Clinical Manual for Management of PTSD


As traumatic events, disasters, and war pervade everyday life around the globe, posttraumatic stress disorder (PTSD) inevitably affects many people. Clinical Manual for Management of PTSD provides clinicians with the latest information on PTSD. In 16 well-organized, accessible chapters, world leaders in research on epidemiology, neurobiology, psychotherapy, psychopharmacology, and other somatic therapies outline the most up-to-date evidence-based approaches to assessment and management of patients with PTSD. This...

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As traumatic events, disasters, and war pervade everyday life around the globe, posttraumatic stress disorder (PTSD) inevitably affects many people. Clinical Manual for Management of PTSD provides clinicians with the latest information on PTSD. In 16 well-organized, accessible chapters, world leaders in research on epidemiology, neurobiology, psychotherapy, psychopharmacology, and other somatic therapies outline the most up-to-date evidence-based approaches to assessment and management of patients with PTSD. This practical guide covers modalities for therapeutics and management ranging from pharmacotherapy to cognitive processing therapy to virtual reality exposure therapy. It can be used as a complete text for residents and students to gain a solid understanding of PTSD and current treatment modalities, or as a desktop reference for experienced clinicians in daily practice to consult for specific information.

Clinical Manual for Management of PTSD provides clinicians and students with a consolidated and thoughtful reference that can be used to complement and enhance their everyday practice. This book bridges the gap between the research community and the clinician by providing a comprehensive resource of clinically relevant information on PTSD.

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Editorial Reviews

From The Critics
Reviewer: Aaron Plattner, MD (Pine Rest Christian Mental Health Services)
Description: This is a comprehensive guide to the use of evidence-based psychiatric treatment for patients suffering from post-traumatic stress disorder (PTSD).
Purpose: Traumatic events, natural disasters, and wars are ongoing events that result in PTSD in patients. This book strives to be a comprehensive resource of clinically relevant information on PTSD by outlining the most recent data in order to equip providers with evidence-based approaches to the assessment and management of these patients.
Audience: While any healthcare provider who directly cares for patients with PTSD will benefit most from this book, anyone who interacts or plans to interact with those with PTSD at any level would also find it helpful.
Features: The first of the book's three sections reviews the history of PTSD, how to best use the book, epidemiological and biological factors associated with PTSD, proper assessment and diagnostic factors, and the consideration of psychiatric comorbidities of PTSD. The second section reviews pharmacological and psychosocial treatment options for PTSD, potential new treatments being developed, and assessing general functioning and disability of patients suffering with PTSD. The final section covers various special populations, including children and adolescents, sexual assault, military and veteran populations, geriatrics, traumatic brain injury, and sociocultural considerations. The chapters use helpful charts, tables, pictures, and graphs to help readers to gain an understanding of the particular topic. Chapters end with a summary of key points, references, and suggestions for further reading.
Assessment: During my training, I was provided with several different articles and chapters as well as lectures on PTSD from several different sources. This book covers all of the essential information on PTSD with additional sections that provide a more comprehensive understanding of the many facets of PTSD. While the first section helps build a foundation in PTSD, each chapter is comprehensive enough to be able to be read alone, which does lead to some overlap between chapters. The chapters review not only a particular topic, but also why the topic is applicable to the treatment of PTSD as well as historical issues that have shaped current understanding. The final section is very helpful in covering the differing aspects of special populations that must be considered, especially with the rising rates of traumatic brain injury, the growing geriatric population, and returning veterans. .
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Product Details

  • ISBN-13: 9781585623594
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 6/15/2010
  • Pages: 494
  • Product dimensions: 5.60 (w) x 8.20 (h) x 1.20 (d)

Meet the Author

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.

American Psychiatric Publishing

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Table of Contents

Contributors xv

Disclosure of Interests xxi

Preface Robert J. Ursano Richard A. Bryant Arieh Y. Shalev Simon Wessely xxiii

Part 1 Introduction and Overview

1 Introduction David M. Benedek Gary H. Wynn 3

A Brief History of PTSD 4

The Purpose of This Manual 5

How to Use This Manual 6

2 Epidemiology Michael C. Freed Kristie L. Gore Charles C. Engel 11

Relationship of Epidemiology to Clinical Practice 11

What Is PTSD? 18

Epidemiology of Criterion A 19

Epidemiology of PTSD Following Traumatic Events 22

Course of Illness and Symptom Persistence 26

Factors That Modify Risk 27

Impact of PTSD on the Community and Health Care System 32

Applying Epidemiological Knowledge to the Clinical Management of PTSD 33

Conclusion 36

Key Clinical Points 37

3 Biology Espen Walderhaug John H. Krystal Alexander Neumeister 45

The Interactive Role of Heritability and Environment in the Etiology of PTSD 46

Influence of Gender in PTSD 48

Neuroendocrine and Neurochemical Aspects of PTSD 49

Neuroimaging Studies in PTSD 54

Conclusion 60

Key Clinical Points 60

4 Assessment and Diagnosis Douglas C. Johnson Murray B. Stein 69

General Considerations 70

PTSD Diagnostic Criteria 71

Threats to Reliability and Validity 75

Assessment of PTSD 83

Differential Diagnosis of PTSD 91

Key Clinical Points 96

5 Psychiatric Comorbidities Carol S. North Alina M. Suris Sunday Adewuyi 101

Theories of Psychiatric Comorbidity With PTSD 102

Psychiatric Comorbidities in Different PTSD Populations: Review of the Research Literature 109

Clinical Implications of Psychiatric Comorbidity With PTSD 118

Key Clinical Points 119

Part II Therapeutics and Management

6 Pharmacotherapy Matthew J. Friedman 131

Antidepressants 133

Antiadrenergic Agents 143

Anticonvulsant/Mood Stabilizer Agents 144

D-Cycloserine 144

Benzodiazepines 145

Atypical Antipsychotic Medications 146

Hypothalamic-Pituitary-Adrenocortical System 146

Applicability to Military and Veteran Populations 147

Gaps in Current Knowledge 148

Combined Therapy 149

Key Clinical Points 150

7 Psychosocial Treatments Katherine M. Iverson Kristin M. Lester Patricia A. Resick 157

Theoretical Foundations of Cognitive-Behavioral Treatments for PTSD 158

CBT Treatments and Techniques for PTSD 164

Treatment Outcome Research in PTSD 168

Future Directions for Treatment Outcome Research 190

Conclusion 94

Key Clinical Points 195

8 Violence and Aggression Thomas A. Grieger David M. Benedek Robert J. Ursano 205

General Risk Factors for Violence or Aggression 209

Assessment and Management of PTSD and Violence 212

Conclusion 217

Key Clinical Points 219

9 Emerging and Alternative Therapies Michael J. Roy Albert Rizzo Joann Difede Barbara O. Rothbaum 227

Virtual Reality Exposure Therapy 228

Other Emerging and Alternative Nonpharmacological Therapies 241

Emerging and Alternative Pharmacological Therapies 244

Conclusion 247

Key Clinical Points 247

10 Assessment of Functioning and Disability Nina A. Sayer Kathleen F. Carlson Paula P. Schnurr 255

Rationale for Assessment of Functioning and Disability 256

Conceptual Framework and Definitions 262

Selection of Domains for Assessment 263

Measures of Global, Social, and Occupational Functioning 264

Assessment of Contextual Factors 276

Conclusion 278

Key Clinical Points 280

Part III Special Topics

11 Children and Adolescents Stephen J. Cozza Jennifer M. Guimond 291

Developmental Considerations of PTSD 292

Comorbidity 294

Childhood Traumatic Grief: A Unique Clinical Condition 294

Childhood Trauma Exposures 295

Prevalence of Childhood PTSD 297

Therapeutic Interventions 298

Conclusion 315

Key Clinical Points 316

12 Sexual Assault Amy E. Street Margret E. Bell C. Beth Ready 325

Sexual Assault and PTSD 327

Social Reactions to Sexual Assault 328

Assessment of Sexual Assault Survivors 328

Treatment Approaches for Sexual Assault Survivors With PTSD 335

Common Treatment Themes 337

Conclusion 343

Key Clinical Points 344

13 Military and Veteran Populations Joshua E. Wilk Charles W. Hoge 349

Rates and Risk Factors for PTSD in Combat Veterans 349

Research on Treatment of Combat-Related PTSD 350

Assessment and Treatment of Service Members and Veterans With PTSD 352

Future Directions 363

Key Clinical Points 364

14 Geriatrics Geoffrey G. Grammer Scott C. Moran 371

Etiologies of Geriatric PTSD 372

Presentation of PTSD 373

Pharmacological Treatments 375

Cognitive-Based Therapies 377

Exposure-Based Therapies 377

Eye Movement Desensitization and Reprocessing 378

Key Clinical Points 378

15 Traumatic Brain Injury Louis M. French Grant L. Iverson Richard A. Bryant 383

Overview of Traumatic Brain Injury 384

Shared Neurobiology 387

TBI and PTSD Comorbidity 388

Neuropsychological Features 393

Substance Abuse, PTSD, and Traumatic Brain Injury 396

Military Aspects 397

Treatment Considerations 400

Conclusion 402

Key Clinical Points 403

16 Sociocultural Considerations Laurence J. Kirmayer Cécile Rousseau Toby Measham 415

Trauma in Cultural Context 416

Assessment 418

Treatment 430

Conclusion 436

Key Clinical Points 438

Index 445

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