Transcript Overview of Trauma and Trauma Treatment

Chapter 6
Posttraumatic Stress Disorder
(PTSD) in Veterans
DSM Diagnostic Criteria for PTSD*
 (According to the DSM-IV-TR; APA, 2000) Exposure to
an actual or perceived threat provoking intense fear or
helplessness.
 Three symptom clusters
 At least one reexperiencing symptom
 At least three avoidance or emotional numbing symptoms
 At least two hyperarousal symptoms
 Symptoms last more than one month.
 Significant distress or impairment in social,
occupational, of other functioning.
----------*Changes being proposed in upcoming revision (DSM-V)
Early Conceptions of PTSD
 Nineteenth century: “traumatic neurosis”
 Freud: Hysteria based on actual or fantasized sexual trauma
 World War I: “shell shock”
Models to Explain PTSD
 Psychodynamic Model
 Early childhood trauma and psychological conflicts
 General Adaptation Syndrome
 Physiological response to stress
 Biological Model
 Chronic or potentially permanent physiological changes
 Transactional Theories of Stress
 Contextual and environmental factors emphasized
 Diathesis-Stress Model
 Amalgam of the above models
 Genetic vulnerabilities, early childhood experiences or brain
abnormalities
Current, More Empirically Supported
Models of PTSD
 Behavioral Models
Feared stimuli overgeneralized
Avoidance of overgeneralized stimuli is
reinforced
 Cognitive Models
Traumatic event reinforces negative beliefs
about one’s safety and competence
Cognitive distortion that the world is a
dangerous place
 Biological Models
Discussion Questions Regarding
Case Study
 Discuss what you know about the case and possible resources.
 What are the societal, cultural, and community contexts of the case?
 What are elements of SSG Brown’s world that could serve to maintain
his problems?
 How would you address the maintenance of problems?
 What else would you want to know about the case and about SSG
Brown’s situation to develop a better understanding of him?
 How would you locate resources for SSG Brown and for yourself as a
social worker?
 What beliefs and perceptions did you have about PTSD and about
veterans before reading this chapter, and how did they change after
reading this chapter?
 How does the veteran experience compare and contrast to the civilian
experience in general and with trauma?