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9781585623594

Clinical Manual for Management of Ptsd

by
  • ISBN13:

    9781585623594

  • ISBN10:

    1585623598

  • Edition: 1st
  • Format: Paperback
  • Copyright: 2010-06-01
  • Publisher: AMERICAN PSYCHIATRIC PUBLISHING INC

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Summary

The Clinical Manual for Management of PTSDbrings together dozens of experts from around the world to provide clinicians with the latest information on posttraumatic stress disorder (PTSD). As a practical resource, this manual covers a wide range of topics relevant to clinical practice and addresses both the basics of each area as well as specific aspects of diagnosis and treatment. This clinical manual is an effort to bridge the gap between the research community and the clinician by providing an easy-to-use source of clinically relevant information on PTSD. This clinical manual is designed to be a practical guide by the bedside, on rounds, or in the classroom. It can be used in multiple ways: • As a complete text for clinicians, residents, and students to gain a solid understanding of PTSD's various manifestations and the current treatment modalities available • As a desktop reference for experienced clinicians to read specific parts that are most pertinent to aspects of their daily practiceFor simple use and ease of reference, this text is divided into several sections: first, an overview of the history, biology, epidemiology, assessment methods, and comorbidities of PTSD; second, explorations of the various modes of therapeutics and management; and third, special topics such as PTSD in military settings, sexual assault, older and juvenile victims of trauma, and traumatic brain injury. This structure ensures that readers understand the complexities of this disorder as well as the best practices for these situations. • Covers neurobiology and epidemiology of the disorder • Provides an overview of diagnosis and comorbidities, as well as PTSD as a manifestation in conjunction with other diagnoses• Describes various treatments, including pharmacology, therapy, managing aggression and violence, emerging therapies, and disability issues• Touches on specific patient populations, such as children and adolescents, sexual assault survivors, military and veteran populations, geriatrics, and TBI patients, as well as sociocultural considerations• Presents controversial aspects of the diagnosis• Includes numerous tables to help summarize the available dataWhile the concepts and therapeutic modalities presented in this manual are supported by convincing research and a robust evidence basis for efficacy, the authors also encourage clinicians to make use of their understanding of the individual patient, the context of any treatment, and further individualized inquiry when considering any therapy discussed in this text. The Clinical Manual for Management of PTSDprovides clinicians and students with a consolidated and thoughtful reference which can be used to complement and enhance their everyday practice.

Author Biography

David M. Benedek, M.D., is Professor, Deputy Chair, and Associate Director and Senior Scientist of the Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Gary H. Wynn, M.D., is Assistant Chief of the Inpatient Psychiatry Service, Walter Reed Army Medical Center, Washington, D.C., and Assistant Professor of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland.

Senior International Editorial Advisory Board: Robert J. Ursano, M.D., (chair), Richard A. Bryant, Ph.D., Arieh Y. Shalev, M.D., and Simon A. Wessely, M.D.

Table of Contents

Contributorsp. xv
Disclosure of Interestsp. xxi
Prefacep. xxiii
Introduction and Overview
Introductionp. 3
A Brief History of PTSDp. 4
The Purpose of This Manualp. 5
How to Use This Manualp. 6
Epidemiologyp. 11
Relationship of Epidemiology to Clinical Practicep. 11
What Is PTSD?p. 18
Epidemiology of Criterion Ap. 19
Epidemiology of PTSD Following Traumatic Eventsp. 22
Course of Illness and Symptom Persistencep. 26
Factors That Modify Riskp. 27
Impact of PTSD on the Community and Health Care Systemp. 32
Applying Epidemiological Knowledge to the Clinical Management of PTSDp. 33
Conclusionp. 36
Key Clinical Pointsp. 37
Biologyp. 45
The Interactive Role of Heritability and Environment in the Etiology of PTSDp. 46
Influence of Gender in PTSDp. 48
Neuroendocrine and Neurochemical Aspects of PTSDp. 49
Neuroimaging Studies in PTSDp. 54
Conclusionp. 60
Key Clinical Pointsp. 60
Assessment and Diagnosisp. 69
General Considerationsp. 70
PTSD Diagnostic Criteriap. 71
Threats to Reliability and Validityp. 75
Assessment of PTSDp. 83
Differential Diagnosis of PTSDp. 91
Key Clinical Pointsp. 96
Psychiatric Comorbiditiesp. 101
Theories of Psychiatric Comorbidity With PTSDp. 102
Psychiatric Comorbidities in Different PTSD Populations: Review of the Research Literaturep. 109
Clinical Implications of Psychiatric Comorbidity With PTSDp. 118
Key Clinical Pointsp. 119
Therapeutics and Management
Pharmacotherapyp. 131
Antidepressantsp. 133
Antiadrenergic Agentsp. 143
Anticonvulsant/Mood Stabilizer Agentsp. 144
D-Cycloserinep. 144
Benzodiazepinesp. 145
Atypical Antipsychotic Medicationsp. 146
Hypothalamic-Pituitary-Adrenocortical Systemp. 146
Applicability to Military and Veteran Populationsp. 147
Gaps in Current Knowledgep. 148
Combined Therapyp. 149
Key Clinical Pointsp. 150
Psychosocial Treatmentsp. 157
Theoretical Foundations of Cognitive-Behavioral Treatments for PTSDp. 158
CBT Treatments and Techniques for PTSDp. 164
Treatment Outcome Research in PTSDp. 168
Future Directions for Treatment Outcome Researchp. 190
Conclusionp. 94
Key Clinical Pointsp. 195
Violence and Aggressionp. 205
General Risk Factors for Violence or Aggressionp. 209
Assessment and Management of PTSD and Violencep. 212
Conclusionp. 217
Key Clinical Pointsp. 219
Emerging and Alternative Therapiesp. 227
Virtual Reality Exposure Therapyp. 228
Other Emerging and Alternative Nonpharmacological Therapiesp. 241
Emerging and Alternative Pharmacological Therapiesp. 244
Conclusionp. 247
Key Clinical Pointsp. 247
Assessment of Functioning and Disabilityp. 255
Rationale for Assessment of Functioning and Disabilityp. 256
Conceptual Framework and Definitionsp. 262
Selection of Domains for Assessmentp. 263
Measures of Global, Social, and Occupational Functioningp. 264
Assessment of Contextual Factorsp. 276
Conclusionp. 278
Key Clinical Pointsp. 280
Special Topics
Children and Adolescentsp. 291
Developmental Considerations of PTSDp. 292
Comorbidityp. 294
Childhood Traumatic Grief: A Unique Clinical Conditionp. 294
Childhood Trauma Exposuresp. 295
Prevalence of Childhood PTSDp. 297
Therapeutic Interventionsp. 298
Conclusionp. 315
Key Clinical Pointsp. 316
Sexual Assaultp. 325
Sexual Assault and PTSDp. 327
Social Reactions to Sexual Assaultp. 328
Assessment of Sexual Assault Survivorsp. 328
Treatment Approaches for Sexual Assault Survivors With PTSDp. 335
Common Treatment Themesp. 337
Conclusionp. 343
Key Clinical Pointsp. 344
Military and Veteran Populationsp. 349
Rates and Risk Factors for PTSD in Combat Veteransp. 349
Research on Treatment of Combat-Related PTSDp. 350
Assessment and Treatment of Service Members and Veterans With PTSDp. 352
Future Directionsp. 363
Key Clinical Pointsp. 364
Geriatricsp. 371
Etiologies of Geriatric PTSDp. 372
Presentation of PTSDp. 373
Pharmacological Treatmentsp. 375
Cognitive-Based Therapiesp. 377
Exposure-Based Therapiesp. 377
Eye Movement Desensitization and Reprocessingp. 378
Key Clinical Pointsp. 378
Traumatic Brain Injuryp. 383
Overview of Traumatic Brain Injuryp. 384
Shared Neurobiologyp. 387
TBI and PTSD Comorbidityp. 388
Neuropsychological Featuresp. 393
Substance Abuse, PTSD, and Traumatic Brain Injuryp. 396
Military Aspectsp. 397
Treatment Considerationsp. 400
Conclusionp. 402
Key Clinical Pointsp. 403
Sociocultural Considerationsp. 415
Trauma in Cultural Contextp. 416
Assessmentp. 418
Treatmentp. 430
Conclusionp. 436
Key Clinical Pointsp. 438
Indexp. 445
Table of Contents provided by Ingram. All Rights Reserved.

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