Preexisting Anxiety Compounds PTSD Risk
> 1/3/2008 11:43:31 AM

Emotionally ravaging events like those involving physical or sexual abuse, natural disasters, terrorist attacks, or the passing of loved ones can affect patients across the social spectrum, often preceding the development of disabling mental health conditions. But lives riddled with any number of recurring anxieties leave subjects more likely to suffer from Post Traumatic Stress Disorder in the wake of particularly disturbing events. Ongoing stress essentially wears down the brain's ability to cope with the shock of traumatic experience and thereby resist the development of PTSD. Financial problems, strained and abusive relationships, chronically ill children and recurring health problems are only some of the disorder's potential triggers.

While PTSD has long been discussed in psychiatric circles under divergent headings (Freud called it Melancholia, while military specialists wrote on "shell shock" or combat fatigue), it has only been recognized and clearly defined by mental health professionals for approximately 20 years. Due to this unfortunate lack of a medical consensus, most previous clinical research on the condition focused on a patient's state of mind at one particular moment in the wake of recent tragedy; this newest study focused on a group of urban Americans directly affected by perhaps the single most traumatic event of our new century: the devastating terrorist attacks of September 11, 2001. In what is, surprisingly, one of the first longitudinal PTSD studies, researchers at the University of Michigan tracked the medical and emotional development of more than 2,500 patients residing in or near the greater New York metropolitan area for 30 months following the attacks, interviewing each participant on 2-4 separate occasions to gague their stability and note the possible emergence of PTSD symptoms.

Amazingly, the instance of PTSD in the sample group leapt from 2.1% in early 2002, when the study began, to 14.3% at its conclusion 2 1/2 years later. Since the study began several months after the attacks, this trend suggests the considerable presence of late-onset PTSD, which is known to be more resistant to treatment and potentially disruptive to a patient's personal and professional lives. Horrors approaching the scale of 9/11 serve as common sources of late-onset PTSD due to the difficulties encountered in assessing and accepting the sheer scope of the relevant tragedy.

These concurrent conditions were more common among minority and low-income patients, and women were considerably more likely to develop the disorder than their male counterparts even after researchers controlled for financial standing and other related variables. Predictably, those with smaller social and family support networks also developed the condition far more often. Previous studies reached very similar conclusions, with PTSD rates for low-income women, particularly of Latin ethnicity, more susceptible to the condition; among depressed women, some have estimated the prevalence of PTSD to reach approximately 33%. The Latino variable has not been sufficiently explained, but some hold the community's generally perceived aversion to psychiatric treatment responsible. This country's quickly expanding Latin community makes further research on the topic crucial.

Perhaps the larger point of this study is that the lives of patients suffering from PTSD (or those who are believed to be experiencing the same) should be observed more carefully in order to detect possible sources of concurrent anxiety. Treatment plans and interventions that only address the incidents responsible for triggering the condition may overlook other significant contributors to the anxiety coloring these patients' everyday lives. If an assault victim also struggles with finances or a behaviorally challenged child, a willful ignorance of these personal details will almost certainly compromise the efficiency of any subsequent treatment plans. Like all mental illnesses, PTSD is a multi-layered disorder subject to the influence of quite a few complicating factors, and they must be taken into account for the well-being of the affected patient.

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