Psychological Trauma

Front Cover
Rachel Yehuda
American Psychiatric Pub, 1998 - Medical - 218 pages
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Psychological Trauma reviews the theory of traumatic exposure as a major factor in psychological disorders like PTSD. It also addresses the differing outcomes of such exposure as well as exciting treatment options for patients. Some highlights from this volume of the 1998 Review of Psychiatry series include: * Complete coverage of the neurological damage from exposure to trauma.* A thoughtful discussion of the reasons some rape survivors suffer from chronic PTSD.* An established connection between PTSD and anxiety disorders and depression.* New uses of pharmacotherapy for patients suffering from PTSD.

The understanding of the connection between trauma and PTSD, is a continuing challenge for physicians. While many patients suffer from the disorder, it is still not commonly understood. Psychological Trauma provides psychiatrists and psychologists accessible and reliable information on the topic.

 

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Contents

Epidemiology of Trauma and Posttraumatic Stress Disorder
1
A Brief Inventory
3
Methodologic Issues in Estimating Exposure and the Conditional Risk of PTSD
7
Estimates of Exposure to Trauma and PTSD
10
Estimates of Exposure to Specific Types of Traumas
12
Sociodemographic and Other Suspected Risk Factors for Exposure
13
The Conditional Risk of PTSD
15
The Most Frequent Precipitating Traumas in Persons With PTSD
18
Rationale for Studying the Neuroendocrinology of Trauma and PTSD
98
HypothalamicPituitaryAdrenal Alterations in PTSD
102
Relationship to the Biology of PTSD
119
Implications of HPA Axis Findings for Understanding Findings of Reduced Hippocampal Volume in PTSD
121
How the HPA Findings Inform Our Understanding of PTSD
123
Conclusions
125
Pharmacotherapy in the Treatment of Posttraumatic Stress Disorder and Other TraumaRelated Syndromes
133
The Role of a Trauma History in Pharmacotherapy
134

Suspected Risk Factors for PTSD
19
Chronicity of PTSD
20
Trauma and the Risk of Other Psychiatric Disorders
22
Summary and Conclusions
25
References
27
Longitudinal Development of Traumatic Stress Disorders
31
The Phenomenology of Posttraumatic Disorders
34
Design and Methods in Studies of Traumatic Stress Disorders
49
Inferred Mechanisms
58
Conclusion
60
References
61
Evaluating the Effects of Psychological Trauma Using Neuroimaging Techniques
67
Paradigmatic Considerations
68
Structural Neuroimaging Research
70
Functional Neuroimaging Research
74
Conclusions
89
References
91
Neuroendocrinology of Trauma and Posttraumatic Stress Disorder
97
Exploring the Meaning of Medication
137
Psychosocial Versus Pharmacologic Treatment in TraumaRelated Disorders
138
When to Consider Pharmacotherapy in Individuals With Trauma Histories
140
Interpreting the Pharmacotherapy Literature in PTSD
147
Subthreshold PTSD
151
Review of the Pharmacotherapy Literature in PTSD
152
Other Pharmacotherapies From Uncontrolled Trials
162
Other Topics for Future Investigation Heterogeneity Within PTSD
168
References
171
Psychosocial Treatments for Posttraumatic Stress Disorder
179
Psychosocial Treatments for PTSD
181
Clinical Application of Prolonged Exposure
194
Decision Making Regarding Treatment Approaches
197
Conclusions
199
Afterword
205
Index
209
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About the author (1998)

Rachel Yehuda, Ph.D., is Director of the Division of Traumatic Stress Studies Program and Professor in the Department of Psychiatry at Mount Sinai School of Medicine and the PTSD Program at the VA Medical Center in Bronx, New York.

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