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PTSD Causes and Triggers
By Sanjay Adhia, M.D.Victims of sexual assault are at high risk for PTSD.
Other triggers are a credible threat they will be killed if they do not comply.
Serious trauma can result in PTSD in men and women.
What Experiences and Traumas Can Cause PTSD?
This discussion, and case study, focus on women who have been trafficked and develop PTSD. It arises out of my work with Physicians for Human Rights Asylum Network.
I have many times encountered PTSD in examinees outside of the human rights work I do, in my work as an expert witness. The circumstances vary widely. PTSD may or may not be present. That does not mean other Disorders are not present. For example, an Anxiety Disorder or Major Depressive Disorder and their symptoms are serious and can be severe, but do not necessarily accompany PTSD.
Men and Women Can Develop PTSD After Traumas
Women are twice as likely to develop PTSD as men. But both women and men can experience trauma, including sexual assault, that results in PTSD. The DSM5TR describes traumas associated with PTSD and they are not gender specific. For example observing a death of a loved one (e.g. in a car accident,) or repeated exposure to death and dismemberment (e.g., in combat.) Other high-risk groups are first responders like firefighters, and police officers. These are primarily male-dominated professions but both men and women first responders are at risk for PTSD.
Why Focus on Trafficked Women?
The extreme experiences of trafficked people are the focus of this PTSD discussion and a case example because of the degree of trauma and ability to describe the symptoms that flag a PTSD diagnosis.
Horrific Experiences
Women are the primary targets of kidnapping for the purpose of human trafficking. Rape, isolation from support, fear of death, loss of freedom not surprisingly can trigger Post-Traumatic Stress Disorder and associated anxiety and depression disorders, including severe and chronic conditions.
Case Study: Symptoms of PTSD, Symptoms of Other Mental Conditions Co-Occurring with PTSD.
A woman who was such a victim, once freed, developed PTSD and a range of behaviors associated with severe and disabling anxiety as a result of her horrific experience. She was unable to leave her house and was constantly fearful. As a result of the actions of others, she has become psychiatrically disabled and the degree to which she can recover was unknown.
Such experiences can leave a permanent emotional mark.
If litigated, a forensic assessment of emotional distress damages has to take into account the prognosis for recovery.
There are treatments for PTSD, but success is difficult to predict and may require a course of treatment and then adjustment to the results.
Psychiatrists have more treatment options to offer for anxiety and depression, even when it is severe and chronic, meaning ongoing and requiring long-term treatment.
Those with PTSD may also be at greater risk for suicide, or drug and alcohol abuse as a perceived “coping” mechanism. A psychiatrist’s treatment may require a complex series of medications and therapy for symptoms of more than one condition, including but not limited to PTSD.
Note that when retained as an expert witness, in no event does Dr. Adhia provide treatment to any party to the action and has no physician/patient relationship.
In Texas, where he is based, Dr. Adhia finds a disproportionate number of these cases are associated with immigrants who give up security and trust to find asylum in the United States.
Background
Dr. Adhia is a physician. he volunteers his forensic services to Physicians for Human Rights Asylum Network. Because of the overlap of psychiatric and medical conditions, he applies his experience and training as a Forensic Psychiatrist. Cases may end up in Immigration Court and require an unbiased and objective assessment.
He has also testified in cases about rape in other circumstances and scenarios, for plaintiff and defense, as well as allegations of assault in a military setting.
