Post-traumatic stress disorder among athletes

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Post-traumatic stress disorder among athletes
Post-traumatic stress disorder world map - DALY - WHO2002.svg
World map representing the presence of Post traumatic stress disorder within different countries
Specialty Psychiatry

Posttraumatic stress disorder (PTSD) is a cognitive disorder, which may occur after a traumatic event. It is a psychiatric disorder, which may occur across athletes at all levels of sport participation. [1]

Contents

There is a difference between the responses of a PTSD episode and a normal response to trauma. If an athlete injures his or herself in a traumatic way, it is normal for them to go through some form of hardship before overcoming the injury. [2] They may develop small flashbacks, have bad dreams, or feel like they can't get the traumatic experience out of their mind. [1] [3] Athletes may also have trouble with emotion regulation and developing coping strategies when they are under intense stress brought on by PTSD. [4] There are many different ways to deal with the matter of having PTSD, with some therapy treatments including psychotherapy, art therapy or social engagement. [2]

An injured athlete could also have Chronic traumatic encephalopathy, which includes too much trauma to the head from practice and games.

History

There are many sports which are fairly dangerous and involve threatening activities, especially during competition. There is always the chance of athletes getting injured while competing or during training which is exactly the reason why a psychologist would eventually encounter a patient who is a serious athlete and is in need of their assistance to rehabilitate their PTSD. [5] [ scientific citation needed ] Psychology as a general occupation has dated back to times of 1878, and around 1897 the first psychologist specialising in sport was established, by the name of Dr. Norman Triplett. Ever since, sport psychologists were helping different athletes, in the mental aspect of their game, in order for them to reach their optimum potential. [5]

PTSD became first evident due to those individuals who suffered extremely horrible experiences from war. Society noticed that those who took part in war, or had family members who took part in war, became distant from themselves and suffered terribly and found it difficult to cope with the tragedies. Researchers took note of this and aimed to evaluate the situation and come to a conclusion with how to rehabilitate these individuals, and while doing this they determined that these people had post-traumatic stress disorder. [6] [ scientific citation needed ]

PTSD is recognized in athletes because they put themselves in situations where their safety is threatened and they can sustain a serious injury, which can result in them developing PTSD from the serious injury and incident. Soon after this new-found disorder was established it made it far more clearer for those sport psychologists to treat their clients, as prior to the discovery of PTSD, sports psychologists, had to come up with alternative options to rehabilitate their clients who were experiencing PTSD. These psychologists often took their clients to play different sports, completely different from their own in aim to treat them in the most comfortable way possible. [5]

Etiology

Athletes may often hide the severity of an injury in order to continue participating in the sport. [7] [8] This denial of the severity of an injury could possibly lead to an early retirement in order for the athlete to refrain from sustaining permanent physical damage. Early retirement for an athlete could lead to feelings such as alienation, distress or uselessness. [9] The degree to which an athlete identifies with a sport may have an impact on their emotional response to a traumatic injury. [8] Individuals who identify strongly as athletes may be at an increased risk for psychopathology such as depression or PTSD after sustaining an injury. [8]

Tiaina Baul "Junior" Seau Jr

An example of an athlete who experienced this is Tiaina Baul "Junior" Seau Jr. Junior Seau was an American NFL player who developed PTSD. He was born on January 19, 1969, and died on May 2, 2012. He played linebacker during his time in the NFL and had extensive experience in this role, despite the many injuries throughout his career. After his career in the NFL he developed differences in his personality due to brain injury. These changes consisted of impaired self-control and regulation, sensitive emotionally and his social skills decreased, which then led to alienation, something which was a strong opposite to his original personality. From there he developed insomnia and committed suicide via a self-inflicted gunshot to his heart.

Junior Seau with his fellow Patriots Junior Seau with Patriots side view.jpg
Junior Seau with his fellow Patriots

Diagnosis

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that usually occurs among individuals who have had a traumatic experience or have witnessed one (What Is Posttraumatic Stress Disorder, 2020). Acute stress disorder (ASD) is a good predictive of PTSD developing in individuals. [10] PTSD usually follows acute stress disorder (ASD) due to them sharing the same symptoms (experiencing a traumatic event, experiencing intense emotional reactions, like an intense feeling of fear, etc). [11] An individual is diagnosed with ASD first, but once the symptoms are prevalent longer than a month, the individual is diagnosed with PTSD. [12] The most common individuals who experience PTSD are those among war, but it is not only veterans who experience this disorder. Individuals who have PTSD tend to have intense feelings and troubling thoughts in regards to their traumatic experience and these occur long after the traumatic experience has happened.

In order to be diagnosed with PTSD, an individual must have had exposure to a traumatic experience or event. According to the American Psychological Association and the DSM-5, to be diagnosed with PTSD, a person must have symptoms lasting for more than one month and it must cause a crucial problem or distress in the individual's daily functions (What Is Posttraumatic Stress Disorder, 2020).

Treatment

Psychotherapies

There are several ways to treat PTSD, including various psychotherapies. [13] Prolonged Exposure therapy (PE) is the most commonly used psychotherapy to treat PTSD, and it is proven a very effective treatment.

Art Therapy

There is also the option of art therapy, this was created by a man called Adrian Hill, in 1942 and is one of the earliest forms of treatment. This treatment is very beneficial to those with an open mind, it involves individuals to speak to a psychologist specializing in art, and the two both either paint, sculpt or any other forms of art.

Medications

Another form of treatment, is treatment through medications; these medications aim to enhance their moments of happiness and reduce their moments of stress and anxiety. [14] Some of these medications include fluoxetine, paroxetine, selective serotonin reuptake inhibitors (SSRIs), benzodiazepines and glucocorticoids. Typically, resulting to medications is a last resort, but unfortunately this type of therapy can be the matter of rehabilitating someone, meaning that the don't have to live with these PTSD symptoms for the remainder of their life which is not a preferred way of life. [15]

Related Research Articles

Neurosis is a term mainly used today by followers of Freudian thinking to describe mental disorders caused by past anxiety, often that has been repressed. In recent history, the term has been used to refer to anxiety-related conditions more generally.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Dialectical behavior therapy</span> Psychotherapy for emotional dysregulation

Dialectical behavior therapy (DBT) is an evidence-based psychotherapy that began with efforts to treat personality disorders and interpersonal conflicts. Evidence suggests that DBT can be useful in treating mood disorders and suicidal ideation as well as for changing behavioral patterns such as self-harm and substance use. DBT evolved into a process in which the therapist and client work with acceptance and change-oriented strategies and ultimately balance and synthesize them—comparable to the philosophical dialectical process of thesis and antithesis, followed by synthesis.

Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences. It must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se. Examples include violence, rape, or a terrorist attack.

Acute stress reaction and acute stress disorder (ASD) is a psychological response to a terrifying, traumatic or surprising experience. Combat stress reaction (CSR) is a similar response to the trauma of war. The reactions may include but are not limited to intrusive or dissociative symptoms, and reactivity symptoms such as avoidance or arousal. It may be exhibited for days or weeks after the traumatic event. If the condition is not correctly addressed, it may develop into post-traumatic stress disorder (PTSD).

Dissociative disorders (DDs) are a range of conditions characterized by significant disruptions or fragmentation "in the normal integration of consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior." Dissociative disorders involve involuntary dissociation as an unconscious defense mechanism, wherein the individual with a dissociative disorder experiences separation in these areas as a means to protect against traumatic stress. Some dissociative disorders are caused by major psychological trauma, though the onset of depersonalization-derealization disorder may be preceded by less severe stress, by the influence of psychoactive substances, or occur without any discernible trigger.

Complex post-traumatic stress disorder is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.

Exposure therapy is a technique in behavior therapy to treat anxiety disorders.

Childhood trauma is often described as serious adverse childhood experiences (ACEs). Children may go through a range of experiences that classify as psychological trauma; these might include neglect, abandonment, sexual abuse, emotional abuse, and physical abuse, witnessing abuse of a sibling or parent, or having a mentally ill parent. These events have profound psychological, physiological, and sociological impacts and can have negative, lasting effects on health and well-being such as unsocial behaviors, attention deficit hyperactivity disorder (ADHD), and sleep disturbances. Similarly, children whose mothers have experienced traumatic or stressful events during pregnancy have an increased risk of mental health disorders and other neurodevelopmental disorders.

Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.

Memory and trauma is the deleterious effects that physical or psychological trauma has on memory.

PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.

Trauma focused cognitive behavioral therapy (TF-CBT) is an evidence-based psychotherapy or counselling that aims at addressing the needs of children and adolescents with post traumatic stress disorder (PTSD) and other difficulties related to traumatic life events. This treatment was developed and proposed by Drs. Anthony Mannarino, Judith Cohen, and Esther Deblinger in 2006. The goal of TF-CBT is to provide psychoeducation to both the child and non-offending caregivers, then help them identify, cope, and re-regulate maladaptive emotions, thoughts, and behaviors. Research has shown TF-CBT to be effective in treating childhood PTSD and with children who have experienced or witnessed traumatic events, including but not limited to physical or sexual victimization, child maltreatment, domestic violence, community violence, accidents, natural disasters, and war. More recently, TF-CBT has been applied to and found effective in treating complex posttraumatic stress disorder.

Trauma-sensitive yoga is yoga as exercise, adapted from 2002 onwards for work with individuals affected by psychological trauma. Its goal is to help trauma survivors to develop a greater sense of mind-body connection, to ease their physiological experiences of trauma, to gain a greater sense of ownership over their bodies, and to augment their overall well-being. However, a 2019 systematic review found that the studies to date were not sufficiently robustly designed to provide strong evidence of yoga's effectiveness as a therapy; it called for further research.

<span class="mw-page-title-main">Post-traumatic stress disorder and substance use disorders</span> Association of PTSD and substance dependencies

Post-traumatic stress disorder (PTSD) can affect about 3.6% of the U.S. population each year, and 6.8% of the U.S. population over a lifetime. 8.4% of people in the U.S. are diagnosed with substance use disorders (SUD). Of those with a diagnosis of PTSD, a co-occurring, or comorbid diagnosis of a SUD is present in 20–35% of that clinical population.

<span class="mw-page-title-main">Trauma and first responders</span> Trauma experienced by first responders

Trauma in first responders refers to the psychological trauma experienced by first responders, such as police officers, firefighters, and paramedics, often as a result of events experienced in their line of work. The nature of a first responder's occupation continuously puts them in harm's way and regularly exposes them to traumatic situations, such as people who have been harmed, injured, or killed.

MDMA-assisted psychotherapy is the use of prescribed doses of MDMA as an adjunct to psychotherapy sessions. Research suggests that MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD), including Complex PTSD, might improve treatment effectiveness. In 2017, a Phase II clinical trial led to "breakthrough therapy" designation by the US Food and Drug Administration (FDA) for potential use as a treatment for PTSD.

Disaster psychiatry is a field of psychiatry which focuses on responding to natural disasters, climate change, school shootings, large accidents, public health emergencies, and their associated community-wide disruptions and mental health implications. All disasters, regardless of exact type, are characterized by disruption: disruption of family and community support structures, threats to personal safety, and an overwhelming of available support resources. Disaster psychiatry is a crucial component of disaster preparedness, aiming to mitigate both immediate and prolonged psychiatric challenges. Its primary objective is to diminish acute symptoms and long-term psychiatric morbidity by minimizing exposure to stressors, offering education to normalize responses to trauma, and identifying individuals vulnerable to future psychiatric illness.

Psychological trauma in adultswho are older, is the overall prevalence and occurrence of trauma symptoms within the older adult population.. This should not be confused with geriatric trauma. Although there is a 90% likelihood of an older adult experiencing a traumatic event, there is a lack of research on trauma in older adult populations. This makes research trends on the complex interaction between traumatic symptom presentation and considerations specifically related to the older adult population difficult to pinpoint. This article reviews the existing literature and briefly introduces various ways, apart from the occurrence of elder abuse, that psychological trauma impacts the older adult population.

Psychedelic treatments for trauma-related disorders are the use of psychedelic substances, either alone or used in conjunction with psychotherapy, to treat trauma-related disorders. Trauma-related disorders, such as post-traumatic stress disorder (PTSD), have a lifetime prevalence of around 8% in the US population. However, even though trauma-related disorders can hinder the everyday life of individuals with them, less than 50% of patients who meet criteria for PTSD diagnosis receive proper treatment. Psychotherapy is an effective treatment for trauma-related disorders. A meta-analysis of treatment outcomes has shown that 67% of patients who completed treatment for PTSD no longer met diagnostic criteria for PTSD. For those seeking evidence-based psychotherapy treatment, it is estimated that 22-24% will drop out of their treatment. In addition to psychotherapy, pharmacotherapy (medication) is an option for treating PTSD; however, research has found that pharmacotherapy is only effective for about 59% of patients. Although both forms of treatment are effective for many patients, high dropout rates of psychotherapy and treatment-resistant forms of PTSD have led to increased research in other possible forms of treatment. One such form is the use of psychedelics.

References

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What Is Posttraumatic Stress Disorder? (2020, August). Retrieved November 15, 2020, from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd [1]

  1. "What Is PTSD?". www.psychiatry.org. Retrieved 2020-11-25.