Recorded PTSD symptoms can be traced back as far as World War I. These symptoms are common in combat veterans, but not much has changed to aid those troops suffering from common symptoms. Traumatic brain injuries are common for soldiers surviving such intensities of combat and can result in many disabilities including physical, cognitive, psychological, psychosocial impairments and functional.
(Anderson, 2008). The term ‘shell-shock’ was introduced in the late 1914’s by a British psychiatrist named Charles Myers. Though this was introduced, it was not until 1980 when the American Psychiatric Association developed the criteria for Post-Traumatic Stress Disorder (PTSD). (Anderson, 2008). Constant conflict over the last twenty-eight years has led troops to constant combat battles. Along with memory loss, those soldiers diagnosed with PTSD has increased. Another option needs to be approached to help these soldiers. Neuroimaging used by researchers can help to identify some of the areas anatomically in which the brain is impacted by PTSD.
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Continuing stress disorders can play a role in the size of the hippocampus and the decrease of it. Some showed signs of an abridged amygdala as well, which gives soldiers difficulties with identifying correctly negative and positive emotional responses. (Van Stegeren, 2009).
In our daily lives, memory is a big part which allows to remember past events/memories, remember the skills that we have acquired over time and helps with bodily functions. Implicit memory is something that a person needs but may not think about. This is used when we learn something that we usually do not think about, like our balance for standing or even walking, or the way we construct words as we read. (Sternberg ; Sternberg, 2016). Explicit memory is also a part of our lives as this allows for the recall of a specific memory (Sternberg ; Sternberg, 2016). Explicit memory can allow a person to function throughout the day and to remember where they may have left an important item. For the cause of memory recall issues, Bedard-Gilligan and Zoellner (2012), established the theories of dissociation and memory fragmentation in PTSD. The result of not fulling processing or being aware of what happened before, during or immediately after an event, especially a traumatic one, would be dissociation.
(Bedard-Gilligan ; Zoellner, 2012). A combination of dissociation and emotional instability around the time of an event is what is thought to cause memory fragmentation. (Bedard-Gilligan ; Zoellner, 2012). For the cause of memory loss, the theory of memory repression is being researched more.
This theory was developed by Freud on the idea that events can be too frightening or painful. As a result, information can be locked away in an unconscious mind through the process of repression. (Funder, 2016). Evidence by Axmacher, Do Lam, Kessler, and Fell (2010) showed that when stimulated simultaneously, the amygdala and hippocampus allowed for memory recall. Every day, those veterans diagnosed with PTSD and memory issues struggle with their daily life. This makes the issue more challenging than initially known. Cognitive Behavioral Therapy or CBT is researched based evidence that focuses on trauma and is effective in treating combat veterans.
Foa, Keane, Friedman ; Cohan (2009) suggest that mental health practitioners use CBT as a first course of therapy. It is problematic for traumatic events to become discussed, especially if a veteran has an issue with the recall. A great tool for this is neuroimaging and the cost would not become an issue because the VA is indebted to treat veterans, especially those which are disabled, at no cost. Since many veterans cannot be tested with an MRI due to many things like pacemakers and other devices (Dill, 2009), this makes neuroimaging more appealing. Though cognitive exercises or therapy can be helpful, if the damage to the brain is structural, there may be a little amount that cognitive exercise or therapy can do.
Stegeren (2009) suggests that a combination of neuroimaging and a drug such as Noradrenaline, could encourage regrowth of the amygdala and the hippocampal regions and could impact memory recall positively. Stimulating both the amygdala and the hippocampus while conducting neuroimaging can aid a veteran in CBT. The question would be: how can mental health therapy include neuroimaging and pharmacological therapy for veterans suffering from memory loss and PTSD? The theory of dissociation was the first theory addressed. In a very basic manner, this theory can make a lot of sense. For a real possibility of memory recall, one must have the capacity to form a memory before, during and after (usually immediately) the trauma has occurred.
(Bedard-Gilligan ; Zoellner, 2012). Though a basic concept, this can mesh well with veterans suffering from PTSD. In extreme cases, not only does a soldier forget about the events or the trauma, but also names of friends or family. (DePrince, Chu ; Visvanathan, 2006). Short-term memory is impacted in many of these cases. The mentioned second theory, memory fragmentation, can be compared to the theory of dissociation.
In thinking, this theory can be clearer but still does not lead to the explanation of memory loss. (DePrince, Chu ; Visvanathan, 2006). An extreme emotional response could be what this is resulting from, but any evidence of this is not proven. Memory repression theory is a very popular theory for memory loss in veterans with PTSD. Sigmund Freud initially developed this theory and believed that to protect itself, the mind places certain disturbing memories in the unconscious for safekeeping. (Funder, 2016). Overall this would be the most logical, as it connects to the possibility of going through something traumatic and later not remembering the occurrence.
Veterans with PTSD can have difficulty remembering certain facts or even parts of what they experienced. (DePrince, Chu ; Visvanathan, 2006). The mind is attempting to protect the soldier from the horrors they may be experiencing. To identify incorporating neuroimaging and pharmacological therapies, this theory offers a good outlet. This can give the best way to see memory loss and recall and can prove that memories can be hidden in an unconscious.
Sadly, some veterans and soldiers suffer from PTSD without being diagnosed. Suffering can be for many reasons; pride, fear of what they are suffering from or unwillingness to accept a diagnosis. For not seeking treatment, the list is limitless, but the treatment for this disorder is not. To say a soldier is suffering from PTSD is not an easy task. Discussing what has happened to the veteran is not an easy task as well but can allow for strides.
Copper et. al. (2015) conducted an experimental study on the cognitive impairment of the memory of Gulf War veterans. These veterans also suffered from PTSD and Gulf War illness. Episodic memory issues were also investigated by having the veterans identifying along with fMRI. Structural abnormalities were shown in the imaging, especially in the basal ganglia and the hippocampus. The severity of the memory loss and structural abnormalities correlated with the PTSD diagnosis. In comparison to Gulf war veterans who were not diagnosed with PTSD, those veterans who were diagnosed with PTSD showed a significance in low recall memory.
The participant information and statistical data make this study strong. One group of veterans were subjected to neurotoxins, so this sets a limitation for this study because impairments could be a result of chemicals and not PTSD. Determination of which veterans were subjected to neurotoxins would expand this study. Studying these patients separately would become ideal to help with whether the neurotoxins impacted cognitive functions, especially impacting memory loss. To identify areas of the brain that would be impacted, neuroimaging would have to continue.
To conclude if memory loss improves and to treat PTSD symptoms by medication, the effects would have to be continued to be studied. This could help with determining if neural plasticity is evident. Cwik et. al. created a review of nineteen studies, this meta-analysis article is reviewed studies completed on 274 patients diagnosed with PTSD. Identification of the area of the brain impacted during intrusive reexperiencing of traumatic events was the goal of researchers involved. Researchers also wished to identify cognitive impairments which are accessed by traumatic stimuli.
A significance in hyperactivation of the anterior cingulate gyrus and the bilateral amygdala was shown (p