Evidence Based Treatment for PTSD during Pregnancy:

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "Evidence Based Treatment for PTSD during Pregnancy:"

Transcription

1 Evidence Based Treatment for PTSD during Pregnancy: What prenatal care providers need to know Robin Lange, Ph.D.

2 Why bother? PTSD in pregnant mothers has been associated with: Shorter gestation Lower birth weight(seng et al., 2011) Providers need to know: Signs and Symptoms Mental health treatment options Best practices for supporting mothers and minimizing risk

3 Psychological Trauma 101

4 Trauma Dictionary Definition 1. Pathology - a body wound or shock produced by sudden physical injury, as from violence or accident. 2. Psychiatry. an experience that produces psychological injury or pain. DSM-V Definition Criterion A: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: Direct exposure, witnessing, in person; indirectly, repeated or extreme indirect exposure to aversive details of the event(s),

5 Response to stressors/trauma 1. Emotional (shock, anger, disbelief, terror, guilt, grief, irritability, helplessness, anhedonia, regression to earlier developmental phase) 2. Cognitive (impaired concentration, confusion, distortion, self-blame, intrusive thoughts, decreased self-esteem/efficacy) 3. Biological (fatigue, insomnia, nightmares, hyperarousal, somatic complaints, startle response) 4. Psychosocial (alienation, social withdrawal, increased stress within relationships, substance abuse, vocational impairment)

6 Types of post traumatic responses National comorbidity study (Kessler, 1995) percent of respondents reported having experienced a trauma in their lifetimes Only 5-10 percent of this sample went on to develop PTSD PTSD is an atypical response to a trauma PTSD is a disorder of impeded recovery related to avoidance

7 80 Symptom severity trajectory following a traumatic event Typical response Impeded recovery Delayed onset 10 0 Month 1 Month 2 Month 3 Month 4 Month 5 Month 6

8 Posttraumatic Stress Disorder E. Alterations in arousal and reactivity D. Negative alterations in cognition and mood B. Intrusion symptoms C. Avoidance

9 PTSD and pregnancy How is it different? How common is it? What are the effects of PTSD on outcome?

10 Incidence and Prevalence in pregnancy Limited research on this important, under studied population Lifetime prevalence of PTSD in women: 10 percent of women will receive a diagnosis of PTSD in their lifetime (Breslau et al., 1998) Approximately 13 million women If untreated, many will experience symptoms for years

11 Types of pregnancy related PTSD Preexisting PTSD PTSD caused by pre-pregnancy history of trauma Pregnancy onset PTSD Trauma that occurs during the pregnancy Birthing Trauma Postpartum PTSD caused by traumatic labor and delivery experiences 3% of women (Alcorn et al, 2010) 1-2%(Stamrood et al., 2011)

12 Effects of PTSD on pregnancy outcome Reduction in mean birth weight (Seng et al., 2011) Shorter gestation (Seng et al., 2011) Negative effects on maternal self care and infant emotional and cognitive development (Murray, 1992) Maternal attachment difficulty

13 Course of PTSD in pregnancy Higher rates of suicidal thoughts and psychiatric comorbidity in pregnant versus non pregnant women with PTSD (Smith et al., 2006) Of women who developed PTSD following a stillbirth, Symptoms generally resolved naturally by 1 year postpartum, (Turton et al., 2001)

14 PTSD risk factors What relevant history should I be aware of?

15 General risk factors for PTSD Berwin et al, 2000 Meta-analysis Being female Experiencing intense or long-lasting trauma Having experienced multiple traumas Having other mental health problems, such as anxiety or depression Lacking a good support system of family and friends Having first-degree relatives with mental health problems, including PTSD Having first-degree relatives with depression Having been abused or neglected as a child

16 Pregnancy specific risk factors previous history of childhood trauma (Seng et al., 2011), sexual trauma, (Hamama, et al., 2010), previous history of spontaneous or elective abortion that was perceived as traumatic (Hamama, et al., 2010), the experience of a stillbirth during a previous pregnancy, (Turton, et al., 2001). Becoming pregnant within a year of a previous stillbirth (Turton, et al., 2001). Preeclampsia and preterm premature rupture of membranes (Stamrood et al., 2011). Depressive symptoms during pregnancy (Stamrood et al., 2011) Death of infant during the postpartum period (Stamrood et al., 2011)

17 Prevalence of PTSD related to childbirth (Stamrood et al., 2011)

18 Factors contributing to birthing trauma Creedy et al., 2000

19 PTSD Warning Signs What should I look for in my patients?

20 20 Warning Signs Dissociation Isolation Not engaging in basic self care Preexisting mental health conditions Part of a vulnerable group Lacking social support

21 What your patient may report Cognitive I don t care about going to therapy anymore. Nothing is working out for me. I am never going to get better. No one cares about me or what I do. What s the point of going on? I m feeling a little down. This must mean that I am going to fall into a deep depression again. Emotional Everyone is getting on my nerves lately. I just don t feel happy, even when I am around people that I know I love. I am beginning to feel really jumpy and on edge. My mood keeps changing rapidly. In minutes, I can go from feeling really happy to really down or terrified. Behavioral I just don t have the energy to take care of myself in the morning. I haven t showered for days. I don t want to be around people anymore. I ve been isolating myself. I ve been drinking more, but just to take the edge off of my feelings a little. I ve noticed that I am less talkative than I used to be.

22 My patient has experienced a trauma What now?

23 Time 23 Trauma Event 0-3 days Phase 1: Psychological First Aid Provide for Basic Needs Evaluate & Assess 3-30 days Phase 2: Intermediate Support Anxiety Management using CBT Refer for PTSD Assessment days Phase 3: PTSD treatment options Continuation of CBT and Anxiety Management Initiate Exposure Based Treatments

24 Psychological First Aid Tasks Contact and engagement Safety and comfort Stabilization (if necessary) Information gathering: Current Needs and Concerns; Risk Factors Practical assistance Shelter, Support, Med Connection with social supports Information on coping Linkage with collaborative services

25 Exposure Therapy PTSD as a disorder of avoidance Intervention based on helping people confront feared objects, situations, memories, and images in the absence of feared consequences Promotes learning Decreases debilitating avoidance and emotion EBT s for PTSD Prolonged Exposure Cognitive Processing Therapy

26 Prolonged Exposure 9-12 weekly sessions Education about common reactions to trauma Safe exposure to trauma triggers and memories In vivo exposure: Confronting safe traumarelated situations between sessions Imaginal exposure: Revisiting trauma memories in session and listening to the audio recorded revisiting between sessions

27 Cognitive Processing Therapy Manualized trauma focused cognitive behavioral therapy for PTSD Originally developed in 1988 to treat rape survivors Protocol is 12 sessions 60 min sessions for individual therapy 90 minute group sessions Can be done with (CPT) or without (CPT-C) a trauma account with similar effects at post treatment (Resick et al., 2008) Goal: To gain and understanding of and modify the meaning attributed to the traumatic experience

28 PE versus CPT (Resik et al., 2007)

29 Exposure treatments during pregnancy Women with PTSD postpartum should be referred to psychotherapy, and be offered treatment during subsequent pregnancy (Turton et al. 2001) Case study research has indicated no adverse effects of Prolonged Exposure treatment on pregnant women, developing fetus, or infant (Twohig & O Donohue, 2007). Therapist required signed letter from OB/GYN to proceed with treatment (Twohig & O Donohue, 2007).

30 Best practices for PTSD in pregnancy

31 For all patients Monitoring mood symptoms throughout the course of the pregnancy Staying aware of any changes in patient s ability or motivation to care for herself Inquiring about relevant trauma history on intake

32 Following still birth and pregnancy loss Encouraging mothers to see and hold their stillborn infant has been associated with increased incidence of PTSD and depression in the mother following the birth (Hughes et al., 2002). Having a funeral and keeping mementos were not associated with averse outcome (Hughes et al., 2002). Helping women to engage their crisis support network was associated with increased resilience following a pregnancy loss (Englehard et al., 2003).

33 PTSD during pregnancy Provide referral for patients to obtain counseling and or additional assessment if you suspect client may have PTSD There is no data showing averse effects of engaging in EBT for PTSD during pregnancy, and benefits likely outweigh any risks Collaboration between health care provider and psychotherapist is encouraged In situations requiring a high level of obstetric intervention, encourage patient involvement in decision making process and help patient to engage social support network.

34 Questions and Comments

35 Selected References Smith, M.V., Poschman, K., Cavaleri, M.A., Howell, H.B., Yonkers, K.A. (2006). Symptoms of posttraumatic stress disorder in a community sample of low income pregnant women. American Journal of Psychiatry, 163, Breslau N, Kessler RC, Chilcoat HD, Schultz LR, Davis GC, Andreski P: Trauma and posttraumatic stress disorder in the community: the 1996 Detroit Area Survey of Trauma. Arch Gen Psychiatry 1998; 55: Engelhard, I. (2003). The Sense of Coherence in Early Pregnancy and Crisis Support and Posttraumatic Stress After Pregnancy Loss: A Prospective Study. Behavioral Medicine, 29, Hamama, L. (2010). Previous experience of spontaneous or elective abortion and risk for posttraumatic stress and depression during subsequent pregnancy. Depression and anxiety, 27, Alcorn, K L. (2010). A prospective longitudinal study of the prevalence of posttraumatic stress disorder resulting from childbirth events. Psychological Medicine, 40, Twohig, M P. (2007). Treatment of Posttraumatic Stress Disorder with Exposure Therapy During Late Term Pregnancy. Clinical case studies, 6, Seng, J. (2011). Post-traumatic stress disorder, child abuse history, birthweight and gestational age: a prospective cohort study. BJOG: an international journal of obstetrics and gynecology, 118, Rogal, S, (2007). Effects of posttraumatic stress disorder on pregnancy outcomes. Journal of affective disorders, 102, Bell, S. (2013). Childhood Maltreatment History, Posttraumatic Relational Sequelae, and Prenatal Care Utilization. Journal of obstetric, gynecologic, and neonatal nursing, 42,

36 My contact info Robin Lange, Ph.D. Clinical Psychologist and CEO Utah Center for Evidence Based Treatment

37 PTSD (DSM-V) Criterion A: death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence, as follows: Direct exposure, witnessing, in person; indirectly, repeated or extreme indirect exposure to aversive details of the event(s), Criterion B: intrusion symptoms: (1 required) re-experiencing, Traumatic nightmares, Dissociative reactions, Intense/prolonged distress, Marked physiologic reactivity Criterion C: avoidance: (1 required) avoidance of stimuli, thoughts/feelings, external reminders Criterion D: negative alterations in cognitions and mood: (2 required) Inability to recall, negative beliefs/expectations about oneself, blame of self or others, negative trauma-related emotions, diminished interest in activities, Feeling alienated from others, Constricted affect Criterion E: alterations in arousal and reactivity: (2 required) Irritable or aggressive behavior, Self-destructive or reckless behavior, Hypervigilance, Exaggerated startle response, Problems in concentration, Sleep disturbance. Criterion F: duration : Persistence of symptoms (in Criteria B, C, D and E) for more than one month. Criterion G: functional significance : Significant symptom-related distress or functional impairment (e.g., social, occupational). Criterion H: attribution : Disturbance is not due to medication, substance use, or other illness.

FACT SHEET. What is Trauma? TRAUMA-INFORMED CARE FOR WORKING WITH HOMELESS VETERANS

FACT SHEET. What is Trauma? TRAUMA-INFORMED CARE FOR WORKING WITH HOMELESS VETERANS FACT SHEET TRAUMA-INFORMED CARE FOR WORKING WITH HOMELESS VETERANS According to SAMHSA 1, trauma-informed care includes having a basic understanding of how trauma affects the life of individuals seeking

More information

Psychiatric Issues and Defense Base Act Claims. Dr. Michael Hilton

Psychiatric Issues and Defense Base Act Claims. Dr. Michael Hilton Psychiatric Issues and Defense Base Act Claims Dr. Michael Hilton Criteria for DSM-IVRPosttraumatic Stress Disorder with changes now in effect with DSM5 a. The person has been exposed to a traumatic event

More information

Jim Boehnlein, M.D. Associate Director for Education, VA Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC)

Jim Boehnlein, M.D. Associate Director for Education, VA Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) Jim Boehnlein, M.D. Associate Director for Education, VA Northwest Network Mental Illness Research, Education, and Clinical Center (MIRECC) Professor of Psychiatry, Oregon Health and Science University

More information

Post Traumatic Stress Disorder (PTSD) Karen Elmore MD Robert K. Schneider MD Revised 5-11-2001 by Robert K. Schneider MD

Post Traumatic Stress Disorder (PTSD) Karen Elmore MD Robert K. Schneider MD Revised 5-11-2001 by Robert K. Schneider MD Post Traumatic Stress Disorder (PTSD) Karen Elmore MD Robert K. Schneider MD Revised 5-11-2001 by Robert K. Schneider MD Definition and Criteria PTSD is unlike any other anxiety disorder. It requires that

More information

PTSD: Updated. Karen Kattar, Psy.D. Psychologist and PTSD Clinic Director Phoenix VA Healthcare System

PTSD: Updated. Karen Kattar, Psy.D. Psychologist and PTSD Clinic Director Phoenix VA Healthcare System PTSD: Updated Karen Kattar, Psy.D. Psychologist and PTSD Clinic Director Phoenix VA Healthcare System Overview New Diagnostic Criteria Resources/Apps Timely Topic: Anger, aggressiveness and PTSD Citation:

More information

Supporting children in the aftermath of a crisis

Supporting children in the aftermath of a crisis Supporting children in the aftermath of a crisis David J. Schonfeld, MD Thelma and Jack Rubinstein Professor of Pediatrics Director, National Center for School Crisis and Bereavement Division of Developmental

More information

Post traumatic Stress Associated with Cancer

Post traumatic Stress Associated with Cancer Post traumatic Stress Associated with Cancer BCCA Survivorship Forum June 8, 2016 Alan Bates, MD, PhD, FRCPC Provincial Practice Leader for Psychiatry BC Cancer Agency None Disclosures Acknowledgments

More information

Supporting Children s Mental Health Needs in the Aftermath of a Disaster: Pediatric Pearls

Supporting Children s Mental Health Needs in the Aftermath of a Disaster: Pediatric Pearls Supporting Children s Mental Health Needs in the Aftermath of a Disaster: Pediatric Pearls Satellite Conference and Live Webcast Thursday, August 25, 2011 5:30 7:00 p.m. Central Time Faculty David J. Schonfeld,

More information

4/25/2015. Traumatized People, Service Delivery Systems, and Learning from 9/11 (NYC)

4/25/2015. Traumatized People, Service Delivery Systems, and Learning from 9/11 (NYC) Traumatized People, Service Delivery Systems, and Learning from 9/11 (NYC) Ryan Edlind MS, MSW, LISW-S April 29, 2015 Traumatized People, Service Delivery Systems, and Learning from 9/11 (NYC) Ryan Edlind

More information

11/26/2013. PTSD in the DSM-5. Summary of Changes in DSM 5

11/26/2013. PTSD in the DSM-5. Summary of Changes in DSM 5 PTSD in the DSM-5 Christine A. Courtois, PhD, ABPP Independent Practice Washington, DC National Clinical Trauma Consultant Elements Behavioral Health, Promises, Malibu/LA CACourtoisPhD@aol.com www.drchriscourtois.com

More information

Acute Stress Disorder and Posttraumatic Stress Disorder

Acute Stress Disorder and Posttraumatic Stress Disorder Acute Stress Disorder and Posttraumatic Stress Disorder Key Messages Traumatic Events Events that involve actual or threatened death or serious injury (real or perceived) to self or others (e.g., accidents,

More information

C HAPTER 9 T RAUMA AND P OST-TRAUMATIC S TRESS D ISORDER IN P ATIENTS W ITH HIV/AIDS

C HAPTER 9 T RAUMA AND P OST-TRAUMATIC S TRESS D ISORDER IN P ATIENTS W ITH HIV/AIDS C HAPTER 9 T RAUMA AND P OST-TRAUMATIC S TRESS D ISORDER IN P ATIENTS W ITH HIV/AIDS Exposure to a traumatic event is normally accompanied by distress. For most individuals such distress resolves spontaneously

More information

WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD

WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD WHAT IS PTSD? A HANDOUT FROM THE NATIONAL CENTER FOR PTSD BY JESSICA HAMBLEN, PHD Posttraumatic Stress Disorder (PTSD) is an anxiety disorder that can occur following the experience or witnessing of a

More information

Understanding PTSD and the PDS Assessment

Understanding PTSD and the PDS Assessment ProFiles PUTTING ASSESSMENTS TO WORK PDS TEST Understanding PTSD and the PDS Assessment Recurring nightmares. Angry outbursts. Easily startled. These are among the many symptoms associated with Post Traumatic

More information

POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm

POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm E-Resource March, 2014 POST-TRAUMATIC STRESS DISORDER PTSD Diagnostic Criteria PTSD Detection and Diagnosis PC-PTSD Screen PCL-C Screen PTSD Treatment Treatment Algorithm Post-traumatic Stress Disorder

More information

Cognitive Behavioral Therapy for PTSD. Dr. Edna B. Foa

Cognitive Behavioral Therapy for PTSD. Dr. Edna B. Foa Cognitive Behavioral Therapy for PTSD Presented by Dr. Edna B. Foa Center for the Treatment and Study of Anxiety University of Pennsylvania Ref # 3 Diagnosis of PTSD Definition of a Trauma The person has

More information

Uncertainty: Was difficulty falling asleep and hypervigilance related to fear of ventricular tachycardia returning, or fear of being shocked again?

Uncertainty: Was difficulty falling asleep and hypervigilance related to fear of ventricular tachycardia returning, or fear of being shocked again? Manuel Tancer, MD Chart Review: PTSD PATIENT INFO 55 Age: Background: Overweight nurse with 6-month history of nightmares, hyperarousal, and flashbacks; symptoms began after implanted defibrillator was

More information

What is Narrative Exposure Therapy (NET)?

What is Narrative Exposure Therapy (NET)? What is Narrative Exposure Therapy (NET)? Overview NET is a culturally universal short-term intervention used for the reduction of traumatic stress symptoms in survivors of organised violence, torture,

More information

2) Recurrent emotional abuse. 3) Contact sexual abuse. 4) An alcohol and/or drug abuser in the household. 5) An incarcerated household member

2) Recurrent emotional abuse. 3) Contact sexual abuse. 4) An alcohol and/or drug abuser in the household. 5) An incarcerated household member Co Occurring Disorders and the on Children: Effectively Working with Families Affected by Substance Abuse and Mental Illness Definition (Co-Occurring also called Dual Dx) A professional diagnosis of addictive/substance

More information

POST-TRAUMATIC STRESS DISORDER (PTSD)

POST-TRAUMATIC STRESS DISORDER (PTSD) POST-TRAUMATIC STRESS DISORDER (PTSD) Post-Traumatic Stress Disorder (PTSD) arises as an immediate, delayed and/or protracted response to a traumatic or stressful event of an exceptionally threatening

More information

The Forgotten Worker: Veteran

The Forgotten Worker: Veteran The Forgotten Worker: Veteran Larry Ashley & Meghan Pierce University of Nevada, Las Vegas Veteran Workforce Statistics The unemployment rate of veterans from all eras is 8.7% (Bureau of Labor Statistics,

More information

Traumatic Stress. and Substance Use Problems

Traumatic Stress. and Substance Use Problems Traumatic Stress and Substance Use Problems The relation between substance use and trauma Research demonstrates a strong link between exposure to traumatic events and substance use problems. Many people

More information

PTSD IN PRIMARY CARE. Kari A. Stephens, PhD & Wayne Bentham, MD Psychiatry & Behavioral Sciences University of Washington

PTSD IN PRIMARY CARE. Kari A. Stephens, PhD & Wayne Bentham, MD Psychiatry & Behavioral Sciences University of Washington PTSD IN PRIMARY CARE Kari A. Stephens, PhD & Wayne Bentham, MD Psychiatry & Behavioral Sciences University of Washington What to expect today? Defining and assessing PTSD Approach for doing differential

More information

Symptoms, Treatment and Self-Help for PTSD

Symptoms, Treatment and Self-Help for PTSD Post-Traumatic Stress Disorder (PTSD) Symptoms, Treatment and Self-Help for PTSD After a traumatic experience, it's normal to feel frightened, sad, anxious, and disconnected. But if the upset doesn't fade

More information

Post Traumatic Stress Disorder & Substance Misuse

Post Traumatic Stress Disorder & Substance Misuse Post Traumatic Stress Disorder & Substance Misuse Produced and Presented by Dr Derek Lee Consultant Chartered Clinical Psychologist Famous Sufferers. Samuel Pepys following the Great Fire of London:..much

More information

Trauma, PTSD, Complex Trauma, and the ARC Framework

Trauma, PTSD, Complex Trauma, and the ARC Framework Trauma, PTSD, Complex Trauma, and the ARC Framework Learning Objectives What do we mean when we use the term trauma? What do different types of traumatic events have in common? Why do people respond differently

More information

NCPTSD: Mission and Vision Mission: To promote the best clinical care and functional status of Veterans through research, education, and training rela

NCPTSD: Mission and Vision Mission: To promote the best clinical care and functional status of Veterans through research, education, and training rela Questions and Answers about PTSD: Posttraumatic Stress Disorder Laurie Slone, PhD Associate Director for Research and Education NCPTSD: Mission and Vision Mission: To promote the best clinical care and

More information

Essential Trauma Informed Practices in Schools. Shannon Cronn, N.C.S.P. Barb Iversen, M.C.

Essential Trauma Informed Practices in Schools. Shannon Cronn, N.C.S.P. Barb Iversen, M.C. Essential Trauma Informed Practices in Schools Shannon Cronn, N.C.S.P. Barb Iversen, M.C. Objectives: Participants attending this session will be able to: Define trauma Explain how trauma may impact child/teen

More information

Can You Help My Nightmares? Palliating Symptoms of Hospital Induced Stress Disorders

Can You Help My Nightmares? Palliating Symptoms of Hospital Induced Stress Disorders Can You Help My Nightmares? Palliating Symptoms of Hospital Induced Stress Disorders Brooke Kaney, MSW, LICSW Clinical Social Work Fellow Palliative Care Program University of Minnesota Medical Center

More information

Domestic Violence, Mental Health and Substance Abuse

Domestic Violence, Mental Health and Substance Abuse Domestic Violence, Mental Health and Substance Abuse Sue Parry, PhD NYS Office for the Prevention of Domestic Violence Why does domestic violence (DV) have so many mental health effects? Put yourself in

More information

CHAPTER 6 Diagnosing and Identifying the Need for Trauma Treatment

CHAPTER 6 Diagnosing and Identifying the Need for Trauma Treatment CHAPTER 6 Diagnosing and Identifying the Need for Trauma Treatment This chapter offers mental health professionals: information on diagnosing and identifying the need for trauma treatment guidance in determining

More information

Trauma and Stress Related Disorders & Dissociative Disorders

Trauma and Stress Related Disorders & Dissociative Disorders Trauma and Stress Related Disorders & Dissociative Disorders Sarah Reed, MD & Jason Roof, MD University of California Davis Department of Psychiatry and Behavioral Science Disclosures Disclaimers & Accolades

More information

The Link Between Trauma and Substance Misuse: Thinking about the Unthinkable

The Link Between Trauma and Substance Misuse: Thinking about the Unthinkable The Link Between Trauma and Substance Misuse: Thinking about the Unthinkable Dr Lisa Reynolds Greater Glasgow and Clyde NHS Trauma Service: The Trauma and Homelessness Team Aims of Discussion Definition

More information

`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí=

`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí= `çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí= Overview: Common Mental What are they? Disorders Why are they important? How do they affect

More information

How Emotional/ Psychological Trauma Affects the Body

How Emotional/ Psychological Trauma Affects the Body How Emotional/ Psychological Trauma Affects the Body Objectives: Define trauma What is the relationship between physical health and PTSD? Identify how trauma is assessed/screened How can family members

More information

Traumatic Stress and Substance Abuse Problems

Traumatic Stress and Substance Abuse Problems Traumatic Stress and Substance Abuse Problems The relation between substance use and trauma Research demonstrates a strong link between exposure to traumatic events and substance use problems. Many people

More information

Supporting Someone with Post-Traumatic Stress Disorder (PTSD) Summary A normal response to trauma becomes PTSD when someone becomes stuck:

Supporting Someone with Post-Traumatic Stress Disorder (PTSD) Summary A normal response to trauma becomes PTSD when someone becomes stuck: Supporting Someone with Post-Traumatic Stress Disorder (PTSD) This handout defines Post-Traumatic Stress Disorder (PTSD), ways to cope and how to support someone with PTSD. The Skills Booklet provides

More information

Impact of Trauma. Anne G. Studzinski Illinois Childhood Trama Coalition

Impact of Trauma. Anne G. Studzinski Illinois Childhood Trama Coalition Impact of Trauma Anne G. Studzinski Illinois Childhood Trama Coalition Learning Objectives 1. Be able to give one example of a one-time traumatic event and a chronic or repeated event. 2. Be able to describe

More information

USVH Disease of the Week #1: Posttraumatic Stress Disorder (PTSD)

USVH Disease of the Week #1: Posttraumatic Stress Disorder (PTSD) USVH Disease of the Week #1: Posttraumatic Stress Disorder (PTSD) Effects of Traumatic Experiences A National Center for PTSD Fact Sheet By: Eve B. Carlson, Ph.D. and Josef Ruzek, Ph.D. When people find

More information

Appendix 5. Victim Impact

Appendix 5. Victim Impact Appendix 5 Victim Impact ACQUAINTANCE RAPE: THE VICTIM Gail Abarbanel Director Rape Treatment Center Santa Monica-UCLA Medical Center Issues in Acquaintance Rapes Not common perception of rape Not real

More information

Overcoming the Trauma of Your Motor Vehicle Accident

Overcoming the Trauma of Your Motor Vehicle Accident Overcoming the Trauma of Your Motor Vehicle Accident Chapter 1 Introduction Case Study: Janelle Janelle s accident happened so suddenly. She was simply making a left turn as she was leaving the shopping

More information

Trauma and Stress-Related Disorders in DSM-5. Matthew J. Friedman MD, PhD National Center for PTSD Geisel School of Medicine at Dartmouth

Trauma and Stress-Related Disorders in DSM-5. Matthew J. Friedman MD, PhD National Center for PTSD Geisel School of Medicine at Dartmouth Trauma and Stress-Related Disorders in DSM-5 Matthew J. Friedman MD, PhD National Center for PTSD Geisel School of Medicine at Dartmouth Disclosures Sources of Research Support 1. U.S. Department of Veterans

More information

Post-traumatic stress disorder overview

Post-traumatic stress disorder overview Post-traumatic stress disorder overview A NICE pathway brings together all NICE guidance, quality standards and materials to support implementation on a specific topic area. The pathways are interactive

More information

Post-Traumatic Stress Disorder - PTSD

Post-Traumatic Stress Disorder - PTSD Post-Traumatic Stress Disorder - PTSD Introduction Post-Traumatic Stress Disorder, or PTSD, is a common disorder in which a person experiences disabling anxiety after a traumatic event. People with PTSD

More information

Traumatic Stress with Alcohol and/or Drug Addiction

Traumatic Stress with Alcohol and/or Drug Addiction Traumatic Stress with Alcohol and/or Drug Addiction information for individuals and families Eastern Trauma Advisory Panel What is Post Traumatic Stress Disorder (PTSD)? How people react to a traumatic

More information

An Unwanted Legacy: Long-term effects of chronic childhood trauma. Matthew Kerr, Ph.D. C.Psych. June 13, 2013

An Unwanted Legacy: Long-term effects of chronic childhood trauma. Matthew Kerr, Ph.D. C.Psych. June 13, 2013 An Unwanted Legacy: Long-term effects of chronic childhood trauma Matthew Kerr, Ph.D. C.Psych. June 13, 2013 Where we are headed What is trauma? How common is childhood trauma? Why is chronic childhood

More information

Manual for the Administration and Scoring of the PTSD Symptom Scale Interview for DSM-5 (PSS-I-5) Past Month Version. Edna B. Foa and Sandy Capaldi

Manual for the Administration and Scoring of the PTSD Symptom Scale Interview for DSM-5 (PSS-I-5) Past Month Version. Edna B. Foa and Sandy Capaldi Manual for the Administration and Scoring of the PTSD Symptom Scale Interview for DSM-5 (PSS-I-5) Past Month Version Edna B. Foa and Sandy Capaldi 1 Introduction The PTSD Symptom Scale Interview for DSM-5

More information

Post-Traumatic Stress Disorder (PTSD) and TBI. Kyle Haggerty, Ph.D.

Post-Traumatic Stress Disorder (PTSD) and TBI. Kyle Haggerty, Ph.D. Post-Traumatic Stress Disorder (PTSD) and TBI Kyle Haggerty, Ph.D. Learning Objects What is Brain Injury What is PTSD Statistics What to Rule Out PTSD and TBI Treatment Case Study What is Brain Injury

More information

Fear Avoidance in Chronic Pain and PTSD. Sarah Gallant, Occupational Therapist Iris Torchalla, Psychologist

Fear Avoidance in Chronic Pain and PTSD. Sarah Gallant, Occupational Therapist Iris Torchalla, Psychologist Fear Avoidance in Chronic Pain and PTSD Sarah Gallant, Occupational Therapist Iris Torchalla, Psychologist Objectives Nature of PTSD and Chronic Pain Theoretical models of comorbidity Role of Fear Avoidance

More information

Manual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I) Elizabeth A. Hembree, Edna B. Foa, & Norah C.

Manual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I) Elizabeth A. Hembree, Edna B. Foa, & Norah C. Manual for the Administration and Scoring of the PTSD Symptom Scale Interview (PSS-I) Elizabeth A. Hembree, Edna B. Foa, & Norah C. Feeny 1 Introduction The PTSD Symptom Scale Interview (PSS-I) was designed

More information

Disability Benefits Questionnaire Initial Post Traumatic Stress Disorder (PTSD) * Internal VA or DoD Use Only* SECTION I:

Disability Benefits Questionnaire Initial Post Traumatic Stress Disorder (PTSD) * Internal VA or DoD Use Only* SECTION I: Name of patient/veteran: SSN: This form is for use only by VHA, DoD, and VBA staff and contract psychiatrists or psychologists who have been certified to perform Initial PTSD Evaluations. VA will consider

More information

EMERGENCY TRIAGE TOOLKIT

EMERGENCY TRIAGE TOOLKIT EMERGENCY TRIAGE TOOLKIT INTRODUCTION This toolkit has been created by the Douglas Hospital and McGill University to help in the triage of victims of traumatic stress in the event of a large-scale catastrophic

More information

Trauma-Informed Practice: What Child Welfare Attorneys Can Do

Trauma-Informed Practice: What Child Welfare Attorneys Can Do Trauma-Informed Practice: What Child Welfare Attorneys Can Do October, 2012 Kimberly Shipman, Ph.D. Kempe Center for Prevention and Treatment of Child Abuse and Neglect Department of Pediatrics, School

More information

After Sexual Assault. A Recovery Guide for Survivors SAFE HORIZON. 24-Hour Hotline: 212 227 3000. www.safehorizon.org

After Sexual Assault. A Recovery Guide for Survivors SAFE HORIZON. 24-Hour Hotline: 212 227 3000. www.safehorizon.org After Sexual Assault A Recovery Guide for Survivors SAFE HORIZON 24-Hour Hotline: 212 227 3000 www.safehorizon.org SAFE HORIZON hopes this guide will help the recovery of anyone whose life has been affected

More information

PTSD: Beyond the Basics D. Ryan Hooper, Ph.D. Jesse Brown VA Medical Center

PTSD: Beyond the Basics D. Ryan Hooper, Ph.D. Jesse Brown VA Medical Center PTSD: Beyond the Basics D. Ryan Hooper, Ph.D. Jesse Brown VA Medical Center. PTSD: Beyond the Basics Overview What is it? How does it develop? How many people have PTSD? What treatment options do we have?

More information

Post Traumatic Stress Disorder

Post Traumatic Stress Disorder Post Traumatic Stress Disorder What Is Post Traumatic Stress Disorder? Post Traumatic Stress Disorder (PTSD) was introduced into the American Psychiatric Association s official manual (DSM) in 1980. PTSD

More information

Relationship Intervention with Traumatized Infants, Young Children, and their Caregivers

Relationship Intervention with Traumatized Infants, Young Children, and their Caregivers Relationship Intervention with Traumatized Infants, Young Children, and their Caregivers Julie A. Larrieu, Ph.D. Institute of Infant and Early Childhood Mental Health Tulane University School of Medicine

More information

Supporting students and staff after the shooting in Aurora, CO

Supporting students and staff after the shooting in Aurora, CO Supporting students and staff after the shooting in Aurora, CO David J. Schonfeld, MD Daniel Nelson, MD National Center for School Crisis and Bereavement Cincinnati Children s Hospital Medical Center david.schonfeld@cchmc.org

More information

Childhood Trauma: A Trauma Informed Systems Approach

Childhood Trauma: A Trauma Informed Systems Approach Childhood Trauma: A Trauma Informed Systems Approach Charles Wilson, MSSW Executive Director The Sam and Rose Stein Endowed Chair in Child Protection Chadwick Center for Children and Families, Rady Children

More information

Fact Sheet: POST TRAUMATIC STRESS DISORDER

Fact Sheet: POST TRAUMATIC STRESS DISORDER Fact Sheet: POST TRAUMATIC STRESS DISORDER What is post traumatic stress disorder? Frightening and overwhelming traumatic experiences can have a strong impact on your mind and emotions, especially if they

More information

Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT?

Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT? Taking Care: Child and Youth Mental Health ANXIETY WHAT IS IT? Open Learning Agency 2004 WHAT IS IT? Anxiety is a normal human feeling characterized by worry, nervousness and fear. Not only does anxiety

More information

Overcoming the Trauma of Your Motor Vehicle Accident

Overcoming the Trauma of Your Motor Vehicle Accident Overcoming the Trauma of Your Motor Vehicle Accident Chapter 1 Introductory Information for Therapists Case Study: Mary The day had begun like any other. Mary was on her way to work early in the morning.

More information

About Postpartum Depression and other Perinatal Mood Disorders

About Postpartum Depression and other Perinatal Mood Disorders About Postpartum Depression and other Perinatal Mood Disorders The entire period of pregnancy up to one year after delivery is described as the perinatal period. Many physical and emotional changes occur

More information

Trauma FAQs. Content. 1. What is trauma? 2. What events are traumatic?

Trauma FAQs. Content. 1. What is trauma? 2. What events are traumatic? Trauma FAQs Content 1. What is trauma? 2. What events are traumatic? 3. Who experiences trauma? 4. What are symptoms of trauma? 5. How can I help someone who may be experiencing trauma? 6. Where can people

More information

Mood and anxiety disorders in patients with a brain tumor

Mood and anxiety disorders in patients with a brain tumor Mood and anxiety disorders in patients with a brain tumor Isabel Schuermeyer, MD Director, Psycho-Oncology Cleveland Clinic Taussig Cancer Institute Jazz Classrooms I & II Overview What has the research

More information

GUIDANCE FOR CAREGIVERS: CHILDREN OR TEENS WHO HAD A LOVED ONE DIE IN THE EARTHQUAKE

GUIDANCE FOR CAREGIVERS: CHILDREN OR TEENS WHO HAD A LOVED ONE DIE IN THE EARTHQUAKE GUIDANCE FOR CAREGIVERS: CHILDREN OR TEENS WHO HAD A LOVED ONE DIE IN THE EARTHQUAKE Introduction to trauma The earthquake was a terrifying disaster for adults, children, families, and communities. The

More information

Postpartum Depression and Post-Traumatic Stress Disorder

Postpartum Depression and Post-Traumatic Stress Disorder Postpartum Depression and Post-Traumatic Stress Disorder Emotional Recovery: Postpartum Depression and Post-Traumatic Stress Disorder By: Lisa Houchins Published: July 23, 2013 Emotions vary widely after

More information

Provide parents and carers with information around what changes they might notice if they have also experienced a trauma.

Provide parents and carers with information around what changes they might notice if they have also experienced a trauma. Aims This guide aims to: Give parents and carers an understanding of what trauma is and some of the common reactions you might see in children and young people who have experienced a trauma (examples of

More information

Postpartum Mood Disorders

Postpartum Mood Disorders Postpartum Mood Disorders The Nurse s Role in Identification and Intervention Van Gogh Mother Roulin 1888 Betty Bowles RNC, MSN Nelda Coleman RN, MSN Lauren Jansen RN, MSN Midwestern State University Wilson

More information

Psychotherapeutic Interventions for Children Suffering from PTSD: Recommendations for School Psychologists

Psychotherapeutic Interventions for Children Suffering from PTSD: Recommendations for School Psychologists Psychotherapeutic Interventions for Children Suffering from PTSD: Recommendations for School Psychologists Julie Davis, Laura Lux, Ellie Martinez, & Annie Riffey California Sate University Sacramento Presentation

More information

Substance Abuse and Sexual Violence:

Substance Abuse and Sexual Violence: Substance Abuse and Sexual Violence: The Need for Integration When Treating Survivors Kelli Hood, M.A. Objective To understand the necessity for therapeutic strategies in clients with cooccurring Substance

More information

Helping Children After a Wildfire: Tips for Parents and Teachers

Helping Children After a Wildfire: Tips for Parents and Teachers Helping Children After a Wildfire: Tips for Parents and Teachers Natural disasters can be traumatic for children and youth. Experiencing a dangerous wildfire can be frightening even for adults, and the

More information

Anxiety Disorders. Symptoms Checklist Presence of symptoms determines the assigning of a diagnosis

Anxiety Disorders. Symptoms Checklist Presence of symptoms determines the assigning of a diagnosis Anxiety Disorders Symptoms Checklist Presence of symptoms determines the assigning of a diagnosis Panic Attack Palpitation, pounding heart, or accelerated heart rate Sweating Trembling or shaking Sensations

More information

Depression Assessment & Treatment

Depression Assessment & Treatment Depressive Symptoms? Administer depression screening tool: PSC Depression Assessment & Treatment Yes Positive screen Safety Screen (see Appendix): Administer every visit Neglect/Abuse? Thoughts of hurting

More information

Psychological First Aid Red Cross Preparedness Academy 2014

Psychological First Aid Red Cross Preparedness Academy 2014 Caring for Survivors of Trauma and Disaster: An Introduction to Psychological First Aid Biographical Information Rev. William F. Engfehr III LutheranChurch MissouriSynod DisasterResponseChaplain Senior

More information

Assessing families and treating trauma in substance abusing families

Assessing families and treating trauma in substance abusing families Children, Trauma and the impact of Substance abuse Day One Outpatient (874-1045) Amy Stevenson LCPC CCS (amys@day-one.org) Don Burke LCPC CCS (donb@day-one.org) Assessing families and treating trauma in

More information

Diagnostic and Statistical Manual-5: Trauma & Stressor-Related Disorders in Children and Adolescents. DSM-5: Proposed Metastructure

Diagnostic and Statistical Manual-5: Trauma & Stressor-Related Disorders in Children and Adolescents. DSM-5: Proposed Metastructure Diagnostic and Statistical Manual-5: Trauma & Stressor-Related Disorders in Children and Adolescents Robert S. Pynoos, M.D., M.P.H. Co-Director UCLA/Duke University National Center for Child Traumatic

More information

Treatment of PTSD in Women Veterans

Treatment of PTSD in Women Veterans Treatment of PTSD in Women Veterans Paula P. Schnurr, PhD National Center for PTSD Geisel School of Medicine at Dartmouth 25 April 2012 www.ptsd.va.gov VA National Center for PTSD Created by PL 98-528

More information

Child Welfare Trauma Referral Tool

Child Welfare Trauma Referral Tool Module 4, Activity 4F; Module 4, Activity 4G Child Welfare Trauma Referral Tool This measure is designed to help child welfare workers make more trauma-informed decisions about the need for referral to

More information

This webinar is presented by

This webinar is presented by Webinar DATE: Working Together to Support the Mental Health of Families with November Pre-term 12, Babies 2008 Tuesday, 7 th October 2014 Supported by The Royal Australian College of General Practitioners,

More information

Introduction to Veteran Treatment Court

Introduction to Veteran Treatment Court Justice for Vets Veterans Treatment Court Planning Initiative Introduction to Veteran Treatment Court Developed by: Justice for Vets Justice for Vets, 10 February 2015 The following presentation may not

More information

Suzanne R. Merlis, Psy. D. Georgia-LLC Licensed Psychologist

Suzanne R. Merlis, Psy. D. Georgia-LLC Licensed Psychologist Suzanne R. Merlis, Psy. D. Georgia-LLC Licensed Psychologist If going to asylum officer at affirmative stage: ASYLUM OFFICER, ARLINGTON ASYLUM OFFICE In the Matter of Mr. X Respondent If referred to judge:

More information

EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY

EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury (TBI) is a common neurological condition that can have significant emotional and cognitive consequences.

More information

Syllabus & Schedule Fall, 2010

Syllabus & Schedule Fall, 2010 CPSY 590-02 Trauma Psychology in Clinical Practice Syllabus & Schedule Fall, 2010 I. INSTRUCTOR: Suzanne Best, Ph.D. e-mail: sbest@lclark.edu Phone: 503 306 2965 II. CREDIT HOURS: 3 III. IV. BRIEF COURSE

More information

Post-traumatic Stress Disorder Within a Primary Care Setting: Effectively and Sensitively Responding to Sexual Trauma Survivors

Post-traumatic Stress Disorder Within a Primary Care Setting: Effectively and Sensitively Responding to Sexual Trauma Survivors Post-traumatic Stress Disorder Within a Primary Care Setting: Effectively and Sensitively Responding to Sexual Trauma Survivors Serena Clardie, MSW, LCSW ABSTRACT It is estimated that 1 in 4 females and

More information

PTSD and Evidenced Based Treatment Available at the VA

PTSD and Evidenced Based Treatment Available at the VA PTSD and Evidenced Based Treatment Available at the VA Tami Burkey, LCSW OEF/OIF/OND Social Work Case Manager VA Nebraska Western Iowa Health Care System 25/September 2013 PTSD DSM-5 DIAGNOSTIC CRITERIA

More information

PTSD, Opioid Dependence, and EMDR: Treatment Considerations for Chronic Pain Patients

PTSD, Opioid Dependence, and EMDR: Treatment Considerations for Chronic Pain Patients PTSD, Opioid Dependence, and EMDR: Treatment Considerations for Chronic Pain Patients W. Allen Hume, Ph.D.,C.D.P. Licensed Psychologist www.drallenhume.com October 2, 2007 COD client with PTSD seeking

More information

PTSD in Service Members and Veterans

PTSD in Service Members and Veterans PTSD in Service Members and Veterans Presented by: Shannon McCaslin, PhD Clinical Psychologist National Center for PSTD Dissemination and Training Division Overview 1) Defining features of PTSD 2) Prevalence

More information

National Defence. Défense nationale A-MD-007-144/JD-004. Preparing for CRITICAL incident. Stress

National Defence. Défense nationale A-MD-007-144/JD-004. Preparing for CRITICAL incident. Stress National Defence Défense nationale A-MD-007-144/JD-004 Preparing for CRITICAL incident Stress Foreword This publication is presented as a resource for the Department of National Defence (DND) community,

More information

Critical Incidents. Information for schools from Derbyshire Educational Psychology Service

Critical Incidents. Information for schools from Derbyshire Educational Psychology Service Critical Incidents Information for schools from Derbyshire Educational Psychology Service Introduction to Critical Incidents A critical incident (CI) is any event that is unexpected, acute, stressful and

More information

Reference document. Understanding and living through grief

Reference document. Understanding and living through grief Reference document Understanding and living through grief Table of content Introduction 2 Definition 2 Myths 2 Stages and symptoms 2 Differentiate grief from depression 3 How to overcome grief 3 When grief

More information

Substance Abuse and Mental Health Services Administration Reauthorization

Substance Abuse and Mental Health Services Administration Reauthorization Substance Abuse and Mental Health Services Administration Reauthorization 111 th Congress Introduction The American Psychological Association (APA) is the largest scientific and professional organization

More information

Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.

Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too. The Family Library DEPRESSION What is depression? Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too. Also called

More information

Haiti and the Children

Haiti and the Children Haiti and the Children Post Earthquake Marlene Goodfriend The Facts Port au Prince and surrounds were at the epicenter 50% of medical facilities in western Haiti were destroyed The pediatric department

More information

Toward a Multicultural Understanding of Mental Health

Toward a Multicultural Understanding of Mental Health Toward a Multicultural Understanding of Mental Health sue.johnston@mnchurches.org 612-203-03213 HEALTH BODY MIND EMOTIONS SPIRIT Well Cold Pneumonia Emphysema Healthy Under the weather Sick Seriously

More information

Original Article: http://www.mayoclinic.com/health/post-traumatic-stress-disorder

Original Article: http://www.mayoclinic.com/health/post-traumatic-stress-disorder 1 of 11 6/29/2012 12:17 PM MayoClinic.com reprints This single copy is for your personal, noncommercial use only. For permission to reprint multiple copies or to order presentation-ready copies for distribution,

More information

Treatment for PTSD and Substance Use Problems in Veterans

Treatment for PTSD and Substance Use Problems in Veterans Treatment for PTSD and Substance Use Problems in Veterans Charity Hammond, Ph.D. PTSD/SUD Psychologist Michael E. DeBakey VA Medical Center Houston, Texas Goals of workshop Define Posttraumatic Stress

More information

Dr. Elizabeth Gruber Dr. Dawn Moeller. California University of PA. ACCA Conference 2012

Dr. Elizabeth Gruber Dr. Dawn Moeller. California University of PA. ACCA Conference 2012 Dr. Elizabeth Gruber Dr. Dawn Moeller California University of PA ACCA Conference 2012 http://www.youtube.com/watch?v=9rpisdwsotu Dissociative Identity Disorder- case presentation Diagnostic criteria Recognize

More information

Perinatal Mood and Anxiety Disorders

Perinatal Mood and Anxiety Disorders Perinatal Mood and Anxiety Disorders Mother love in infancy and childhood is as important for mental health as are vitamins and proteins for physical health ~ John Bowlby YOU ARE NOT TO BLAME The Spectrum

More information

Assessment and Treatment of Post Traumatic Stress Disorder (PTSD) in Veterans

Assessment and Treatment of Post Traumatic Stress Disorder (PTSD) in Veterans Assessment and Treatment of Post Traumatic Stress Disorder (PTSD) in Veterans Kristen H. Sorocco, PhD OKC Veterans Affairs Medical Center Donald W. Reynolds Department of Geriatric Medicine, University

More information