Posttraumatic Stress Disorder (eBook)

Scientific and Professional Dimensions

Christine A. Courtois, Jon D. Elhai, Julian D Ford, Damion J. Grasso (Autoren)

eBook Download: PDF | EPUB

2015 | 2. Auflage
618 Seiten
Elsevier Science (Verlag)
978-0-12-801439-4 (ISBN)

Infos

This comprehensive overview of research and clinical practice in PTSD includes new insights into assessment with regard to DSM-5 and ICD-11, discussion of ongoing controversies in the field as to what constitutes safe and effective care, and new research as to assessment, diagnosis, treatment, and prevention of PTSD. The second edition includes new coverage of the neurobiology of PTSD, PTSD in special populations, and forensic issues relating to PTSD. - Synthesizes research and clinical developments on PTSD - Highlights key controversies, issues, and developments in the field - Provides case studies for better understanding of clinical care - Encompasses DSM-5 and ICD-11 major revisions to PTSD symptoms - Includes new coverage of neurobiology and genetics of PTSD - Includes advances in prevention and treatment of PTSD - Includes new coverage of forensic issues related to PTSD

Inhalt

Front Cover 1
Posttraumatic Stress Disorder 4
Copyright Page 5
Contents 6
Preface 10
1 Understanding psychological trauma and posttraumatic stress disorder (PTSD) 16
“Is there a life after trauma?”: The case of Marian M. 18
History of popular and scientific conceptions of psychological trauma and PTSD 20
From stress reactions to traumatic stressors and posttraumatic disorders 33
Complex PTSD: can traumatic stress affect a person’s core self? 36
PTSD becomes complex in the DSM-5 39
Complex PTSD emerges as a (proposed) subtype of PTSD in the ICD-11 46
From trauma exposure to developing (and recovery from) traumatic stress disorders 46
Epidemiology of PTSD: how often (and to whom) does PTSD occur? 47
Etiology of PTSD: potential causes and risk factors for developing PTSD 48
Biology of PTSD: alterations in the body and in physical health associated with PTSD 49
Research and clinical assessment of psychological trauma and PTSD 49
Treatment and prevention of PTSD 50
Forensic issues in the PTSD field 51
Social, cultural, and ethical issues in the PTSD field 52
Careers in the PTSD field and impact of psychological trauma on the professional 52
References 53
2 The impact of psychological trauma 58
When the other shoe falls: What makes stressful events traumatic? 58
In the beginning: acute traumatic stress reactions and acute stress disorder 67
Acute traumatic stress reactions 67
Acute stress disorder 69
Life after trauma: Positive and problematic trajectories of adaptation 73
Positive posttraumatic life trajectories 74
Problematic posttraumatic life trajectories 80
Research on the impact of traumatic stress on the course of people’s lives 83
References 89
3 Etiology of PTSD: What causes PTSD? 96
Understanding etiology: causes? Or risk and protective factors? 102
Causal risk factors for PTSD 107
Degree or severity of exposure to traumatic stressor(s) 108
Preexisting psychiatric disorders 116
Potential genetic or biological causal risk factors 120
Cognitive processing capacities 123
Potential risk factors for exposure to traumatic stressors 127
Vulnerability factors for PTSD 128
Outcome risk factors 133
Protective factors 134
Conclusion 136
References 137
4 Epidemiology of PTSD 148
Epidemiology of exposure to traumatic stressors 151
Traumatic stressor exposure in early childhood 152
Traumatic stressor exposure among school-age children 153
Traumatic stressor exposure in adolescence 154
Traumatic stressor exposure in adulthood 156
Traumatic stressor exposure among older adults 158
Poly-victimization 158
Epidemiology of PTSD 163
Criterion A: evidence of trauma exposure 163
PTSD in early childhood 165
PTSD in school-age children and adolescents 166
PTSD among adults 167
PTSD among older adults 168
Comorbid psychiatric and medical disorders 168
Gender and the epidemiology of PTSD 176
Ethnocultural and socioeconomic background and the epidemiology of PTSD 184
References 187
5 Neurobiology of traumatic stress disorders and their impact on physical health 198
Alterations in the body’s stress response systems in PTSD 200
ANS reactivity in PTSD 201
Stress hormones and PTSD 204
Alterations in brain structure, functioning, and chemistry in PTSD 212
Brain structure and PTSD 212
Brain functioning and PTSD 220
Brain chemistry and PTSD 226
Putting it all together: the learning brain versus the survival brain in PTSD 227
Genetics and PTSD 228
PTSD and physical health problems and medical illness 231
PTSD and medical illness 231
Exposure to traumatic stressors, PTSD, and health risk behaviors 233
Exposure to traumatic stressors, PTSD, and somatic dissociation 234
Somatic complaints and medical illness as precipitants for PTSD 235
Conclusion 236
References 237
6 Assessment of psychological trauma and PTSD 248
Scientific criteria for PTSD assessment 248
Clinical issues in PTSD assessment: 1. Assessing trauma history 252
Assessing past exposure to traumatic stressors (trauma history) 255
Trauma history measures 256
Assessment of PTSD: identifying symptoms and confirming the diagnosis 260
PTSD assessment with children 265
PTSD symptom and diagnosis measures 266
Assessment of psychiatric problems commonly comorbid with PTSD 273
Assessment of posttraumatic dysregulation 274
Screening for PTSD 275
Conclusion 307
References 308
7 Treatment of adults with PTSD 314
Best practice principles in the treatment of PTSD 316
Phases of therapy for PTSD 319
PTSD treatment: practical issues 335
Evidence-based treatments for PTSD 337
CBT for PTSD 340
CBT interventions for special populations of adults with PTSD 346
Psychotherapies for Affect and Interpersonal Regulation (PAIR) 349
Hypnosis and hypnotherapy for PTSD 354
Psychodynamic therapies for PTSD 355
Integration of experiential and psychodynamic psychotherapies for PTSD 356
Body-focused psychotherapy for PTSD 357
Family and couples therapies for PTSD 358
Group therapies for PTSD 359
Pharmacological therapies (medication) for PTSD 360
Conclusion 360
References 370
8 Treatment of children and adolescents with PTSD 382
Evidence-based and empirically informed psychotherapy models for children with PTSD 382
Trauma-focused Cognitive Behavioral Therapy 384
Trauma Affect Regulation: Guide for Education and Therapy 394
Emerging evidence-based psychotherapies for children and youth with PTSD 395
Prolonged Exposure Therapy 396
Cognitive Processing Therapy 396
Eye Movement Desensitization and Reprocessing 397
Trauma and Grief Components Therapy for Adolescents 397
KID Narrative Exposure Therapy 398
Seeking Safety 399
Cognitive Behavioral Intervention for Trauma In Schools 399
ERASE-Stress 400
Child-Parent Psychotherapy 400
Other empirically based psychotherapy models for adolescents with PTSD 401
Pharmacotherapy for children with PTSD 402
Creative arts therapies 404
Real-world challenges in treating children with PTSD 410
Conclusion 420
References 421
9 Prevention of PTSD 428
Overview of biopsychosocial approaches to prevention 431
Theoretical foundations and principles of PTSD prevention 442
PTSD prevention interventions 445
Conclusion 467
References 467
10 Forensic issues in the traumatic stress field 474
Forensic mental health roles for traumatic stress professionals 475
Child welfare service and CPS 483
Family law courts 487
Juvenile justice system 489
Adult criminal justice system 492
Forensic challenges for PTSD clinicians and researchers 494
Forensic mental health standards of care and standards of practice 509
References 512
11 Social, cultural, and other diversity issues in the traumatic stress field 518
The role of gender, ethnicity, culture, and social resources in PTSD 521
Discrimination due to gender or sexual orientation and PTSD 527
Physical and developmental disabilities and PTSD 530
Poverty, psychological trauma, and PTSD 532
Victims of political repression, genocide (“ethnic cleansing”), and torture 535
Refugee survivors of political violence and catastrophic disasters 545
Programs addressing the social and political aspects of catastrophic traumatic stressors 553
Conclusion 556
References 556
12 Careers and ethical issues in the traumatic stress field 562
Careers in the traumatic stress field: 1. The research scientist 565
Careers in the traumatic stress field: 2. The clinician practitioner 568
Careers in the traumatic stress field: 3. The scientist practitioner 573
Careers in the traumatic stress field: 4. The health services researcher 576
Careers in the traumatic stress field: 5. The educator 579
Careers in the traumatic stress field: 6. The program director 580
Ethical issues in PTSD research and treatment 584
References 590
Afterword 600
Index 604

Textauszug

Preface

The published literature on posttraumatic stress disorder (PTSD) has grown rapidly over the past 25 years, almost doubling in size since the 2009 first edition of this book. Now there are more than 10,000 journal articles and hundreds of books on this topic that are widely read by scientists, clinicians, educators, trainees, and laypersons—and increasingly by policy makers, judges and attorneys, organizational leaders, and opinion leaders in the media and popular and political culture. PTSD offers a widely accepted framework for understanding the effects of experiencing potentially traumatic events such as terrorism, domestic and community violence, physical and sexual assault, child maltreatment, human trafficking, refugee adversity homicide, disaster, life-threatening illness and accidents, torture, genocide, and the injury done to both civilians and military combatants in war. Public as well as professional awareness has grown commensurately as most people now recognize the profound impact of psychological trauma and the need for proactive and scientifically based approaches to timely prevention, humanitarian relief, and evidence-based treatment for traumatized persons, communities, and nations.

As a result, scholars, researchers, and educators in the social, biological, medical, political, and behavioral sciences need a current and comprehensive source on PTSD for their studies and teaching. The Handbook of PTSD, Second Edition (Friedman, Keane, & Resick, 2014) and The Encyclopedia of Trauma (Figley, 2012) provide snapshots of key issues and topics in the PTSD field, but practitioners, clinicians, students, and trainees in the health care and human and social services need a concise and complete overview of PTSD as their source of authoritative information on PTSD. This Second Edition of Posttraumatic Stress Disorder: Science and Practices was designed to meet that need for a comprehensive yet concise textbook on PTSD that will be useful to researchers, educators, clinicians, and trainees in graduate and advanced undergraduate courses in the mental health, health care, social and human services, and criminal justice fields.

This text covers all major topics in the traumatic stress field, from etiology to neurobiology to assessment and diagnosis to evidence-based treatment and prevention. All topics covered in the two comprehensive Encyclopedias on PTSD (Figley, 2012; Reyes, Elhai, & Ford, 2008) are addressed in this text. A balanced view of each topic includes (i) material relevant to scientific researchers and clinical practitioners; (ii) multiple theoretical vantage points; (iii) answers to questions that aspiring trainees have about becoming a traumatic stress researcher or clinician; (iv) key points for educators to use in teaching; (v) recognition in every section of the book (and special emphasis in Chapter 11) of the critical role that ethnicity, culture, gender and sexual identity, and legal and economic factors have in influencing PTSD and its assessment, treatment, and prevention; and (vi) a developmental focus on the nature of PTSD across the life span from infancy to older adulthood.

The book is written at the level suitable for both advanced undergraduate and graduate trainees, as well as for educators, clinicians, or researchers seeking an overview of the traumatic stress field. The text uses language that is free of technical jargon except for key terms that are supplemented with nontechnical definitions and examples. The focus is on describing state-of-the-art research and clinical methodologies in down-to-earth terms with interesting examples and both research and clinical case studies. The text introduces the major issues, controversies, and findings in the field, as well as highlights what is not yet known and how researchers and clinicians are (or can) make further discoveries.

Chapter 1, Understanding Psychological Trauma and Posttraumatic Stress Disorder (PTSD), describes the history of scientific knowledge and popular conceptions of psychological trauma from the earliest writings several thousand years ago to modern definitions and diagnoses. Controversies such as the nature and validity of memories of childhood traumatic exposure, potential bias in diagnosis and treatment of females and persons of color, gender and ethnocultural differences in the experience and impact of psychological trauma, major expansion in the field’s understanding of the range of problems involved in PTSD and diagnostic definitions of PTSD in the United States (the 2014 Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5) and internationally (the 2016 International Classification of Diseases, Eleventh Edition, ICD-11), and the interplay of mind and body (including genetics and brain development) in psychological trauma are highlighted. Each major topic from subsequent chapters is previewed.

Chapter 2, The Impact of Psychological Trauma, provides a description of the longitudinal course of psychological trauma and PTSD: the unfolding impact of traumatic stress from initial exposure[s] through the following months, years, and decades, and across generations. Acute reactions to psychological trauma and their biological, psychological, and sociocultural bases are described, followed by a description of positive trajectories (e.g., resistance, resilience) and problematic trajectories (e.g., acute posttraumatic stress problems, PTSD, complex PTSD) in the wake of psychological trauma—including the different manifestations of formal diagnoses of PTSD and comorbid disorders as they occur at different developmental epochs and over time.

Chapter 3, Etiology of PTSD: What Causes PTSD?, provides an overview of scientific knowledge and clinical and popular theories of the causes of PTSD. Risk factors for developing PTSD and related behavioral health disorders or sociovocational and legal problems are summarized. Protective factors and contexts that promote stress “resistance” or “resilience” are summarized. An integrative model that takes into account risk and protective factors and the impact of different types of psychological trauma at different developmental phases is presented in order to provide the reader with a unified approach to understanding how PTSD develops and can be effectively treated (discussed in Chapters 7 and 8) or potentially prevented (discussed in Chapter 9). The role of family, community, culture, and service systems in increasing risk of, or resilience/recovery from, traumatic stress disorders is illustrated through case examples.

Chapter 4, Epidemiology of PTSD, describes research on the incidence (how often something occurs) and prevalence (how commonly something is found in a population) of exposure to different types of psychological trauma, Acute Stress Disorder, PTSD, and comorbid psychiatric/addictive disorders and sociovocational and legal problems among children and adults. Differences in the extent and nature of traumatic stressor exposure and PTSD are highlighted across community, clinical (mental health), medical, and criminal justice (juvenile and adult) populations. Approaches to increasing the accuracy and completeness of epidemiological studies of psychological trauma and PTSD are discussed.

Chapter 5, Neurobiology of Traumatic Stress Disorders and Their Impact on Physical Health, distills the extensive animal and human research literatures on the biological foundations of stress and posttraumatic stress in a summary that addresses (i) alterations in the body’s stress response systems; (ii) alterations in brain chemistry, structure, and functioning; (iii) the role of genetics and epigenetics (changes in genes caused by life experiences) in PTSD; and (iv) the impact of psychological trauma and traumatic stress disorders on physical health. Classic and contemporary studies on the physiology, neurobiology, and alterations in brain functioning that may contribute to PTSD are highlighted to bring to life the complex biological underpinnings of psycho­logical trauma and its impact on physical as well as psychological health.

Chapter 6, Assessment of Psychological Trauma and PTSD, presents an overview of approaches to clinical and research assessment of people’s life history of exposure to traumatic stressors and past or current PTSD. Measures with the strongest evidence base are described, along with concise definitions of the psychometric criteria (the standards for accurate measurement) that are required for assessment to be considered to be reliable, valid, and clinical useful. Approaches to the following aspects of assessment are described: (i) screening to identify individuals who may have experienced trauma and may be suffering traumatic stress symptoms; (ii) structured interview assessment of psychological trauma history and traumatic stress disorders; (iii) standardized questionnaires assessing trauma history, PTSD and its symptoms, and key comorbid psychosocial problems; (iv) psychophysiological and neuropsychological assessment of trauma survivors; and, (v) forensic (juvenile and criminal justice, civil law) assessment of psychological trauma survivors.

Chapters 7 and 8, Treatment of Adults with PTSD and Treatment of Children and Adolescents with PTSD, describe the classic three-phase model of treatment for PTSD and discuss the essential clinical and ethical/legal ingredients that transcend any single therapeutic theory or intervention (such as engagement, working alliance, confidentiality/privilege, mandated reporting, crisis prevention and management, identifying and therapeutically...

Produkt-Details

• Erscheint lt. Verlag: 31.7.2015
• Sprache: englisch
• Themenwelt: Geisteswissenschaften ► Psychologie ► Allgemeine Psychologie
• Themenwelt: Geisteswissenschaften ► Psychologie ► Biopsychologie / Neurowissenschaften
• Themenwelt: Geisteswissenschaften ► Psychologie ► Klinische Psychologie
• Themenwelt: Geisteswissenschaften ► Psychologie ► Persönlichkeitsstörungen
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Psychiatrie / Psychotherapie
• Themenwelt: Sozialwissenschaften ► Soziologie
• ISBN-10: 0-12-801439-3 / 0128014393
• ISBN-13: 978-0-12-801439-4 / 9780128014394