PSY 353
STRESS, TRAUMA AND THE PSYCHOLOGICAL EXPERIENCE OF COMBAT
SPRING 2015
THUR 1530-1800, LS 248
Heidi Kraft, Ph.D.
hkraftpsych@gmail.com
Office hours by appointment
Course Description:
This course will focus on the vital human process of stress in the brain, body and
behavior. It will define stress, the stress response, and how stress is related to
illness and disease. It will chronicle different responses to stress, to include that
of traumatic experiences and how they affect us. Psychological diagnosis and
treatment of trauma will be explored. The second half of the course will discuss
a specific stressor and (for some) traumatic experience, the life-changing experience of combat. It will describe the history of the American warrior, including
veterans of the current long wars in Iraq and Afghanistan, with emphasis on the
emotional impact of war and its aftermath. The experience of combat, including
combat stress injuries, combat trauma, and post-trauma growth, will be discussed.
Textbook:
Why Zebras Don’t Get Ulcers by Sapolsky
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Available in the bookstore or online (paperback)
Grading Format:
This class will involve a great deal of discussion. In addition, there will be movie
and/or readings on some weeks to be completed outside of class. There will be
a midterm exam and a final exam.
• 40%: (5) online assignments (8% of grade each): Off-site viewing of
four films and out of class reading of one article, and online submission of
three answers for each
** For each of these out of classroom assignments, there will be an online assignment to complete. The assignment will be posted in advance to give students the chance to view the film or complete the reading on their own timelines. The online assignment questions will post to Blackboard Sunday morning
of the week they are due, and entry will be closed at 6pm the Friday of that
week. **
• 30%: Midterm exam
• 30%: Final exam (not cumulative)
** Attendance is not mandatory nor will be taken. However, the tests may be
heavily influenced by in-class and online discussion points. **
Course Learning Objectives: By the end of this class, you will be able to:
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Define stress, stress response, and explain why stress makes people sick
Define the role stress plays in diseases of the cardiovascular, digestive, immune, reproductive, endocrine systems
Define psychological trauma
Define PTSD and how it is diagnosed and treated
Describe the evolution of the warrior through past American wars
Describe the history of combat stress injuries and stigma
Describe positive and negative emotional responses to combat experience
Describe the military’s efforts to intervene in combat trauma
Discuss post-trauma growth
Additional Department Level Learning Objectives: In addition to those
outlined above, other learning objectives identified as important across the Psychology Curriculum that overlap with this course are:
1.
Distinguish among various types of mental disorders (SLO 1.6).
2. Characterize the nature of psychology as a scientific discipline and identify its
primary objectives: to describe, understand, predict, and control behavior and
mental processes (SLO 1.7).
3.
Identify appropriate applications of psychology in solving problems such as
the pursuit and effect of healthy lifestyles, origin and treatment of abnormal behavior, psychological tests and measurements, psychology-based interventions,
and the resolution of interpersonal and intercultural conflicts (SLO 2.2).
4. Apply psychological concepts, theories, and research findings as these relate
to everyday life (SLO 2.4).
5.
Identify ways (actions, behaviors) that emphasize the importance of interacting effectively and sensitively with people of diverse abilities, backgrounds,
and cultural perspectives (SLO 6.2).
6. Identify how sociocultural and international contexts influence individual differences (SLO 6.3).
7.
Explain how individual differences influence beliefs, values, and interactions with others and vice versa.(SLO 6.4)
CALENDAR
Thur Jan 22
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Intro to course and each other
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Review of syllabus
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Breathing and meditation
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What is stress?
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Different types of stressors
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Allostasis, stressors and stress responses
Reading: Sapolsky Chapter 1
Thur Jan 29
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Reading:
Why does stress make us sick?
Theories on positive and negative stress
The two parts of the nervous system
Sympathetic and parasympathetic NS effect on the body
The cardiovascular stress response
Sapolsky, pages 20-23, 37-56
Thur Feb 5
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Stress and the digestive system
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Irritable bowel syndrome
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Ulcers
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Stress and the reproductive system
Reading: Sapolsky, pages 71-91, 120-143
OUT OF CLASS ASSIGNMENT:
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Watch: Stress: Portrait of a Killer (PBS documentary can be found
online)
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Answer 3 questions on Blackboard (due Friday 2/6 at 6pm)
Thur Feb 12
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Stress and the Immune System
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Cancer, AIDS, other diseases
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Sleep and Exercise
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Changing your thinking
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Social support
Reading: Sapolsky, pages 145-185, 385-418
Thur Feb 19
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Trauma
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Types of trauma
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Subjective experience
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Diagnostic criteria
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New DSM-V
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Physiological experience of trauma in the brain
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Cumulative effect
Thur Feb 26
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PTSD
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Perception
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Definition (DSM-V)
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Operational definition
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Functional impairment due to symptoms
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Treatment
Review for Midterm
Thur Mar 5 - NO CLASS MEETING
OUT OF CLASS ASSIGNMENT:
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Watch Good Will Hunting
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Answer 3 questions on Blackboard (due Friday 3/6 at 6pm)
Thur March 12
MIDTERM EXAM in CLASS
Thur March 19
• History of the Warrior
• What is a warrior?
o Words that describe them
o Why do people choose this path?
• The experience of the US Soldier, Sailor, Marine through our wars
o Training/ deployment time
o Country support/involvement
▪ The warrior paradox
▪ The concept of combat stress
o Early definitions/descriptions/conceptualization
o Evolution through conflicts
o Combat stress injury
• Warriors through the ages
• The Illiad – still applies today
• Why we fight
Thur March 26
• The experience of combat
• Physical preparation/ physical toll
• Emotional toll
o Reality of taking a life/knowing someone is trying to kill you
• Are certain people predisposed to be able to kill if needed?
• What is the difference between these people and criminal killers?
**OUT OF CLASS ASSIGNMENT:
• Watch: Either The Hurt Locker or Lone Survivor
• Answer 3 questions online (due Friday 4/3)
Thursday April 2: NO CLASS MEETING — Spring Break
Thur April 9
o Response to combat situations: positive
▪ Positive/affirming/life-changing moments
▪ Intensity/adrenaline
▪ Friendships/loyalty/comradery
▪ Simplicity/meaning/feeling of contribution to something
• Response to combat situations: negative
• Four types of combat stress injury
• Combat stress injury: who develops it?
• Factors that influence who will develop CSI
• Fear, exhaustion, the elements, horror and guilt, hate Aftermath of
trauma in the combat zone - stigma
** OUT OF CLASS ASSIGNMENT: WATCH Cover Me (documentary
sponsored by the Semper Fi Fund) (You Tube)
• Answer 3 questions on Blackboard (due Friday 4/10)
Thur April 16
o Combat trauma and PTSD
o Definition of trauma (DSM-V)
▪ Specific combat scenarios
• Infantry, CASEVAC
• Medical, Convoys
• EOD, Mortuary Affairs
• Why combat is different from other traumatic situations
Thur April 23
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Co-morbidity with traumatic brain injury and physical injury
Development of combat stress injury symptoms
Typical course of sxs and military response/plan in the field
PIES principal for tx of acute combat trauma
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Group intervention
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History of CISD for first responders
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Current military strategy for “After Action Debriefing”
** OUT OF CLASS ASSIGNMENT
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READ: WSJ article on “Comradeship as Treatment” by Michael Phillips – ON BLACKBOARD, questions due Fri 4/24
Thur April 30
• Post-Traumatic growth and recovery
• Resilience
• Meaning and growth after trauma
• Emotional recovery/Spiritual growth
• Friendships and family relationships
• Rehabilitation
Thur May 7
• Case study
• Discussion of WSJ article
• Final exam review
• Wrap up, review, student feedback, Q and A
Thur May 14
FINAL EXAM : 1600 - 1800
About the Instructor
Heidi Kraft received her Ph.D. in clinical psychology from the UCSD/SDSU Joint
Doctoral Program in Clinical Psychology. She completed medical psychology internship at Duke University Medical Center, and joined the Navy in 1996. In
2004, she deployed to Iraq with a USMC surgical company. RULE NUMBER TWO
is a memoir of that experience. She left active duty in 2005, and now serves as
a contractor for Navy medicine and an adjunct professor at SDSU. She currently
treats PTSD patients, and provides invited talks on combat stress, stigma and
caring for the caregiver.