The Reality of PTSD

In the US Military
November 13th 2018 1300-1430
174th Attack Wing Air National Guard Base

Teaching Project NUR 346

Utica College
Cherice Marie Stebbins
Detailed Content Outline
Define What are the risk factors for PTSD
 Percentage in the military is higher
 Importance of knowledge and education

Define Signs and Symptoms of PTSD

 Cognition
 Mood Symptoms (depression)
 Substance Abuse

Available Resources to those who suffer from PTSD

 Several listed (Slide 22)

Interventions that can be used to help treat PTSD

 Active Listening
 Providing Social Support
 The Health Problem?
Risk for Post Traumatic Stress Disorder focused on the members of the US military

Group Being Taught

Members of the NY Air National Guard currently assigned to the 174th Attack Wing.

Relevant topic for this group

This particular group is at high risk from suffering from PTSD due to the increasing amount
of traumatic events that occur as part of the job. Post-traumatic stress disorder prevention
and treatment is a very important matter for the military population because it can lead to
severe stress, incidents at home and even suicide if left untreated. PTSD in a military
member is a disorder that is usually from experiences they member has went through. This
can be a traumatic event such as being in combat, or a mom combatic war event (think of
9/11), or serious injuries. PTSD can also me completely un military related such as sexual
assault or family violence (Journals.plos.org).
Time and place of proposed class

 Date: Tuesday November 20th

 Time: 1300-1430
 Place: 174th Attack Wing Air National Guard
Address: 6001 E Molloy Rd, Syracuse NY 13211 - Building 648
Phone: (315) 233-2264
POC: SMSgt Matthew Warner
Methods of teaching
 PowerPoint presentation with full explanation of what PTSD is and who is at risk,
this powerpoint will be used for the educator to use as the lecture portion of the
teaching class.
 A video will be played for everyone and then members will break into groups and
have cross talk discussion
 A second video will be played so members can pick out PTSD within the videos and
the symptoms the individuals are portraying, after these videos we will have cross
talk and a role play style learning. One out of 3 people will act as if they are
suffering from PTSD and then there will be 3-4 people that will have to try and
pick out why has PTSD, from what, and how to assist them

Aids Available
 A handout with available resources will be given to everyone (slide 20)
 An exit survey (slide 25) will be given to everyone who attends
Teaching Objectives:
We all hear PTSD, but what is it?

Today we will:
 Define PTSD
 Who is at risk for PTSD
 What are the signs and symptoms of PTSD
 What resources are available if you suffer from PTSD
 What interventions can be used to help treat PTDS
 Learning Objectives:
1. You will be able to define what PTSD is

2. You will be able to define who is at Risk for PTSD

3. You will be able to name Two Symptoms of PTSD

4. You will be able to explain 2 therapeutic ways to communicate with an

individual suffering from PTSD?
Quote of the day:

 “Instead of being ashamed of what you’ve been

through, be proud what you have overcome”
- Dr. Phil
What is PTSD?

 We have all heard this abbreviation. Whether it was in the media, at work, or
even in your favorite TV show, but what really is PTSD?
 PTSD is Post-traumatic Stress Disorder
 The American Psychiatric Association defines PTSD as
“ a psychiatric disorder that can occur in people who have
experience or witnessed a traumatic event such as natural disaster,
a serious accident, a terrorist act, war/combat, rape or other
violent personal assault” (What Is Posttraumatic Stress Disorder, 2017)
What is PTSD?
 How many people here have been personally or know someone personally that
has been ion a traumatic event?
 To further understand PTSD, we need to dissect the definition. As we know
not all that experience a traumatic event have PTSD.
 Who can tell me what the “flight or fight” response is?
What is PTSD?

 The National Institute of Mental Health expands on the definition of PTSD

stating:
“People with PTSD may feel stressed or frightened even when they are not in
danger” (The National Institute of Mental Health, 2016)

 Referring back to our “flight or fight” image. Imagine experiencing a rapid

heart rate, trembling, and anxiety without any actual signs of danger.
Who is at risk?
 Now that we have defined PTSD, we can ask ourselves who is at risk?
 Do you think a child could suffer from PTSD?
 We know that PTSD is caused by a traumatic event. Traumatic events
can be experienced by anyone at any age. So PTSD is a diagnosis that
can occur across the lifespan. Stereotypical perspectives of PTSD are
combat veterans or emergency responders.
Who is at risk?

 If PTSD can occur across the lifespan, how do you define who is at risk?

 The Mayo Clinic has defined some risk factors associated with PTSD:
 Experience of long lasting/ intense trauma
 Experience of trauma early in life, such as child abuse
 Having a profession that is previewed to traumatic events regularly
 Having a substance abuse problem
 Lacking a stable support system
 Having a history of mental illness in the individual or family.
Video Time!

 As we watch this video I want you to think of how we defined PTSD and how
we established who is at risk for PTSD.

https://www.youtube.com/watch?v=qOkJeAbddDw
Video: Cross Talk
---Please Break into Groups---
 What were some of the key points you saw during the video?

 How would you define PTSD?

 Who would you say is at risk for PTSD?

What are the Signs and Symptoms of PTSD?

 We have already touched on this a little in our previous image of the “Fight or
Flight” response. However PTSD is much more complex than that.
 PTSD can be broken down into four symptoms:
 Re-Experiencing can also be referred to as intrusion
 Avoidance
 Arousal/ Reactivity
 Cognition/ mood
What are the Signs and Symptoms of
PTSD?
 Re-experiencing symptom
 This is the most known symptom of PTSD. Most refer to them as “flash backs”
 These “flash backs,” can be devastating to an individuals daily routine. These can
be sparked by any stimuli brining the individual right back to the traumatic
incident.
 Have any of you been reminded by a incident from something such as a smell,
movie, or sound?
 Now picture being reminded of that traumatic event and feeling as though you
were reliving it and the “Flight or Fight” response was engaged.
What are the Signs and Symptoms of
PTSD?
 Avoidance symptoms:
 The avoidance symptom is defined in its title. This is when you avoid anything that
could lead to a possible trigger of remembering an event.

 Some of you may be thinking “this is a good idea” however imagine if this was
driving a car, or going to a grocery store, or staying out of public areas.

 This could cause sever impairment of daily living activities and isolation.
What are the Signs and Symptoms of
PTSD?
 Arousal/ reactivity symptoms:
 The National Institute of Mental Health define the arousal and reactivity symptom
as being “easily startles, feeling tense or on edge, havening difficulty sleeping, and
having angry outburst.”
 This is a way of life for a PTSD individual. This differs from the past two symptoms
in that it remains constant.
What are the Signs and Symptoms of
PTSD?
 Cognition and mood symptoms:
 This symptom is related to disorders such as depression and anxiety disorder.
 These conditions can worsen over time and contribute to substance abuse,
isolation, and overall anhedonia (overall disinterest/ pleasure with life)

 To be diagnosed PTS you have to experience these symptoms and meet the criteria
listed in DSM-5 (Diagnostic and Statistical Manual of mental Disorders)
VIDEO TIME!

Individually while you watch this video I want you to answer

 What Symptoms of PTSD has this individual displayed?

 What other characteristics have you noted of this individuals communication?

 What key elements helped this individual reduce the symptoms of PTSD?

https://www.youtube.com/watch?v=-Fc6_aTnRXQ
 Video Role Play!
 After watching this video I want 9-12 volunteers and then these volunteers to break off into
groups of 3 or 4. Each group will act, but one person will be suffering from PTSD. I will give each
group a scenario to play.
Scenarios:
A. Everyone is deployed, but one person has financial issues going on back home and he/she
cannot physically be there for their family. He is completely fine with free food, housing, ect
through the deployment. Other members are deployed as well and dealing with various work stress,
and or minimal home stress
B. Each person is active duty and one person found out their schedule is changing dramatically
and he/she cannot care for their sick mother, now the mom has to go into a nursing home. The
others have normal day to day stressors going on.
C. All members are out for drinks during a social hour, but one member is drinking excessively,
another person asks them about it but they state they’re fine and they drink like this all of the time.

 The “non volunteers” in the audience will have to pick out of the group who is the person
suffering from PTSD, and what is the best action to take a a person who suspects PTSD in this
person in this particular situation.
Resources Available:

 There are many resources available to you.

 Of course you can discuss the symptoms of PTSD with you Primary Health Care
Provider.
 There is also a great diagnostic tool found at
https://www.ptsd.va.gov/apps/decisionaid/introduction-2.aspx that can help you
seek treatment for PTSD.
 Locally there is support groups
 NAMI support/ Access CNY and sharing meeting at 420 E. Genesee St. Syracuse, NY
 Hutchinson Psychiatric Center Syracuse, NY and is based on family education services
 VA community center Syracuse, NY (315)425-4455
 Veteran Crisis line (800)273-TALK
 National Crisis line (888)777-4443
What interventions can be used to help treat PTDS:

 We have talked a lot about PTSD and its impact on the individual. As seen in our
video this is the impact on the family.
 What interventions can be used to help ease the stresses of PTSD?
 Get involved with support groups and education groups for PTSD
 HelpingGuide.org gives some therapeutic approaches for a family living wit PTSD.
 Providing social support
 What are some ways you can provide support to a peer or family
member dealing with PTSD
- Don’t force the individual to talk
- Try to keep a normal environment
- MANAGE YOUR STRESS!
What interventions can be used to help
treat PTDS:
 Active Listening, who can define what this means?
 Listen attentively
 Watch your non-verbal and verbal cues
 Do not interrupt or state they have told you something before
 Listen without judgment and use empathy throughout the communication
What interventions can be used to help
treat PTDS:
 Anticipate and manage triggers:
 Providing a safe environment is key to a individual with PTSD
 Understanding their triggers may help alleviate the symptoms
 Build trust & rapport to establish a therapeutic foundation
 Understand the individuals coping mechanisms, if a trigger were to occur
 If a “flash back” occurs let the individual know that it is happening and help them
move into a calm, less stimulating setting.
 Always remain calm and if necessary give space to the individual.
 NEVER PUT YOURSELF OR FAMILY IN HARMS WAY
 Research Journal Summary
The Military population is one of the most vulnerable groups when you consider being at risk for post-traumatic
stress disorder. As a person joins the military the number of traumatic events related to the job dramatically
increases. post-traumatic stress disorder prevention and treatment is a very important matter for the military
population because it can lead to severe stress, incidents at home and even suicide if left untreated. Knowledge
on post-traumatic stress disorder early to late signs can decrease the amount of cases and PTSD related suicides.
When you think of PTSD the military context, it is estimated that 11% to 20% of US military personnel who served
in Iraq or Afghanistan have diagnosed or undiagnosed PTSD. PTSD in a military member is a disorder that is usually
from experiences they member has went through. This can be a traumatic event such as being in combat, or a
mom combatic war event (think of 9/11), or serious injuries. PTSD can also me completely un military related
such as sexual assault or family violence (Journals.plos.org).
An excellent teaching/ dynamic model that has been established by creating a systems model based on military
members and veterans who served from 2000-2014 whom have been affected by PTSD. These results were then
taken to be used as a forecast for trends onto the next decade (2015-2025). There are a four major insights of
this model and they are as follows:
1)The population of patients and system costs are very sensitive to US involvement in future wars, and screening
and treatment policy interventions have marginal effects in comparison
In an optimistic scenario based on the status quo (about 1% deployment of military personnel to intense/combat
zones in 2014) and assuming that no war will happen in the next decade, estimated PTSD prevalence among
veterans in 2025 will be 10%;
3) During wars, resiliency-related policies are the most effective for decreasing PTSD; in a postwar period, there
is no silver bullet for overcoming the problem of PTSD, and the current screening and treatment policies must be
revolutionized to have any noticeable effect
4) It takes a long time, on the order of 40 years, to mitigate the psychiatric consequences of a war.
(journals.plos.org)
Research Journal Summary Continued..
What do those four major insights mean you may ask yourself, when we think of the
population of patients and systems costs  
they are referring to, and that is the annual costs of PTSD for the military members and the
retired military members (utilizing the VA programs).  Average cost per patient was
extracted from a 2014 report by the Institute of Medicine: $4,500 and $6,244 per PTSD
patient in the military and VA (journals.plos.org). Next, we talk about the scenario that we
will not enter war by 2025 and that 10% of veterans will suffer from PTSD. The next model
insight stated, resiliency-related policies are the most effective for decreasing PTSD- these
policies came from the formulations that a condition where resiliency to trauma was
doubled, meaning that the chance of developing PTSD after experiencing trauma was
halved (journals.plos.org). And lastly the it can take 40 years, to mitigate the psychiatric
consequences of a war, with those statistics a individual can suffer from PTSD the rest pf
their lives.
This Research journal has a lot of hypothetical situations and scenarios but sums it all
p to be based on the fact that PTSD is serous military related mental health disease and
there are several resources and options out there for someone to get help and become
resilient to PTSD. These scenarios would change dramatically if we did go into war again, r
if we consider the increasing female population in the military as females may have higher
likelihood of sustaining PTSD in a combat situation. (journals.plos.org)
THE REALITY OF PTSD EXIT SURVEY
1. How Would You Define PTSD
2. Who is at Risk for PTSD
3. Name Two Symptoms of PTSD
4. What are 2 therapeutic ways to communicate with an individual
suffering from PTSD?
5. Did you find the videos informative?
6. Was the presenter clear in their communication?
7. Did you find the presentation informative?
8. What areas do you feel were exceptional?
9. What areas of the presentation you feel need to be improved?
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References Continued

 Ghaffarzadegan, N., Ebrahimvandi, A., & Jalali, M. S. (n.d.). A Dynamic Model of Post-Traumatic Stress
Disorder for Military Personnel and Veterans. Retrieved from
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161405
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