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Psychological therapies for post-traumatic stress disorder

  • Gwen Adshead (a1)
Abstract
Background

After exposure to traumatic stressors, a subgroup of survivors (20–30%) will develop post-traumatic stress disorder (PTSD).

Aims

Since the incidence and prevalence rates for PTSD in the community are significant, it is important that general practitioners and psychiatrists be familiar with possible therapeutic options. In this review we shall look at the published evidence about the effectiveness of psychological treatments for PTSD.

Method

The psychopathological mechanisms involved in PTSD are discussed. Studies of the effectiveness of different psychological therapies are reviewed.

Results

The review suggests that persistent fear or shame reactions are key aspects of PTSD. Evidence from systematic reviews suggests that psychotherapeutic treatments are effective in the therapy of reactions based on fear, and may increase the effectiveness of pharmacological therapy. There is less systematic evidence for the efficacy of interventions for symptoms based on shame.

Conclusions

Although a proportion of patients with complex or chronic PTSD may require specialist interventions, most patients can be treated effectively by a general psychiatric service which can offer both pharmacological and psychological interventions.

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Copyright
References
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American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (4th edn) (DSM–IV). Washington, DC: APA.
Andrews, B. (1998) Shame and childhood abuse. In Shame: Interpersonal behaviour, Psychopathology and Culture (eds Gilbert, P. & Andrews, B.), pp. 176190. Oxford: Oxford University Press.
Bisson, J. I., Jenkins, P. L., Alexander, J., et al (1997) Randomised controlled trial of psychological debriefing for victims of acute burn trauma. British Journal of Psychiatry, 171, 7881.
Bolwig, T. (1998) Debriefing after psychological trauma. Acta Psychiatrica Scandinavica, 98, 169170.
Dodge, K. A., Pettit, G. & Bates, J. E. (1997) How experience of early physical abuse leads children to become chronically aggressive. In Developmental Perspectives on Trauma: Theory, Research and Intervention (eds Cicchetti, D. & Toth, S.), pp. 263288. Rochester, NY: University of Rochester Press.
Embry, C. (1990) Psychotherapeutic interventions in chronic post-traumatic stress disorder. In Posttraumatic Stress Disorder: Etiology, Phenomenology and Treatment (eds Wolf, M. & Mosnaim, A.), pp. 226237. Washington, DC: American Psychiatric Press.
Foa, E. & Kozak, M. (1986) Emotional processing of fear: exposure to corrective information. Psychological Bulletin, 99, 2035.
Helzer, J. E., Robins, L. N. & McEvoy, L. (1987) Posttraumatic stress disorder in the general population. New England Journal of Medicine, 317, 16301634.
Herman, J. L. (1992) Trauma and Recovery. New York: Basic Books.
Kessler, R. C., Sonnega, A., Bromet, E., et al (1995) Post-traumatic stress disorder in the National Co-Morbidity Survey. Archives of General Psychiatry, 52, 10481060.
Lindy, J. (1996) Psychoanalytic psychotherapy of post-traumatic stress disorder: the nature of the therapeutic relationship. In Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body and Society (eds van der Kolk, B., McFarlane, A. & Weisaeth, L.), pp. 525536. New York: Guilford.
Marks, I., Lovell, K., Noshirvani, H., et al (1998) Treatment of post-traumatic stress disorder by exposure and/or cognitive restructuring. Archives of General Psychiatry, 55, 317325.
Read Johnson, D. (1997) Introduction: inside the specialised inpatient PTSD units of the Department of Veterans Affairs. Journal of Traumatic Stress, 10, 357360.
Resick, P. A. & Schnicke, M. K. (1993) Cognitive Processing Therapy for Rape Victims: A Treatment Manual. London: Sage.
Richards, D., Lovell, K. & Marks, I. (1994) Posttraumatic stress disorder: Evaluation of a behavioural treatment programme. Journal of Traumatic Stress, 7, 669 680.
Roth, S., Newman, E., Pelcovitz, D., et al (1997) Complex PTSD in victims exposed to sexual and physical abuse: results from the DSM–IV field trial for Posttraumatic Stress Disorder. Journal of Traumatic Stress, 10, 539 556.
Rothbaum, B. O. & Foa, E. (1996) Cognitive–behavioural therapy for posttraumatic stress disorder. In Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body and Society (eds van der Kolk, B., McFarlane, A. & Weisaeth, L.), pp. 491509. New York: Guilford.
Shalev, A., Bonne, O. & Eth, S. (1996) Treatment of post-traumatic stress disorder: a review. Psychosomatic Medicine, 58, 165182.
Sherman, J. J. (1998) Effects of psychotherapeutic treatments for PTSD: a meta-analysis of controlled trials. Journal of Traumatic Stress, 11, 413436.
Turner, S., McFarlane, A. & van der Kolk, B. (1996) The therapeutic environment and new explorations in the treatment of post-traumatic stress disorder. In Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body and Society (eds van der Kolk, B., McFarlane, A. & Weisaeth, L.), pp. 537558. New York: Guilford.
van Etten, M. L. & Taylor, S. (1998) Comparative efficacy of treatment for post-traumatic stress disorder: a meta analysis. Clinical Psychology & Psychotherapy, 5, 126144.
Wessely, S., Rose, S. & Bisson, J. (1997) A systematic review of brief psychological interventions (“debriefing”) for the treatment of trauma-related symptoms and the prevention of post-traumatic stress disorder. Cochrane Review 25/11/97. Oxford: Update Software.
World Health Organization (1992) The ICD–10 Classification of Mental and Behavioural Disorders. Geneva: WHO.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Psychological therapies for post-traumatic stress disorder

  • Gwen Adshead (a1)
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