War-related post-traumatic stress disorder: preventing the consequences.
PTSD adversely affects the quality of life and is also associated with significant healthcare costs. This is why it is crucial to address the consequences of traumatic experiences promptly, and if PTSD or other mental health issues do arise, to treat the victims using scientifically validated methods, assert researchers from SWPS University and the University of Warsaw.
Refugees are particularly vulnerable to post-traumatic stress. Three years ago, on February 24, 2022, Russia invaded Ukraine. Millions of people fled their home country to save their lives. Many of those forced to escape experienced military trauma related to violence or direct threats to their lives.
Refugees constitute a group at high risk of developing mental health issues, including post-traumatic stress disorder (PTSD). Despite a number of studies identifying the most effective treatment methods, few receive adequate assistance, particularly in the realm of psychotherapy. Many refugees may have required such support, as research indicates that every war doubles the incidence of PTSD among its victims, who continue to grapple with its consequences long after the war has ended.
PTSD: Recurrent Memories, Flashbacks, and Chronic Arousal
Agnieszka Popiel, Ewa Pragłowska, and Bohdan Zawadzki, authors of the article “(Why?) Evidence-Based Treatments for War-Related Post-Traumatic Stress Disorder,” published in the journal Migration Studies – Review of Polish Diaspora, emphasize that PTSD symptoms are not related to the type of trauma experienced. These symptoms include: recurrent memories, flashbacks of the event (such as bombings or direct threats to life), a state of chronic arousal (which is why PTSD is classified as a stress disorder), outbursts of anger, sleep disturbances, and avoidance of situations that may be associated with the trauma (reluctance to talk about it, avoiding shelters and people who were present in that situation).
All these symptoms negatively impact quality of life and lead to deterioration in functioning across many areas. Unfortunately, PTSD can be difficult to diagnose, as patients often avoid all unpleasant memories and refuse to discuss them — which is why, in many cases, the issue remains undiagnosed.
While for some individuals “time heals wounds” and they regain their mental balance after a few months, the condition of others worsens over time.
If no improvement is observed, it is essential to conduct a professional diagnosis and provide the patient with appropriate evidence-based treatment. This concept is based on the premise that therapeutic decisions should be supported by evidence rather than, for example, relying on intuition or traditional beliefs.
The goal is to provide patients with the most effective assistance based on the current state of scientific knowledge, explains Agnieszka Popiel, PhD, a professor at SWPS University, and head of the Center for Advanced Clinical Research and Best Practices in Therapy at the Institute of Psychology of SWPS University.
What Does Proper Treatment Mean?
Treatment for mental disorders includes pharmacotherapy and/or psychotherapy. The former may be recommended by physicians, including primary care doctors. In more complex cases, a consultation with a psychiatrist may be necessary, who will recommend appropriate therapy for the specific patient. PTSD psychotherapy should be conducted by psychotherapists (psychologists, physicians, or other healthcare professionals) who, in addition to general psychotherapeutic training, are trained in proven and recommended methods for treating PTSD.
The chosen treatment method should be suitable for this type of disorder. Over the past 50 years, numerous studies on psychotherapy methods have been conducted, identifying both the most effective and ineffective or even harmful ones. However, some methods remain completely unexplored. This is why it is crucial for mental health professionals to consider scientific evidence when selecting a treatment approach.
Among the organizations that provide recommendations on this topic are the British National Institute for Health and Care Excellence (NICE), the American Psychological Association, the American Psychiatric Association (APA), and the International Society for Traumatic Stress Studies (ISTSS). These organizations recommend psychotherapy for PTSD treatment, primarily including methods known as trauma-focused cognitive-behavioral therapy. Pharmacotherapy may also be considered if psychotherapy is currently unavailable or impossible due to other factors, such as cultural reasons.
PTSD Also Affects Military Personnel and Medical Workers
The authors of the article also emphasize the need for special attention to the prevention of PTSD among individuals who, due to their profession or service, cannot avoid traumatic events. Despite the obvious assertion that “prevention is better than cure,” there is relatively little research on the effectiveness of PTSD prevention measures. One of the few sources of data on the effectiveness of such initiatives is the Polish PTSD prevention program for individuals at risk of occupational trauma, “Effective Work Under Stress.”
Untreated post-traumatic disorders affecting millions of people can have negative impacts on both individuals and society as a whole, and resources for assistance will always be limited. This is why the authors of the article emphasize the necessity of careful planning in the post-war period to enable victims of conflict to return to life before the trauma.
Adhering to recommendations and selecting evidence-based treatment methods allows for the assessment of timelines and risks associated with any psychological and medical intervention.