More research is needed

Post traumatic stress disorder is a serious condition and warrants extensive research. This research provides insights into which people are more or less at risk, and can help identify these factors for early intervention. Many studies show that PTSD is a common affliction among first responders, especially paramedics. There are promising therapies for both detecting and treating those who suffer from PTSD, such as Cognitive Behaviour Therapy. There are also some drugs which can help, such as oxytocin. Experiencing trauma is part of being a paramedic, but hopefully the impact and resultant harm can be reduced.

How to prevent PTSD and reduce the rate

Along with determining who is at a higher/lower risk of developing PTSD and finding the most effective treatment, it is important to identify ways of preventing PTSD and reducing the rate at which paramedics are diagnosed. It has been discovered that daily oxytocin injections posttrauma can be effective in preventing PTSD. According to a 2017 study, “Repeated intranasal oxytocin is a promising early preventive intervention for PTSD for individuals at increased risk for PTSD due to high acute symptom severity.” (Frijling, 2017) Stress hormone targeted pharmacological interventions have also been known to help certain people to prevent them from having PTSD. According to a 2016 study, “Stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors.” (Qi, Gevonden, & Shalev, 2016) CBT is used both to help prevent PTSD, as well as an effective treatment option for it. “CBT is currently the mainstay of early prevention of PTSD.” (Qi et al., 2016) These drug treatments can hopefully be used to help prevent PTSD in the first place.

Determining the most effective treatment for PTSD

In order to improve the quality of life for paramedics who suffer from PTSD, it is important to determine the most effective treatment for PTSD. A study was conducted to determine whether brief exposure (CBT-B) or prolonged exposure (CBT-L) Cognitive Behavioural Therapy was more beneficial. It found that both CBT-L and CBT-B are very effective. According to that study, “CBT, which can include either long or brief imaginal exposure, is efficacious in reducing PTSD in emergency service personnel.” (Bryant et al., 2018) In the same study, when they put some of the patients on a waitlist (WL) instead of giving them treatment right away, they discovered that the waitlist was not as effective. “At post-treatment, participants in WL had smaller reductions in PTSD severity (Clinician Administered PTSD Scale), depression, maladaptive appraisals about oneself and the world, and smaller improvements on psychological and social quality of life than CBT-L and CBT-B.” (Bryant et al., 2018) Research has also been done with cannabinoids, and they are discovering that these may decrease PTSD symptoms. According to a 2016 study, “There is substantial evidence from studies in humans and animal models for a role of the endocannabinoid system in the control of emotional states.” (Zer-Aviv, Segev, & Akirav, 2016) Paramedics with PTSD need access to these forms of treatment.

Who is at risk of developing PTSD?

There are certain types of people who are at a higher or lower risk of developing PTSD than others. Many studies show that people who have a good sense of coherence are less likely to develop PTSD. “It has been suggested that a good sense of coherence (SOC) and high resilience lower the risk for developing PTSD.” (Streb, Häller, & Michael, 2014) As well, it has been discovered that people who have a high resiliency rate are less likely to develop PTSD. According to a 2014 study, “Enhancing resilience, and especially SOC, seems a promising approach to reduce PTSD symptom severity in high risk groups like paramedics.” (Streb, et al., 2014) People with pre-trauma risk factors are at an increased risk of developing PTSD. Studies have shown that “Participants at risk of developing episodes of PTSD or depression could be identified within the first week of paramedic training.” (Wild, et al., 2016) These risk factors should be considered in preventing PTSD.

Exploring PTSD in relation to paramedics

Post traumatic stress disorder (PTSD) is a mental health condition that is caused by experiencing a traumatic event. Some symptoms of PTSD include: re-experiencing the trauma through distressing recollections of the event, flashbacks, and nightmares; emotional numbness; and avoidance of places, people, and activities that are reminders of the trauma. It can also include increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered. PTSD is prevalent among paramedics and should be researched, treated, and prevented as much as possible. The topics that will be focused on in this blog are that some people are at a higher risk of developing PTSD than others, that it is important to determine the most effective treatment for PTSD, and that there are ways of preventing PTSD and reducing the rate.

 References:

 Bryant, R. A., Kenny, L., Rawson, N., Cahill, C., Joscelyne, A., Garber, B., . . . Nickerson, A. (2018). Efficacy of exposure-based cognitive behaviour therapy for post-traumatic stress disorder in emergency service personnel: A randomised clinical trial. Psychological Medicine,1-9. doi:10.1017/s0033291718002234

 Frijling, J. L. (2017). Preventing PTSD with oxytocin: Effects of oxytocin administration on fear neurocircuitry and PTSD symptom development in recently trauma-exposed individuals. European Journal of Psychotraumatology,8(1), 1302652. doi:10.1080/20008198.2017.1302652

 Qi, W., Gevonden, M., & Shalev, A. (2016). Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions. Current Psychiatry Reports,18(2). doi:10.1007/s11920-015-0655-0

 Streb, M., Häller, P., & Michael, T. (2014). PTSD in Paramedics: Resilience and Sense of Coherence. Behavioural and Cognitive Psychotherapy,42(04), 452-463. doi:10.1017/s1352465813000337

 Wild, J., Smith, K. V., Thompson, E., Bear, F., Lommen, M. J., & Ehlers, A. (2016). A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression. Psychological Medicine,2571-2782. Retrieved November 27, 2018.

 Zer-Aviv, T. M., Segev, A., & Akirav, I. (2016). Cannabinoids and post-traumatic stress disorder. Behavioural Pharmacology,27(7), 561-569. doi:10.1097/fbp.0000000000000253