Functional Assessment of PTSD

Memory, Attention, and Concentration Memory dysfunction is a common presenting problem from patients with PTSD and can be observed by third parties, such as family members, coworkers, or employers. Patients are told they are forgetting conversations they've had or tasks they were expected to perform. Memory problems can also be observed clinically in patients' inability to recall information from their pasts surrounding the traumatic event, missing appointment times, or forgetting to do...

What Exactly Is a Traumatic Stressor

The truth is that even though we are all exposed to high levels of stress, including some of us who have been exposed to war, combat, and related stressors that would be defined as traumatic stressors, research has continued to show that most individuals exposed to stressors that would meet the definition of a traumatic stressor fail to develop PTSD, much like the citizens of Israel and Palestine. According to Breslau, Andreski, Federman, and Anthony (1998) only 9 percent of those exposed to...

Posttraumatic Stress Disorder and Neurochemical Processes

As was mentioned earlier, what lies at the root of brain alterations in PTSD are alterations in neurochemicals such as neurotransmitters, hormones, and neuro-peptides. These alterations ultimately lead to changes at the synaptic level, which lead to changes in circuitry and connectivity and the way different brain areas interact with and influence each other. These neural changes occur within the larger behavioral and neurobiological context of the stress response and the fear response and its...

Basic Principles of Behavior and Cognitive Behavioral Therapy

Behavior therapy involves the application of the principles of learning and behavior. Classical conditioning is used to explain the acquisition of abnormal behaviors through contingency learning in PTSD, this might account for the pairing of certain sounds (loud bangs or breaking glass) with arousal and escape or avoidance behavior. Operant conditioning, with its principles of positive reinforcement, negative reinforcement, and punishment accounts for behavior through an analysis of the...

Cognitive Behavioral Therapies for PTSD

The treatments covered in this section fall into one of the three (behavior, cognitive, or CBT) categories listed in the preceding section to one degree or another. However, most therapies are combined. In order to simplify things a bit, we will discuss the various treatments or therapies separately as behavior, cognitive, or CBT where appropriate and helpful. That is, if a therapy is primary behavioral, it will be discussed as a behavioral treatment, and so on. Table 12.1 might help with...

Psychopharmacological Therapy for PTSD

There appears to be professional consensus that pharmacotherapy in PTSD is a critical and important treatment component for PTSD (Friedman et al., 2000a) for a number of reasons research supported biological abnormalities in PTSD overlap with other disorders that are very responsive to drug treatment, such as depression and Panic Disorder and its general acceptance by patients despite side effects and often prohibitive costs. The National Center for Post-Traumatic Stress Disorder proposes the...

Rape and Sexual Assault

Edna Foa and Barbara Olasov Rothbaum 1988 outline a comprehensive cognitive-behavioral treatment CBT approach to PTSD from rape and sexual assault. Earlier analyses of posttraumatic reactions to rape have been referred to as rape trauma syndrome Burgess amp Holmstrom, 1974 . Foa and Rothbaum outline these common affective and functional sequelae to rape in addition to PTSD core symptoms Anxiety intense fears of rape-related situations and generalized anxiety Depression may be more common than...

Integrated Theories and Models

Integrated Medical Model

Yule's, Williams, and Joseph's Integrated Psychosocial Model Yule, Williams, and Joseph present what they call a multifactorial model of PTSD that includes numerous components from other models and combines them into a complex of interrelated variables. Perhaps, the easiest way to approach an understanding of their model is to first present it as shown in Figure 7.1. FIGURE 7.1 An Integrated Psychosocial Model. FIGURE 7.1 An Integrated Psychosocial Model. To understand the model, begin with the...

Cognitive Theories and Models

All cognitive theories of Posttraumatic Stress Disorder have the following features or components in common, according to Dalgleish (1999) Individuals have pretrauma beliefs and models of the world, self, and others that come into play when a trauma occurs. Traumatic stressors provide salient and typically incompatible information relative to these beliefs and models. Such information cannot be easily ignored nor integrated or assimilated into these existing belief structures and models. The...