Assessment and Treatment Planning for PTSD

Assessment and Treatment Planning for PTSD......Page 5
Copyright......Page 6
Contents......Page 7
Acknowledgments......Page 9
Chapter 1: Introduction and Overview......Page 11
Historical and Societal Perspectives......Page 12
An Evolving Disorder......Page 14
Epidemiology of PTSD: Posttraumatic Morbidity Versus Resilience......Page 16
Individual Risk Factors......Page 17
The Etiological Nature of the Trauma......Page 18
PTSD Symptom Criteria: Symptom Overlap and Factor Structure......Page 19
Memory and Trauma......Page 20
The Forensic Aspect of PTSD......Page 21
References......Page 22
Chapter 2: Using Evidence-Based Practices......Page 27
Evidence-Based Practice—What Is It and Why Should We Care?......Page 28
The Process of Evidence-Based Practice......Page 33
Randomized Clinical Trials (RCTs)......Page 34
Critical Reviews, Meta-Analyses, Consensus Panels, and Agency Guidelines......Page 35
What About Cultural Competence in EBP?......Page 36
References......Page 38
Assessing Trauma History......Page 41
What Is a Traumatic Stressor?......Page 51
Should Subjective Peritraumatic Distress Be Assessed?......Page 52
Why Assess Trauma History?......Page 53
How to Sensitively Assess Trauma History......Page 56
Clinical Interpretation and Use of Trauma History......Page 67
Conclusion......Page 75
References......Page 76
Chapter 4: Assessing PTSD......Page 81
Strategies for Trauma History Assessment......Page 82
Instruments......Page 83
Technical Considerations: Response Validity......Page 84
Assessing PTSD Symptom Criteria......Page 85
Connecting PTSD Symptom Inquiries to an Index Trauma......Page 86
Defining PTSD Symptoms Accurately......Page 88
Labeling a PTSD Symptom as Clinically Significant......Page 89
Strategies for Assessing PTSD Symptoms......Page 93
Instruments......Page 94
References......Page 95
PTSD's Comorbidity......Page 101
Recommendations for Assessing PTSD's Comorbidity......Page 103
Structured Diagnostic Interviews......Page 104
Objective Personality Assessment......Page 105
Self-Report Measures......Page 106
References......Page 108
Chapter 6: Considering Ethnicity, Race, and Culture......Page 113
Trauma Exposure......Page 114
Utilization of Services for Traumatic Stress Disorders......Page 115
The Role of Racism and Discrimination......Page 116
Racism and Discrimination as Risk Factors for Trauma Exposure......Page 117
Racism and Other Forms of Identity-Based Bias as Psychological Trauma......Page 118
The Interaction of Ethnicity and Gender......Page 119
Displacement and Loss of Social Networks......Page 120
Social Support and Safety......Page 121
Beliefs About the Meaning of Trauma Exposure and Posttraumatic Symptoms and Disorders......Page 122
Assessing Adversity With Sensitivity to Ethnoracial and Cultural Factors......Page 124
Assessing and Enhancing Access to Services and Supports......Page 125
Conclusion......Page 126
References......Page 127
Unpacking "Secondary Gain": Motives for Symptom Exaggeration in PTSD......Page 131
Financial Incentives......Page 132
Avoiding Criminal Penalties......Page 133
Stolen Valor......Page 134
Records-Based Confirmation......Page 135
Overall Assessment Strategies......Page 136
Psychological Testing......Page 138
Treatment Implications......Page 140
References......Page 141
Chapter 8: Working With Children and Adolescents: Conceptual and Clinical Foundations......Page 147
Self-Regulation as a Framework for Assessing Posttraumatic Impairment......Page 149
Diagnosis of PTSD in Children and Adolescents: DSM-IV and DSM-5......Page 151
Clinical Considerations in Conducting Assessment With Traumatized Children......Page 160
Therapeutic Relationship and Alliance......Page 162
Strengths-Based Approach to Assessment......Page 163
Assessing Dissociation......Page 165
Identifying Somatic Manifestations of Posttraumatic Symptoms......Page 166
Determining With Whom, When, and How to Address Traumatic Memories......Page 167
Preventing and Managing Relational Discontinuities and Psychosocial Crises......Page 168
References......Page 170
Chapter 9: Assessing Children and Adolescents: Evidence-Based Assessment Instruments......Page 175
Child and Adolescent Trauma History Assessment......Page 176
Assessment Measures for Child and Adolescent PTSD......Page 179
Measures of Posttraumatic Dysregulation......Page 183
Treatment Strategies......Page 186
References......Page 189
Chapter 10: Working With Veterans......Page 195
PTSD Onset and Course......Page 196
Historical, Contextual, and Socioeconomic Factors......Page 199
Media and Popular Culture Influences......Page 201
Compensation and Pension Evaluations and Treatment Planning Implications......Page 202
Clinical Assessment With Veterans......Page 204
The Basics of Assessment......Page 205
Unique Factors Associated With Combat and Military Service......Page 206
Unique Clinical Needs of Veterans......Page 208
Detection and Management of Malingering and Symptom Overreporting......Page 209
Working Within the Veterans Affairs System......Page 213
Conclusion......Page 214
References......Page 215
Primary Care Settings......Page 219
PTSD Screeners for Primary Care......Page 221
Treatment of PTSD in Primary Care......Page 222
Psychopharmacological Treatment of PTSD......Page 223
Assessment Issues......Page 225
Treatment Issues......Page 226
Rural Populations......Page 230
Prisoners......Page 233
References......Page 234
Psychosocial Treatments for PTSD......Page 239
Psychopharmacological Treatment of PTSD......Page 248
Variability in Treatment Response......Page 249
PTSD Interventions for Patients With Comorbid Conditions......Page 250
Providing Feedback......Page 254
PTSD Interventions in Need of Further Testing......Page 258
References......Page 259
Within-Session Tracking......Page 263
Between-Session Tracking......Page 267
Monitoring of Other Psychiatric Conditions or General Functioning......Page 270
Treatment Adjustments......Page 271
References......Page 272
Chapter 14: Going Forward: New Frontiers and Future Directions......Page 275
New Frontiers in the Field Relevant to Assessment and Treatment Planning......Page 278
Proposed Criteria for PTSD in DSM-5......Page 279
Proposed Criteria Changes to DSM-5......Page 280
Criterion A: The Traumatic Stressor......Page 281
Other Considerations Regarding the Proposed PTSD Criteria for DSM-5......Page 283
Conclusions on the Near Future of PTSD in the DSM......Page 286
Final Remarks......Page 287
References......Page 289
Author Index......Page 293
Subject Index......Page 305