Cognitive Processing Therapy (CPT) for Trauma and PTSD
There are several different ways of assessing stress, including traumatic events, life events, chronic role strain, and daily stressors or hassles. In the last decade, it has rapidly become apparent that both type and frequency of stressors change with age. While early studies suggested that the number of stressful life
Children whose mothers have been physically and emotionally abused are considered victims of family violence. We know from research studies that individual children respond differently to the violence, from those who evidence major psychological disorders and posttraumatic stress symptoms, to those who appear resilient and unaffected by the trauma. Approximately 40 to 60 of children who witness the abuse of their mothers are above the clinical cutoff level on measures of mood and behaviors. That is, they are in need of clinical treatment for their anxiety, depression, and aggressive behavior. In one study, more than half of the children who witnessed domestic violence had symptoms of posttraumatic stress, and 13 qualified for a full Posttraumatic Stress Disorder (PTSD) diagnosis the diagnosis first given to returning combat veterans who showed extreme stress reactions to the atrocities witnessed during war.
Many battered women are clinically depressed. They are more likely to have major depressive episodes than women with serious relationship problems that do not include violence. Depression and low self-esteem, in turn, influence the woman's coping, as she may become less active and more avoidant as she feels a loss of personal control. Recall that batterers strive to take control away from the woman so as to more easily dominate her. Several studies of battered women in shelters report that approximately 40 to 60 experience posttraumatic stress disorder related to the threats to their life, repeated physical assaults, and the extent and severity of abuse. However, with more time out of the abusive relationship, the rates of PTSD decrease, depression abates, and women can be helped to feel a sense of control over their lives once more.
The extraction of teeth is a potentially traumatic experience. The decision to extract should be made with an awareness of the risks of treatment, including the psychological impact of the procedure. The General Dental Council in its guidance to dentists of professional and personal conduct makes it clear that dentists who refer patients for general anaesthesia must make it clear what justification there is for the procedure. The duties of the treating dentist include a thorough and clear explanation of the risks involved as well as the alternative methods of pain control available. The use of general anaesthesia is usually considered in dealing with unerupted teeth, first molars, multiple extractions in four quadrants and specific phobias.
B. (1991). Diagnostic issues in posttraumatic stress disorder. Journal of Abnormal Psychology, 100, 346-355. March, J. S. (1990). The nosology of posttraumatic stress disorder. Journal of Anxiety Disorders, 4, 61-82. Stein, M. B., Walker, J. R., Hazen, A. L., & Forde, D. R. (1997). Full and partial posttraumatic stress disorder Findings from a community survey. American Journal of Psychiatry, 154, 1114-1119.
Pennington (2002) proposed a category called disorders of motivation, which includes (1) depression and dysthymia, (2) anxiety disorders, (3) posttraumatic stress disorder, and (4) bipolar illness. Each of these involves disruptions in the arousal motivation system of the brain. To this category I have added obsessive-compulsive disorder as well as substance abuse and dependence. These two additional disorders are also essentially disruptions in the brain's normal regulation of arousal and motivation. Each of the six disorders in this expanded list occurs more frequently among persons with ADHD. Specific phobias involve an individual's being very fearful when faced with some specific situation for example, encountering a dog, snake, or spider sleeping alone in a dark room entering an elevator or flying in an airplane though they may experience no extraordinary fear otherwise. Doug met DSM-IV diagnostic criteria for several different anxiety disorders separation anxiety, specific...
Posttraumatic stress disorder The array of possible impacts is considerable. However, not every child is seriously affected. In fact in a 1993 survey of 45 comparative studies of the impact of sexual abuse, Kendall-Tackett, Williams, and Finkelhor found that about a third of the victims of child sexual abuse were reported to be asymptomatic. In addition, about two-thirds of children showed recovery during the first year to year-and-a-half after the abuse. Although children with a history of child sexual abuse had more symptoms than both clinical and nonclinical comparison groups fear, PTSD, behavior problems, sexualized behaviors, and low self-esteem being the most frequently noted, no single symptom characterized the majority of children.
Psychopharmacologic treatment of anxiety disorders began with the use of sedative-hypnotics (e.g., bromide salts, alcohol, chlorol hydrate) at the turn of the twentieth century. Barbiturates (e.g., phenobarbital, pentobarbital) were introduced early in the twentieth century but their adverse side effects, including addiction liability and toxic overdose, limited the use of these agents. The development of the benzodiazepines (e.g., chlordiazepoxide, diazepam) in the 1960s as general anxiolytics (separate from the muscle relaxant properties) was a major breakthrough because of the wide effective dose range and the limited adverse side effects. Subsequently, beta-adrenergic receptor antagonists (e.g., propranolol), antihistamines (e.g., hydroxyzine), and anticholinergic agents were used to treat specific cases of anxiety disorders (e.g., speech anxiety, posttraumatic stress disorder PTSD ). More recently, azapirones (e.g., buspirone) that act via serotonergic antagonism and some...
Dards proposed in the current chapter versus those proposed by the American Psychological Association. (See its Ethics Code published in 1992.) The latter defines competence in terms of education, training, or experience. Specifically, principle 1.04 (a) reads that psychologists provide services, teach, and conduct research only within the boundary of their competence, based on their education, training, supervised experience, or appropriate professional experience (italics added). The problem with this definition of competence is that it does not indicate that training must be in something for which there is some scientific knowledge. For example, training in the alleviation of posttraumatic stress disorder (PTSD) could involve people whose trauma was supposedly that of being kidnapped by aliens. In fact, (see Dawes, 1994, Chapter 5) there is a set of psychotherapists who have exactly this specialty, and one of them mentions the others in the back of her book, others who are licensed...