Introduction
PTSD is a psychological condition that is known to occur as a result of a certain traumatic experience, such as partner violence, kidnapping and hostage situation, physical abuse, neglect in childhood, and concentration camp imprisonment, among others (NIMH, n.d.). The condition is known to produce numerous socioemotional, cognitive, and physical issues. In combination, these issues are known to have a detrimental effect on the individual’s development (Weston, 2014). The following paper identifies developmental issues characteristic for adults with PTSD and describes an intervention expected to address them.
Developmental Issues
The most common socioemotional behavior associated with the condition is avoidance – the tendency of an individual to deliberately or subconsciously avoid experiences related to trauma. On the most basic level, this behavior can affect decisions regarding visits to certain places or events. In more complex cases, certain types of emotions, feelings, and thoughts can fall within the avoidance range (Boden et al., 2013). The latter constitutes a major lifespan issue due to its potential for disruption of daily routines. For instance, a victim of a particularly traumatizing traffic accident may start avoiding cars and other means of transportation, which, in some scenarios, can introduce social challenges.
Another widespread developmental issue is related to disproportional reactivity and arousal. Adults with PTSD are known to experience sleep problems and are more likely to engage in angry behaviors, such as emotional outbursts (Pineles et al., 2013). In addition, individuals with PTSD are more likely to be startled and perceive excessive tension. Unlike the avoidance-related issues, increased arousal and reactivity is rarely tied to specific environmental situations. Instead, it is characterized by prolonged exposure and, over time, accumulates into a feeling of anger and stress, described by the sufferers as “being on edge” (Pineles et al., 2013). As a result, it may become more difficult for an individual to concentrate on relatively simple tasks such as eating or sleeping.
The third area of developmental issues impacts the cognitive domain. Adults with PTSD experience difficulties remembering details of a traumatic event, which is commonly considered a psychological defensive mechanism intended to shield them from excessive stress. However, this issue also creates a range of social and emotional aspect of the client’s life. Specifically, a client may feel guilty and blame oneself either for the initial traumatic event or subsequent adverse outcomes associated with it (Alabama State Department of Education, 2017). On a broader scale, these feelings may facilitate dissatisfaction with the surrounding reality. Finally, the loss of satisfaction with enjoyable activities can be observed.
At this point, it is important to mention that the occurrence of these issues within a short time does not necessarily constitute a PTSD-related developmental issue. In many cases, people experience the same effects within few weeks after the traumatic event with no long-term consequences, in which case lifespan issues do not manifest afterwards. However, once the duration of the symptoms exceeds one month, they become noticeable on a social and psychological level. Specifically, the loss of interest coupled with negative thoughts about oneself impairs individual’s functioning ability and contribute to the sense of detachment from family and friends. In the long run, these factors increase the likelihood of substance abuse and depression and, by extension, lead to a significant decline in health due to constant stress.
It is also necessary to address the impaired functioning ability mentioned in the previous section. According to the current understanding of neurobiological behavior, visuospatial skills, attention, working memory, and social cognition are closely related to cognitive capacity of the individual. Thus, according to the psychodynamic learning theory, the loss or noticeable decline of any of these functions leads to significant developmental deficiencies. In other words, PTSD-impacted populations are at an increased risk of developmental impairment.
Intervention Description
As can be seen from the information above, PTSD-related issues can become detrimental to the individual’s development. Thus, it is necessary to facilitate an intervention that would address the main adverse effects of the condition. The proposed intervention is a family-oriented event. This choice can be attributed to the positive role of the family in the emotional and cognitive function of a sufferer. Simply put, psychological and emotional support offered by friends and relatives is known to improve coping ability and mitigate adverse effects associated with the condition (Boden et al., 2013). In order to achieve the described effect, it is necessary to ensure sufficient understanding of the impacted individual’s needs by their peers. The proposed intervention is to be in the form of a workshop for families of adults with PTSD. The duration of the program is four weeks, with one hour-sessions on a weekly basis. Such timing would ensure adequate coverage of essential information necessary for an understanding of the condition. At the same time, it would provide the participants with an opportunity to test the learned techniques, assess and discuss the results with an instructor, and introduce necessary adjustments.
The intervention will cover strategies and techniques of managing interpersonal difficulties, such as addressing the avoidance of certain routines disruptive for behavior. Next, the information on the enhancement of communication skills will be included in the program’s plan. For a client, this component will provide valuable insights for improving social interactions. At the same time, the client’s family members will be able to avoid a number of potentially risky scenarios common for PTSD-impacted populations (CACREP, 2016). From the strategic perspective, this approach would guarantee the reduction of family-based conflicts and, by extension, would mitigate the perceived dissatisfaction with life characteristic for the impacted individuals.
It is equally necessary to cover common erroneous beliefs and misconceptions associated with the disorder. For instance, it will be necessary to explain to the family the causes of impaired affective involvement observed among individuals with PTSD. In many instances, family members attribute the effect to emotional numbing whereas in reality, disengagement with reality and depersonalizing effect of PTSD are responsible for it (Pineles et al., 2013). Establishing sufficient understanding of the condition enables trust and improves emotional attachment within the family, which has an overall positive effect on the client’s well-being.
Finally, it is important to capitalize on the development of condition-specific communication skills. First, such an approach will contribute to the understanding of the PTSD-related effects and symptoms, thus eliminating confusion and frustration (CACREP, 2016). In addition, it will allow family members to identify and address emerging issues in a timely manner or refer the client to a professional. On a broader scale, they will also contribute to the restoration of social functions and emotional intimacy.
The primary outcome expected to occur as a result of the described intervention is the reduction of negative exchanges between the affected individuals and their families. By extension, the reduced hostility, criticism, and emotional detachment will add to the perceived social and emotional comfort, reducing the likelihood of conflicts and establishing positive developmental conditions.
Individual, Group, and Family Interventions
According to the data available in the academic literature, two types of interventions can be suggested for individuals within the VA dealing with PTSD. The first category includes generic components aimed at treatment of disrupted relationships and mitigating mental health-related issues. The most recognized type of a generic intervention is behavioral therapy (e.g. traditional couple-oriented therapy). The objective of such a therapy is to promote problem-solving skills and increase the proportion of positive family-related experiences. The second common component is the promotion of openness and expression of unusual feelings. According to the attachment theory perspective, this component is expected to strengthen interpersonal communications. Generic interventions can be oriented towards individuals, couples, families, and groups of PTSD sufferers.
The second category includes condition-specific therapies. These interventions are based mostly on the cognitive-behavioral framework (CACREP, 2016). In contrast to generic approaches, these interventions are aimed at the reduction of social dysfunctions and emotional distress. Such an intervention usually delivers psycho-education on PTSD-related effects, communication-enhancing techniques, and address avoidance behaviors. Tightly scheduled training exercises are necessary to create sustainable effects of avoidance reduction and positive family experience promotion.
Conclusion
As can be seen, some of the symptoms associated with PTSD in adults produce a range of developmental issues. In most cases, the effect of these symptoms is both prolonged and cumulative, leading to significant long-term effects when left unaddressed. Therefore, it is necessary to develop an intervention that would mitigate the identified issues. The suggested intervention is expected to improve emotional and social functions of adults with PTSD and facilitate support from family members and friends. In addition to direct therapeutic effect, it will improve understanding and, by extension, establish trusted and emotionally-satisfying social environment.
References
Alabama State Department of Education. (2017). Chapter 290-3-3: Educator preparation. Web.
Boden, M. T., Westermann, S., McRae, K., Kuo, J., Alvarez, J., Kulkarni, M. R.,… Bonn-Miller, M. O. (2013). Emotion regulation and posttraumatic stress disorder: A prospective investigation. Journal of Social and Clinical Psychology, 32(3), 296-314.
CACREP. (2016). CACREP standards. Web.
NIMH. (n.d.). Post-traumatic stress disorder. Web.
Pineles, S. L., Suvak, M. K., Liverant, G. I., Gregor, K., Wisco, B. E., Pitman, R. K., & Orr, S. P. (2013). Psychophysiologic reactivity, subjective distress, and their associations with PTSD diagnosis. Journal of Abnormal Psychology, 122(3), 635-644.
Weston, C. S. (2014). Posttraumatic stress disorder: A theoretical model of the hyperarousal subtype. Frontiers in Psychiatry, 5, 37-57.