Medico- Legal Psychological Consequences of Trauma- Introduction

In my previous post I had quoted Van der Kolk. But does everyone respond to traumatic events in a similar fashion? The obvious answer is no. And that is the beauty of us Human Beings. Naturally then, one would think of ‘resilience’ factors (what keeps people going without succumbing to trauma), factors related to the intensity & the nature of trauma and equally the duration of the trauma. And since there are always two poles in virtually any concept we may think of in life, there are certain ‘vulnerability’ factors for the nature and degree of response to trauma. From a medico- legal standpoint, our justice system and our society have an equally important role to play in terms of legitimising trauma victims and providing supportive frameworks to deal with clinical and legal issues related to trauma and it’s consequences.

In this little introduction, allow me to restrict myself to a list of Psychiatric sequalae of trauma-

– Initial shock phase
– Delayed shock
– Anger and frustration
– Adaptation reactions- adjustment, reliving the trauma, processing by the brain to establish a meaning of the trauma in our lives to name a few.
– Normality and being back to routine functions
– Psychiatric Syndromes- Adjustment Disorder, Travel Anxieties, Exacerbations of pre- existing conditions, PTSD (Post Traumatic Stress Disorder), Substance Misuse (resorting to drug or alcohol misuse or an exacerbation of pre- existing misuse/dependence).

As a Tier 1 Association of Personal Injury Lawyers (APIL Expert) dealing with psychological trauma and its consequences is a regular part of my medico- legal work. I will cover these issues in more detail in subsequent posts.


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PTSD- Big ‘T’ or small ‘t’ Traumas

How much force is required to crack an egg?
Many people still harbour this myth that PTSD cannot develop if the traumatic event was trivial. The personal meaning that is attached to the event is an important and fundamental aspect, so the individual’s integrity as a functional being becomes an issue of primacy or a forerunner for symptoms. Thus whether the event was a natural disaster, war (Big ‘T’ Traumas), abuse in its various forms (Big T or small ‘t’ traumas), RTA or something apparently trivial, if personal safety and integrity as a human being is endangered, the individual can become more vulnerable to develop PTSD. Of course there are other factors that may play a role as well such as pre- existing conditions and resilience factors to name a few.

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Gambling Addiction- Introduction

The last British Gambling Prevelance Survey in 2010 showed that as high as 73% of the British Population had taken part in a gambling activity in the previous 12 months with National Lottery being the most popular. Fortunately though the Gambling Pendulum (Sakhuja 2011) swings predominantly on the left side to the centre with the amount of people with pathological gambling being the least out of the three- Social Gambling, Problem Gambling and Pathological Gambling. However, when it comes to Pathological Gambling, there are a lot of similarities with addiction (will be posting a recent presentation done for our department in my next post).

Treatments for this involve a combination of medication, psychological interventions and social interventions. One of the social intervention is Financial Management- Education and Debt Management. I am sharing a link by the UK government on Debt Management and this website has a wealth of free information on this topic.

In my next post, I will add the presentation and in subsequent posts will share the different treatments available on a private basis for Gambling Addiction in Wales by Serenity- Recover the Peaceful Way…

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