Friday, November 20, 2009
Predicting PTSD Ahead of Time
The U.S. military is undertaking a large research project using its own soldiers to see if there is a way to predict who will suffer from Post Traumatic Stress Disorder. They are screening hundreds of soldiers before they deploy, including their baseline stress rate, brain scans, family histories and past history of mental illness, and will be looking to see if any factor or combination of factors can predict who is at highest risk.
This is a very new way to look at PTSD, and raises interesting issues for those of us who work in trauma response. The conventional wisdom which we learn in training is that the factors that affect whether someone will develop PTSD are mostly things that occur with the trauma. We are taught that people who are more closely and directly exposed to an incident are more likely to have PTSD. People who experience dissociation and/or depression immediately surrounding the trauma are at increased risk. In addition, the more closely held beliefs, expectations and worldviews are violated, the more likely you are to have PTSD down the line.
This experiment aims to short-circuit most of those factors. What if we could predict who is most likely to experience those predictors? What if we knew that this person is at increased risk for dissociation, and that person will react particularly strongly to the violation of their worldview? What would that mean for trauma responders? What would that mean for the people themselves?
Let's suppose, for the sake of argument, that we discover that certain people have a particular kind of activity in a particular part of their brain, and that if you have that activity you are more prone to PTSD. Do we allow those people to serve in the military? Can they be police officers or firefighters? What if it turns out that that same anomaly is associated with bravery and calm under pressure, so these people also make especially good soldiers and first responders? How will we decide?
We also have to think about how we treat those people. Traumas will always happen, even if we exclude those most at risk for PTSD from serving. If we come upon someone at increased biological risk who has, say, witnessed a murder, will they immediately be referred for further care, or can early intervention still help? Will we be doing brain scans at the scene?
I often say that I love crisis work and I hate that I love crisis work. I feel guilty that I get so much satisfaction out of helping with other people's misery -- shouldn't I be hoping they aren't miserable? If this research is successful, it's possible that the whole way we proceed with this work will change. It's hard to imagine, though, that we won't need to do it at all.
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Meet the Quarterback
- Naomi Zikmund-Fisher
- is a clinical social worker, former school Principal and a Crisis Consultant for schools and community organizations. You can learn more about her at www.SchoolCrisisConsultant.com
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2 comments:
I think this experiment is garbage. It raises more questions than answers. War is a tough business and we need to concentrate more on healing the affected. The fact that this has gotten so much attention is proof that our citizens are soft and sheep like followers. Generations of warriors have gone and fought for their countries. It is a time honored tradition. People get shot and dismembered in war, that's what war is. PTSD should be treated like any other injury and researched from a cure perspective and not a psuedo science prevention perspective.
Jason
OperationPTSD.com
Preventing PTSD in soldiers? How about not sending the soldiers to war? I think that would be a more effective and less expensive method of preventing it.
As for fire fighters and other rescue workers, I guess knowing who is more prone to it just means you watch for it...just like those who are more prone to skin cancer make sure to cover up in the sun...
I do think that there are better things for the military to be spending money on. But, then, what is new about that?
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