Clinician's Guide to Posttraumatic Stress Disorder E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 488

Veröffentlichungsjahr: 2010

Beschreibung

Praise for Clinician's Guide to Posttraumatic Stress Disorder

"Rosen and Frueh's important book takes a huge leap toward clarity. The chapters are authored by leading experts in the field, and each addresses one of the pressing issues of the day. The tone is sensible and authoritative throughout, but always with a thoughtful ear toward clinical concerns and implications."
—George A. Bonanno, PhD Professor of Clinical Psychology Teachers College, Columbia University

"All clinicians and researchers dealing with anxiety disorders should have a copy of Rosen and Frueh's Clinician's Guide to Posttraumatic Stress Disorder on their shelves. Moreover, they should read it from cover to cover. This compilation . . . is authoritative, very readable, and extremely well crafted. The issues are looked at from many vantage points, including assessment and treatment, cross-cultural, cognitive, and categorical/political."
—Michel Hersen, PhD, ABPP Editor, Journal of Anxiety Disorders Dean, School of Professional Psychology, Pacific University

Clinician's Guide to Posttraumatic Stress Disorder brings together an international group of expert clinicians and researchers who address core issues facing mental health professionals, including:

• Assessing and treating trauma exposure and posttraumatic morbidity

• Controversies and clinical implications of differences of opinion among researchers on the definition and diagnosis of the condition

• Treating the full range of posttraumatic reactions

• Cross-cultural perspectives on posttraumatic stress

Leseprobe

Table of Contents

Title Page

Copyright Page

Author Biographies

Preface

PART I - Core Issues

CHAPTER 1 - Posttraumatic Stress Disorder and General Stress Studies

HISTORICAL AND SOCIETAL PERSPECTIVES

EPIDEMIOLOGY OF TRAUMATIC EVENTS AND POSTTRAUMATIC SYMPTOMS

THEORIES UNDERLYING THE PTSD DIAGNOSIS

ISSUES AND CONTROVERSIES

PTSD, STRESS STUDIES, AND THE NEED FOR EVIDENCE-BASED PRACTICE

REFERENCES

CHAPTER 2 - Normal Reactions to Adversity or Symptoms of Disorder?

OVERVIEW AND CAVEATS

HISTORICAL COMMENTS

NATURAL AND PATHOLOGICAL RESPONSES TO TRAUMA

ADAPTIVE RESPONSES

DIFFICULTY OF DEFINING THE BOUNDARY OF PTSD

PTSD AS A CHALLENGE TO THE WEB OF BELIEF

WHY DOES IT MATTER?

REFERENCES

CHAPTER 3 - Criterion A: Controversies and Clinical Implications

CRITERION A

THE EVOLUTION OF CRITERION A

DSM-III

DSM-III-R

DSM-IV

CONTENTIOUS ASPECTS OF CRITERION A

UNDERSTANDING WHY PTSD SYMPTOMS MAY OCCUR AFTER NON CRITERION A EVENTS

IMPLICATIONS FOR THE CLINICIAN

CONCLUSION

REFERENCES

CHAPTER 4 - Posttraumatic Memory

THE “INNER LOGIC” OF PTSD

TRAUMATIC AMNESIA

FALSE MEMORIES

RECOVERED MEMORIES

CLINICAL IMPLICATIONS

REFERENCES

CHAPTER 5 - Searching for PTSD’s Biological Signature

VALIDATING PSYCHIATRIC DIAGNOSES: PTSD AS A CASE EXAMPLE

THE “CORTISOL HYPOTHESIS”

NEUROANATOMY

PSYCHOPHYSIOLOGICAL REACTIVITY

IMPLICATIONS FOR THE CLINICIAN

REFERENCES

PART II - Clinical Practice

CHAPTER 6 - Assessing Trauma Exposure and Posttraumatic Morbidity

CASE STUDY INTRODUCTION

ASSESSING HISTORY OF EXPOSURE TO TRAUMATIC STRESSORS

ASSESSING PTSD’S SYMPTOM CRITERIA

ASSESSING COMORBIDITY

CASE STUDY: METHODS AND RESULTS

CONCLUSION

REFERENCES

CHAPTER 7 - Early Intervention in the Aftermath of Trauma

THE DEBRIEFING MODEL

COMMUNITY RESPONSES

ACQUIRING FUNDAMENTAL SKILL SETS

SUGGESTED PROTOCOLS FOR COMMUNITY-AND PATIENT-LEVEL INTERVENTION

APPLYING A COMMUNITY-BASED MODEL

REFERENCES

CHAPTER 8 - Cognitive Behavioral Treatments for PTSD

TRAUMA AND PTSD

EMOTIONAL PROCESSING THEORY

TREATMENT OUTCOME STUDIES

PROLONGED EXPOSURE THERAPY

IMPLICATIONS FOR CLINICAL PRACTICE

REFERENCES

CHAPTER 9 - Treating the Full Range of Posttraumatic Reactions

PSYCHOLOGICAL DISORDERS FOLLOWING TRAUMA

WHEN DOES ONE PROVIDE TREATMENT?

IMMEDIATE AFTERMATH OF TRAUMA

INTERVENTION STRATEGIES FOR POSTTRAUMATIC DISORDERS

CASE STUDY

CONCLUDING COMMENT

REFERENCES

CHAPTER 10 - Cross-Cultural Perspectives on Posttraumatic Stress

WHAT IS CULTURE?

POSTTRAUMATIC STRESS DISORDER

POSTTRAUMATIC RESPONSES ACROSS CULTURES

POSTTRAUMATIC RESPONSES ACROSS HISTORY

ASSESSMENT OF POSTTRAUMATIC REACTIONS

CULTURALLY SENSITIVE TREATMENT

ADDITIONAL STRATEGIES AND CONCERNS

CONCLUDING POINTS

REFERENCES

AFTERWORD

PTSD’S UNCERTAIN FUTURE IN THE DSM

SOCIOPOLITICAL CONSIDERATIONS

CLINICAL IMPLICATIONS FOR UNDERSTANDING POSTTRAUMATIC DISORDERS

REFERENCES

Author Index

Subject Index

This book is printed on acid-free paper.

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Library of Congress Cataloging-in-Publication Data:

Clinician’s guide to posttraumatic stress disorder / edited by Gerald M. Rosen, B. Christopher Frueh.

p. cm.

Includes index.

ISBN 978-0-470-45095-6 (cloth); 978-0-470-64668-7 (e-book); 978-0-470-64691-5 (e-book); 978-0-470-64692-2 (e-book)

1. Post-traumatic stress disorder. I. Rosen, Gerald M., 1945—II. Frueh, B. Christopher.

RC552.P67C55 2010

616.85’21—dc22

2010000767

Author Biographies

RICHARD BRYANT, PhD, is Scientia Professor of Psychology at the University of New South Wales. Dr. Bryant also is director of the Traumatic Stress Clinic at Westmead Hospital, Sydney. He has published over 250 journal articles, with a research focus on biological and cognitive mechanisms in traumatic stress and the treatment of posttrauma disorders. Dr. Bryant has consulted with many civilian and military agencies around the world to advise on appropriate mental health responses in the aftermath of trauma.

JOHN COOPER, MBBS, MPM, FRANZCP is a psychiatrist who has worked clinically for over 20 years in the area of posttraumatic mental health. Dr. Cooper is an expert consultant to the Australian Centre for Posttraumatic Mental Health (ACPMH), and provides expert advice to state and federal government in the area of posttraumatic mental health. He has written a number of peer-reviewed papers examining best practice guidelines for treating posttraumatic stress disorder.

MARK CREAMER, PhD, is director of the Australian Centre for Posttraumatic Mental Health (ACPMH) and professor of psychology in the Department of Psychiatry at the University of Melbourne. Dr. Creamer has worked extensively with individuals, communities, and organizations following traumatic incidents of natural and human origin. He regularly consults with state and federal governments, has published over 100 journal publications, and serves on the Board of Directors of the International Society for Traumatic Stress Studies.

GRANT J. DEVILLY, PhD, is associate professor at Griffith University in Brisbane, Australia. Dr. Grant’s research focus is predominantly on preventing long-term pathology following trauma. He has worked at the Institute of Psychiatry in London, England, and as a senior psychologist at both Queensland and Victorian psychiatric hospitals in Australia. Dr. Grant also has a part-time private practice in clinical psychology.

JON D. ELHAI, PhD, is assistant professor of psychology at the University of Toledo. Dr. Elhai has published numerous scientific articles and edited book chapters on posttraumatic stress disorder. His publications primarily focus on assessment, psychopathology, and health services issues. Dr. Elhai serves on the editorial boards of several journals, including the Journal of Traumatic Stress, Journal of Trauma and Dissociation, and Psychological Trauma.

EDNA B. FOA, PhD, is professor of clinical psychology in psychiatry at the University of Pennsylvania, and director of the Center for the Treatment and Study of Anxiety. Dr. Foa is internationally recognized for her studies on the psychopathology and treatment of anxiety disorders. She has published several books and over 350 articles; chaired the DSM-IV Subcommittee for OCD; co-chaired the DSM-IV Subcommittee for PTSD; and chaired the Treatment Guidelines Task Force of the International Society for Traumatic Stress Disorders. Dr. Foa’s work has been recognized with numerous awards and honors including a Lifetime Achievement Award presented by the International Society for Traumatic Stress Studies.

JULIAN D. FORD, PhD, is associate professor of psychiatry at the University of Connecticut School of Medicine and director of the University’s Health Center Child Trauma Clinic and Center for Trauma Response Recovery and Preparedness. Dr. Ford conducts research on psychotherapy and family therapy, health services utilization, psychometric screening and assessment, and psychiatric epidemiology. He serves on the Editorial Board of scientific and professional journals such as Clinical Psychology: Science & Practice and Child Maltreatment.

EVAN M. FORMAN, PhD, is associate professor of psychology at Drexel University, where he is the director of the doctoral program in clinical psychology. Dr. Evans’ research interests include the development and evaluation of acceptance-based behavior interventions, mediators of psychotherapy outcome, and posttraumatic stress disorder. He is the author of numerous scholarly papers and chapters, as well as co-editor of a forthcoming book Acceptance and Mindfulness in Cognitive-Behavior Therapy.

B. CHRISTOPHER FRUEH, PhD, is a clinical psychologist and professor of psychology at the University of Hawaii, Hilo, HI, and McNair Scholar and director of Clinical Research at the Menninger Clinic, Houston, TX. Dr. Frueh has served as Principal Investigator (PI) on 13 federally funded research grants and authored over 170 scientific publications. His clinical and research focus has been on improving mental health services for trauma survivors, including veterans, civilians, and adults with severe mental illnesses. When work on this book was initiated, Dr. Frueh was a professor of psychiatry at Baylor College of Medicine.

ELKE GERAERTS, PhD, is assistant professor of clinical psychology and principal investigator of the Clinical Cognition Lab at the Erasmus University of Rotterdam in the Netherlands. Dr. Geraerts obtained her PhD degree at Maastricht University and was a postdoctoral fellow at Harvard University. Her research has focused on how people remember and forget traumatic events, and the cognitive functioning of those who report recovered memories of abuse. Dr. Geraerts has published over 30 peer-reviewed articles and has served as an expert witness on cases of childhood abuse.

RICHARD GIST, PhD, is a public health psychologist and principal assistant to the director of the Kansas City (Missouri) Fire Department. Dr. Gist holds research affiliations at Kansas City University of Medicine and Biosciences, and with the Department of Emergency Medicine at the University of Missouri (Kansas City). He has authored more than a hundred publications related to disaster response. Dr. Gist recently chaired for the National Fallen Firefighters Foundation a series of consensus meetings on occupational behavioral health in the fire service.

ANOUK L. GRUBAUGH, PhD, is associate professor in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina, and a research health scientist at Charleston VAMC. Dr. Grubaugh has authored over 50 peer-reviewed publications, primarily on posttraumatic stress disorder, severe mental illness, and issues related to treatment adherence in public sector settings. She is the recipient of a VA Health Services Research and Development career development award.

ELIZABETH A. HEMBREE, PhD, is associate professor of psychology in the Department of Psychiatry, University of Pennsylvania. Dr. Hembree was director of clinical training in the Center for the Treatment & Study of Anxiety at University of Pennsylvania from 1999-2009. She is currently a member of the Board of Directors of the International Society of Traumatic Stress Studies. Dr. Hembree has consulted with the US Department of Veterans Affairs and the Department of Defense to train mental health workers in the provision of effective, evidence-based treatments.

JAMES D. HERBERT, PhD, is professor of psychology at Drexel University, where he directs the Anxiety Treatment and Research Program and serves as associate dean in the College of Arts and Sciences. Dr. Herbert’s research focuses on acceptance-based behavior therapy, anxiety disorders, remote Internet-based clinical services, and the promotion of evidence-based practice in mental health. He is associate editor of the Scientific Review of Mental Health Practice and a fellow with several organizations including the Institute for Science in Medicine.

ALLAN V. HORWITZ, PhD, is currently dean of social and behavioral sciences at Rutgers University. He is a professor of sociology and has published numerous articles, chapters, and books on various aspects of mental illness. Dr. Horwitz’s most recent books include Diagnosis, Evidence, and Therapy: Conundrums of American Medicine (with Gerald Grob; 2009) and The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder (with Jerome Wakefield; 2007).

SCOTT O. LILIENFELD, PhD, is professor of psychology at Emory University and editor-in-chief of the Scientific Review of Mental Health Practice. His principal areas of interest are personality disorders, psychiatric diagnosis, and evidence-based practice in clinical psychology. Dr. Lilienfeld is past president of the Society for a Science of Clinical Psychology and a fellow with the Association for Psychological Science. He has authored and co-authored numerous books including 50 Great Myths of Popular Psychology (2010).

PAUL R. MCHUGH, MD, was Henry Phipps Professor and Director of the Department of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine and psychiatrist-in-chief at Johns Hopkins Hospital from 1975 through 2001. Dr. McHugh is now University Distinguished Service Professor of Psychiatry. He is author of The Perspectives of Psychiatry and Try To Remember: Psychiatry’s Clash Over Meaning, Memory, and Mind.

JAMES A. NAIFEH, PhD, is research assistant professor in the Department of Psychiatry, Uniformed Services, University of the Health Sciences, and a scientist at the Center for the Study of Traumatic Stress. Previously, Dr. Naifeh was a postdoctoral fellow at the University of Mississippi Medical Center. His research focuses on issues related to the assessment of post-traumatic stress disorder (PTSD) and the role of cognitive-emotional vulnerabilities in PTSD and related disorders.

MEAGHAN O’DONNELL, PhD, is a clinical psychologist and acting research director at the Australian Centre for Posttraumatic Mental Health, University of Melbourne. Dr. O’Donnell has published over 40 peer-reviewed papers and book chapters in the area of posttraumatic mental health, and continues to conduct active research. She acts within a scientific advisory capacity for the Australian federal government, and is on the scientific panel for a number of research conferences including the Australian Conference for Traumatic Stress.

SCOTT P. ORR, PhD, is a medical research scientist at the Veterans Affairs Medical Center in Manchester, NH; psychologist (Psychiatry Service) at Massachusetts General Hospital; and associate professor of psychology in the Department of Psychiatry, Harvard Medical School. Dr. Orr also serves as the research and development coordinator at the Manchester VA Medical Center. He has over 25 years of research experience focused on various aspects of posttraumatic stress disorder and serves as a member on national scientific review groups.

GERALD M. ROSEN, PhD, is a clinical psychologist in Seattle, Washington. He holds licenses in Washington, Alaska, and Oregon and is credentialed with the American Board of Professional Psychology. Dr. Rosen holds an appointment as clinical professor with the University of Washington’s Department of Psychology, and with the medical school’s Department of Psychiatry and Behavioral Sciences. He currently serves on the editorial board of the Scientific Review of Mental Health Practice, and is a fellow with the Association for Psychological Science.

ROBERT L. SPITZER, MD, is professor of psychiatry at Columbia University. Dr. Spitzer is most well known for his role in overseeing the development of psychiatry’s Diagnostic and Statistical Manual, 3rd edition (DSM-III) and its revision (DSM-III-R). He has authored more than 200 publications, primarily dealing with issues of diagnosis and assessment. Dr. Spitzer also authored the Research Diagnostic Criteria and several assessment instruments in psychiatry such as the Structured Clinical Interview for DSM-IV (SCID) and the PHQ-9 (an instrument widely used in primary care research and clinical settings for the assessment of depression).

JEROME C. WAKEFIELD, PhD, DSW, is University Professor of Social Work and Professor of Psychiatry at New York University. He also is a licensed clinical social worker who has practiced both in community mental health and private practice. Dr. Wakefield has authored over 160 publications, primarily focused on the conceptual foundations of the mental health professions. He currently serves on editorial boards including the Clinical Social Work Journal. Dr. Wakefield co-authored with Allan Horwitz, The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder (2007).

Preface

Since its introduction in 1980, posttraumatic stress disorder (PTSD) has changed the landscape of stress studies and created an array of sociopolitical, conceptual, and clinical issues. For the better, research has grown exponentially over the years, providing clinicians, healthcare administrators, and policy makers with a better understanding of post-traumatic psychiatric morbidity. Despite this progress, controversies abound as to how clinicians should diagnose and treat psychiatric disorder in the aftermath of trauma. Further, a number of misconceptions and myths concerning PTSD have adversely influenced clinical practice and traumatic stress studies. This is of great concern, for it creates the risk of doing harm in our clinical work.

To address the core issues facing clinicians, we have brought together an international group of leading clinicians and clinical researchers. Their scholarly reviews of the literature are joined with recommendations for clinical practice, thereby providing the clinician with insights and skills based on the best available evidence. In the first section (Chapters 1 through 5), the reader is provided with an overview of stress studies and core issues that concern the PTSD construct. The second section (Chapters 6 through 10) covers issues in the assessment and treatment of posttraumatic disorders. The Clinician’s Guide concludes with an Afterword that considers future definitions of PTSD, and how changes may impact how we, as clinicians, conceptualize our patient’s problems.

As the reader progresses through the chapters and learns more about recent research findings, several closely held beliefs are likely to be challenged. On those occasions, when a particular misconception or myth is examined, we ask that the reader remain open to new ideas. It is in this spirit that contributing authors have lent their time and expertise.

Gerald M. Rosen B. Christopher Frueh

PART I

Core Issues

CHAPTER 1

Posttraumatic Stress Disorder and General Stress Studies

GERALD M. ROSEN B. CHRISTOPHER FRUEH JON D. ELHAI ANOUK L. GRUBAUGH JULIAN D. FORD

In the relatively short span of three decades, posttraumatic stress disorder (PTSD) has captured the attention of mental health professionals, their patients, and the public at large. First introduced into the third edition of psychiatry’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III; APA, 1980), the diagnosis of PTSD has served as the focus of more than 12,000 studies in peer-review journals. Clinicians have found the diagnosis useful when conceptualizing patients’ reactions to horrific and life-threatening events. Finding PTSD of benefit, clinicians have expanded its application in an effort to help patients with a variety of stress issues.

The general public has increasingly applied the “PTSD model” to their understanding of adjustment in the aftermath of trauma. Public awareness of psychiatric posttrauma tic issues has been furthered by extensive news coverage of events around the globe, including terrorist attacks in New York, London, and Madrid; Hurricane Katrina, earthquakes, and other natural disasters; widely publicized cases in America of child sexual abuse and international stories of child trafficking; mass genocides and other atrocities; and reports on the psychiatric casualties of war, including America’s veterans who have fought in Iraq and Afghanistan.

To appreciate why PTSD was introduced in the DSM-III, and to understand the spiraling growth of research and clinical interest, it is instructive to step back and consider the origins from which the diagnosis emerged. By looking at PTSD’s origins, its underlying assumptions, and the fruits of three decades of research, clinicians will better understand posttraumatic morbidity and issues surrounding patient care.

HISTORICAL AND SOCIETAL PERSPECTIVES

The field of general stress studies was greatly influenced by the early work of Walter Cannon (e.g., Cannon, 1929) and his proposal that “critical stress” can disrupt the body’s homeostatic mechanisms. Later, Hans Selye proposed a General Adaptation Syndrome (Selye, 1936), which conceived of stressors as “etiologically nonspecific.” Selye’s model held the view that any event of sufficient intensity (i.e., the stressor) was capable of producing a physiological adaptation response (i.e., the syndrome) whose features were constant regardless of event type.