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Attributive Language:

Anthony Charuvastra: A doctor in psychology that trained at the top ranked UCLA-West Los Angeles VA training program, and presently he is an Assistant Professor at New York University Medical Center in the Department of Child and Adolescent Psychiatry

Marylene Cloitre: Research Professor and Senior Research Scientist at NYU Silver School of Social Work that specializes in

Annual Review of Psychology: Annual Review of Psychology is a peer-reviewed academic journal that specifically publishes articles on all spectrums of psychology.

Evidence:

In conclusion, the highest form of trauma that most likely triggers PTSD in people are forms of trauma caused by other people. Sexual assault, physical harm, and even threats to harm someone cause more cases of PTSD than things such as natural disasters or pandemics. In addition to this, social support can help prevent or even alleviate the symptoms of PTSD, where counter supportive relationships do quite the opposite. Therefore, therapy should prove to play an important role in both the development and treatment of PTSD.

In-text Citation:

“Epidemiological studies have consistently reported relatively higher rates of PTSD for events resulting from human intent. The most statistically and methodologically sound data on the incidence and prevalence of different types of mental illness in the United States comes from the National Comorbidity Survey (NCS) (Kessler et al. 1994, 2005; Kessler & Merikangas 2004). The NCS survey data indicate that among men and women who report rape as their most upsetting trauma, 65% of men and about 46% of women developed PTSD from this” (Charuvastra & Cloitre, p. 3).

Connection to Claim:

This source connects with my research question because it talks about the main cause of PTSD, which is trauma that comes from human interactions. PTSD arises when fear responses become dysregulated, leading to many forms of emotional distress. However, strong but supportive social bonds through friends and family can buffer against these effects by promoting feelings of safety and emotional support, proving to be a deterrent to developing PTSD.

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The biggest cause of PTSD within the African American community lines up with the most common cause, which are negative social interactions, but due to racial discrimination. However the biggest barrier when it comes to the treatment of PTSD in African American communities where unfortunately many are in a position of low-income because of the lack of generational wealth, is the cost of therapy and medicine that could treat PTSD.

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Attributive Language:

Ateka A Contractor: Member of the Center for Psychosocial Health Disparities Research, University of Texas, and specializes in research on PTSD as well as the comorbidities that come along with it such as depression.

TCPHDR, University of Texas: The Center for Psychosocial Health Disparities Research aims to find connections between mental and physical health in humans, and sponsors countless research cases on causes and remedies for such.

Evidence:

The results showed a decrease in symptoms of PTSD within the patients after recollecting positive memories. This would be shown in the decrease in negative feelings over time as well as thoughts related to their trauma which tended to interfere with their lives. In contrast, the positive effects were only perceived by the patients after the tests, but shortly returned to their previous state (included with the deficit in negative effects). These methods included verbal, mental, and scriptural forms of recollection. It is also important to note that symptoms of depression still linger.

In-text Citation:

“The differential pattern of findings for affect may reflect the transient nature of affect evoked by recalling positive memories. In the narrating condition, participants had a pattern of decreases in negative affect over time, which was in line with study hypotheses. For positive effect, in contrast, the effects were more transitory, in that effect was elevated post-task on both occasions, but returned to baseline between the two sessions. In this case, it is likely that between-session factors may have impacted participants’ moods” (Contractor et al. p. 10).

Connection to Claim:

This source connects to my research question by highlighting that positive memory recollection can temporarily reduce PTSD symptoms, although, it does not solve it. More importantly however, the exposure to negative memories would further the symptoms of PTSD long term. Therefore

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Attributive Language:

Stéphane Guay: Scientific Director at the Research Center of the University Institute of Mental Health of Montreal

CIHR (Canadian Institute of Health Research): CIHR is the federal agency responsible for funding health and medical research in Canada.

Evidence:

As a result of their study, the researchers were able to conclude that counter supportive (negative) interactions for PTSD patients worsened their symptoms. Anxiety and depression, a comorbidity that comes with PTSD are further enhanced in the presence of negative relationships. In contrast to this information, having positive interactions in relationships did not contribute much to the severity of symptoms caused by PTSD. However, this somewhat neutral effect meant that no harm was done to the patient.

In-text Citation:

“The results of this study yield highly relevant clinical implications. First, the results demonstrate that perceived counter supportive interactions between PTSD patients and their most significant other directly correlate with the development and maintenance of symptoms” (Guay, p. 14).

Connection to Claim:

This source connects to my research question because it shows how social interactions can interfere with the development of PTSD. The source stated how negative relationships would worsen the symptoms of PTSD, therefore it is important that we should address this problem. By focusing our attention to the causes of severe PTSD, addressing the problem of PTSD within the United States would be substantially easier as it would allow for prevention of the causes, such as negative relationships for PTSD patients.

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Attributive Language:

Meghna Ravi: ORISE Research Fellow in the Division of Violence Prevention at CDC who received her PhD from Emory University for neuroscience.

Evidence:

The evidence suggests that racial discrimination is a strong predictor of PTSD. This is most likely due to the traumatic nature that racial discrimination possesses, which could lead to the development of PTSD . Additionally, the study highlights the importance of considering multiple forms of oppression such as racism and economic hardship when diagnosing and treating PTSD in Black women.

In-text Citation:

“Racial discrimination manifests in chronic and unpredictable ways, and Black individuals may feel unsafe in many everyday situations (Lewis et al., 2015; Utsey et al., 2000). As a result, racial discrimination acts as a significant and chronic stressor that can exacerbate responses to traumatic events (Utsey et al., 2013; Utsey et al., 2000) and also function as a traumatic stressor in and of itself (Carter, 2007; Kirkinis et al., 2021; Williams et al., 2018). Experiences of racial discrimination can result in traumatic stress responses, including hypervigilance, re-experiencing symptoms, negative cognitions, and avoidance, all of which are cardinal symptoms of PTSD (Carter & Forsyth, 2010)” (Ravi, p. 9).

Connection to Claim:

This study connects to my research question because it addresses the causes as to why Black communities have a higher population with PTSD in comparison to others. By exploring the effects of racial discrimination and poverty when it comes to the effects of PTSD, this study provides important insights into why Black women experience PTSD at higher rates. As a result, finding solutions to make healthcare and therapy more accessible to Black communities in poverty could prove to effectively address PTSD.

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Attributive Language:

Rachel Kaadzi Ganash: An essayist that won the Pulitzer Prize for Feature Writing.

College board: A not for profit organization that aids students in transitioning from high school to college and are known for creating AP exams along with the SAT.

Evidence:

Floods of nostalgic memories came to Rachel. There she was able to acknowledge her struggles, pleasant memories, and family roots, which all made her experience a variety of emotions. In the end, although she was reluctant to visit her great-grandparent’s grave, she was able to address her past wrongs and let go of the burden that she gave herself, giving her a feeling of relief.

In-text Citation:

“The one back across the Mason-Dixon line, back to the South, back to the place that was once home. Perhaps, because I am now thirty, I’ve found that I want for my mother and her family in a way that even I don’t understand. This hunger for them, a biological tug to return, scares me—a hunger that goes unrequited, since I cannot go back into their arms, their wombs, or their laps” (Ganasha, p. 10).

Connection to Claim:

As nostalgia and memories intermingle with one another, so does PTSD. While nostalgia brings up positive memories, PTSD often brings up painful and traumatic ones. However, what the takeaway from this source is that some people with PTSD use nostalgia as a coping mechanism to escape traumatic memories. They might romanticize the past because the present feels unsafe or overwhelming, giving themselves a sense of relief.

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Attributive Language:

Haiyin Li: Doctor of philosophy and staff scientist at Wistar Institute

JCI (Journal of Clinical Investigation): A Peer-reviewed medical journal established in 1924 that covers biomedical research.

Evidence:

After examining the properties GR-FKBP51 contained, the researchers found that this correlates with PTSD, as PTSD patients would have a higher concentration of this receptor in comparison to non PTSD patients. In the case of the mice study, after incorporating a peptide that would inhibit the expression of this complex (TAT-GRpep), a reduction in negative memory call appeared, and was essentially suppressed.

In-text Citation:

“We also obtained evidence that the elevated GR-FKBP51 interaction is specific to PTSD and not just a biomarker of trauma exposure per se, by performing a replication and extension analysis in 42 subjects from the Grady Trauma Project in Atlanta, GA (14, 39, 40). All subjects had significant trauma exposure, but while 21 had severe PTSD, the age-, sex-, and race-matched trauma controls had few symptoms (Supplemental Table 2). We found significantly elevated GR-FKBP51 in peripheral blood from PTSD subjects versus trauma-exposed controls (P < 0.001, Student’s t test, n = 21, power = 0.99853, Figure 5C), with no significant difference in direct immunoprecipitation of FKBP51 between the 2 groups (Figure 5C). These combined data suggested that the FKBP51-GR complex might be a biomarker for PTSD. In addition, major depressive disorder (MDD) has some similarities with PTSD in the context of GR signalling that involves FKBP5 (41, 42)” (Li et al., p. 884).

Connection to Claim:

This source connects to my research question because it reveals another solution to dealing with PTSD. Memory is a very important factor when acknowledging how PTSD functions, therefore currently we use a lot of methods that involve psychotherapy. However, with information the study provided, implementing other forms of healthcare can also affect the memory of PTSD patients, furthering our advancements in finding new solutions towards PTSD.

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The big takeaway from this section is that the most significant cause of PTSD are negative interactions with other individuals. Negative relationships both cause and worsen the effects of PTSD since they create a higher amount of emotional distress than other forms of stress. These include all forms of negative interactions, wether it be physical harm, sexual assault, or even threats, which causes the most amount of stress for most individuals.

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The big takeaway is that these sources explain how PTSD works. In short, when your stress receptors are exposed to high levels of stress, they cause deformations within your brain, causing symptoms like the inability experience pleasure or increased recall of negative memories. Although most people know the effects of PTSD, knowing how it works would allow people to understand the importance of the causes and solutions later in the presentation.

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Attributive Language:

Susan G. Lazar, M.D.: Part of the Committee on Psychotherapy, and is widely known for her publishing articles on cost effective psychotherapy.

William Offenkrantz, M.D.: Psychiatrist who has written about psychoanalytic psychotherapy and Sigmund Freud, and has relations to the University of Chicago, along with the Department of Psychiatry.

Evidence:

As a result, studies on innovative PTSD treatments show some mixed but mostly promising results. Cognitive-behavioral therapy (CBT) for children and adolescents after a single trauma was highly effective. In addition, research on combat-related PTSD and trauma-focused therapy for adolescents also indicates positive results, showing that financially, psychotherapy is a cost effective alternative.

In-text Citation:

“A study comparing psychodynamic psychotherapy, hypnotherapy, systematic desensitization, and a wait-list control group (Brom et al. 1989) found that the psychodynamic group achieved a greater reduction in avoidance symptoms but a lesser change in intrusion symptoms. Patients treated with either hypnotherapy or desensitization showed the reverse, with a greater reduction in intrusive symptoms and less improvement in avoidance symptoms” (Lazar & Offenkrantz, p. 91)

and

“With some exceptions (Amir et al. 1998), specialized exposure therapies that desensitize to trauma as well as psychodynamic and cognitive-behavioral psychotherapies have all been shown to be effective for PTSD. With one negative report of the cost-effectiveness of psychotherapy for PTSD (Durham et al. 2005) and little direct positive evidence of its cost-effectiveness, there are nonetheless many studies demonstrating psychotherapy’s efficacy for this condition. It is clear that any psychotherapy that has been demonstrated to be effective for this disorder will also ultimately be cost-effective” (Lazar & Offenkrantz, p. 95).

Connection to Claim:

One of the main problems that the African American community faces is their economic status in the United States. After years of oppression, the state at which a large margin African Amreicans are in economically is of considerable size. This source brings up a cost effective solution that does work, catering to low-income PTSD patients.

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Attributive Language:

Christian Schrader: Well renowned psychiatrist that spent 24 years as a military psychiatrist for the US.

Abigail Ross: Doctor of medicine that graduated from New York Institute of Technology that majored in Osteopathic Medicine.

Missouri Medicine: Bi-monthly, peer reviewed journal that is renowned for award winning health related articles.

Evidence:

They found that the Veterans Affairs (VA) has changed how healthcare practitioners diagnosed PTSD throughout history. In the past, the word “nostalgia” or “homesickness” was the acceptable diagnosis for PTSD, but thanks to modern science this fortunately changed. In addition to this, we also developed different forms of treatment involving many methods of cognitive therapy, which are the “gold standard” of treatment as of now. However, medicine is only sometimes used as some types of medicine

In-text Citation:

“Out of the many treatments researched, the trauma-focused therapies, delivered individually, with use of a manual by the therapist showed the most benefit in treatment. While very effective the patient may be limited by access to a therapist who has been trained in trauma-focused therapy, who may not wish to use a manualized treatment approach, or by cost and/or insurance coverage” (Schrader, p. 551).

Connection to Claim:This source connects to my research question since it addresses our current solutions. By knowing what the current solutions are, we could figure out what the main problem is within our current forms of treatment. It becomes evident that the cost of therapy is one of the main problems, therefore finding a solution to the cost of therapy should be a main focus.

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Attributive Language:

Hannah Gibbs: PhD researcher in Music Psychology at the University of York.

Hauke Egermann: Postdoctoral Research Fellow at the Centre for Interdisciplinary Research in Music Media and Technology and now is a part of University of York and directs the York Music Psychology Group.

Frontiers in Psychology: A peer-reviewed open access academic journal covering all aspects of psychology.

Evidence:

Based on the test results, they were able to find that a large portion of people during the 2019 covid-pandemic used music as a form of coping. Essentially it evoked memories of a time where these individuals found it enjoyable. However, the reasons as to why they listened to the music that they chose are from a wide variety. Aside from this, the researchers found that the overall well-being of these individuals were better than the people that didn’t listen to nostalgic music as a coping mechanism.

In-text Citation:

“Feelings of nostalgia are said to occur during times of hardship and difficult transitionary periods, such as the first COVID-19 lockdown in the United Kingdom in 2020. Here, the reassurance of the past might have held certainty that could sustain a sense of meaning and purpose in life and influence wellbeing. The aims of the presented study were to explore the nature of music-induced nostalgia during the lockdown, by analysing participants’ narratives conjured by the music and their emotional responses to them, and to determine the extent that using nostalgic music listening as an emotion regulation strategy had an impact on wellbeing” (Gibbs & Egermann, p.1).

Connection to Claim:

This source relates to my research question since it focuses on the prevention of PTSD. Although this source never mentions PTSD, it does reference the possible causes of this disorder. Many causes of PTSD are due to being placed in highly stressful environments, such as the covid-19 lockdown. Therefore, using coping mechanisms to reduce stress like nostalgic music can possibly lower the chances of developing PTSD.

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Attributive Language:

Kristin W. Samuelson: Clinical and forensic psychologist, currently a professor at the California School of Professional Psychology. Most of her work specializes in neuropsychological functioning in PTSD.

Servier Laboratories: Publisher of the peer reviewed medical journal, Dialogues in Clinical Neuroscience, that covers neurology and clinical neuropsychiatry.

Evidence:

The results have proven that PTSD more than likely will result in the reduction of efficiency in declarative memory. High levels of stress lead to an increase in chemicals that could prove to be toxic to certain sections of the brain. This has been especially seen in the hippocampus, although it is important to note that it is not as consistent, and also the prefrontal cortex. It is also important to mention that there is a genetic and cognitive factor that increases the risk of being prone to develop PTSD, which does have to do with memory. Essentially, researchers have proven that when someone has poorer neurocognitive functioning prior to experiencing high levels of stress, it increases the risk of developing signs of PTSD.

In-text Citation:

“Gibertson et al75 studied monozygotic twin pairs who were discordant for combat exposure and found that the identical co-twins of combat veterans with PTSD, who had not experienced combat exposure or PTSD themselves, showed similar deficits in verbal memory. In addition, both combat veterans with PTSD and their co-twins exhibited smaller hippocampi, 76 sug-gesting that a smaller hippocampus and memory impair-ments in PTSD represent a pre-existing genetic factor” (Samuelson p. 349).

Connection to Claim:

This source connects with my research question because it analyzes the effects of recollection and cognitive function with PTSD, particularly in memory related brain regions (hippocampus and prefrontal cortex). Since high stress leads to neurotoxic effects, affecting the efficiency of memory related sessions within your brain, healthcare systems should integrate stress management interventions, including therapy to reduce the biological impact of stress, lowering the risk of PTSD.

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Attributive Language:

Narcyz Ghinea: A leading researcher at Macquarie University, where his work focuses on overcoming the legal and political barriers that hinder access to health.

Internal Medicine Journal: A leading internal medicine publication, publishing original medical research related to human diseases.

Evidence:

The study reveals that the increase in drug costs are a major barrier to treatment, with high cost medicines consuming most healthcare spending while benefiting only a small percentage of patients. Many expensive drugs offer limited clinical value, but still remain unaffordable for lower income individuals. In short, pharmaceutical companies prioritize profit over public health, with pricing driven more by shareholder interests than research costs. Public healthcare systems struggle to reduce cost on essential treatments and physicians face ethical dilemmas about addressing cost barriers.

In-text Citation:

“However, industry's use of high research and development (R&D) costs as a justification for high prices has been challenged on several grounds. First, it ignores the fact that the public sector plays an important part in funding early drug development, without which many drugs could not be developed, yet the benefits of these investments are enjoyed by private individuals for profit.31, 32 Second, the return on R&D is incredibly high at up to 10 times the investment for some large companies,33 and the profitability of the pharmaceutical industry overall is almost two times that of other industries, raising the question of whether prices do indeed need to be so high for these companies to be profitable” (Ghinea, p. 547).

Connection to Claim:

This source connects to my research question since it explains one of the biggest struggles that low income PTSD patients have to worry about, which is the cost of medicine. This source reveals that medicine only costs so much because of corruption, therefore having a cheap alternative to the medicine provided or increased research to make medicine worth the cost would be a probable solution.

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Together, these sources reveal that PTSD among Black Americans, is deeply rooted in structural inequalities like racial discrimination and poverty. This means that effective diagnosis and treatment must go beyond clinical symptoms and address the broader social context in which trauma occurs.

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This source mentions that the main cause of PTSD is due to trauma based on human interactions. Source number 4 is an example of this as it expresses similar results in a different study. Both mention that sexual assault, physical altercations, in addition to chronic negative interactions is a major cause of PTSD.

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Source 9 talks about how nostalgia can deal with PTSD. In source 13, the author experiences nostalgia and effectively addresses her past trauma. Source 9 proves this to be an effective stress reliever since many individuals during the COVID 19 pandemic have documented this to work through this study, which would reduce the chances of PTSD occurring since it reduces chronic stress.

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TRANSITION: CONNECTION FROM CLAIM TO CLAIM

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TRANSITION: CONNECTION FROM CLAIM TO CLAIM

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After telling the reader how PTSD functions and why stress plays an important role in the development of PTSD, it is important to explore what are the main causes of such forms of stress.

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Main Idea (Thesis): Whether it is a conclusion, resolution, or a solution, this should be the answer your research question.

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Main Idea (Thesis): Whether it is a conclusion, resolution, or a solution, this should be the answer your research question.

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In order for this to take place, American healthcare has to provide cost effective forms of treatment, in addition to making healthcare more accessible for the African American community via methods that address poverty.

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The barriers and causes of why PTSD within the African American community can be addressed by healthcare through the application of cost effective solutions and decrease in healthcare costs. However, there are numerous limitations to these solutions. The main being that this does not offer any form of prevention, and only offers treatment. In addition to this, the efficacy of nostalgia is questionable. Although they do work and lower the risk of PTSD, studies show that stress relievers are only a temporary solution to changing the effects of this disorder. Therefore, more research should go into how we could make nostalgia based therapy more efficient, in addition to finding ways to reduce racial discrimination.

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Both sources highlight the contrast between advancements in mental health care and the ongoing challenges in making those treatments accessible. The first source shows how far we've come in understanding and treating PTSD, which includes evidence-based cognitive therapies. In contrast, the second source reveals that despite these medical improvements, many people still struggle to access treatment due to the high cost of medication.

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TRANSITION: CONNECTION FROM CLAIM TO CLAIM

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TRANSITION: CONNECTION FROM CLAIM TO CLAIM

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PTSD can be caused by prolonged exposure to trauma, including violence, systemic oppression, and chronic stress. Black communities often face disproportionate rates of these experiences, such as racial discrimination, community violence, and economic hardship, which contributes to higher rates of PTSD.

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TRANSITION: CONNECTION FROM CLAIM TO CLAIM

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TRANSITION: CONNECTION FROM CLAIM TO CLAIM

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Because Black communities experience higher rates of PTSD due to systemic factors like racial trauma and community violence, addressing these root causes is essential for healing. But because of the cost of therapy and medicine that has been in development of PTSD, there is a need for cost-effective solutions.

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Together, these sources show that while medical understanding and treatment of PTSD have advanced over time, social inequalities, like racism, poverty, and lack of access to education, continue to influence who is most affected and who receives care. The science may have improved, but not everyone benefits equally due to ongoing systemic barriers, especially within marginalized communities like Black Americans.

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This source talks about how positive memories can temporarily serve as a solution to PTSD, as it decreases symptoms of PTSD for a short amount of time. In source 13, the author is brought back to her past and is reminded of a nostalgic past that is held dear to her, providing an example of how exposure to positive memories can serve as a stress reliever.

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The big takeaway from this claim is that there are a lot of cost-effective solutions to PTSD patients that don't have a lot of money to afford treatment. While the cost of therapy is a lot, cost-effective does not necessarily mean cheap, but good for it's price. For many individuals, this should be the sure fire way to reduce the effects of PTSD. But in addition to this, making pyschotherapy and CBT cheaper, as well as increasing funding towards medical insurance to cover for therapy are surefire ways to reduce the number of PTSD cases within the African American community. However, there are alternatives, since inducing nostalgic feelings that increased the recollection of positive memories can aim to prevent the build up of chronic stress, as well as being a short term treatment to the effects of PTSD.

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This source talks about how PTSD is caused by high levels of stress and trauma, leading to detrimental effects within your brain. This source connects to source number 6 because source number 6 discusses a solution to PTSD through the inhibition of receptors within your brain.

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Both of these sources talk about forms of therapy that induce positive feelings within PTSD patients. In addition to this, both of these forms of treatment are cost effective. While it still costs money, psychotherapy in the long run would effectively treat PTSD in comparison to other forms of therapy at a lower price. The other form of treatment can be performed by anyone the PTSD patient is surrounded with, since creating/ recollecting positive memories is a simple task that everyone experiences everyday.

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What is the most effective way for healthcare in the United States to address PTSD within the African American community?

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Attributive Language:

Audrey Jones: Health services researcher with the VA’s Informatics, with her primary focus on improving access to mental health care access.

Journal of Aging and Health: medical journal published by SAGE Publications, focusing on basic health services along with prevention of diseases.

Evidence:

Black Americans have the highest risk of developing PTSD during their teens due to the pressures society pushes on to them due to racial discrimination. In addition to this, depending on their economic status, poverty can also tend to lead to an increase in risk for PTSD. In middle aged Black adults, PTSD is linked to unemployment and lack of education for men, unemployment and divorce for women, and poverty, stress, and racial discrimination for both.

In-text Citation:

“There are a number of factors known to contribute to the excess burden of PTSD among Black adults in the U.S. including elevated exposure to types of potentially traumatic events that confer risk for PTSD, such as childhood maltreatment, physical and sexual assault, and military combat (McLaughlin et al., 2019; Roberts et al., 2011). In addition to specific types of trauma, cumulative trauma exposure and limited psychosocial resources contribute to elevated PTSD risk in Black women (Gaffey et al., 2019; Gluck et al., 2021)” (Jones et al., p. 2).

Connection to Claim:

This source connects to my research question because it focuses on the main topic of PTSD within the African American community. In short, this source tells us that the main cause of PTSD that African Americans face is through social interactions within their childhood, but can even be developed further into their lifetime. Although negative social interactions can be applied to any race within the US, this source explains that the main form of negativity that African Americans are exposed to are forms of racial discrimination.

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Context + Introduction + Focus (Problem/Issue Statement)

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Context + Introduction + Focus (Problem/Issue Statement)

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PTSD, has a long history of being seen within troops returning from war, as long as violent conflict existed. But this disorder, commonly found within veterans because of their traumatic experiences on the front lines, within the United States, is highly prevalent within the African American community. Andrea L. Roberts, a principal researcher at Harvard University, wrote an article about the development of PTSD within different ethnic groups and races within the United States. She found that 8.7%, almost one in ten African Americans, will develop PTSD during their lifetime. But in order to address PTSD within the African American community effectively, it is necessary for our government to tackle this problem via numerous approaches

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CLAIM 3: Why African Americans have the highest rate of PTSD and the problems.

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CLAIM 3: Why African Americans have the highest rate of PTSD and the problems.