Acute Stress Disorder and Posttraumatic Stress Disorder
|
|
- Delphia Rogers
- 2 years ago
- Views:
Transcription
1 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, assault, natural disasters and wars) and evoke feelings of fear, helplessness or horror. Certain events (e.g., interpersonal violence, direct life threat and prolonged duration) are more likely to result in a traumatic response. ASD and PTSD ASD and PTSD are disorders characterised by symptoms that include distressing re-experiencing and active avoidance of the traumatic memories, emotional numbing and hyperarousal. (See Additional Information for diagnostic criteria). Symptom Trajectory Most people recover after a traumatic event without serious problems. Some develop more severe and persistent symptoms like PTSD. Those who develop chronic PTSD (i.e., lasting longer than three months) are unlikely to improve without effective treatment. Prevalence Around 15 25% of people who experience a potentially traumatic event (PTE) may develop PTSD making it one of the most common anxiety disorders. Psychological First Aid In the immediate aftermath of trauma, practitioners should monitor the person s mental state and provide tailored support. This includes attending to the person s practical needs and encouraging the use of existing coping strategies and social supports. Screening ASD and PTSD are treatable disorders often missed in clinical practice. Screening is an important means of rectifying this and facilitating appropriate care (see Quick Guide). Therapy Trauma-focussed psychological therapy is the most effective treatment for people who develop ASD and PTSD. Medication Where medication is required for the treatment of PTSD in adults, selective serotonin reuptake inhibitor antidepressants should be considered as the first choice. Other Disorders Following Trauma Other common mental health disorders that people can develop following exposure to a traumatic event include depression, substance abuse and other anxiety disorders. THE ROYAL This brochure is based on: The Australian Guidelines for Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder. For a complete copy of the Guidelines please refer to: www. acpmh.unimelb. edu.au/resources/ resources-guidelines.html This brochure is intended to assist practitioners in providing best practice clinical care for persons with ASD and PTSD. It is to be followed subject to the medical practitioner s judgment in each individual case. The Guidelines include advice on issues pertaining to special populations and trauma types. Please see the following publications for more information about the Guidelines: Treating adults with acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in primary care: A clinical update. The Medical Journal of Australia, (2007) 187 (2), The Australian guidelines for the treatment of adults with acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). The Australia and New Zealand Journal of Psychiatry, (2007) 41, The Australian Centre for Posttraumatic Mental Health (ACPMH) would like to thank the Australian Government Department of Veterans Affairs for funding the development of this brochure. These Guidelines are endorsed by the Royal Australian College of General Practitioners, the Royal Australian and New Zealand College of Psychiatrists and the Australian Psychological Society. For more information: AUSTRALIAN AND NEW ZEALAND COLLEGE OF PSYCHIATRISTS
2 Recent Trauma (Within two weeks of trauma exposure) Psychological first aid Monitor the person s mental state and screen for ASD and PTSD (see Quick Guide). Support the person s use of adaptive coping strategies (e.g., enlisting the support of family and friends), as well as his or her own coping strategies if they seem helpful. Encourage the person to re-engage in normal routines. Also: Attend to any injuries or physical health concerns. Ensure basic needs are met (e.g., housing, safety). CONTINUED DISTRESS Most people recover from initial psychological distress. However, if distress/symptoms persist for more than two weeks, consider diagnosis of ASD/PTSD. Symptoms may include: Distressing or unwanted memories of the trauma Avoidance of reminders and memories Hyperarousal Risk factors for developing ASD/PTSD include: Exposure to severe trauma Lack of social supports and other stressful life events A past history of trauma and/or previous psychiatric disorder TALKING ABOUT THE TRAUMA EXPERIENCE Support those who want or need to talk about the experience. Do not push those who prefer not to talk about the experience. REFERRAL GPs have an important role in referral and care coordination. Referrals to psychiatry, psychology and allied health professionals can be made under Medicare arrangements which may include completion of a mental health care plan. When referring for psychological interventions, consider referring to practitioners trained in trauma-focussed interventions (e.g., CBT). Referral for mental health care under third party funding arrangements should be considered where appropriate.
3 ASD/PTSD Suspected or diagnosed (ASD can be diagnosed between two days to four weeks following trauma. PTSD can be diagnosed from four weeks onward.) SUPPORT AND SCREEN Encourage, and if necessary facilitate, engagement with social supports. Stabilise and introduce simple stress or anxiety management strategies (e.g., controlled breathing, exercise or other coping strategies). Screen for ASD and PTSD (see Quick Guide). REFER OR PROVIDE: ASSESSMENT Conduct a thorough assessment of ASD/PTSD, including comorbid diagnoses such as depression, substance use disorders, safety issues, physical health, social and vocational functioning, and social supports. The Posttraumatic Checklist (PCL) can be used to assess all PTSD diagnostic criteria. TREATMENT First line treatment is trauma-focussed psychological therapy. This includes addressing the traumatic memory and the use of in vivo exposure (for details see Additional Information). Training in the use of trauma-focussed treatment is recommended. If one form of trauma-focussed therapy fails to produce a sufficient response, consider another and/or the use of pharmacotherapy. Trauma-focussed therapy should be embedded in a treatment plan that includes stabilisation, psycho-education, symptom management and attention to key relationships and roles. therapy alternatives Where no trauma-focussed psychological therapies are effective, available, or acceptable to the person, consider referral for nontrauma-focussed interventions (e.g., anxiety management) and/or pharmacotherapy. PHARMACOTHERAPY CHOICES 1 SSRI antidepressants (evidence does not distinguish a preferred SSRI) 2 Other newer antidepressants or tricyclic antidepressants 3 MAOI antidepressants (preferably by a psychiatrist) Where symptoms have not responded to antidepressant treatment, controlled studies have demonstrated potential benefits of adjunctive atypical anti-psychotics (preferably by a psychiatrist). Increase dose if non-responsive, being mindful of side effects. If effective, provide 12-month initial course. Stopping antidepressants should be via gradual weaning. Only use as first line if trauma-focussed psychological therapy is not available. Pharmacotherapy should always be supported by optimal psychotherapy.
4 PTSD with comorbidity Priorities for treatment of comorbid disorders PTSD and Depression Treat PTSD first when depression is mild to moderate as depression will often improve as PTSD symptoms reduce. If depression symptoms are severe, however, they should be treated first to minimise suicide risk and improve the ability of the person to tolerate therapy. PTSD and Substance Use Disorders: Treat both simultaneously because the two are likely to interact to maintain each other. When treating simultaneously, the substance use should be controlled before the trauma-focussed component of PTSD treatment begins. When people present with substance dependence, intoxication or acute withdrawal, the substance disorder should be treated first. MANAGING COMPLICATIONS AND PERSISTING PROBLEMS Safety People with PTSD may have fluctuating or continued severe distress and significant potential for self-harm (see Severe Distress). These people should be referred for urgent psychiatric care and stabilisation. Treatment Primary treatment interventions still apply but may involve multiple practitioners (e.g., GP, psychologist, psychiatrist and social/vocational rehabilitation consultants). A high level of communication and coordination of interventions is essential. Treatment review If a person s PTSD symptoms appear to be resistant to change, the following aspects of treatment should be revised where necessary: Consider whether the skill-set and experience of the treating practitioner are adequate for the treatment of the persisting problems. Consider referral for a second opinion. Consider whether the duration, intensity and setting of treatment are appropriate. SEVERE DISTRESS If a person presents with severe distress at any stage, particularly if they express thoughts about self-harm or suicide, appropriate steps to ensure safety include psychiatric care or hospitalisation. Other indicators of severe distress include severe insomnia, agitation, dissociation and social withdrawal. Acute treatment may involve pharmacotherapy using sedating, calming or antidepressant medication. Long term use of benzodiazepines is not recommended. They do not treat the underlying condition and involve risk of dependency.
5 ADDITIONAL INFORMATION What is trauma-focussed psychological therapy? First line treatment should be trauma-focussed therapy (trauma-focussed cognitive behaviour therapy (CBT) or eye movement desensitisation and reprocessing (EMDR) in addition to in vivo exposure). Key elements of trauma-focussed psychological therapy Addressing the traumatic memory in a controlled and safe environment (imaginal exposure) Confronting avoided situations, people or places in a graded and systematic manner (in vivo exposure) Identifying, challenging and modifying biased or distorted thoughts and interpretations about the event and its meaning (cognitive therapy) As the available evidence does not support the importance of the eye movements per se in EMDR, treatment gains are more likely to be due to the engagement with the traumatic memory, cognitive processing and rehearsal of coping and mastery responses Treatment duration Within the overall course of treatmment, 8 12 sessions of trauma-focussed treatment are generally needed but more may be required for more severe or complex cases. Ninety minutes should be allowed for sessions that involve imaginal exposure. The development of a robust therapeutic alliance may require extra time for people who have experienced prolonged and/or repeated traumatic exposure. Further sessions may be required where: there are several problems that arise from multiple traumatic events; PTSD co-occurs with traumatic bereavement; or PTSD is chronic and associated with significant disability and comorbidity. Psychosocial rehabilitation To reduce the likelihood of an enduring disability, people with ASD and PTSD should be actively encouraged to return to their normal social and occupational roles as quickly as they feel able and in an appropriately managed way. This may mean that they will continue to experience symptoms, albeit at reduced levels, as they return to previous roles. There should be a focus on psychosocial rehabilitation from the beginning of treatment. SPECIFIC POPULATIONS AND TRAUMA TYPES For more information on specific populations (Aboriginals and Torres Strait Islanders, refugees and asylum seekers, military and emergency service personnel, motor vehicle accident and other injury survivors, victims of crime, sexual assault, natural disasters, survivors of terrorism) download the PDF on these populations under publications and resources at DSM-IV Criteria for PTSD A1. The person experienced, witnessed, or was confronted with an event that involved actual or threatened death or serious injury to self or others. A2. The person s response involved intense fear, helplessness or horror. B. Re-experiencing (1 required) C. Avoidance / Numbing (3 required) D. Hypervigilance (2 required) 1. Recurrent and intrusive distresssing recollections of the event, including images, thoughts or perceptions 2. Recurrent distressing dreams of the event 3. Acting or feeling as if the event were re-occurring 4. Intense psychological distress at exposure to internal or external cues that symbolise or resemble an aspect of the event 5. Psychological reactivity on exposure to internal or external cues that symbolise or resemble an aspect of the event 1. Efforts to avoid thoughts, feelings or conversations associated with the event 2. Efforts to avoid activities, places or people that arouse recollections of the event 3. Inability to recall an important aspect of the event 4. Markedly diminished interest or participation in significant activities 5. Feeling of detachment or estrangement from others 6. Restricted range of affect (e.g., unable to have loving feelings) 7. Sense of foreshortened future (e.g., does not expect to have a normal lifespan) 1. Difficulty falling or staying asleep 2. Irritability or outbursts of anger 3. Difficulty concentrating 4. Hypervigilance 5. Exaggerated startle response E. Duration of the symptoms (criteria B, C and D) is more than 1 month. F. The symptoms cause clinically significant stress or impairment in social, occupational, or other important areas of functioning.
6 Quick Guide for ASD and PTSD If the person reports having experienced a potentially traumatic event: Is it a recent trauma (within the first 2 weeks)? If yes, provide Psychological First Aid: Monitor mental state and stabilise if required Encourage re-engagement in routines and use of social supports Ensure basic needs are met (e.g., housing, safety) Review in a week or two If symptoms do not settle following the first 2 weeks, or if the trauma is not recent: Assess for ASD or PTSD (ASD can be diagnosed between 2 days and 4 weeks; PTSD from 4 weeks onwards) see brief screen below Consider comorbidity e.g., depression, substance abuse (see PTSD with Comorbidity for treatment sequencing) Ensure stabilisation and safety Refer for (or provide if appropriate) trauma-focussed therapy (see Additional Information) Consider pharmacotherapy Encourage resumption or maintenance of family and work roles as far as functioning allows Screen for PTSD (Prins, et al., 2004, Primary Care Psychiatry) In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, in the past month, you: 1. Have had nightmares about it or thought about it when you did not want to? 2. Tried hard not to think about it or went out of your way to avoid situations that reminded you of it? 3. Were constantly on guard, watchful, or easily startled? 4. Felt numb or detached from others, activities, or your surroundings? If two or more are answered with yes, a diagnosis of PTSD is probable. A copy of the screen for PTSD is available at For a more complete scale including all 17 PTSD symptoms see the PTSD Checklist (PCL). This scale is useful for diagnostic purposes and monitoring change over time.
7 Quick Guide for ASD and PTSD How do I make a referral? Referrals to psychiatry, psychology, and allied health care can be made under Medicare arrangements. This should include completion of a mental health plan. Referral for mental health care under third party funding arrangements should be considered where appropriate. To whom? Practitioners trained in trauma-focussed interventions (e.g., CBT) are preferred. Psychologists: A list of psychologists can be found at: Psychiatrists: A list of psychiatrists can be found at: Social workers and other allied health professionals with mental health training Mental health plan Consider recommendations regarding trauma-focussed CBT for required treatments. See Additional Information when completing mental health plans. In addition to the K10, consider including the PTSD Checklist (PCL). It can also be used for re-assessment to monitor progress at treatment review. Focus on psychosocial rehabilitation: emphasise functional outcomes (e.g., social and vocational goals) from the outset. Screening for traumatic events GPs should also ask about past traumatic events where a person has repeated non-specific health problems. A good opening question is: Have you ever experienced a particularly frightening or upsetting event? It is often useful to ask about specific events that the person may have experienced, such as the following: Serious accident (like a car accident or industrial accident) Natural disaster (like a fire or flood) Physical attack or assault Sexual assault Seeing somebody being badly hurt or killed Domestic violence or abuse Physical or emotional abuse as a child Being threatened with a weapon or held captive War (as a civilian or in the military) Torture or an act of terrorism Any other extremely stressful or upsetting event THE ROYAL AUSTRALIAN AND NEW ZEALAND COLLEGE OF PSYCHIATRISTS
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
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
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
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
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
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
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
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
Acute Stress Disorder and Posttraumatic Stress Disorder
AUSTRALIAN GUIDELINES FOR THE TREATMENT OF ADULTS WITH Acute Stress Disorder and Posttraumatic Stress Disorder Practitioner Guide Copies of the full set of the Guidelines, this guide and a booklet for
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
Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) Post traumatic stress disorder is a condition where you have recurring distressing memories, flashbacks, and other symptoms after suffering a traumatic event. Treatment
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.
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
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
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
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
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
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
Post Traumatic Stress Disorder and its Comorbidities. RANZCP Webinar series for rural trainees Tuesday 16 September 2014
Post Traumatic Stress Disorder and its Comorbidities RANZCP Webinar series for rural trainees Tuesday 16 September 2014 WEBINAR OUTLINE Intro & Housekeeping Dr Magella Lajoie, Director of Training, child
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
Post-traumatic stress disorder (PTSD)
Issue date: March 2005 Quick reference guide Post-traumatic stress disorder (PTSD) The management of PTSD in adults and children in primary and secondary care Clinical Guideline 26 Developed by the National
The treatment of. post-traumatic stress disorder (PTSD) in adults and children
The treatment of post-traumatic stress disorder (PTSD) in adults and children Understanding NICE guidance information for people with PTSD, their advocates and carers, and the public The paragraphs are
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
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
Livingstones Session MANAGING A CRITICAL INCIDENT AT WORK. Managing a Critical Incident at Work Workbook Prepared by Livingstones Australia 1
Livingstones Session MANAGING A CRITICAL INCIDENT AT WORK 1 OBJECTIVES Understand what a critical incident is, and why we should care how we manage critical incidents Describe the different impacts that
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
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
Post Traumatic Stress Disorder and Substance Abuse. Impacts ALL LEVELS of Leadership
Post Traumatic Stress Disorder and Substance Abuse Impacts ALL LEVELS of Leadership What IS Post Traumatic Stress Disorder (PTSD) PTSD is an illness which sometimes occurs after a traumatic event such
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
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
Stuck in a Moment in Time: PTSD and Substance Use Disorders
Stuck in a Moment in Time: PTSD and Substance Use Disorders Dr Glenys Dore. May 2012 Northern Sydney Drug & Alcohol Service gdore@nsccahs.health.nsw.gov.au NDARC Integrated treatment studies PTSD & illicit
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
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.
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
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
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
Post-traumatic stress disorder (PTSD): the treatment of PTSD in adults and children
Post-traumatic stress disorder (PTSD): the treatment of PTSD in adults and children Understanding NICE guidance information for people with PTSD, their advocates and carers, and the public March 2005 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 What to expect today? Defining and assessing PTSD Approach for doing differential
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
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
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,
Asthma, anxiety & depression
Anxiety and are common in people with asthma. The good news is that there are effective treatments both for asthma and for anxiety and. With careful management, the symptoms of anxiety and can be treated
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,
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
North Pacific Epilepsy Research 2311 NW Northrup Street Suite #202 Portland, Oregon 97210 Tel: 503-291-5300 Fax: 503-291-5303
North Pacific Epilepsy Research 2311 NW Northrup Street Suite #202 Portland, Oregon 97210 Tel: 503-291-5300 Fax: 503-291-5303 Post-Traumatic Stress Disorder (PTSD) Post-traumatic stress disorder (PTSD)
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
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
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:
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
Anxiety Disorders. Agoraphobia
Anxiety Disorders Most of us know what it feels like to get anxious now and then. The sensations of a racing heart or butterflies in the stomach are normal responses to fear or stress. These feelings of
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,
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
Speciality: Mental Health Clinical problem: Post Traumatic Stress Disorder
St. Richard s Hospital Speciality: Mental Health Clinical problem: Post Traumatic Stress Disorder Scope of Problem PTSD is a problematic psychological condition that can occur in individuals who have witnessed
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
COMBAT PTSD Recognition and Treatment. Harry Croft, M.D. TOMA San Antonio, June, 2012
COMBAT PTSD Recognition and Treatment Harry Croft, M.D. TOMA San Antonio, June, 2012 Research and Speaking Honoraria Astra Zeneca Boehringer Ingelheim BMS Eli Lilly Forest Pharmaceuticals GSK Otsuka Pfizer
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
PTSD and Substance Use Disorders. Anthony Dekker DO Chief, Addiction Medicine Fort Belvoir Community Hospital
PTSD and Substance Use Disorders Anthony Dekker DO Chief, Addiction Medicine Fort Belvoir Community Hospital Disclosure Anthony Dekker, DO has presented numerous programs on Chronic Pain Management and
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
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
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
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
The American Legion POST TRAUMATIC STRESS DISORDER. A guide to identification and getting help.
The American Legion POST TRAUMATIC STRESS DISORDER A guide to identification and getting help. POST TRAUMATIC STRESS DISORDER What is it? Stress is a natural reaction to a traumatic or life-threatening
Differentiating PTSD and ADHD. Elizabeth Risch, Ph.D. & Melissa Hakman, Ph.D.
Differentiating PTSD and ADHD Elizabeth Risch, Ph.D. & Melissa Hakman, Ph.D. ADHD vs. PTSD One is a disruptive behavior disorder and the other is a reaction to trauma.so what s to differentiate??? The
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
Do you help people recover from trauma? training programs
Do you help people recover from trauma? 2015 training programs Do you or your staff help people who have experienced trauma? Phoenix Australia s training programs teach the skills required by a range of
DSM-5: Trauma-and Stressor- Related Disorders
DSM-5: Trauma-and Stressor- Related Disorders Criteria, Changes, and Clinical Implications Jennifer Sweeton, Psy.D. Oklahoma City VA Medical Center Trauma- and Stressor-Related Disorders 1. Posttraumatic
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,
Post-traumatic stress disorder. Understanding post-traumatic stress disorder
Post-traumatic stress disorder Understanding post-traumatic stress disorder Understanding post-traumatic stress disorder Post-traumatic stress disorder (PTSD) may emerge months or sometimes years after
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
International Association of Chiefs of Police, Orlando October 26, 2014
International Association of Chiefs of Police, Orlando If I dodged the bullet, why am I bleeding?" Manifestations of exposure trauma in emergency responders who do not have Posttraumatic Stress Disorder
Challenges to Detection and Management of PTSD in Primary Care
Challenges to Detection and Management of PTSD in Primary Care Karen H. Seal, MD, MPH University of California, San Francisco San Francisco VA Medical Center General Internal Medicine Section PTSD is Prevalent
Post-traumatic Stress Disorder
Parkland College A with Honors Projects Honors Program 2012 Post-traumatic Stress Disorder Nicole Smith Parkland College Recommended Citation Smith, Nicole, "Post-traumatic Stress Disorder" (2012). A with
Treatment of PTSD in Children
Treatment of PTSD in Children Why Treat PTSD in Kids? Distress & Disabling Impairs Functioning Development Affected Co- morbid Problems Chronicity Limited research on Child PTSD Treatment Combined approach
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
9/11Treatment Referral Program How to Get Care
9/11Treatment Referral Program How to Get Care Health 9/11 Treatment Referral Program The 9/11 Treatment Referral Program was created to help enrollees and others find care for WTC-related health problems.
Understanding PTSD treatment
Understanding PTSD treatment Do I need professional help? Whether or not you need help can only be determined by you and a mental health professional. However, you can take the self-assessment in the PTSD
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
AUSTRALIAN GUIDELINES FOR THE TREATMENT OF ADULTS WITH. Acute Stress Disorder and Posttraumatic Stress Disorder
AUSTRALIAN GUIDELINES FOR THE TREATMENT OF ADULTS WITH Acute Stress Disorder and Posttraumatic Stress Disorder The development of these guidelines has been generously supported by: Emergency Management
Promoting recovery after trauma. Acute Stress Disorder & Posttraumatic Stress Disorder. in Children & Adolescents. A Practitioner Guide to Treatment
Promoting recovery after trauma Acute Stress Disorder & Posttraumatic Stress Disorder in Children & Adolescents A Practitioner Guide to Treatment This guide provides an overview of important points to
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
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
Promoting recovery after trauma. Recovery after Trauma. A Guide for People with Posttraumatic Stress Disorder
Promoting recovery after trauma Recovery after Trauma A Guide for People with Posttraumatic Stress Disorder 2 Posttraumatic stress disorder (PTSD) can occur after someone has been through a traumatic event.
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
Psychopharmacotherapy for Children and Adolescents
TREATMENT GUIDELINES Psychopharmacotherapy for Children and Adolescents Guideline 7 Psychopharmacotherapy for Children and Adolescents Description There are few controlled trials to guide practitioners
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:
Initial Evaluation for Post-Traumatic Stress Disorder Examination
Initial Evaluation for Post-Traumatic Stress Disorder Examination Name: Date of Exam: SSN: C-number: Place of Exam: The following health care providers can perform initial examinations for PTSD. a board-certified
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
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
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
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
Evidence Based Treatment for PTSD during Pregnancy:
Evidence Based Treatment for PTSD during Pregnancy: What prenatal care providers need to know Robin Lange, Ph.D. Why bother? PTSD in pregnant mothers has been associated with: Shorter gestation Lower birth
Posttraumatic Stress Disorder in Veterans and Active Duty Military
Posttraumatic Stress Disorder in Veterans and Active Duty Military Nancy C. Bernardy, PhD and Matthew J. Friedman, MD, PhD Veterans Affairs National Center for PTSD Geisel School of Medicine at Dartmouth
Post Traumatic Stress Disorder. Christy Hutton, PhD April 3, 2007
Post Traumatic Stress Disorder Christy Hutton, PhD April 3, 2007 Trauma statistics 25-80% of women and 20+% of men have a history of sexual victimization. Girls in high income families are at greatest
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
Posttraumatic Therapy
1498 Posttraumatic Therapy PTSD ASD PTSD PTSD PTSD g GABA 1499 posttraumatic stress disorder PTSD Diagnostic and Statistical Manual of Mental Disorders, fourth edition, text revision DSM IV TR A B C D
Mental Health Needs Assessment Personality Disorder Prevalence and models of care
Mental Health Needs Assessment Personality Disorder Prevalence and models of care Introduction and definitions Personality disorders are a complex group of conditions identified through how an individual
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
`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
TREATING PANIC DISORDER
TREATING PANIC DISORDER A Quick Reference Guide Based on Practice Guideline for the Treatment of Patients With Panic Disorder, originally published in May 1998. A guideline watch, summarizing significant
Management of depression in young people
Management of depression in young people A guide for primary care health professionals For young people not in immediate danger of suicidal behaviour, management of major depressive disorder is likely