PTSD - New Approaches to Posttraumatic Stress Disorder...

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New Approaches to Posttraumatic Stress Disorder Robert K. Schneider, MD Assistant Professor Departments of Psychiatry and Internal Medicine The Medical College of Virginia of the Virginia Commonwealth University
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Epidemiology Epidemiological Catchment Area Study (1987) Lifetime prevalence: 1-2% Urban sample of HMO enrollees (1991) 11.3% of women National Comorbidity Study (1995) 7.8% of responders
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Diagnosis Exposure of self or others to an “extreme” stressor (“the trauma”) Avoidance Re-experiences Hyperarousal
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Avoidance or Numbing Avoidance of associated thoughts, feelings, activities, or places Diminished interest Detachment Restricted range of affect
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Re-experience the trauma Flashbacks Nightmares Intrusive thoughts Intense reaction when exposed to “triggers”
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Hyperarousal Sleep problems Irritability Hypervigilance Exaggerated startle Difficulty concentrating
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Progression of symptoms - Blank Acute stress disorder Acute PTSD Chronic PTSD Delayed PTSD Intermittent Residual Reactivated
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Areas of focus tonight The “Great Imposter” Management Update
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Stressor Criteria Exposed to event that involved serious injury, or a threat to the physical integrity of self or others The person’s response involved intense fear, helplessness or horror (change from DSM-IIIR)
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Trauma and PTSD in the community,  The 1996 Detroit area survey of trauma
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PTSD - New Approaches to Posttraumatic Stress Disorder...

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