Posttraumatic Stress Disorder (eBook)

Front Cover 1
Posttraumatic Stress Disorder: Scientific and Professional Dimensions 4
Copyright Page 5
Contents 6
Preface 10
CHAPTER 1 Understanding Psychological Trauma and Posttraumatic Stress Disorder (PTSD) 14
Is there a life after trauma? The case of Marian M 17
History of popular and scientific conceptions of psychological trauma and PTSD 19
Contemporary definitions of traumatic stress and the diagnosis of PTSD 25
Beyond PTSD: Can traumatic stress affect a person's core self? 31
From exposure to a traumatic stressor to the development of (and recovery from) PTSD 37
Etiology of PTSD: Potential causes and risk factors for developing PTSD 38
Epidemiology of PTSD: how often (and to whom) does PTSD occur? 38
Biology of PTSD: Alterations in the body and in physical health associated with PTSD 39
Research and clinical assessment of psychological trauma and PTSD 39
Treatment and prevention of PTSD 40
Forensic issues in the PTSD field 42
Social, cultural and ethical issues in the PTSD field 42
Careers in the PTSD field and impact of psychological trauma on the professional 43
CHAPTER 2 The Impact of Psychological Trauma 44
When the other shoe falls: what makes stressful events traumatic? 47
In the beginning: acute traumatic stress reactions and acute stress disorder 48
Acute traumatic stress reactions 48
Acute stress disorder 49
Life after trauma: positive and problematic trajectories of adaptation 52
Positive posttraumatic life trajectories 53
Problematic posttraumatic life trajectories 59
Research on the impact of traumatic stress on the course of people's lives 62
CHAPTER 3 Etiology of Traumatic Stress Disorders 68
Understanding etiology: causes or risk factors and protective factors? 73
Causal risk factors for PTSD 76
Degree or severity of exposure to traumatic stressor(s) 76
Pre-existing psychiatric illness 78
Potential genetic or biological causal risk factors 81
Alterations in cognitive processing 83
Potential risk factors for exposure to traumatic stressors 87
Vulnerability factors for PTSD 88
Protective factors 103
Conclusion 107
CHAPTER 4 Epidemiology of Psychological Trauma and Traumatic Stress Disorders 108
Epidemiology of PTSD in adulthood: 1. Prevalence of exposure to traumatic stressors 110
Epidemiology of PTSD in adulthood: 2. Prevalence of PTSD 111
Epidemiology of PTSD in adulthood: 3. Comorbid psychiatric and medical disorders 112
Epidemiology of PTSD in childhood: 1. Prevalence of exposure to traumatic stressors 114
Epidemiology of PTSD in childhood: 2. Prevalence of PTSD 114
Epidemiology of PTSD in childhood: 3. Comorbid psychiatric and medical disorders 122
Gender and the epidemiology of PTSD 123
Ethnocultural and socioeconomic background and the epidemiology of PTSD 128
CHAPTER 5 Neurobiology of Traumatic Stress Disorders and Their Impact on Physical Health 130
Alterations in the body's stress response systems in PTSD 132
Alterations in brain chemistry, structure and functioning in PTSD 140
Emotion regulation 141
Information processing 142
Brain structure and PTSD 144
Brain function and PTSD 147
Brain chemistry and PTSD 148
PTSD and physical health problems and medical illness 148
Medical illness 149
Psychological trauma, PTSD and health risk behaviors 150
Psychological trauma, PTSD and somatic dissociation 152
Health problems and medical illness as precipitants for PTSD 153
Conclusion 154
CHAPTER 6 Assessment of Psychological Trauma and Traumatic Stress Disorders 156
Scientific criteria for PTSD assessment 158
Reliability 159
Validity 160
Clinical issues in PTSD assessment: 1. Assessing trauma history 161
Assessing past experiences of psychological trauma 163
Trauma history measures 164
Assessments of PTSD symptoms and diagnosis 172
PTSD symptom and diagnosis measures 176
Assessment of psychiatric problems commonly comorbid with PTSD 180
Screening for PTSD 189
Conclusion 194
CHAPTER 7 Treatment of Adults with Traumatic Stress Disorders 196
Best practice principles in the treatment of PTSD 198
Phase 1 199
Phase 2 202
Phase 3 205
PTSD treatment: practical issues 206
Duration of treatment 206
Frequency of and type of services 206
Treatment outcomes 207
Evidence-based practices and treatments for PTSD 207
Cognitive behavior therapy for PTSD 210
CBT interventions for special populations of adults with PTSD 213
CBT for PTSD and substance use disorders (SUD) 213
Cognitive behavior therapy for severe mental illness (CBT-SMI) 214
Research evidence base 214
Self-regulation and interpersonal therapies for PTSD 214
Trauma affect regulation: guide for education and therapy (TARGET) 217
Present centered therapy (PCT) 218
Anxiety management skills training 219
Trauma recovery and empowerment model (TREM) 220
Hypnosis and hypnotherapy for PTSD 220
Experiential therapies for PTSD 221
AEDP 221
EFTT 229
Psychodynamic therapies for PTSD 230
Body-focused psychotherapy for PTSD 231
Family and couples therapies for PTSD 232
Group therapies for PTSD 232
Pharmacological therapies (medication) for PTSD 233
Conclusion 234
CHAPTER 8 Treatment of Children and Adolescents with Traumatic Stress Disorders 236
Evidence-based and empirically-informed psychotherapy models for children with PTSD 238
Trauma focused-cognitive behavior therapy (TF-CBT) 238
Eye Movement Desensitization and Reprocessing (EMDR) 244
Cognitive behavior therapy in schools 247
Psychodynamic therapies 248
Creative arts therapies 248
Family systems therapies 249
Affective and interpersonal regulation therapies 249
Psychopharmacotherapy 254
Integrative psychotherapy and pharmacotherapy models 255
Real world challenges in treating children with PTSD 256
Conclusion 262
CHAPTER 9 Prevention of Traumatic Stress Disorders 264
Overview of approaches to prevention 266
Theoretical foundations and principles of PTSD prevention 271
Hobfoll's theory of conservation of resources (COR) 271
De Jong's ecological resilience model 272
Saxe's trauma systems therapy (TST) model 273
Brom and Kleber's minimal learning model of resilience 274
PTSD prevention interventions 275
Community and school-based violence and delinquency prevention programs 275
Psychological first aid in the wake of disaster and terrorism 280
Critical incident stress management (CISM) 287
Cognitive behavior therapy (CBT) prevention models 289
Pharmacological prevention of PTSD 290
PTSD prevention with children 291
Conclusion 291
CHAPTER 10 Forensic Issues in the Traumatic Stress Field 294
Forensic mental health roles for traumatic stress professionals 296
Child welfare and child protective services 298
Expert witness role 298
Forensic testimony related to specific cases 299
Family law courts 301
Juvenile justice system 305
Adult criminal justice system 309
Forensic challenges for PTSD clinicians and researchers 310
Exaggeration of PTSD symptoms for legal or disability compensation (malingering) 310
PTSD as a mitigating factor in criminal culpability 314
Credibility of witness and defendant memories of potentially traumatic events 318
Dangerousness (and rehabilitation) of sexual and violent offenders 320
Forensic mental health standards of care and standards of practice 321
CHAPTER 11 Social, Cultural and Ethical Issues in the Traumatic Stress Field 326
The role of ethnicity, culture and social resources in PTSD 328
Discrimination due to gender or sexual orientation and PTSD 333
Physical and developmental disabilities and PTSD 336
Poverty, psychological trauma and PTSD 339
Victims of political repression, genocide ('ethnic cleansing') and torture 341
Torture 344
Refugee survivors of political violence and catastrophic disasters 350
Programs addressing the social and political aspects of catastrophic traumatic stressors 357
CHAPTER 12 Careers and Ethical Issues in the Traumatic Stress Field 362
Careers in the traumatic stress field: 1. The research scientist 368
Careers in the traumatic stress field: 2. The clinician practitioner 370
Careers in the traumatic stress field: 3. The scientist practitioner 375
Careers in the traumatic stress field: 4. The health services researcher 378
Careers in the traumatic stress field: 5. The educator 380
Careers in the traumatic stress field: 6. The program director 382
Ethical issues in PTSD research and treatment 386
Afterword 392
References 396
Index 438
A 438
B 439
C 440
D 442
E 443
F 444
G 444
H 445
I 445
J 446
K 446
L 446
M 446
N 447
O 448
P 448
Q 450
R 450
S 451
T 452
U 453
V 454
W 454
Y 454
Z 454