Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Separation anxiety disorder wikipedia , lookup
Conversion disorder wikipedia , lookup
Generalized anxiety disorder wikipedia , lookup
Glossary of psychiatry wikipedia , lookup
Depersonalization disorder wikipedia , lookup
Posttraumatic stress disorder wikipedia , lookup
PTSD and Veterans: Understanding and Accommodating Presented by: Cheryl Chesney-Walker, Executive Director for Health Careers/Education and Special Services for Students, VCU Medical Center, MCV Campus September 26, 2008 AHEAD Fall Conference Background on PTSD • Posttraumatic Stress Disorder • The person has been exposed to a traumatic event in • • • which both of the following were present: The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others The person’s response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior Source: DSM-IV-TR PSTD Criteria • The traumatic event is persistently re-experienced in one (or more) of the following • • • • • • ways: Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: in young children, repetitive play may occur in which themes or aspects of the trauma are expressed Recurrent distressing dreams of the event. Note: in children, there may be frightening dreams without recognizable content Acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event Physiological reactivity on exposure to internal or external clues that symbolize or resemble and aspect of the traumatic event Source: DSM-IV-TR Symptoms and Behaviors of PSTD • Persistent avoidance of stimuli associated with the trauma and • • • • • • • • numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following: Efforts to avoid thoughts, feelings, or conversations associated with the trauma Efforts to avoid activities, places, or people that arouse recollections of the trauma Inability to recall an important aspect of the trauma Markedly diminished interest or participation in significant activities Feeling of detachment or estrangement from other Restricted range of affect (e.g., unable to have loving feelings) Sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span) Source: DSM-IV-TR Symptoms and Behaviors Continued • Persistent symptoms of increased arousal (not • • • • • • present before the trauma), as indicated by two (or more) of the following: Difficulty falling or staying asleep Irritability or outbursts of anger Difficulty concentrating Hypervigilance Exaggerated startle response Source: DSM-IV-TR Acute Stress Disorder • The person has been exposed to traumatic • • • event in which both of the following were presented: The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others The person’s response involved intense fear, helplessness, or horror Source: DSM-IV-TR Symptoms and Behaviors of Acute Stress Disorder • Either while experiencing or after experiencing the distressing event, the • • • • • • • individual has three (or more) of the following dissociative symptoms: A subjective sense of numbing, detachment, or absence of emotional responsiveness A reduction in awareness of his or her surroundings (e.g., “begin in a daze”) Derealization Depersonalization Dissociative amnesia (i.e., inability to recall an important aspect of the trauma) Marked symptoms of anxiety or increased arousal (e.g., difficulty sleeping, irritability, poor concentration, hyper vigilance, exaggerated startle response, motor restlessness). Source: DSM-IV-TR Generalized Anxiety Disorder • Excessive anxiety and worry (apprehensive expectation), occurring more • • • • • • • • • days than not for at least 6 months, about a number of events or activities (such as work or school performance). The person finds it difficult to control the worry. The anxiety and worry are associated with three (or more) of the following six symptoms (with at least some symptoms present for more days than not for the past 6 months). Note: Only one item is required in children. Restlessness or feeling keyed up or on edge Being easily fatigued Difficulty concentrating or mind going blank Irritability Muscle tension Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep) Source: DSM-IV-TR Combat Related Hearing Loss • VA’s National Center for Rehabilitative Auditory Research recommends hearing protection for sounds louder than a lawn mover (90 decibels). Weapons and equipment used in the military often far exceed this level. Military Sound Levels • • • • • • Apache helicopter, pilot, Decibels: 104 9mm pistol, Shooter, Decibels: 157 Grenade, within 50 ft., Decibels:164 105mm towed howitzer, Gunner, Decibels: 183 MAAWS recoilless rifle, Gunner, Decibels: 190 Source: U.S. Army Center for Health Promotion and Preventive Medicine Symtomology of Hearing Loss for Veterans • Depression • Lack of socialization caused by inability to • • • • understand others in conversations. Mild to moderate brain damage from combat blast exposure. This is a new phenomenon with little research. Isolated Paranoid Emotionally unstable Statistics on Hearing Loss and PTSD for Iraq and Afghanistan Veterans • Tinnitus (loud noise exposure is a very common • • • cause of tinnitus, and it often damages hearing as well) is the No. 1 service connected health condition for Iraq and Afghanistan veterans, with nearly 70,000 diagnoses, according to the Veterans Benefits Administration. Defective hearing is No. 3 with almost 60,000 cases. PTSD is No. 4 with 38,000 cases. Source: VFW September 2008 What we do know. • Many Iraq and Afghanistan veterans will be returning to • • • • • postsecondary education to utilize the 2008 GI Bill. Many of the veterans will have disability needs that will need to be accommodated. Veterans will need support in different aspects of postsecondary education life. They may have difficulty adjusting to civilian life. They may have interpersonal relationship difficulties at home and at school. They may or may not know that they need disability support services and how to seek out such services. What can we do? • Create linkages and support networking with our university and • • • • • college Veteran’s Affairs office. Create a referral system between DSS and Veteran’s Affairs office personnel. Provide information on both the DSS and Veteran’s websites on referrals, services, policies and procedures to seek out disability support services. Provide informational “fact sheets” on disability services for your office to be disseminated to the Veteran’s prior to their enrollment in coursework. Be sensitive to their unique needs as a non-traditional student returning to postsecondary education. Provide other educational resources to the Veteran’s. I.e. University Counseling services, Vets Clubs (if they exist on your campus), financial aid services, etc. What is your plan? • • • • Who needs to be involved? How will your referral and support system work? How will you put it into motion? How will you evaluate whether or not your plan is a good one? What if it doesn’t work well for the Veterans, DSS and Veteran’s Affairs office? • How many people will be involved and how many more may be needed? • What are some of the most common accommodations that you feel you will need to encounter with Veteran’s? Are you prepared to do so? If not, what steps need to be taken? • Does anyone on campus need to be educated about returning Veterans to postsecondary education? Who and how will this happen? Conclusion: • Questions and answers • Resources: – Suicide Prevention: 1–800–273–TALK (8255) – Vocational Rehabilitation and Employment Program's http://www.vba.va.gov/bln/vre/index.htm – Regional VA Benefits Office: Roanoke Regional Office 210 Franklin Rd. SW Roanoke, VA 24011 1-800-8271000 – On-Line Resources for Veterans: http://www.vba.va.gov/bln/vre/resources.htm