Posttraumatic stress disorder. Thus, individuals with PTSD have

Posttraumatic
Stress Disorder, commonly known as (PTSD) is diagnosed when individuals have
experienced a traumatic event that either have negative changes to their
thoughts and mood, avoid stimuli’s that are related to the event and have
re-experiences the traumatic event. These factors must occur for as long as a
month post trauma. Some people that are diagnosed with posttraumatic stress
disorder may have the subtype such as disorientation; this includes a distorted
sense of reality of their surroundings. According to the DSM-5 by Rosenburg and
Kossleyn (2014) that PTSD is not attributable to the physiological effects of
substance or another medical condition.’ Posttraumatic Stress disorder can be
affected by neurological factors e.g. neurotransmitters as well as nervous
system reactions. Psychological factors also play a role into why individuals
develop PTSD this is because individuals have two specific beliefs that the
world is a dangerous place and that they’re not good at controlling stress. In
addition, social factors also play a part as to why people develop PTSD;
socioeconomic factors, social support and culture are all social factors that
can develop Posttraumatic Stress Disorder.

The first
factor that causes PTSD is the neurological factors; in the brain people who
have PTSD have an abnormal functioning of the hippocampus as well as an exposed
sympathetic nervous system. Orr et al (1993) found evidence to support that
people with PTSD have sympathetic nervous systems. “They assessed the heart
rate, skin conductance, and left lateral frontalis electromyographic responses
of World War II (WWII) and Korean War male veterans to recollection of their
combat experiences by using a script-driven imagery technique previously
validated in Vietnam veterans.” They found that those with PTSD have strong
associated cues with their trauma; such as sweating or increased heart rate. In
addition, that skin conductors were the clearest method of distinction when
measuring the trauma of those with posttraumatic stress disorder and those
without posttraumatic stress disorder. Thus, individuals with PTSD have a
stronger reaction to relevant cues than people without PTSD. It has also been
found that individuals with PTSD have to use more of their hippocampus and it
must work harder in order for it to remember information than individuals
without this disorder (Shin et al., 2004). They explored the blood flow in the
hippocampus of 16 firefighters, 8 with PTSD and 8 without, the firefighters
with PTSD had significant lower volumes in the hippocampus than those without
PTSD. Demonstrating individuals with PTSD have to use more of their hippocampus
and it needs to work harder when recalling information. In addition, McNally et
al (1995) found that individuals with PTSD found it hard to recall
autobiographical memories, suggested that an impaired hippocampus does impair
peoples’ memory and ability to recall information. From this we can understand
that the hippocampus is a critical part in the brain that enables our recall of
information (Squire and Kandel, 2000). 
The impaired hippocampus can help explain why one student developed
PTSD, but the other didn’t as the individual who suffers from PTSD might have had
to use a larger volume of their hippocampus when recalling memories than the
other, in everyday activities and their normal life before the traumatic
incident the friend could have had an impaired hippocampus, so it made the friend
have a higher risk of developing Posttraumatic stress disorder than the other
without the impaired hippocampus.

Neurotransmitters
are also present with individuals who suffer with Posttraumatic Stress
Disorder, the most common neurotransmitters associated with PTSD are
norepinephrine and serotonin. Research by Southwick et al (1993) found that
responses differed from patients with PTSD than those without. He gave
participants a drug that rises the levels of norepinephrine in the body when
the drug became effective he found that individuals with PTSD, 70% had a panic
attack while 40% had flashbacks of their traumatic event. Those without PTSD
had small effects when the drug became effective in the body. Implying that
norepinephrine does affect the cardiovascular system for those who suffer from
PTSD. Similarly, research has found that serotonin is a factor that effects
patients with PTSD. Adamec et al (2008) found that individuals who have genetic
alleles are at a higher risk of developing PTSD after a traumatic event. Grabe
et al (2009) further supports this and found that there was a gene-environment
interaction with an L allele which lead to frequent trauma in PTSD, more than
60% of carriers of the L allele are exposed to three or more traumas which
developed in PTSD as a ‘result of an interaction between genotype and
exposure.’ One friend may have also developed Posttraumatic stress disorder
while the other didn’t after the shooting as the friend could be a carrier of L
alleles of serotonin which means that he has a higher risk of developing PTSD
as Grabe et al (2009) found that L alleles are exposed to three or more traumas
that later develop into Posttraumatic Stress Disorder.

Psychological
Factors also lead an individual to develop Posttraumatic stress disorder as
individuals who have psychological factors that occur before a traumatic event
happens it will increase the chances of that individual developing PTSD. There
are two specific beliefs that increase the vulnerability of someone developing
PTSD: first, believing your unable to control stress (Heinrichs et al., 2005)
and second, the belief that the world you live in is a dangerous place (Keane,
Zimering, & Caddell 1985). They studied Vietnam veterans and concluded a
two-factor theory with individuals with PTSD. When people are exposed to a life-threatening
experience, just as Pavlov’s study with fear, we can become conditioned to
stimuli’s sounds and smells. Suffers of PTSD tend to believe we live in a dangerous
world is because they have conditioned certain sounds, smells and stimuli to
that life threating experience that they encountered. There are many other
reasons why people are vulnerable to develop PTSD. For example, individuals who
use dissociate as a coping mechanism after a traumatic event. Shalev et al (1996)
examined patients that were admitted to hospital and were screened for any
physical injuries after a traumatic event. They found that individuals who were
likely to be diagnosed with PTSD had higher levels of peritraumatic dissociation
and severe depression and anxiety. After 6 months it was found that peritraumatic
dissociation was the main factor above all the others that suffers of Posttraumatic
stress disorder had. This psychological factor can help explain why one friend
developed PTSD and the second one didn’t because they had different coping
mechanisms. The friend that developed PTSD after the school shooting most
possible have used disassociating to cope and deal with the trauma whereas the
friend who didn’t develop PTSD after the school shooting could have used a different
coping strategy such as speaking to family and friends about the incident or
revisiting the same place where the shooting happened.

Furthermore,
other psychological factors that can develop PTSD are already having an anxiety
disorder. Copeland et al (2007) supported claim and suggested that because most
anxiety disorders involve hypervigilance this can lead to individuals react to traumatic
events negatively and ways that increase a stress disorder. They also found by conducting
a longitudinal study where they studied 1420 children ages 9, 11 and 13 that
children who experienced childhood traumas were more likely to develop Posttraumatic
stress (PTS) symptoms. Children that experienced violent or sexual trauma had
the strongest correlation for developing the highest number of symptoms for PTS.
The friend could have developed PTSD because he could have experienced childhood
trauma which meant that he could have developed PTS symptoms and when he got
older and witnessed the school shooting it reinforced those symptoms and made
him develop PTSD. Classical and operant conditioning can explain how to avoid
PTSD attacks. Classical conditioning is explained by a traumatic event occurring
leading the traumatic stress is the unconditioned stimulus and the persons
feeling the conditioned stimuli which can then produce strong, aversive conditioned
emotional responses (Keane, Zimering, & Caddell, 1985). Therefore, when the
individuals experience a similar situation to the traumatic one it induces aversive
reactions which lead that individual to avoid the situation. To explain operant
conditioning Jacobsen et al (2001) found that people who have PTSD have a higher
number of substance use disorder than those who experienced a trauma but didn’t
develop PTSD. Thus, to avoid PTSD attacks you need to use negative reinforcement
for example alcohol and drugs.

The last
factor that has an involvement with individuals developing PTSD are social
factors. The social factors before and after a traumatic event can help us
determine whether or not individuals will develop PTSD. In addition, socioeconomic
factors can affect an individual’s ability to cope with stressors.Individuals
with financial difficulties that have a concern of whether they can feed and
house themselves or their family, find it more challenging to cope with a
traumatic event than those with financial stability or financial fortune. Mezey
and Robbins (2001) found that when the less privileged face challenges it could
reduce emotional resources that are needed to cope with stress and traumatic events
which increase the risk of PTSD. This can be another explanation as to why one friend
developed PTSD and the other didn’t. The friend who developed PTSD could be
from a less privileged background to his friend where he is hardly eating at home
due of his family’s financial difficulties, therefore find it more difficult to
deal with traumatic events as he doesn’t have strong enough emotional resources
to help him cope with the school shooting. Moreover, people who are deprived
socioeconomically are more prone to experience trauma (Himle et al., 2009).
Norris et al (2003) found that people who are from a disadvantaged socioeconomically
background are more likely to witness crimes or become a victim, as in more
deprived areas there is a higher crime percentage than rich areas. Furthermore,
when individuals receive social support after a trauma have a lower risk of
developing PTSD (Kaniasty & Norris 1992). This is supported by Jakupcak et
al (2006) who found that military servicemen and women who had a strong social
support when returning home after experiencing a trauma while they were at service
were less likely to develop PTSD. Social support can also explain why one
friend developed PTSD and the other didn’t. The friend who developed PTSD could
be because after the incident he didn’t have a large social support system, so
he could have felt isolated and no one wanted to speak to him or support him
after the shooting. Finally, culture can determine whether someone develops
PTSD or not; their surroundings can help understand which PTS symptoms are more
dominant. Cultural styles allow teaching of coping mechanisms to what work and
what doesn’t work. Perilla et al (2002) examined 404 residents 6 months after hurricane
Andrew and found that “ethnic groups differed strongly in the prevalence of
posttraumatic stress disorder”; Caucasian victims showed the lowest rate of 15%
and Latino victims showed the highest rate of 38%. Implying that different
cultures have different coping mechanisms to trauma as there is a difference in
behaviour of ethnic groups.

Neurological
factors, psychological factors and social factors can all explain why one friend
developed PTSD and the other did not. As demonstrated through research a neurological
reason for the one who developed PTSD was that he has an L allele gene that contain
serotonin which increases the chances of developing PTSD. The psychological
explanation could be that he already experienced a traumatic event from young
and then experienced the school shooting, or after the school shooting he coped
with this trauma by dissociating. The social explanation is that the friends
are from different socioeconomically backgrounds, the one who developed PTSD could
be from a poorer less fortunate family. In addition, after the incident of the school
shooting he could not have had the correct social support system around him to
help him deal with that trauma and that his culture was different to his
friends. Having a different culture means that each culture has different copying
mechanisms and his friend could be from a culture that has stronger coping
mechanisms to deal with traumatic events than his own culture.