I need an abstract 300 words
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Research Proposal
BSHS/435
October 31, 2016
Proposed data analyses VETERENS PTSD
Research Proposal
Abstract
Introduction and Literature Review:
SSRI is an effective treatment for veterans that suffer from combat that have been diagnosed with PTSD. SSRI is not a one size fit all drug. Oftentimes when the correct medication is prescribed the SSRI has the ability to improve and individual’s mood and behavior. I have experienced clients that complain that taking SSRIs change them into people they are not. Other complaints were that they were tired and unable to do normal activities, however for the most part SSRIs are used to eliminate negative feelings and unveiling the true self. The side effects that come along with taking these medications may defeat the purpose if they are not taken properly and can sometimes do more harm than good. Zoloft, Paxil and Lexapro are most commonly used to treat PTSD although there are others. Patients should report to the prescribing physician if they are taking any other medications, especially to avoid adverse reactions. The effects of combining SSRI and certain medication are dangerous when these interactions occur. Psychotherapy sessions also called “Self-Talk” and medication monitoring are important components to taking these medications.
Exposure Therapy helps to allow the individual to safely address the fear. Virtual reality is a therapy that is used to help the client to re-visit the trauma. “The military has used Prolonged Exposure therapy for years to have the individual talk through the traumatic event over and over until the event is no longer activating.” (Cite required) Cognitive behavior therapy helps the patient to work towards changing the way they think after a traumatic events or episode. The ultimate goal is to identify thoughts that contribute to the events of PTSD.’
According to a recent article, The U.S. Food and Drug Administration (Cite required) has put out an advisory on the side effects of antidepressants because of the risk of suicide it can cause. With SSRIs, they are typically used when treating symptoms of PTSD. Some studies have shown that they work best when compared with a placebo, for non-combat related PTSD. There are more symptoms that SSSRIs can help with over other medicines. In one study, they targeted twelve male veterans who were suffering with PTSD to try a placebo study. Out of six participants, two of them responded (33%) to the usage of a placebo.
Special medications for the soldiers dealing with PTSD, we must understand that soldiers just did not start in the era of the new aged soldier. PTSD was referred in previous war time situations as being called Shell Shocked because they were seen as a reaction to the explosion of artillery shells. Symptoms included panic and sleep problems, among others. Shell shock was first thought to be the result of hidden damage to the brain caused by the impact of the big guns. PTSD is no longer an anxiety disorder, because it is sometimes associated with other mood states of depression. Dealing with military personnel and the treatment for this disorder there must be a checklist which shows temporal stability, internal consistency and validity and sensitivity to change in their environment. There must be caution when using the studies of PTSD and the medications involved due to differences from other disorders for their treatment for specific individuals. Research for PTSD should extend to the areas from previous post wars, the after effects of individuals, and the statistics that may include suicidal rates with the primary limitation of this review is the variability in available data. Understanding the problem and the effects on the individual’s health, relationships, and functioning within their environment comes with treatment classes and medications. Understanding the effects of SSRI medications on Veterans suffering from Post-Traumatic Stress Disorder allows for proper treatment and diagnosis. (Statement of the Research Question)
Methodology:
The research was made of the studies in ethnic groups as well as veterans from the ages 18 to 65 or older. The ethnic groups consisted of 2.6% Hispanic, 0.2%American Indian, 6.7% African American .2% Asian, 26% White American. Comparisons of suicide rates within subjects before and after SSRI treatment were conducted using McNemar’s test, is a statistical test used on paired nominal data, created by Quinn McNemar, who was a professor of the Psychology and Statistics Department at Stanford University in 1947. These diagnostic codes and entrance criteria were selected to define a reasonably same group population of patients who were experiencing a new depressive episode.
During the research, it showed that individuals using antidepressants were less likely to commit suicide compared to those who did not use antidepressants. Results show that antidepressants decrease the risk of suicide attempt in depressed patients. Comparisons of suicide risks of different antidepressant agents are difficult to conduct given the enormous sample sizes required. The differences observed in findings suggest continued caution when using observational data to assess suicide risks associated with antidepressant agents.
(Recruitment and Informed Consent Process)
The study examines the relationship between using antidepressants in treatment and the number of suicide attempts in patients by analyzing data of more than 220,000 veteran patients. The patients should have been diagnosed with depression between 2003 and 2004, had no history of depression there before and had at least more than fifteen months of follow-up after the diagnosis (Gibbons et al., 2007). This study was taken to analyze the viability of U.S Food and Drug Administration advisory committee’s proposal of extending the 2004 black box warning on suicidal ideation due to receiving antidepressant treatment to include young adults.
The design used in the study addressed the study question as the researcher used the FDA’s findings as a basis for the research. The design used in the research is best identified with Multiple Baseline Design, which a baseline was determined before treatment to facilitate the research. (Leedy & Ormrod, 2010) This design allowed researchers to determine a baseline in which the data could then be collected and identified. This form of design uses the independent and dependent variables. The veterans who participated in this study all had a treatment that started at different times. The independent variables in this study were the SSRI medications and the treatment application. The dependent variables were the veterans who participated in the study.
Formative research involves gathering data that can be used in developing programs. It outlines what procedures will be implemented within a program. Such data is gathered through interviews, focus groups, surveys, and observations of what is occurring within the selected population. An example of formative research is to develop effective strategies including communication for influencing behavior change; it helps researches to identify and understand the characteristics that interest and the needs where the influence their decision and action, also to help and improve program activities. Formative research is useful in outlining a foundation of how programs can better meet the needs of Veteran’s who are struggling with Post Traumatic Stress Disorder. Understanding the needs of Veteran’s and their struggles with finding a treatment plan that will combat depression, anxiety, nightmares, and the feelings with recalling those traumatic events.
The research method to be used will be formative research. It will help to point out the statistics of veteran’s that are suffering from PTSD and their journey getting through it with the help or lack of help from certain types of treatments. It will help to provide reliable evidence of our findings and prove that it is valid information. Formative research looks at the community in which an agency is situated, and helps agencies understand the interests, attributes and needs of different populations and persons in their community (What is formative research and how can it help your agency?, 1998).
“Post-traumatic stress disorder (PTSD) is a severe and disabling psychiatric syndrome. With the advent of selective serotonin reuptake inhibitors (SSRIs), major strides have been made in the realms of pharmacotherapy. The multiplicity of symptom complex includes specific target symptoms, such as intrusiveness, aggression, sleep disturbances, and co-existing psychotic symptoms. Consequently, atypical antipsychotics gradually have been gaining ground in terms of adjunctive utilization.”(Cite required) Soldiers that have survived the war zone are required to have a psychiatric and a medical evaluation in order to rule out issues that have the potential to develop psychiatric systems or disorders. According to the Department of Veterans Affairs(Cite required) it is estimated that PTSD afflicts; Almost 31 percent of Vietnam veterans, as many as 10 percent of Gulf War (Desert Storm) veterans, 11 percent of veterans of the war in Afghanistan, and 20 percent of Iraqi war veterans.
The introduction presents the issue of suicidal ideation due to taking antidepressant treatment as the research problem. This is supported by a literature review that establishes the importance of other forms of treatment such as selective serotonin reuptake inhibitors (SSRIs) and the new-generation non-serotonergic-specific (non-SSRI) antidepressants. The selective serotonin reuptake inhibitors (SSRIs) reduce the risk of suicide since it was observed in the study that treatment with SSRIs has a protective effect in all adult age groups (Gibbons et al., 2007). This supports the hypothesis that SSRIs lower the risk of suicide attempts in depressed adults.
This study aims at determining the relationship between antidepressants treatment and the figures on suicide attempts by analyzing data from the Veteran Administration on Healthcare system. The research problem is consistent with various hypotheses contained in the study. One hypothesis states that treatment with SSRIs lowers the risk of suicide attempts in depressed adults (Gibbons et al., 2007). Another hypothesis in the study states that taking antidepressants during treatment will decrease the risk of suicide attempts in depressed patients during their entire adulthood. From the findings of the study, it is important to note that the suggestion to extend to young adults the black box warning on the risk of suicidal ideation in patients treated with antidepressants will increase the suicide attempts in individuals with depression.
The design technique applied in the study is appropriate since it collects substantial evidence which is useful in supporting their conclusion together with facts and correct figure. The variables in the study were clearly articulated. Independent variables in the study include antidepressant treatment and SSRI and non-SSRI treatment. The dependent variables in the study include suicide attempts.
Proposed data analyses:
Descriptive Statistic:
Descriptive statistics are used to describe the basic features of the data in a study (Descriptive Statistics, 2006). The researcher conducting the study collected data that included 226,866 veterans that have been diagnosed with depression during the years 2003 and 2004. Those involved in the study were around the same age and same sex. In this study, measures of association were used in collecting the data. This describes the relationships between variables. It is broken down into the characteristics of the veterans and their results for either antidepressant, SSRI monotherapy, non-SSRI monotherapy or tricyclic monotherapy.
The characteristics include their age, duration of follow-up, that they are male and African American, their diagnosis and method of suicide attempt. The methods used to describe the data are both appropriate and sufficient within this study. It allows for the reader to clearly see the results of the study and who was part of the study as well. Through their findings and the results posted, they can show exactly what they are trying to prove about the relationship between antidepressants and suicide attempts in U.S. veterans. They provided quantitative indicators of what is common or typical about the variable being used, how much diversity or difference there is in that variable, and how values on one of the variables are associated with values of one or more of the other variables being used.
In the field of Human Services, there is a great need for United States Veterans who are dealing with post-traumatic stress disorder. Post-traumatic stress disorder is a mental health condition that is brought on due to traumatic events. There are many reasons as to why a veteran may be suffering from this type of disorder. It can make become a difficult population to serve because either some do not know they have PTSD or they do not want to accept the help. Not only does having this disorder affect that person but it can affect their loved ones as well. This can also have an effect on the community as a whole. Unfortunately, if the veterans do not receive the proper help then it can lead to more serious outcomes such as depression which can then lead to suicide. There are a variety of medications in which someone who is suffering from PTSD can be prescribed however; it can lead to both positive and negative effects.
Timeline for the proposed study:
The evaluation of the system of methods used to study between antidepressants and suicide attempts amongst veterans with PTSD. The study came from the data of more than a quarter-million veterans and the suicide attempts of those who were diagnosed with depression who did not suffer from this in the years before 2002 to 2003. This was done with the veterans who had at least six months of follow-up treatments. The research study addresses the issues of veterans before and after their diagnosis of depression.
References
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