percentage of lactase persistent in the class that was expected was going to be near 95% (Curry, 2013). However, such a high percentage was not found. Of the class, only 49.3% of individuals were determined to possess a genotype that results in a phenotype of lactase persistence. Conversely, 40.8% of the class was found to carry the genotype lct/lct which results in the phenotype of lactase non-persistence. Therefore, the results are nearly 50% off from what we expected initially. This could be for numerous reasons, but perhaps the assumption should not have been made. The results fit much better when compared to the world ave rage occurrence of lactase persistence. Curry notes that out of all individuals over the age of 8 years old, only 35% still possess the ability to digest and breakdown the lactose in dairy products (2013). 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