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PTSD

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Sawyer Helton

on 25 November 2013

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Transcript of PTSD

P.T.S.D
SUBTOPICS

EMDR- DOMESTIC VIOLENCE VICTIMS

EMDR- CHILDREN and SEXUAL ABUSE

TF-CBT- FEMALE TRAUMA SURVIVORS

CPT- MILITARY SEXUAL TRAUMA
PREVALENCE OF PTSD

SYMPTOMS
EVIDENCE BASED RESOURCES
GOOGLE SCHOLAR
PSYCHINFO
ASU LIBRARIES
COCHRAN
DV AND EMDR
TF-CBT
WHY DO WE CARE?
Would TF-CBT or Medication be more efficacious for female trauma survivors in decreasing PTSD symptoms?

Trauma survivors AND Trauma focused cognitive behavior therapy AND Medication AND PTSD symptoms: 4,657 hits

Trauma survivors AND TF-CBT AND Medication AND PTSD symptoms: 114 hits

If victims of domestic violence suffer from symptoms of anxiety, then will Eye Movement Desensitization and Reprocessing (EMDR) prove to be more effective than lack of treatment in alleviating these symptoms?

Victims of domestic violence AND anxiety = 319,259

Victims of domestic violence AND symptoms of anxiety = 189,750

Victims of domestic violence AND EMDR AND random = 1,320

Victims of domestic violence AND EMDR AND controlled clinical trial = 2,900

Victims of domestic violence AND anxiety AND EMDR AND controlled clinical trial = 507

Victims of domestic violence AND anxiety AND EMDR AND random = 463

Anxiety AND EMDR = 3,015

MST AND CPT
cognitive processing therapy" AND "military sexual trauma" - 55 results

"cognitive processing therapy" AND "military sexual trauma" AND "medication" -88 results

"military sexual trauma victims" AND "PTSD" AND "medication" - 2 results

military sexual trauma victims AND PTSD -14,400 results

If female military personnel are sexual trauma victims, then will receiving Cognitive Processing Therapy (CPT) or medication alleviate their depressive symptoms?

EMDR- CHILDREN
Female child and sexual abuse (1107)
children and sexual abuse (1694)
Daughters and sexual abuse (26)
Caucasian child and sexual abuse (10)
EMDR (153)
Children and PTSD (753)
Children and anxiety (51)
Children and isolation (390)
children and defense mechanism (104)
child sexual abuse and EMDR (3), child abuse and treatment (1699)
If Caucasian female children between the ages of 5-12 receive EMDR therapy or no treatment at all then will they experience a reduction in traumatic stress symptoms?

CRITICALLY APPRAISED TOPICS (CATS)
What we learned...
INTERVENTION
CBT - best used with clients who have suffered traumatic brain injury, have open court case, and clients with seizure disorders/epilepsy

EMDR is less distressing/traumatic for children, efficient in short amount of time, although CANNOT be used with clients with substance abuse issues and self-harming behaviors, clients who have used cocaine in the last 60 days, clients who are blind, clients with neurological disorders, clients with dissociative disorders, in an ongoing threatening situation (DV, etc.),

EMDR CAN be used with clients who are stable, not involved in court proceedings, and who are open to the idea of EMDR, can be effective years after trauma occurs - no window or time frame for treatment

Psycho-pharmacology best for people with psychosis, unstable, low-level functioning, in conjunction with other therapy

TF-CBT shown to be most effective with children

Cognitive Processing Therapy (CPT) is a treatment specifically designed to address post traumatic stress disorder (PTSD) in sexual assault survivors.

CPT NOT recommended for clients with active suicidal behavior, current psychosis, significantly impaired cognition, or those without memory of traumatic event

CPT recommended for clients with PTSD and comorbid diagnoses

DIVERSITY
Research found was not specific to, but did include a small number of women of Hispanic ethnicity (for example, in one study 96% White participants, as compared to 4% Hispanic participants)

Native American culture was not represented in research

Research studies did not take any steps towards cultural competency or cultural sensitivity that would otherwise be required when working with cultures of the Southwest.

It may be difficult to conduct this type of study with Native populations on reservations due to unlikelihood of disclosure of trauma to outsiders, unknown mental health professionals, etc.

THE UNKNOWN
Lack of research with specific populations of the Southwest

Studies with very small sample sizes (example: study with sample of 6 women) and limited populations

Studies addressed EMDR and it’s efficacy in decreasing symptoms of PTSD, lack of a broader range of conditions that EMDR could be applied to

Little research comparing the efficacy of TF-CBT and medication for PTSD

Unable to assess superiority of CPT for victims of sexual trauma, as no studies were comparative

REFERENCES
A review of trauma-informed treatment for adolescents (2012)

A multi-site randomized controlled trial of cognitive processing therapy for military-related post-traumatic stress disorder (2012)

When medicine hurts: A psychological exploration of women's reluctance to take medication for symptoms of trauma (2002)

Treating PTSD and Disordered Eating in the Wake of Military Sexual Trauma A Case Study (2012)

Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: Design of a randomized controlled trial (2012)

Cognitive processing therapy for sexual assault victims

A Randomized Clinical Trial of Cognitive Processing Therapy for Veterans With PTSD Related to Military Sexual Trauma (2013)

Eye movement desensitization and reprocessing (emdr) therapy in the treatment of victims of domestic violence: A pilot study (2012)

Benefits of "eye movement desensitization and reprocessing" psychotherapy in the treatment of female victims of intimate partner rape (2012)

Emdr: An evidence-based treatment for victims of trauma (2009)

Eye movement desensitization and reprocessing (emdr) treatment for psychologically traumatized individuals (2005)

Black, P.J. (2012). A review of trauma-informed treatment for adolescents. Canadian Psychology , 53(3), 192-203. doi:10.1037/a0028441

Cohen, J.A. (2003). Treating acute posttraumatic reactions in children and adolescents. Society of Biological Psychiatry, 53:827-833. doi:10.1016/S0006-3223(02)01868-1

Forbes, D., Lloyd, D., Nixon, R.D.V., Elliott, P., Varker, T., Perry, D., Creamer, M. (2012). A multisite randomized controlled trial of cognitive processing therapy for military-related post-traumatic stress disorder. Journal of Anxiety Disorders, 26, 442-452. Doi:10.1016/j.janxdis.2012.01.006

Gelfond, H. S. (2002). When medicine hurts: A psychological exploration of women's reluctanceto take medication for symptoms of trauma. (Order No. 3055854, Harvard University).ProQuest Dissertations and Theses, 172-172 p. Retrieved from http://login.ezproxy1.lib.asu.edu/login?url=http://search.proquest.com/docview/252090228?accountid=4485. (252090228).

Mott, J. M., Menefee, D. S., & Leopoulos, W. S. (2012). Treating PTSD and Disordered Eating in the Wake of Military Sexual Trauma A Case Study.Clinical Case Studies,11(2), 104-118.

Polak, A.R., Witteveen, A.B., Visser, R. S., Opmeer, B.C., Vulink, N., Figee, M., … Olff, M.(2012). Comparison of the effectiveness of trauma-focused cognitive behavioral therapyand paroxetine treatment in PTSD patients: Design of a randomized controlled trial. BMCPsychiatry, 12. doi:10.1186/1471-244X-12-166

Resick, P. A., & Schnicke, M. K. (1992). Cognitive processing therapy for sexual assault victims. Journal of Consulting and Clinical Psychology 60(5), 748-756. doi:http://dx.doi.org/10.1037/0022-006X.60.5.748

Surís, A., Link-Malcolm, J., Chard, K., Ahn, C. and North, C. (2013), A Randomized Clinical Trial of Cognitive Processing Therapy for Veterans With PTSD Related to Military Sexual Trauma. J. Traum. Stress, 26: 28–37. doi:10.1002/jts.21765

Tarquinio, C., Brennstuhl, M. J., Rydberg, J. A., Schmitt, A., Mouda, F., Lourel, M., & Tarquinio, P. (2012). Eye movement desensitization and reprocessing (emdr) therapy in the treatment of victims of domestic violence: A pilot study. European Review of Applied Psychology, 62(4), 205-212. doi: http://dx.doi.org/10.1016/j.erap.2012.08.006

Tarquinio, C., Schmitt, A., Tarquinio, P., Rydberg, J. A., & Spitz, E. (2012). Benefits of "eye movement desensitization and reprocessing" psychotherapy in the treatment of female victims of intimate partner rape. Sexologies, 21(2), 60-67. doi: http://dx.doi.org/10.1016/j.sexol.2011.05.002


Solomon , E. P., Solomon , R. M., & Heide, K. M. (2009). Emdr: An evidence-based treatment for victims of trauma. Victims and Offenders, 4(4), 391-397. doi: DOI: 10.1080/15564880903227495

Wilson, S. A., Becker, L. A., & Tinker, R. H. (1995). Eye movement desensitization and reprocessing (emdr) treatment for psychologically traumatized individuals. Journal of Consulting and Clinical Psychology, 63(9), 928-937. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/8543715

*Helen, a Clinical Psychologist (2011). Child abuse and voice hearing: Finding healing through EMDR. Psychosis, 3(1), 90-95.

Jarero, I., Roque-Lopez, S., & Gomez, J. (2013). The provision of an EMDR-based multi-component trauma treatment with child victims of severe interpersonal trauma. Journal of EMDR Practice and Research, 7(1), 17-28. Greyber, L. R., Dulmus, C. N., & Cristalli, M. E. (2012). Eye movement desensitization reprocessing, posttraumatic stress disorder, and trauma: A review of randomized controlled trials with children and adolescents. Child Adolescent Social Work Journal, 29, 409-426.

Edmond, T., & Rubin, A. (2004). Assess the long-term effects of EMDR: results from an 18-month follow-up study with adult female survivors of childhood sexual abuse. Journal of Child Sexual Abuse, 13(1), 69-86.

















Many individuals who survive traumatic experiences develop post-traumatic stress disorder (PTSD) and related psychological problems.

More than half of the United States population has been affected by psychological trauma.

About 5.2 million adults have PTSD during a given year.

Women are more likely than men to develop PTSD. About 10% of women develop PTSD sometime in their lives compared with 5% of men.

26,000 military men and women sexually assaulted in 2011 increase from 19,000 in 2010

Rape victims may constitute largest numbers of PTSD sufferers in U.S.

64% of women who have experienced abuse develop PTSD

Social Workers care about this topic because of it’s prevalence in all demographics: women, survivors of abuse, survivors of rape, veterans, trauma survivors, etc.



How to be efficient with research
CBT and EMDR are both effective but EMDR is more efficient
CPT is effective but not superior
TF-CBT is more effective than medication alone
Gains from EMDR retain after 18 months

Intrusive memories
Nightmares / Flashbacks
Intense or prolonged distress after exposure to traumatic reminders.
Marked physiologic reactivity after exposure to trauma-related stimuli.
Avoidance
Negative alterations in cognitions and mood
Dissociative amnesia
Distorted, negative beliefs
Fear, horror, anger, guilt, or shame
Diminished interest in (pre-traumatic) activities.
Detachment or estrangement
Inability to experience positive emotions.
Irritable or aggressive behavior
Self-destructive or reckless behavior
Hypervigilance
Exaggerated startle response
Poor concentration
Sleep disturbance
Full transcript