PTSD in American Youth

PTSD in American Youth Problem Statement PTSD is a mental health condition that occurs due to exposure to a traumatic event.

Events that may cause PTSD are accidents, combat, human-caused or natural disasters, and violent personal attacks (National Institute of Mental Health, 2020). The majority of research about PTSD revolves around veterans and older adults. However, young adults (18-29) are an essential group in addressing PTSD because this group also suffers from the psychological traumas of traumatic events. American adults acknowledge that they have undergone trauma before their 16th birthdays.

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The most common forms of traumatic experiences are refugee trauma, bullying, terrorism, accidents, and child maltreatment (Gerson & Rappaport, 2012). The paper provides an analysis of PTSD among American youth and suitable interventions to combat the issue.

PTSD in the USA Approximately 3.6% of American adults experience PTSD annually. Female adults record higher rates of PTSD compared to their male counterparts, i.e., 5.2% versus 1.8%. The statistics for PTSD across various age-groups are 13-18 (5.0%), 19-29 (4.0%), 30-44 (3.5%), 4559 (5.3%), and 60+ (1%) (National Institute of Mental Health, 2020). PTSD comes in various severities and has adverse impacts on a person’s health. In the past year, 36.6%, 33.1%, and 30.2% of adults with PTSD had serious, moderate, and mild impairment, respectively (National Institute of Mental Health, 2020). The statistics show that American youth are at high risk of PTSD as they represent the second- and third-highest age group affected by the condition (13-18 at 5% and 19-29 at 4%) after people aged 45-59. Therefore, there should be suitable interventions for the disease to protect the future of the country.

Literature Review High violence rates among American youth explains the high rates of PTSD in the population. Every year, the US government makes 2.11 million youth arrests. The number accounts for 16% of all violent crimes and 26% of property crime arrests (Abram, Teplin, King, & Longworth, 2013). The American society promotes youth violence through pop culture (gangrelated music); such messages normalize violent activities. The victims of violent acts may not recover from the psychological trauma and develop PTSD.

Also, some groups of American youth are at a higher risk of getting PTSD than their peers. Individuals involved with the juvenile justice system. Studies in the North-western Juvenile Project indicate that 92.5% of the youth in the institution experienced at least one form of trauma, 84% experienced more than one form, and 56.8% experienced trauma at least six times (Abram et al., 2013). The most common form of violence in the institution is witnessing violence. 1 in every 10 detainees had PTSD a year before the interview, and 93% of the participants suffered at least one comorbid mental health disorder (Abram et al., 2013).

Apart from this, youth from low socio-economic backgrounds are at higher risk of developing PTSD compared to their peers. Families that raise children in urban, low-income neighborhoods are exposed to several on-going traumas that increase the possibilities of poor health consequences. Meagre resources and crowded conditions expose children and youth to trauma (Family-Informed Trauma Treatment Center, 2010). Limited resources in poor neighborhoods lead to high crime rates, which exposes members of the community to violence and drug abuse.

Interventions to Combat PTSD Stakeholders have implemented several strategies to reduce PTSD among American youth. Trauma-Focused Cognitive Behavioral Therapy reduces PTSD symptoms among adolescents and children. The intervention covers two aspects: the caregiver’s role and developing the individual’s coping and emotion regulation capabilities (Arellano, Lyman, & Delphin-Rittmon, 2014). The first aspect involves analyzing the emotional reaction of the adolescent’s parents or caregiver. Treatment providers use cognitive-restructuring and exposure principles to treat the affected people (Arellano et al., 2014). Exposure entails gradually introducing the patient to tangible reminders of the trauma, e.g., people, places, or memories to

reduce the distress linked to these reminders. Cognitive structuring involves abandoning negative beliefs and thoughts (self-blame) and formulating more adaptive methods of reacting to trauma (Arellano et al., 2014).

Additionally, the Reauthorization of the Juvenile Justice Delinquency Prevention Act requires states that get federal funding to develop programs that target female offenders.

According to the act, states must provide trauma-informed services and health services that concentrate on individual empowerment (Ford, Chapman, Connor, & Cruise, 2014). Violence in juvenile detention facilities increases the risk of developing PTSD. Some of the detainees also have PTSD due to traumatic experiences before juvenile detention. The act helps fight PTSD since it addresses the different psychiatric needs of female and male juvenile detainees.

Concentrating on gender differences in PTSD treatment is important because women are more likely to suffer from PTSD than men.

Research Gap The initiative above helps reduce PTSD among the youth. However, they do not address the causes of youth violence and the social class disparities in PTSD among American youth.

The research paper will investigate the role of pop culture in encouraging violence and how to prevent negative peer pressure. The report will also address the racial disparities in PTSD prevalence among the youth and suggest methods of helping the marginalized ethnicities/communities.

Research Objective The objective of the research is to reduce PTSD occurrence through violence-prevention initiatives and to lower PTSD levels in poor communities. Violence is among the most

significant causes of PTSD. Hence, getting to the root of the problems helps in minimizing its adverse effects on the youth. Individuals in low-income neighborhoods experience more traumas and have limited healthcare facilities to address the PTSD that comes from traumatic events.

Hypothesis Adolescents with a diagnosis of PTSD who receive standard CBT, are more likely than those who receive IPT to have lower levels of anxiety.

Independent variable = Treatment (CBT and IPT) Dependent Variable = Level of anxiety Specific Research Questions Gender, Family support, and Ethnicity 1. Is there a statistically significant difference between males and females with respect to the level of anxiety?

2.

Is there a statistically significant relationship between the level of family support and the level of anxiety?

3.

Does the level of anxiety vary by ethnicity?

Theoretical Framework Cognitive-behavioral therapy (CBT) is a practical talk therapy where a mental health

client works with a therapist or psychotherapist in a structured approach. The mental health client attends a limited number of sessions to evaluate the inaccurate and negative thoughts to manage the challenging psychological problem (David, Cristea & Hofmann, 2018). CBT effectively manages mental health cases like post-traumatic stress disorder (PTSD), depression, and eating disorder. CBT is a more preferred treatment approach in managing anxiety than other treatment methods like interpersonal psychotherapy (IPT). IPT focuses on evidence-based

approach strategies that are time-limited in managing anxiety mental disorders (Lemmens et al., 2017). However, the nature of anxiety in clients with mental disorders is affected by other secondary factors like gender, family support, and anxiety.

The effect of gender differences in anxiety among PTSD patients is a factor that determines the most effective treatment approach. Studies have revealed that biological sex and culture gender have a key impact on PTSD severity among clients. According to the National Comorbidity Survey (NCS), there is a close association between sex and ethnicity on the prevalence of anxiety among mental health patients (Rapp, Lau & Chavira, 2017). The sex differences between the male and female gender that affect anxiety include both the beginning of puberty and menopause, gender role identification, and gonadal hormones. Therefore, there is a statistical difference between the level of anxiety portrayed by male and female individuals managing PTSD. Relationship and family status also have a key impact on the level of anxiety among PTSD clients. The family is considered as the basic unit in society. An individual's family gives them a sense of belonging and allows an individual to establish their initial relationships with other family members. The type of relationship that a PTSD patient establishes with their family members determines the type and level of support the client receives (Cox, Bakker & Naifeh, 2017). Family support can be portrayed in several ways, including offering financial aid, which is significant in managing mental health illnesses. Family support can also be incorporated by creating a conducive environment for the client. A stress-free environment reduces the patient's level of anxiety. Lastly, a family can also support a PTSD patient with the practical management of their condition. Family support, therefore, plays a vital role in the management of anxiety among patients with PTSD.

Lastly, ethnic differences are also a critical factor in the management of anxiety among PTSD clients. The current generation is characterized by high cultural diversity. Cultural diversity has influenced the existence of marginalized communities. Marginalized communities are often exposed to acts of discrimination and prejudice by other members of society. The levels of anxiety among the marginalized PTSD clients are thus considered high compared to the level of anxiety among the other community members (Conradt, Carter, & Crowell, 2020). Cultural differences also expose individuals to different beliefs and practices, which could affect the level of anxiety among clients with PTSD. The differences in cultural attributes, therefore, have a significant impact on the level of anxiety among clients who are managing post-traumatic stress disorder.

Study Rationale The research study results will play a significant role in determining the different aspects of cognitive-behavioral therapy. The aspects of CBT play a critical function in treating and managing depression among the marginalized groups of individuals in society. The primary subgroup of individuals who are likely to benefit from the research study includes the minority communities in the United States of America and the female gender representation. The marginalized female individuals, therefore, comprise the primary target group in the research study. Therefore, the research study clarifies which category of individuals should be targeted in the management of PTSD and anxiety. Identifying the challenges that different categories of clients face allows the healthcare sector to establish effective management strategies for different patients with PTSD. Reduced cost for client care among marginalized communities is a practical strategy that can be used to improve anxiety among mental health patients. Public health information is also

effective in educating society members on how to manage clients with post-traumatic stress disorder. Community members can be educated on how they can provide the clients with a favorable environment to reduce stress and anxiety levels. The interventions provided above will be beneficial to every citizen in the United States who is managing PTSD.

References Abram, K. M., Teplin, L. A., King, D. C., & Longworth, S. L. (2013). PTSD, trauma, and comorbid psychiatric disorders. Juvenile Justice Bulletin. Retrieved from https://ojjdp.ojp.gov/sites/g/files/xyckuh176/files/pubs/239603.pdf Arellano, M. A., Lyman, R., & Delphin-Rittmon, M. E. (2014). Trauma-Focused Cognitive Behavioral Therapy: Assessing the Evidence. Psychiatric Services, 65(5), 591602.

Conradt, E., Carter, S. E., & Crowell, S. E. (2020). Biological Embedding of Chronic Stress Across Two Generations Within Marginalized Communities. Child Development Perspectives.

Cox, D. W., Bakker, A. M., & Naifeh, J. A. (2017). Emotion dysregulation and social support in PTSD and depression: A study of trauma‐exposed veterans. Journal of Traumatic Stress, 30(5), 545-549.

David, D., Cristea, I., & Hofmann, S. G. (2018). Why cognitive behavioral therapy is the current gold standard of psychotherapy. Frontiers in psychiatry, 9, 4.

Family-Informed Trauma Treatment Center. (2010). Understanding the impact of trauma and urban poverty on family systems: Risks, resilience and interventions. Retrieved from https://www.nctsn.org/sites/default/files/resources/resource-guide/ understanding_impact_trauma_urban_poverty_family_systems.pdf Ford, J. D., Chapman, J., Connor, D. F., & Cruise, K. R. (2014). Complex trauma and aggression in secure juvenile justice settings. Criminal Justice and Behavior, 695-722.

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Gerson, R., & Rappaport, N. (2012). Traumatic Stress and Posttraumatic Stress Disorder in youth: Recent research findings on clinical impact, assessment, and treatment. Journal of Adolescent Health.

Lemmens, L. H., Galindo-Garre, F., Arntz, A., Peeters, F., Hollon, S. D., DeRubeis, R. J., & Huibers, M. J. (2017). Exploring mechanisms of change in cognitive therapy and interpersonal psychotherapy for adult depression. Behaviour Research and Therapy, 94, 81-92.

National Institute of Mental Health. (2020). Post-Traumatic Stress Disorder (PTSD).

Retrieved from nimh.nih.gov: https://www.nimh.nih.gov/health/statistics/post-traumaticstress-disorder-ptsd.shtml Rapp, A. M., Lau, A., & Chavira, D. A. (2017). Differential associations between social anxiety disorder, family cohesion, and suicidality across racial/ethnic groups: Findings from the National Comorbidity Survey-Adolescent (NCS-A). Journal of anxiety disorders, 48, 1321.