Abnormal Psychology

The literature review will be addressing the concern of Post-Traumatic Stress Disorder with different methods of treatment and the effectiveness of therapies regarding the same.

Post-Traumatic Stress Disorder (PTSD) is a psychiatric illness that may progress as a result of being exposed to extremely terrifying or threatening incidents (Bisson et al., 2015). Following trauma, many individuals demonstrate exceptional resilience and recovery ability (Bisson et al., 2015). It may happen as a result of long-term trauma exposure or a single traumatic incident, such as sexual assault as a child. There has been a lot of debate about what constitutes a traumatic incident (Sareen, 2014). The external stressor was described in earlier editions of the DSM as an occurrence that was distressing to everyone and occurred outside of the context of so-called normal human knowledge (Sareen, 2014). More recent editions of the DSM have included a wider spectrum of traumatic incidents, as well as a criterion for extreme horror, terror, and helplessness in the person's response (Sareen, 2014).

Since Post-Traumatic Stress Disorder is associated with substantial emotional, social, and economic costs, this investigation is of critical public health significance (Lewis et al., 2020). People with Post-Traumatic Stress Disorder (PTSD) have a great risk of psychological comorbidity, which causes issues with coping and leads to negative outcomes such as struggles with job earnings, educational attainment, child-rearing, and marriage attainment throughout their lives (Lewis et al., 2020). After a disturbing incident, such as a car misfortune, a in-service injury, or an attack, primary care can detect Post-Traumatic Stress Disorder (Kirkpatrick & Heller, 2014). A history of sustained or persistent trauma exposure, such as recurrent childhood abuse or domestic violence, may also be mentioned by the patient (Kirkpatrick & Heller, 2014). If the person has frequent hospital visits and unexplained symptoms, he or she can check for a potential trauma background. Experts should also ask about clear evasion, re-experiencing, and hyperarousal symptoms (Kirkpatrick & Heller, 2014).

After a traumatic event, adolescents and children may present contrarily than grown-ups and may not show direct grievances of indications. Traumatic events can be re-enacted over and over again by play (Kirkpatrick & Heller, 2014). Reduced play habits, social withdrawal, sleep shifts, and reduced effect or explosive tantrums are all possible signs that warrant further investigation. A feeling of a reduced future can also be present in children and adolescents (Kirkpatrick & Heller, 2014). Symptoms are often manifested somatically as headaches, stomachaches, or other ailments. Collateral knowledge about behavioral changes obtained from parents and/or caregivers may be particularly useful. Asking children specifically about their experiences may also help with assessment (Kirkpatrick & Heller, 2014).

Acute stress disorder is a condition in the DSM-5 that explains stress reactions that occur during the first month of trauma acquaintance (Bryant, 2019). This identification was first used in the DSM-IV to describe highly disturbed people who could not be identified with Post-Traumatic Stress Disorder in the first month, as well as to recognize people who were at high risk for advanced Post-Traumatic Stress Disorder (Bryant, 2019). Because of this focus on dissociative responses such as derealization, depersonalization, and decreased perception of one's environment immediately following trauma exposure, the DSM-IV now requires the presence of dissociative symptoms to fulfill the criteria for the condition (Bryant, 2019). Despite the connection between peri-traumatic disconnection and future Post-Traumatic Stress Disorder, convergent studies revealed that many people who experience Post-Traumatic Stress Disorder do not exhibit dissociative retorts in the acute period of trauma (Bryant, 2019).

Many of the risk factors are common to a variety of including female gender, psychiatric disorders, previous mental illness, low socioeconomic status, disturbing childhoods, and family history of mental disorders. In regard to Post-Traumatic Stress Disorder susceptibility features, the disorder is more likely to occur following interpersonal traumatic events or prolonged trauma (Bryant, 2019). The severity of Post-Traumatic Stress Disorder is closely linked to the emotional response to the incident, with catastrophic appraisals of the event's outcome and acute dissociative responses (Bryant, 2019). Unending stressors and low social sustenance donate to the danger of emerging Post-Traumatic Stress Disorder in such communities.

Interest in using medications to supplement therapeutic treatment for people who have already been diagnosed with Post-Traumatic Stress Disorder is growing (Miao et al., 2018). The findings of a recent RCT combining psychotherapy and the psychedelic 3,4-methylenedioxymethylamphetamine for treatment-resilient Post-Traumatic Stress Disorder were encouraging (Miao et al., 2018). These techniques are still in their early stages, and more stylish clinical trials are needed to see if they can deliver on their early promise.

Trauma-focused rehabilitations target prompts of the traumatic incident, as well as opinions and moods about it. It includes Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE). Non-trauma-focused therapies tend to relieve Post-Traumatic Stress Disorder indications without specifically pointing the traumatic event's memories, emotions, or feelings.

The aim is to go over the approach used in each set of 2017 strategies and then talk about the psychotherapeutic interventions for Post-Traumatic Stress Disorder in adults that both sets of guidelines strongly suggest (Watkins et al., 2018). The guidelines recommended a diversity of drugs for the management of Post-Traumatic Stress Disorder, including Paroxetine, Sertraline, Venlafaxine, and Fluoxetine; however, for the purposes of this study, we could only look at psychotherapy. Both of these recommendations do not advocate combining medication and psychotherapy (Watkins et al., 2018).

Individuals suffering from Post-Traumatic Stress Disorder may benefit from a variety of psychotherapeutic therapies (Kirkpatrick & Heller, 2014). While trauma-related rehabilitations are typically operative at symptom diminution, they require a sufficient degree of psychological stabilization to be effective (Kirkpatrick & Heller, 2014). Before starting trauma-related therapy, patients with low psychological steadiness can advantage from sympathetic, ego-strengthening, or motivational care. However, when it comes to pharmacological treatments, the advice is mixed (Merz et al., 2019). Selected serotonin reuptake inhibitors are recommended as a potential first-line therapy by the American Psychological Association and the International Society for Traumatic Stress Studies, for example, but most recommendations, including those of the National Health Service, do not and depending on the seriousness, comorbidity, and patient's reaction to psychotherapeutic treatment, the National Institute of Health and Care Excellence and the Medical Research Council agree that pharmacological therapies should be used as a second-line or adjuvant treatment (Merz et al., 2019).

Trauma-related treatments, such as exposure therapy and cognitive behavioral therapy, provide the strongest evidence for symptom remission (CBT) (Kirkpatrick & Heller, 2014). Gradual exposure to situations that trigger the fear response is used in exposure therapy to help the person become desensitized to fright indications (Kirkpatrick & Heller, 2014). Both the American Psychological Association and VA/DoD recommendations strongly advocate prolonged exposure for the conduct of Post-Traumatic Stress Disorder (Watkins et al., 2018). Prolonged Exposure is established on the emotional dispensation hypothesis, which states that stressful experiences are not emotionally handled at the moment they occur (Watkins et al., 2018).

To restructure how to deal with and perceive a traumatic experience, Cognitive Processing Therapy, which was designed primarily to treat Post-Traumatic Stress Disorder, combines elements of conventional cognitive therapy with information processing theory. Counselors use Cognitive Processing Therapy to benefit clients advance control over disturbing symptoms by focusing on how subordinate emotions and understandings resulting from skewed perceptions of a traumatic event can influence forthcoming emotional performances and procedures (Lenz et al., 2014). Guilt, mental health disability, lower eminence of life, health beliefs, and social functioning are all secondary signs of Post-Traumatic Stress Disorder (Minnen et al., 2012). Rather than being abnormal, Post-Traumatic Stress Disorder symptoms, according to Cognitive Processing Therapy, epitomize a divergence from usual, inherent healing mechanisms (Lenz et al., 2014). Cognitive Processing Therapy is focused on the idea that reminiscences of an incident must be triggered in the present to identify and replace false attributions, expectations, and symptoms that obstruct their processing with corrective knowledge (Lenz et al., 2014).

In retort to the COVID-19 pandemic, the American Psychological Association issued recommendations for the use of telehealth and accomplished care payment policies that have quickly developed to lodge the delivery of mental health services (Moring et al., n.d.). For example, regardless of their geographic location, clients can now obtain treatment live through videoconferencing in their homes deprived of having to travel to a succeeding inventing site for Medicare telehealth experiences (Moring et al., n.d.). Furthermore, to comply with mandatory physical distancing protocols, many providers are shifting to virtual treatment. As stay-at-home demands and shelter-in-place orders become more common across the country, providers and healthcare systems have turned precisely toward home-based telehealth delivery (Minnen et al., 2012). For many factors, Prolonged Exposure was chosen as the subject of this investigation. First, the Division of the American Psychological Association, which deals with empirically validated psychological therapies, concluded that Prolonged Exposure has a lot of science behind it, making it a well-established cure for Post-Traumatic Stress Disorder (Powers et al., 2010).

Moreover, the effectiveness of extended exposure has been studied in many new randomized controlled trials. Furthermore, because of its effectiveness, major healthcare administrations have chosen Prolonged Exposure for national dissemination (Powers et al., 2010). By integrating several randomized controlled trials with Prolonged Exposure, the meta-analysis would include an up-to-date estimate of treatment effectiveness for Post-Traumatic Stress Disorder (Powers et al., 2010). Furthermore, by providing conditions that control for non-specific variables, this meta-analysis discusses some of the concerns posed above (Powers et al., 2010). The outcome variables were divided into two groups, i.e., main and secondary. The client was successfully treated using Prolonged Exposure Therapy. During the progression of care, a variety of influences were measured, including verbal, specific Hispanic cultural factors, and the client's undocumented status (Benuto & Bennett, 2015).

Individual-level effects of posttraumatic stress disorder are typically low, with co-occurring conditions like depression and drug abuse, as well as physical health issues (Miao et al., 2018). According to the DSM-5, more than 80% of Post-Traumatic Stress Disorder patients have one or more comorbidities; for example, Post-Traumatic Stress Disorder with associated moderate TBI has a morbidity of 48% (Miao et al., 2018). Furthermore, cognitive dysfunction has been linked to Post-Traumatic Stress Disorder on several occasions. Military service members and troupers have a confirmed prevalence rate of Post-Traumatic Stress Disorder that ranges from 5.4 to 16.8%, which is nearly double that of the general population (Miao et al., 2018). The occurrence of Post-Traumatic Stress Disorder is estimated to vary based on the patient population surveyed, the traumatic events that happened, and the assessment system used.

The best way to describe Post-Traumatic Stress Disorder is as a sickness of failed recapture. It's one of the few mental illnesses with a well-known trigger or cause. Practitioners should understand that escaping is often the glue that holds the condition together, so therapies should focus on reducing avoidance and titrating exposure to promote acclimatization. Patients will learn that there are many successful therapies for Post-Traumatic Stress Disorder, and that remission is very likely for many patients, thanks to primary care providers. We are lucky to be practicing at a time when there is a lot of research being done on successful therapies for Post-Traumatic Stress Disorder, and many of them are showing promising results. Many drugs can help with the control of certain symptoms, but psychotherapy is considered the first-line treatment. Practitioners should be vigilant when administering sedatives, hypnotics, and anxiolytics, since these drugs have a high risk of addiction and may also maintain avoidance, compromising psychotherapeutic efficacy.

Each treatment has a wide body of evidence supporting its efficacy. These therapies are all trauma-focused, which means they explore memories of the traumatic experience as well as opinions and feelings allied with it. Where possible, the most evidence-based dealings for Post-Traumatic Stress Disorder should be used first, enchanting into account patient requirements and beliefs, as well as clinician involvement. Patients' key therapeutic messages include optimism for healing through a variety of successful therapies, such as asking for help from others who care, identifying themselves as survivors, sharing their experiences, engaging in healthy habits such as getting enough sleep, avoiding drug use, and eating well, and developing or re-establishing everyday routines.

References for Post Traumatic Stress Disorder

Benuto, L., & Bennett, N. (2015). Using Prolonged Exposure Therapy to Treat PostTraumatic Stress Disorder a Latina Female with a Complex Trauma History. International Journal Of Psychology And Psychological Therapy15(1), 143-153.

Bisson, J., Cosgrove, S., Lewis, C., & Roberts, N. (2015). Post-traumatic stress disorder. BMJ351, 1-7. https://doi.org/http://dx.doi.org/10.1136/bmj.h6161

Bryant, R. (2019). Post‐traumatic stress disorder: a state‐of‐the‐art review of evidence and challenges. World Psychiatry18(3), 259-269. https://doi.org/https://doi.org/10.1002/wps.20656

Kirkpatrick, H., & Heller, G. (2014). Post-Traumatic Stress Disorder: Theory and Treatment Update. The International Journal Of Psychiatry In Medicine47(4), 337-346. https://doi.org/http://dx.doi.org/10.2190/PM.47.4.h

Lenz, A., Bruijn, B., Serman, N., & Bailey, L. (2014). Effectiveness of Cognitive Processing Therapy for Treating Posttraumatic Stress Disorder. Journal Of Mental Health Counseling36(4), 360-376. https://doi.org/http://dx.doi.org/10.17744/mehc.36.4.1360805271967kvq

Lewis, C., Roberts, N., Andrew, M., Starling, E., & Bisson, J. (2020). Psychological therapies for post-traumatic stress disorder in adults: systematic review and meta-analysis. European Journal Of Psychotraumatology11(1). https://doi.org/https://dx.doi.org/10.1080%2F20008198.2020.1729633

Merz, J., Schwarzer, G., & Gerger, H. (2019). Comparative Efficacy and Acceptability of Pharmacological, Psychotherapeutic, and Combination Treatments in Adults With Posttraumatic Stress Disorder. JAMA Psychiatry76(9), 904. https://doi.org/10.1001/jamapsychiatry.2019.0951

Miao, X., Chen, Q., Wei, K., Tao, K., & Lu, Z. (2018). Posttraumatic stress disorder: from diagnosis to prevention. Military Medical Research5(1). https://doi.org/https://doi.org/10.1186/s40779-018-0179-0

Minnen, A., Harned, M., Zoellner, L., & Mills, K. (2012). Examining potential contraindications for prolonged exposure therapy for PTSD. European Journal Of Psychotraumatology3(1). https://doi.org/http://dx.doi.org/10.3402/ejpt.v3i0.18805

Moring, J., Dondanville, K., Fina, B., Hassija, C., Chard, K., & Monson, C. et al. Cognitive Processing Therapy for Posttraumatic Stress Disorder via Telehealth: Practical Considerations During the COVID-19 Pandemic. Med.stanford.edu. Retrieved from https://med.stanford.edu/content/dam/sm/fastlab/documents/jts.22544.pdf.

Powers, M., Halpern, J., Ferenschak, M., & Gillihan, S. (2010). A Meta-Analytic Review of Prolonged Exposure for Posttraumatic Stress Disorder. Clinical Psychology Review30(6). https://doi.org/http://dx.doi.org/10.1016/j.cpr.2010.04.007

Sareen, J. (2014). Posttraumatic Stress Disorder in Adults: Impact, Comorbidity, Risk Factors, and Treatment. Canadian Journal Of Psychiatry59(9), 460-467. https://doi.org/https://dx.doi.org/10.1177%2F070674371405900902

Watkins, L., Sprang, K., & Rothbaum, B. (2018). Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions. Frontiers In Behavioral Neuroscience12. https://doi.org/http://dx.doi.org/10.3389/fnbeh.2018.00258

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