Table of Contents

World Psychiatric Association Evidence and Experience in Psychiatry Series

Series Editor: Helen Herrman, WPA Secretary for Publications, University of Melbourne, Australia

 

Depressive Disorders, 3e

Edited by Helen Herrman, Mario Maj and Norman Sartorius

ISBN: 9780470987209

 

Substance Abuse Disorders

Edited by Hamid Ghodse, Helen Herrman, Mario Maj and Norman Sartorius

ISBN: 9780470745106

 

Schizophrenia 2e

Edited by Mario Maj, Norman Sartorius

ISBN: 9780470849644

 

Dementia 2e

Edited by Mario Maj, Norman Sartorius

ISBN: 9780470849637

 

Obsessive-Compulsive Disorders 2e

Edited by Mario Maj, Norman Sartorius, Ahmed Okasha, Joseph Zohar

ISBN: 9780470849668

 

Bipolar Disorders

Edited by Mario Maj, Hagop S Akiskal, Juan José López-Ibor, Norman Sartorius

ISBN: 9780471560371

 

Eating Disorders

Edited by Mario Maj, Kathrine Halmi, Juan José López-Ibor, Norman Sartorius

ISBN: 9780470848654

 

Phobias

Edited by Mario Maj, Hagop S Akiskal, Juan José López-Ibor, Ahmed Okasha

ISBN: 9780470858332

 

Personality Disorders

Edited by Mario Maj, Hagop S Akiskal, Juan E Mezzich

ISBN: 9780470090367

 

Somatoform Disorders

Edited by Mario Maj, Hagop S Akiskal, Juan E Mezzich, Ahmed Okasha

ISBN: 9780470016121

Current Science and Clinical Practice Series

Schizophrenia

Edited by Wolfgang Gaebel

ISBN: 9780470710548

 

Obsessive Compulsive Disorder

Edited by Joseph Zohar

ISBN: 9780470711255

Other recent World Psychiatric Association titles

Special Populations

 

The Mental Health of Children and Adolescents: an area of global neglect

Edited by Helmut Remschmidt, Barry Nurcombe, Myron L. Belfer, Norman Sartorius and Ahmed Okasha

ISBN: 9780470512456

 

Contemporary Topics in Women's Mental Health: global perspectives in a changing society

Edited by Prabha S. Chandra, Helen Herrman, Marianne Kastrup, Marta Rondon, Unaiza Niaz, Ahmed Okasha, Jane Fisher

ISBN: 9780470754115

 

Approaches to Practice and Research

 

Religion and Psychiatry: beyond boundaries

Edited by Peter J Verhagen, Herman M van Praag, Juan José López-Ibor, John Cox, Driss Moussaoui

ISBN: 9780470694718

 

Psychiatric Diagnosis: challenges and prospects

Edited by Ihsan M. Salloum and Juan E. Mezzich

ISBN: 9780470725696

 

Recovery in Mental Health: reshaping scientific and clinical responsibilities

By Michaela Amering and Margit Schmolke

ISBN: 9780470997963

 

Handbook of Service User Involvement in Mental Health Research

Edited by Jan Wallcraft, Beate Schrank and Michaela Amering

ISBN: 9780470997956

 

Psychiatrists and Traditional Healers: unwitting partners in global mental health

Edited by Mario Incayawar, Ronald Wintrob and Lise Bouchard,

ISBN: 9780470516836

 

Depression and Comorbidity

 

Depression and Diabetes

Edited by Wayne Katon, Mario Maj and Norman Sartorius

ISBN: 9780470688380

 

Depression and Heart Disease

Edited by Alexander Glassman, Mario Maj and Norman Sartorius

ISBN: 9780470710579

 

Depression and Cancer

Edited by David W. Kissane, Mario Maj and Norman Sartorius

ISBN: 9780470689660

This edition first published 2011 © 2011 by John Wiley & Sons, Ltd.

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Library of Congress Cataloging-in-Publication Data

Post-traumatic stress disorder / [edited by] Dan Stein, Matthew Friedman, and Carlos Blanco.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-470-68897-7 (cloth)

1. Post-traumatic stress disorder. I. Stein, Dan J. II. Friedman, Matthew J. III. Blanco, Carlos, 1962-

[DNLM: 1. Stress Disorders, Post-Traumatic. WM 172]

RC552.P67P6616 2011

616.85′21–dc23

2011014924

A catalogue record for this book is available from the British Library.

This book is published in the following electronic format: ePDF 9781119998488; Wiley Online Library: 9781119998471; ePub 9781119971481; Mobi 9781119971498

Preface

Post-traumatic stress disorder (PTSD) is arguably the most controversial of all the psychiatric diagnoses. There are disagreements about the qualifying events that count as sufficiently traumatic to precipitate PTSD, disagreements about the nature of the typical symptoms that follow exposure to trauma, disagreements about how best to prevent and treat PTSD, and disagreements about what kind of compensation is owed to people with PTSD by society.

At the same time, there have been major advances in our understanding of many aspects of PTSD. The diagnostic classifications of both the World Health Organization (WHO) and the American Psychiatric Association (APA) include the same broad symptom categories (e.g. re-experiencing, avoidance/numbing and arousal) and emphasise that exposure to extremely stressful events can produce profound alterations in cognitions, emotions and behaviour that may persist for decades or a lifetime.

There is also a growing appreciation of the public health burden of PTSD. Trauma continues to be a pervasive aspect of life in the 21st century, in high-, middle- and low-income countries [1]. Furthermore, PTSD and other trauma-related disorders are highly prevalent and disabling, are often associated with other psychiatric and medical disorders, and lead to significant costs for society [2, 3].

We are gradually advancing our scientific understanding of how exposure to traumatic events can produce neurobiological and psychological alterations which, if untreated, may persist indefinitely [4]. Furthermore, although there is not complete consensus across different clinical guidelines [5], there is general agreement that cognitive behaviour therapy and certain medications are the most effective clinical approaches for PTSD.

Many challenges remain. Fundamental information on the psychobiology of PTSD must be translated into effective, evidence-based clinical interventions. The development and testing of additional evidence-based treatments, especially treatments that are culturally sensitive and effective in more traditional ethnocultural settings, is required [6]. A further challenge is to move beyond the traditional clinic to the public health arena, where the focus must shift to resilience, prevention and selective interventions for populations at risk following disasters or mass violence [7].

The World Psychiatric Association (WPA) Evidence & Experience series provides a useful opportunity to work towards an evidence-based and integrative approach to different psychiatric conditions. In this volume, expert clinicians and researchers from around the world rigorously synthesise the data on PTSD, and provide balanced and judicious approaches to the controversies and challenges noted above. The chapters cover many aspects of PTSD, ranging from work on epidemiology and nosology, through research on psychobiology, to work on pharmacotherapy, psychotherapy and community approaches to intervention. Commentaries on each chapter, again from authors around the globe, provide additional depth.

Taken together, this work documents the many advances in empirical work on PTSD, negotiates a middle path through the theoretical controversies and provides clinicians and policy-makers with a practical approach to clinical and community interventions. Given that the field has learned much in recent decades about the kinds of trauma that are typically associated with PTSD, about the natural course of symptoms in response to such traumas, about optimal ways to evaluate and measure such symptoms, and about the best pharmacotherapeutic, psychotherapeutic and community approaches to the prevention and management of PTSD, we believe that this volume is timely. We hope that it will be useful to a broad range of readers.

We thank the many individuals who contributed to this volume, particularly the chapter authors. We also thank Joan Marsh of Wiley-Blackwell, Helen Herrman and Mario Maj of the WPA, and Marianne Kastrup, for their guidance and support; their vision and enthusiasm were pivotal in ensuring the initiation and progress of the volume. We wish to dedicate it to those individuals who have shared their symptoms and histories with us, teaching us the clinical aspects of PTSD and providing inspiring models of courage and resilience in the face of immense adversity.

Dan J. Stein, Carlos Blanco, Matthew J. Friedman

References

1. Green, B.L., Friedman, M.J., de Jong, J. et al. (2003) Trauma Interventions in War and Peace: Prevention, Practice, and Policy, Kluwer Academic/Plenum, Amsterdam.

2. Watson, P.J., Gibson, L. and Ruzek, J.I. (2007) Public health interventions following disasters and mass violence, in Handbook of PTSD: Science and Practice (eds M.J. Friedman, T.M. Keane and P.A. Resick), Guilford Press, New York, pp. 521–539.

3. Blumenfield, M. and Ursano, R.J. (2008) Intervention and Resilience after Mass Trauma, Cambridge University Press, Cambridge, UK.

4. Friedman, M.J., Keane, T.M. and Resick, P.A. (2007) Handbook of PTSD: Science and Practice, Guilford Press, New York.

5. Forbes, D., Creamer, M.C., Bisson, J.I. et al. (2010) A guide to guidelines for the treatment of PTSD and related conditions. Journal of Traumatic Stress, 23, 537–552.

6. Marsella, A.J, Johnson, J.L., Watson, P. and Gryczynski, J. (2008) Ethnocultural Perspectives on Disaster and Trauma: Foundations, Issues and Applications, Springer, New York.

7. Friedman, M.J. (2005). Every crisis is an opportunity. CNS Spectrums, 10, 96–98.

List of Contributors