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Post traumatic stress disorder (PTSD)A survey published in 1995 of 5,877 people ages 15 to 54 years as part of the National Comorbidity Survey found the estimated lifetime prevalence of PTSD to be 7.8% (). Women and previously married people of either sex had the highest PTSD prevalence. The highest risk among women was for those who had been raped or sexually molested. Physical assaults led to 29% of women experiencing PTSD some time in their lives. Among men, the highest risk was having participated in combat and witnessing violent death. Combat led to a lifetime prevalence of 39% in these men. They also found that only two-thirds of those experiencing PTSD recover even after many years. Common somatic complaints in folks with PTSD include cardiovascular disease, autoimmunity, and chronic pain. The underlying mechanism for alterations in immune functions is thought to be increased activity in the neuroendocrine systems (). Several different psychological treatments are being used for PTSD. The principle types of therapies are trauma-focused cognitive behavioral therapy (TFCBT), stress management (SM), eye movement desensitization and reprocessing (EMDR), group cognitive behavioral therapy (GCBT), supportive therapy, psychodynamic therapy, hypnotherapy, and non-directive counseling. Published in 2007, the relative effectiveness of these different psychological treatments for PTSD was reviewed (). They concluded that TFCBT, EMDR, SM, and GCBT improved PTSD symptoms more than usual care or wait-list controls. TFGBT and EMDR seemed to be the best and equally efficacious and some evidence suggested that both of these may be superior to SM. And SM may be better than the other therapies. The reviewers state that the first-line psychological treatments for PTSD should be trauma focused, i.e. TFCBT or EMDR. At Heather Hills Therapy Center we use TFCBT. TFCBT includes any technique that makes use of trauma focused cognitive, behavioral, or cognitive-behavioral methods. TFCBT facilitates the participant to identify and challenge distorted thinking patterns in relationship to the trauma, themselves and the external world. Exposure therapy is a popular type of TFCBT. It asks the individual to relive the trauma in their imagination. It can take several forms. One technique is to gradually re-expose the patient to various stimuli that were associated with the original trauma. Another technique is to make a detailed audio tape recounting the trauma and play it repeatedly. |
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