Post+Traumatic+Stress+Disorder

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MAKE SURE YOU FILE THE PAGE CORRECTLY: Add the correct tag so it shows up in the navigation correctly bio - biological level of analysis cog - cognitive level of analysis socio - sociocultural level of analysis paperthree - research methods abnormal - abnormal behaviour option health - health psychology option 1. Evaluate psychological research relevant to the study of Post-Traumatic Stress Disorder FROM TEXT BOOK: BIOLOGICAL: Hauff and Vaglum (1994) Twin research Genetic predisposition to Post Traumatic Stress Disorder Geracioti (2001) Role of noradrenaline, a neurotransmitter which plays an important role in emotional arousal. Stimulating the adrenal system. In post traumatic stress patients induced a panic attack in 70% of patients and flashbacks in 40% of patients. No control group participants experienced these symptoms. This acts as evidence for increased sensitivity of noradrenaline receptors in patients with PTSD. Bremner (1998) COGNITIVE: Albert Rizzo Flooding (over-exposure to stressful events) as a treatment of PTSD. That stressful reactions will eventually fade out due to habituation… power of the cues that trigger traumatic memories eventually diminishes. University of Southern California Therapeutic tool using a virtual reality to treat PTSD veterans 'Virtual Iraq' Traumatised soldiers can re-experience the horrors of the war and the therapist can manipulate the variables that are relevant to each individual Sutket et al. (1995) Gulf war veterans had a sense of purpose and commitment to the military and has less chance of suffering PTSD than other veterans. Seudfeld (2003) Studied survivors of the Holocaust Their attributional style tends to be much more external. Shows that attributional style may have an effect of whether a person suffers PTSD and to what extent. Evaluation: Question needs to be raised as to whether the attributional style of the Holocaust survivors is particular to the Jewish community or brought about as a result of the Holocaust. Perhaps more about sociocultural factors than cognitive ones. SOCIOCULTURAL: Roysicar (2000) Among Vietnam war veterans, 20.6% Black, 27.6% Hispanic and 13% White veterans met the criteria for PTSD. Suggests experiences with racism and oppression are predisposing factors for PTSD Kaminer et al. (2000) Cultural factor behind PTSD Studied children in Bosnia, Sarajevo In 1998 approx. 73% of girls and 35% of boys suffered symptoms of PTSD. Credited the higher rate in girls to their fear of rape Evaluation: Reporting bias FROM THE INTERNET: Trauma and Posttraumatic Stress Disorder in the CommunityJuly 1998 Naomi Breslau, PhD; Ronald C. Kessler, PhD; Howard D. Chilcoat, ScD; Lonni R. Schultz, PhD; Glenn C. Davis, MD; Patricia Andreski, MA Background The study estimates the relative importance of specific types of traumas experienced in the community in terms of their prevalence and risk of leading to posttraumatic stress disorder (PTSD). Methods A representative sample of 2181 persons in the Detroit area aged 18 to 45 years were interviewed by telephone to assess the lifetime history of traumatic events and PTSD, according to DSM-IV. Posttraumatic stress disorder was assessed with respect to a randomly selected trauma from the list of traumas reported by each respondent, using a modified version of the Diagnostic Interview Schedule, Version IV, and the World Health Organization Composite International Diagnostic Interview. Results The conditional risk of PTSD following exposure to trauma was 9.2%. The highest risk of PTSD was associated with assaultive violence (20.9%). The trauma most often reported as the precipitating event among persons with PTSD (31% of all PTSD cases) was sudden unexpected death of a loved one, an event experienced by 60% of the sample, and with a moderate risk of PTSD (14.3%). Women were at higher risk of PTSD than men, controlling for type of trauma. Conclusions The risk of PTSD associated with a representative sample of traumas is less than previously estimated. Previous studies have overestimated the conditional risk of PTSD by focusing on the worst events the respondents had ever experienced. Although recent research has focused on combat, rape, and other assaultive violence as causes of PTSD, sudden unexpected death of a loved one is a far more important cause of PTSD in the community, accounting for nearly one third of PTSD cases. Pasted from <[]> Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Tolin, David F.; Foa, Edna B. November 2006 Abstract Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for PTSD, although they were less likely to experience PTEs. Female participants were more likely than male participants to experience sexual assault and child sexual abuse, but less likely to experience accidents, nonsexual assaults, witnessing death or injury, disaster or fire, and combat or war. Among victims of specific PTEs (excluding sexual assault or abuse), female participants exhibited greater PTSD. Thus, sex differences in risk of exposure to particular types of PTE can only partially account for the differential PTSD risk in male and female participants. (PsycINFO Database Record (c) 2010 APA, all rights reserved) Pasted from <[]> A prospective examination of post-traumatic stress disorder in rape victims.Barbara Olasov Rothbaum, Edna B. Foa, David S. Riggs, Tamera Murdock and William Walsh Abstract Post-traumatic stress disorder (PTSD) and related psychopathology were examined in 95 female rape victims beginning soon after the assault (mean=12.64 days). Subjects were assessed weekly for 12 weeks. Ninety-four percent of women met symptomatic criteria for PTSD at Assessment 1, decreasing to 65% at Assessment 4 (mean=35 days postassault), and 47% at Assessment 12 (mean=94 days postassault). PTSD and related psychopathology decreased sharply between Assessments 1 and 4 for all women. Women whose PTSD persisted throughout the 3-month study did not show improvement after the fourth assessment; women who did not meet criteria for PTSD 3 months postassault showed steady improvement over time. This pattern was evidenced even after initial PTSD severity was statistically controlled. Moreover, PTSD status at 3 months postassault could be predicted with a high degree of accuracy by two brief self-report measures administered at the first assessment. The implications of the present findings and directions for future research are discussed. Pasted from <[]> Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Ozer, Emily J.; Best, Suzanne R.; Lipsey, Tami L.; Weiss, Daniel S. Abstract This reprinted article originally appeared in Psychological Bulletin, 2003, Vol 129(1), 52-73. (The following abstract of the original article appeared in record [|2002-11509-005].) A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved) Pasted from <[]> Common Heritable Contributions to Low-Risk Trauma, High-Risk Trauma, Posttraumatic Stress Disorder, and Major Depression Sartor et al. Arch Gen Psychiatry March 2012 Context Understanding the relative contributions of genetic and environmental factors to trauma exposure, posttraumatic stress disorder (PTSD), and major depressive disorder (MDD) is critical to developing etiologic models of these conditions and their co-occurrence. Objectives To quantify heritable influences on low-risk trauma, high-risk trauma, PTSD, and MDD and to estimate the degree of overlap between genetic and environmental sources of variance in these 4 phenotypes. Design Adult twins and their siblings were ascertained from a large population-based sample of female and male twin pairs on the basis of screening items for childhood sexual abuse and physical abuse obtained in a previous assessment of this cohort. Setting Structured psychiatric telephone interviews. Participants Total sample size of 2591: 996 female and 536 male twins; 625 female and 434 male nontwin siblings. Main Outcome Measure Lifetime low- and high-risk trauma exposure, PTSD, and MDD. Results In the best-fitting genetic model, 47% of the variance in low-risk trauma exposure and 60% of the variance in high-risk trauma exposure was attributable to additive genetic factors. Heritable influences accounted for 46% of the variance in PTSD and 27% of the variance in MDD. An extremely high degree of genetic overlap was observed between high-risk trauma exposure and both PTSD (r = 0.89; 95% CI, 0.78-0.99) and MDD (r = 0.89; 95% CI, 0.77-0.98). Complete correlation of genetic factors contributing to PTSD and to MDD (r = 1.00) was observed. Conclusions The evidence suggests that almost all the heritable influences on high-risk trauma exposure, PTSD, and MDD, can be traced to the same sources; that is, genetic risk is not disorder specific. Individuals with a positive family history of either PTSD or MDD are at elevated risk for both disorders and should be closely monitored after a traumatic experience for symptoms of PTSD and MDD. Pasted from <[]> OTHER LINKS: [][] <-- The bottom of this site is amazing and has lots of other studies on Post-Traumatic Stress Disorder

2. **Describe symptoms and prevalence of the anxiety disorder Post-Traumatic Stress Disorder.** **Symptoms** **SYMPTOMS LINKS** [] - Good overview of PTSD **Prevalence Rates** **PREVALENCE LINKS** [] - Rates of PTSD in general [] - Rates of PTSD in Firefighters
 * Lasts for more than 30 days
 * Develops in response to a specific stressor
 * Characterised by intrusive memories of the event, emotional withdrawal, and heightened autonomic arousal - resulting in insomnia, hyper-vigilance, or loss of emotional control
 * Often experience a decreased interest in others, and a sense of estrangement.
 * Affective - anhedonia (inability to experience pleasure), callousness
 * Behavioural - flashbacks, paranoia and hyper-vigilance (an enhanced state of sensory sensitivity accompanied by heightened emotional arousal), nightmares
 * Cognitive - intrusive memories of traumatic event, problems concentrating, hyper-arousal
 * Somatic - lower back pain, digestion issues, insomnia, losing ability to control bladder
 * In communities that have experienced PTSD, prevalence rates generally rise to 9%
 * In the US - 1-3% with lifetime prevalence of 5% in men and 10% in women
 * Davidson et al., 2007; Breslau et al., 1998 found that PTSD affects 15-24% of people who experience a traumatic event
 * Usually co-occurs with other disorders, like depression and substance abuse
 * Following 9/11, a positive correlation was found between proximity to the attack and PTSD rates
 * The most frequent trauma that triggers PTSD is the loss of a loved one
 * 3% of those who experience a personal attack, 20% of wounded veterans, and 50% of rape victims develop PTSD
 * The National Vietnam Veterans Readjustment Study (1988) estimated that the prevalence of PTSD among veterans was 15.2% at the time, and 30% had experienced the disorder since returning from Vietnam.
 * It has been observed that other Veteran populations experienced PTSD, with many of the similar features
 * Important to note that not all individuals that are exposed to trauma develop PTSD

6. Evaluate the use of biomedical, individual and group approaches to the treatment of Post-traumatic stress disorder. - [] REALLY GOOD

Treatments -biomedical-antidepressants, (valium and Xanax ), Marshall (1994) found that treatment of depression contributes to an improvement/treatment in PTSD, regardless of how PTSD is itself treated.
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 * [|http://books.google.com.au/books?hl=en&lr=&id=n_8Rde3s5aAC&oi=fnd&pg=PR7&dq=+post+traumatic+stress+disorder+treatment&ots=TvYOXRv_y5&sig=gkSsbjM6iq-llYml3_amNHelSJk#v=onepage&q=post%20traumatic%20stress%20disorder%20treatment&f=false] (book)
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-individual-CBT-Foa (1986)-involves making sufferers understand talking about trauma is not the same as experiencing it. Keane (1992) found/pointed out that patients undergoing CBT become worse during initial stages of CBT.

-testimonial- Weine (1998) found to be effective decreasing from 100% to 53% sufferers after 6 months.

-group- Friedman and Schnurr (1996) looked at group therapy effects on Vietnam war veterans found that it helped in more intensive therapies later.

-biomedical- Boehnlein (1985) found in his study of Cambodian refugees that tricyclics were helpful in treating the depression as well as the PTSD symptoms of nightmares, startle reactions and intrusive thoughts

-individual- Dyregrov, Gjestad and Raundalen (1999) found that time alone did little to alleviate IES scores among Iraqi children and adolescents following the Gulf War. The IES is a rather reliable indicator of PTSD


 * Crisis intervention-having psychologists treat survivors of a trauma right after before PTSD sets in. Mayou et al (2000) argues that crisis intervention may do more harm than good