Future Directions with PTSD

In reviewing the database PsycINFO just for the last 2 years, I found that well over 1,200 journal publications were found. In just 2005, well over 300 publications were found. These numbers represent a staggering amount of work being done on PTSD. If one was to predict the next big thing in the field, it might be reading and consuming the massive amounts of information being produced. Emerging trends and current research directions ascertained from PsycINFO for the year 2005 include the following:

■ Focus on the elderly

■ Development of more broad-based, eclectic, and integrated therapies

■ Exploration of the relationship between PTSD and various health problems, including fibromyalgia, human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), and severe acute respiratory syndrome (SARS)

Terrorism and PTSD

■ Alternative therapies, such as mindfulness and acceptance and commitment therapy

■ Telehealth

■ Issues of treatment adherence

Neurofeedback treatment of PTSD

The American Psychiatric Association is in the process of developing the newest version of their Diagnostic and Statistical Manual of Mental Disorders (DSM), the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V). The process has begun with the development of several white papers outlining the research agenda for the various teams or workgroups that will eventually come together to decide what the DSM-V should consist of. Part of this process has included the development of diagnosis-related research conferences, one of which is the Stress-Induced and Fear Circuitry Disorder Conference. The following is a list of directions and relevant issues produced by the participants that are not redundant with the preceding PsycINFO list:

■ Addressing the inclusiveness or exclusiveness of the PTSD diagnostic criteria

■ Subsyndromal PTSD

■ Cross-cultural variability of PTSD

■ The importance or nonimportance of structural brain abnormalities

■ Focus on resilience and vulnerability factors

■ The connection between childhood Anxiety Disorder and later adult manifestations

■ Genetic issues

■ Classification of the disorder by neurological or cognitive symptoms rather than in a descriptive fashion

■ Comorbidity issues in diagnosis and treatment

■ Role of cognition in development of PTSD

■ Psychosocial factors in the development of PTSD

■ Neuroendocrinological factors in etiology and maintenance of PTSD

■ Neuroimaging methods in research

Posttraumatic Stress Disorder and Substance Abuse or Dependence

A final list of future directions consists of research and practice issues discussed in two quarterly journals put out by the National Center for Post-Traumatic Stress Disorder, a division of the Veteran's Administration and Department of Defense. Beginning with 2003 and covering until the winter of 2005 issue, the following topics have emerged (again, only those that are different than those found in the previous two lists are listed):

■ Sexual revictimization

■ Iraq war veterans, PTSD, and Gulf War syndrome

■ Posttraumatic Stress Disorder and sleep

■ Posttraumatic Stress Disorder and 9/11

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