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Psychosis and ptsd


Posttraumatic Stress Disorder with Secondary Psychotic Features (PTSD-SP): Diagnostic and Treatment Challenges

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Psychotic symptoms in posttraumatic stress disorder

. 2000 Sep;5(9):52-7.

doi: 10.1017/s1092852900021659.

S E Lindley  1 , E Carlson, J Sheikh

Affiliations

Affiliation

  • 1 National Center for PTSD, Palo Alto VA Health Care System, Menlo Park, CA, USA.
  • PMID: 17637580
  • DOI: 10.1017/s1092852900021659

S E Lindley et al. CNS Spectr. 2000 Sep.

. 2000 Sep;5(9):52-7.

doi: 10.1017/s1092852900021659.

Authors

S E Lindley  1 , E Carlson, J Sheikh

Affiliation

  • 1 National Center for PTSD, Palo Alto VA Health Care System, Menlo Park, CA, USA.
  • PMID: 17637580
  • DOI: 10. 1017/s1092852900021659

Abstract

Recent data suggest that the presence of psychotic symptoms in patients suffering from posttraumatic stress disorder (PTSD) may represent an underrecognized and unique subtype of PTSD. Among combat veterans with PTSD, 30% to 40% report auditory or visual hallucinations and/or delusions. The presence of psychotic symptoms in PTSD is associated with a more severe level of psychopathology, similar to that of chronic schizophrenia. In this review, the differential diagnosis of psychotic symptoms in PTSD is discussed, including possible comorbid schizophrenia, psychotic depression, substance-induced psychosis, and personality disorder. A recent biologic study supporting the existence of a unique subtype of PTSD with psychotic features is also addressed, as are the similarities between PTSD with psychotic features and psychotic depression disorder. Finally, data on the treatment implications of psychotic symptoms in PTSD are presented. The intriguing recent findings on psychotic symptoms in PTSD need further investigation in noncombat-related PTSD populations before findings can be generalized to all individuals with PTSD.

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Post-traumatic stress disorder (PTSD) | English translation

However, most people realize what happened after a few weeks, sometimes a little longer, and then their symptoms will begin to disappear.

Research shows that certain groups of people are at increased risk of developing post-traumatic stress disorder. The risk of developing PTSD is reduced when a person has:

Any traumatic event can cause PTSD, although the more severe the shock, the more likely it is to develop PTSD. For example, PTSD is more likely to develop if the event:

  • is a sudden and unexpected
  • lasts a long time
  • , it happens when you get into a trap from which
  • could not get out of
  • deaths
  • leads to injuries
  • include children

if you are still stressed and in an uncertain state, this will make it difficult to get rid of the symptoms of PTSD.

How do I know that I have overcome a traumatic experience?

You may have already gotten over the traumatic event if you can:

  • think about it without worrying
  • not feel like you are under constant threat
  • not think about it all the time

Why is PTSD not always diagnosed?

There are a number of reasons why a person with PTSD may not be diagnosed.

Stigma and misunderstanding

People with PTSD often avoid talking about their feelings to avoid thinking about the traumatic event.

Some people believe that the symptoms they are experiencing (such as avoidance or emotional numbness) help them cope and do not realize that they are caused by PTSD.

When people are very ill, it is difficult for them to believe that they are able to feel the way they did before the traumatic event. This may discourage them from getting help.

There is also a common misconception that only military personnel suffer from PTSD. In fact, PTSD can happen to anyone, and any experience of PTSD is real.

Misdiagnosis

Some people with PTSD may be misdiagnosed with conditions such as anxiety or depression. Some people have other mental and physical health problems that make PTSD go unnoticed.

They may also experience medically unexplained symptoms such as:

  • gastrointestinal disorders
  • pain syndromes
  • headaches

These symptoms may mean that their PTSD goes unnoticed.

Other difficulties

Some people with PTSD may also have other problems, such as difficulties in human relationships or addiction to alcohol and drugs. They may be caused by post-traumatic stress disorder, but these problems will manifest themselves more clearly than PTSD itself.

Can children develop PTSD?

PTSD can develop at any age. In addition to the symptoms of PTSD common to adults, children may also experience:

  • Nightmares - In children, these dreams may or may not reflect an actual traumatic event.
  • Repetitive play - some children act out a traumatic event during play. For example, a child who has been in a serious traffic accident may recreate the accident with toy cars.
  • Physical symptoms - they may complain of abdominal pain and headaches.
  • Fear of imminent death - they may find it hard to believe that they will live long enough to become adults.

What treatments are available for PTSD?

There are a number of different treatments for PTSD, including trauma-focused cognitive behavioral therapy (TF-CBT), eye movement desensitization and processing (EMDR), and medications.

Psychotherapy

Psychotherapy for PTSD will focus on the traumatic experience, not your past life. They will help you:

  • Acceptance - learn to accept the fact that although you cannot change what happened, you can think differently about the event, the world around you and your life.
  • Memory of the event - remembering what happened, you will not feel fear or anxiety. You will be able to think about what happened when you yourself want it, and not through obsessive thoughts or memories.
  • Explaining your experiences in words - by saying out loud what happened, your mind can push the memories away and do other things.
  • Finding a sense of security - helps you to better control your feelings. This will make you feel more secure and eliminate the need to avoid memories.

All psychotherapy must be administered by a properly trained and accredited professional. Sessions are usually conducted by the same therapist at least once a week, with a total duration of at least 8-12 weeks.

Sessions usually last about an hour, sometimes they can last up to 90 minutes.

Therapy for PTSD includes:

Trauma-focused Cognitive Behavioral Therapy

A form of talking therapy that can help you change the way you think. Over time, this can help you feel better and behave differently. It is usually done individually, although there is evidence that CBT for trauma can also be done in groups.

Eye Movement Desensitization and Reprocessing (EMDR)

A technique that uses eye movements to help the brain process traumatic memories.

You will be asked to remember the traumatic event and what it made you think and feel. While you do this, you will be prompted to move your eyes or receive other "two-way stimulation" such as tapping your hand. It turns out that this reduces the emotional burden experienced in connection with the traumatic memory and helps to cope with the trauma.

The GERD must be carried out by a qualified person. EPDH usually requires 8-12 sessions, lasting from 60 to 90 minutes.

Some other forms of talking therapy may be useful for treating certain symptoms (eg, poor sleep) in people for whom EMRT or CBT have not been effective for trauma.

Medications

If you have tried various treatments for PTSD and find that they do not work for you, your doctor may prescribe antidepressants for you.

Selective serotonin reuptake inhibitors (SSRIs) are antidepressants that can help reduce symptoms of post-traumatic stress disorder. They can also help you if you are suffering from depression.

If SSRIs are not working for you, you may be offered other drugs, but this should usually be done on the advice of a mental health professional.

Which treatment is more effective?

There is evidence that Cognitive Behavioral Therapy for Trauma and Eye Movement Desensitization and Reprocessing are the best first line treatments. Medication can help those who refuse talking therapy or cannot easily access it.

Which treatment should I take first?

Trauma-focused psychological therapy (TF-CBT or EMBT) should be offered prior to medication, to the extent possible. This is in line with the UK National Institute for Health and Clinical Excellence (NICE) guidelines.

How can I help myself?

There are some things you can do to help you get better if you develop PTSD. Your therapist will help with this and make sure you apply them in a timely manner:

Stick to your daily routine - As far as possible, try to return to or maintain your normal daily routine. By continuing to lead a life as normal as possible, you can gain a sense of support.

Talk to someone you trust - Although you shouldn't feel like you need to talk to everyone about what happened, talking to someone you trust can help you sort out your feelings in a safe environment. It can also help to talk to someone who has gone through the same thing as you, or someone who has gone through something similar before, as long as it doesn't hurt you.

Try relaxation exercises - Try self-meditation and other relaxation exercises. Relaxing with PTSD can be challenging, so talk to your therapist about exercises or activities that can help you.

Return to work or school - if you feel empowered, it can help you return to work, school or university by giving you a sense of routine. However, you should try to avoid situations in which you may be subjected to further injury or severe stress. It is usually best to work in a supportive, low-stress environment before starting treatment.

Eat and exercise regularly - Try to eat at regular times, even if you don't feel hungry. If you feel fit, try to exercise regularly. It can also help you feel tired before bed.

Spend time with others - Spending time with the people you care about will help you feel supported.

Expect to get better - Concentrating on thoughts that you will feel better over time will be useful for your recovery. Remember that you should not strain yourself in an attempt to recover faster.

Go back to where the traumatic event happened - If you feel you can do it, you may want to go back to where the traumatic event happened. Talk to your therapist or doctor if you are considering this so they can support you through this step.

There are also some things you should avoid while recovering. However, doing the "right things" can be very difficult, and you shouldn't feel guilty if you find yourself doing any of the following:

Self-criticism - PTSD symptoms are not a sign of weakness. This is a normal reaction to violent experiences.

Keep your feelings to yourself. If you have PTSD, don't feel guilty about sharing your thoughts and feelings with others. Talking about how you are feeling can help your recovery.

Expect things to get back to normal quickly - PTSD can take some time to heal. Try not to demand too much of yourself in a short amount of time.

Stay away from other people. Spending a lot of time alone can increase your sense of isolation and make you feel less well.

Drink alcohol or smoke. While alcohol can help you relax, and coffee and nicotine can act as stimulants, they can make you feel worse over time if you're experiencing symptoms associated with post-traumatic stress disorder.

Overwork. Post-traumatic stress disorder can make it difficult to sleep, but as much as possible, try to stick to your regular sleep schedule and stay up late, as this can make you feel worse. You can learn more about good sleep in our resource.

Finally, you should be careful while driving. After a traumatic episode, people may have more accidents.

What is complex PTSD?

Some people develop complex post-traumatic stress disorder, caused by an experience or series of events that is extremely threatening or terrifying. These events can occur in childhood or adulthood.

Often such events are difficult or impossible to avoid. For example:

  • torture
  • slavery
  • genocide
  • living in war zones
  • prolonged domestic violence
  • repeated sexual and physical abuse

In addition to symptoms of post-traumatic stress disorder, people with complex post-traumatic stress disorder may also:

  • emotions and emotional reactions
  • have difficulty maintaining relationships and feelings of closeness with other people

How do I recover from complex PTSD?

People with complex post-traumatic stress disorder are characterized by a lack of trust in other people and in the world at large.

Emotional stabilization

During the stabilization phase, you will learn to trust your therapist and to understand and manage feelings of distress and alienation.

As part of stabilization, you can familiarize yourself with the work with supports - "grounding techniques". This can help you focus on familiar physical sensations and remind you that you are living in the present, not the past.

Stabilization can help you "unplug" your feelings of fear and anxiety from the memories and the emotions they evoke, helping to make those memories less frightening.

The goal of stabilization is so that you can eventually live your life free from anxiety or memories.

Sometimes stabilization may be the only help needed.

Trauma Focused Therapy

Trauma Focused Therapy, including EMDR (Eye Movement Desensitization and Processing) or Trauma Focused Cognitive Behavioral Therapy, can help you deal with traumatic experiences. Other types of psychotherapy, including psychodynamic psychotherapy, may also be helpful. For complex post-traumatic stress disorder, care must be taken as these treatments can make things worse if not used properly.

Reintegration and recovery

Reintegration into normal life can help you adjust to the real world at a time when you have emerged from the dangerous situation you were in before. This can help you begin to see yourself as a person with a choice.

Reintegration can help you:

  • be compassionate towards yourself and others
  • restore trust in yourself and others
  • renew friendships, intimate relationships, and activities that promote your health and well-being

Medications

As with PTSD, antidepressants or other medications may be used along with psychotherapy. Medication may also be used if psychotherapy does not help or is not available to you. It would also be helpful to have a mental health professional help you oversee your medication.

Self Help

If you develop complex PTSD, it may be helpful to try to do ordinary things that have nothing to do with your past traumatic experience. 9Ol000 . However, this can take time, and there is no need to be ashamed that at first these things will seem difficult to you or you will not be able to do them right away.

How do you know if someone has PTSD?

If you know someone who has just experienced a traumatic event, there are a few things you should be aware of. These moments can be signs that a person is not coping:

  • Changes in behavior - low productivity at work, lateness, sick leave, minor accidents.
  • Changes in emotions - anger, irritability, depression, lack of interest and lack of concentration.
  • Changes in thought - preoccupation with threats or fears, negative outlook on the future
  • Unexpected physical symptoms such as shortness of breath, nervousness or abdominal pain.

If you think a person may be showing signs of PTSD, you can suggest that they talk to their doctor. If you don't feel close enough to him for such a recommendation, talk to someone in his family or friends who could do it for you.

They may also find it helpful to refer to information about PTSD, such as this resource, to help identify the difficulties they face.

How can I help someone who has experienced a traumatic event?

For those who have experienced a traumatic event, the following actions may help:

  • Be there - invite people to be with them. If they refuse, you can reassure them that you will be with them if they change their mind. Should not be imposed, but try to convince them to accept your help.
  • Listen - try not to pressure people if they don't want something. If they want to talk, try to listen without interrupting or trying to share your own experience with them.
  • Ask general questions - When you ask questions, try to keep them general and non-judgmental. For example, you might ask, "Have you talked about this with anyone else?" or “Can I help you find more help?”
  • Offer real (practical) help - Some people may have difficulty taking care of themselves or doing daily activities. Offer help, such as cleaning the house or preparing meals;

Try not to tell people:

  • That you know how they feel - even if you have experienced something like this, people experience situations differently. Comparing your experience with that of others is not always helpful;
  • How lucky they are to be alive - people who have experienced traumatic events often don't think they are "lucky". Often they feel guilty about the fact that they survived while others died;
  • Belittling the significance and seriousness of the experience - try not to tell people that things could be much worse, even if you do it out of good intentions and thereby try to help them. Such statements can make people feel that their experiences are not being taken seriously by others;
  • Giving inappropriate advice - Try not to give advice or suggestions, even if it has helped you in the past. All people are different and often they have already tried what you offer.

References:

This information was prepared by the Public Engagement Editorial Board of the Royal College of Psychiatrists (PEEB). It reflects the best available evidence at the time of writing.

Special thanks to PTSD UK for kindly providing feedback on this resource.

Expert Editor: Prof. Neil Greenberg

Full links to this resource are available upon request.

Translated by Elena Fage, Specialty doctor in CAMHS

PTSD

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PTSD is a normal reaction
for severe traumatic events.
This booklet deals with symptoms,
symptoms and treatments for PTSD.

New York State
Department of Mental Health

Have you experienced a terrible and dangerous event? Note please, those cases in which you recognize yourself.

  • Sometimes, out of the blue, everything that happened to me is happening again. I never know when to expect it again.
  • I have nightmares and memories of the terrible incident which I have experienced.
  • I avoid places that remind me of that incident.
  • I jump on the spot and feel uneasy at any sudden movement or surprise. I feel alert all the time.
  • It's hard for me to trust someone and get close to someone.
  • Sometimes I just feel emotionally drained and deaf.
  • I get angry very easily.
  • I am tormented by guilt that others died, but I survived.
  • I sleep poorly and experience muscle tension.

PTSD is a very serious condition that needs to be treated.

Many people who have experienced terrible events suffer from this disease.

It is not your fault that you fell ill, and you should not suffer from it.

Read this booklet to find out how you can be helped.

You can get well and enjoy life again!

What is post-traumatic stress disorder (PTSD/PTSD)?

PTSD is a very serious condition. PTSD symptoms may occur in a person who has experienced a terrible traumatic event. This disease is susceptible medical and therapeutic treatment.

PTSD can occur after you:

  • Have been a victim of sexual abuse
  • Have been a victim of physical or emotional domestic violence
  • Victim of a violent crime
  • Been in a car accident or plane crash
  • Survived a hurricane, tornado or fire
  • Were at war
  • Survived a life-threatening event
  • Witnessed any of the above events

If you have post-traumatic stress, you often have nightmares or memories associated with the event. you try to hold on away from anything that might remind you of the experience.

You are angry and unable to trust or care for others. You are always on your guard and see a hidden threat in everything. You become not by itself, when something happens suddenly and without warning.

When does PTSD start and how long does it last?

In most cases, post-traumatic stress manifests itself approximately three months after the traumatic event. In some cases, signs Post-traumatic stress symptoms only show up years later. Post-traumatic Stress affects people of all ages. Even children are not immune from it.

Some get better after six months, others may suffer from it illness for much longer.

Am I the only one with this disease?

No, you are not alone. Every year, 5.2 million Americans suffer from PTSD.

Women suffer from this disease two and a half times more often than men. The most common traumatic events that cause PTSD in men are: rape, participation in hostilities, abandonment and abuse in childhood. The most traumatic events in women are rape, sexual molestation, physical assault, threat weapons and childhood abuse.

What other conditions can accompany PTSD?

Common depression, alcoholism and drug addiction, or other anxiety disorders. The likelihood of successful treatment increases if these comorbidities to identify and treat in time.

Frequent headaches, gastroenterological problems, problems with the immune system, dizziness, chest pain or discomfort in other parts of the body. It often happens that a doctor treats physical symptoms, unaware that their cause lies in PTSD.

The National Institute of Mental Health (NIMH) recommends therapists to learn from patients about experiences of violence, recent losses and traumatic events, especially when symptoms persist are returning. After diagnosing PTSD, it is recommended to refer patient to a mental health specialist who has experience in the treatment of patients with PTSD.

What can I do to help myself in this situation?

Talk to your doctor and tell him about your experience, and how you feel. If you are visited by terrible memories, overcomes depression and sadness if you have trouble sleeping and constantly embittered - you should tell your doctor about all this. Tell him Are any of these conditions preventing you from doing your daily activities? lead a normal life. You may want to show this booklet to your doctor. This may help explain to him how you feel. Ask your doctor examine you to make sure there are no physical illnesses.

Ask your doctor if he has previously had patients suffering from post-traumatic stress. If your doctor does not have a special preparation, ask him for directions to doctor with relevant experience.

How can a doctor or psychotherapist help me?

Your doctor may prescribe medicine to help reduce your fear or tension. However, it should be borne in mind that usually several weeks before the medicine starts to work.

Many PTSD sufferers benefit from talking with a professional or other people who have experienced traumatic events. This is called "therapy". Therapy will help you get over your nightmare.

One man's story:
"After I was attacked, I He constantly felt fear and depression, became irritable. I couldn't sleep well and lost my appetite. Even when I tried not think about what happened, I was still tormented nightmares and terrible memories.

“I was completely at a loss and didn't know what to do. one buddy advised to see a doctor. My doctor helped me find a specialist in post-traumatic stress."

“I needed a lot of strength, but after medication and a course of therapy, I gradually come to my senses. It’s good that I called my doctor then.”

PTSD and the military

If you are in the military, you have probably been in combat. You, probably got into terrible and life-threatening situations. They shot at you you have seen your friend shot, you have seen death. experienced you events can cause PTSD.

Experts say PTSD occurs:

  • Nearly 30% of Vietnam War veterans
  • Nearly 10% of Gulf War veterans (Operation Desert Storm)
  • Almost 25% of veterans of the war in Afghanistan (operations "Introducing freedom") and veterans of the war in Iraq (operations "Iraqi Freedom")

Other factors of the military situation can serve as an additional stress to and so stressful situation and can contribute to the development of PTSD and other mental problems. Among these factors are the following: your military specialty, the political aspects of the war, where the battle takes place and who your enemy is.

Another reason that contributes to PTSD in military personnel can be Military Sexual Assault (MST) – any form of sexual harassment or sexual abuse while serving in the military. MST can happen with men and women, and can occur in peacetime, during war training or during the war.

Veterans Affairs (VA) health care approximately:

  • 23 out of 100 women (23%) report sexual violence during military service
  • 55 out of 100 women (55%) and 38 out of 100 men (38%) were exposed to sexual harassment while serving in the army

Although the trauma of sexual assault is more common in the military among women, more than half of veterans who have experienced sexual trauma violence in the army - it's men.

Remember, you can get the help you need right now:

Tell your doctor about your experience and how you feel. If your doctor does not have special training in the treatment of PTSD, ask him for a referral to a doctor who has relevant experience.

PTSD research

To help those suffering from PTSD, the National Institute of Conservation Mental Health (NIMH) supports research into the study of PTSD, as well as other thematically related to PTSD research on problems anxiety and fear. The challenge for research is to find new ways to help people cope with trauma, as well as find new treatment options and, The main thing is to prevent disease.

Research on possible risk factors for PTSD

Today, the attention of many scientists is focused on genes that play a role in having terrible memories. Understanding the mechanism of "creation" of scary memories can help improve or find new ways to alleviate symptoms of PTSD. For example, PTSD researchers have identified genes that are responsible for:

Statmin - a protein involved in the formation terrible memories. During one experiment, mice were placed in environment designed to instill fear in them. In this situation mice lacking the statmin gene, in contrast to normal mice were less likely to "freeze" - i.e. exercise natural defensive response to danger. Also in the environment designed to evoke innate fear in them, they demonstrated it to a lesser extent than normal mice, more willingly mastering the open "dangerous" space. 1

GRP (gastrin-releasing peptide/ GRP) - signal substance brain released during emotional events. At in mice, GWP helps control the fear response, and lack of GWP can lead to a longer memory of fear. 2

Scientists have also discovered a variant of the 5-HTTLPR gene that controls serotonin (a brain substance associated with mood), which, as it turns out, feeds the fear response. 3 It seems that, like in the case of other mental disorders, in the development of PTSD different genes are involved, each of which contributes to the formation of the disease.

Understanding the causes of PTSD can also be helped by studying different areas brain responsible for fear and stress. One of these areas is cerebellar amygdala, responsible for emotions, learning and memory. It turned out that she plays an active role in the emergence of fear (or other words, "teaches" to be afraid of something, for example, to touch a hot stove), as well as in the early phases of fear repayment (or in other words, "teaches" Do not be scared). 4

The storage of faded memories and the weakening of the initial fear reaction are connected with the prefrontal cortex (PFC / PFC) of the brain, 4 responsible for decision making, problem solving and situation assessment. Each zone PFC has its own role. For example, when the PFC believes that a stressor is amenable to control, the medial prefrontal zone of the PFC suppresses the anxiety center deeply in the brainstem and controls the response to stress. 5 Ventromedial PFC helps maintain long-term fading of fearful memories, and her ability to perform this feature can be affected by its size. 6

Individual differences in genes or characteristics of regions of the brain brain can only set the stage for PTSD, but by themselves do not cause no symptoms. environmental factors such as childhood trauma, head trauma or mental illness in family, favor the development of the disease and increase the risk of disease, affecting the brain in the early stages of its growth. 7 Except In addition, how people adapt to trauma is likely to be influenced by and characteristics of character and behavior, such as optimism and a tendency to consider problems in a positive or negative way, as well as social factors such as availability and use of social support. 8 Further research may show what combination of these factors or what other factors will allow ever predict who has a traumatic event cause PTSD, and who doesn't.

Research on PTSD

Currently, psychotherapy is used in the treatment of PTSD ("talk" therapy), drugs or drug-therapeutic combination.

Psychotherapy

Cognitive behavioral therapy (CBT) helps you learn differently think and react to frightening events that are the impetus for development PTSD, and can help bring the symptoms of the disease under control. There are several types cognitive behavioral therapy, including:

"Push" method - uses mental images, notes or visiting a place experienced trauma to help those affected face the overwhelming their fear and take control of it.

Behavior restructuring (cognitive restructuring) - encourages survivors of a traumatic event express depressing (often erroneous) thoughts about experienced trauma, challenge these thoughts and replace them with more balanced and appropriate.

Implementation in a stressful situation - teaches ways to reduce anxiety and the ability to cope with it, helping to reduce the symptoms of PTSD, and helps to correct the erroneous train of thought associated with the trauma experienced. NIMH is currently conducting research to study the reaction brain response to cognitive behavioral therapy versus response sertraline (Zoloft) - one of two drugs recommended and approved US Food and Drug Administration funds (FDA) for the treatment of post-traumatic stress. This research may help find out why some people respond better to medications, and others for psychotherapy

Medicines

Recently, in a small study, NIMH researchers found that if patients who are already taking a dose of prazosin (Minipress) at bedtime, add a daily dose, then this weakens the general symptoms of PTSD and stress reaction to reminders of the trauma experienced. 9

Another drug of interest is D-cycloserine (Seromycin), which increases the activity of a brain substance called N-methyl-D-aspartate, needed to pay off fear. During the study, which was attended by 28 people suffering from a fear of heights, scientists found that patients who received "push" therapy before a session D-cycloserine, showed lower levels of fear during the session compared to those who did not receive the drug. 10 Currently scientists study the effectiveness of the combined use of D-cycloserine and therapy for the treatment of post-traumatic stress.

Propranolol (Inderal), a beta-blocker drug, also under study whether it can be used to reduce post-traumatic stress and break the chain of scary memories. First experiments gave consoling results: it was possible to successfully weaken and, it seems, prevent PTSD in a small number of victims of traumatic events. 11

For example, in one preliminary study, scientists created a website self-help, based on the use of a psychotherapeutic method implementation in a stressful situation. First, patients with PTSD meet in person with doctor. After this meeting, participants can go to the site to find more information about PTSD and how to deal with the problem; their doctors may also visit the site to give advice or briefing. In general, scientists believe that therapy in this form - promising treatment for a large number of people suffering from PTSD. 12

Scientists are also working to improve methods for testing early treatment and monitoring of survivors of massive trauma, on developing ways to teach them self-assessment skills and introspection and referral mechanism to psychiatrists (if necessary).

Prospects for PTSD research

In the last decade, rapid progress in the study of mental and biological PTSD has led scientists to conclude that there is a need to focus on prevention, as the most realistic and important goal.

For example, in order to find ways to prevent PTSD, with funding NIMH conducts research to develop new and orphan drugs, aimed at combating the underlying causes of the disease. During another research scientists are looking for ways to enhance behavioral, personality and social protective factors and minimizing risk factors for prevent the development of PTSD after trauma. Another study is studying the question of what factors influence the difference in response to one or another method of treatment, which will help in the development of more individual, effective and productive methods of treatment.

Where can I find more information?

MedlinePlus - resource from the American National Library of Medicine (U.S. National Library of Medicine and the National Institutes of Health) - offers the latest information on many health issues. Information about You can find PTSD at: www.nlm.nih.gov/medlineplus/posttraumaticstressdisorder.html.

National Institute of Mental Health
Office of Science Policy, Planning, and Communications
[National Institute of Mental Health
Science Policy Division research, planning and communications]
6001 Executive Boulevard
Room 8184, MSC 9663
Bethesda, MD 20892-9663
Phone: 301-443-4513; Fax: 301-443-4279
fax answering system Free answering machine: 1-866-615-NIMH (6464)
Text phone: 1-866-415-8051 toll-free
Email: nimhinfo@nih. gov

National Center for Post-traumatic Stress Disorder
[National PTSD Center]
VA Medical Center (116D)
215 North Main Street
White River Junction, VT 05009
802-296-6300
www.ncptsd.va.gov

NOTES

  1. Shumyatsky GP, Malleret G, Shin RM, et al. Stathmin, a Gene Enriched in the Amygdala, Controls Both Learned and Innate Fear. cell. Nov 18 2005;123(4):697-709.
  2. Shumyatsky GP, Tsvetkov E, Malleret G, et al. Identification of a signal network in lateral nucleus of amygdala important for inhibiting memory specifically related to learned fear. cell. Dec 13 2002;111(6):905-918.
  3. Hariri AR, Mattay VS, Tessitore A, et al. Serotonin transporter genetic variation and the response of the human amygdala.Science. Jul 192002;297(5580):400-403.
  4. Milad MR, Quirk GJ. Neurons in medial prefrontal cortex signal memory for fear extinction. Nature. Nov 7 2002;420(6911):70-74.
  5. 5 Amat J, Baratta MV, Paul E, Bland ST, Watkins LR, Maier SF. Medial prefrontal cortex determines how stressor controllability affects behavior and dorsal raphe nucleus. Nat Neurosci. Mar 2005;8(3):365-371.
  6. Milad MR, Quinn BT, Pitman RK, Orr SP, Fischl B, Rauch SL. Thickness of ventromedial prefrontal cortex in humans is correlated with extinction memory. Proc Natl Acad Sci USA. Jul 26 2005;102(30):10706-10711.
  7. Gurvits TV, Gilbertson MW, Lasko NB, et al. Neurological soft signs in chronic posttraumatic stress disorder.Arch Gen Psychiatry. Feb 2000;57(2):181-186.
  8. Brewin CR. Risk factor effect sizes in PTSD: what this means for intervention. J Trauma Dissociation. 2005;6(2):123-130.
  9. Taylor FB, Lowe K, Thompson C, et al. Daytime Prazosin Reduces Psychological Distress toTrauma Specific Cues in Civilian Trauma Posttraumatic stress disorder. Biol Psychiatry. Feb 3 2006.
  10. Ressler KJ, Rothbaum BO, Tannenbaum L, et al. Cognitive enhancers as adjuncts to psychotherapy: use of D-cycloserine in phobic individuals to facilitate extinction of fear. Arch Gen Psychiatry. Nov 2004;61(11):1136-1144.
  11. Pitman RK, Sanders KM, Zusman RM, et al. Pilot study of secondary prevention of posttraumatic stress disorder with propranolol.Biol Psychiatry. Jan 15 2002;51(2):189-192.
  12. Litz BTWL, Wang J, Bryant R, Engel CC.A therapist-assisted Internet self-help program for traumatic stress. Prof Psychol Res Pr. December 2004;35(6):628-634.

New York State Department of Mental Health expresses thanks to the National Institute of Mental Health for the information, used in this booklet.

Published by the State Division of Mental Health New York, June 2008.

New York State
Andrew M. Cuomo Governor

Mental Health
Department Manager Michael F.

Learn more