Recognition and Treatment of Posttraumatic Stress Disorder

Department of Psychiatry and Behavioral Sciences, Box 3812, Duke University Medical Center, Durham, NC 27710, USA.
JAMA The Journal of the American Medical Association (Impact Factor: 30.39). 08/2001; 286(5):584-588. DOI: 10.1001/jama.286.5.584

ABSTRACT The reports on posttraumatic stress disorder (PTSD) in this issue of
draw attention to 3 important facts: PTSD is a worldwide problem, reaching
alarming proportions in countries torn by violent conflict; it is associated
with persistent disability and comorbidity for many people; and treatments
can produce a meaningful reduction in distress. These studies, which tell
clinicians not to forget about PTSD, provide the opportunity to focus on what
is known about PTSD as a medical problem, and its presentation, recognition,
and management. Perhaps the 3 main lessons to be learned are that PTSD often
presents in medical disguise, it is largely unrecognized, and it can be treated

  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract
  • [Show abstract] [Hide abstract]
    ABSTRACT: Combat exposure among military personnel results in increased risk of posttraumatic stress disorder (PTSD), major depression, substance use, and related health risks. PTSD symptoms require innovative approaches to promote effective coping postdeployment. PTSD's nature and scope requires an approach capable of integrating multiple health risks while reaching large populations. This article provides the rationale and approach to adapt and evaluate a Pro-Change computerized tailored intervention (CTI) targeted at behavioral sequelae (i.e., smoking, stress, and depression) for veterans with or at risk for PTSD. The three-phase approach includes: 1) focus groups to review and, subsequently, adapt content of the existing CTI programs; 2) usability testing; and 3) feasibility testing using a three-month pre-postdesign. Effective, theory-based, real-time, multiple behavior interventions targeting veterans' readiness to quit smoking, manage stress, and depression are warranted to provide potential health impact, opportunities for learning veteran-specific issues, and advance multiple health behavior change knowledge.
    12/2011; 1(4):595-603. DOI:10.1007/s13142-011-0088-1
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective Posttraumatic stress disorder (PTSD) and depression are known to be highly comorbid. However, previous findings regarding the nature of this comorbidity have been inconclusive. This study prospectively examined whether PTSD and depression are distinct constructs in an epidemiologic sample, as well as assessed the directionality of the PTSD-depression association across time.Methods Nine hundred and forty-two Detroit residents (males: n = 387; females: n = 555) were interviewed by phone at three time points, 1 year apart. At each time point, they were assessed for PTSD (using the PCL-C), depression (PHQ-9), trauma exposure, and stressful life events.ResultsFirst, a confirmatory factor analysis showed PTSD and depression to be two distinct factors at all three waves of assessments (W1, W2, and W3). Second, chi-square analysis detected significant differences between observed and expected rates of comorbidity at each time point, with significantly more no-disorder and comorbid cases, and significantly fewer PTSD only and depression only cases, than would be expected by chance alone. Finally, a cross-lagged analysis revealed a bidirectional association between PTSD and depression symptoms across time for the entire sample, as well as for women separately, wherein PTSD symptoms at an early wave predicted later depression symptoms, and vice versa. For men, however, only the paths from PTSD symptoms to subsequent depression symptoms were significant.Conclusions Across time, PTSD and depression are distinct, but correlated, constructs among a highly-exposed epidemiologic sample. Women and men differ in both the risk of these conditions, and the nature of the long-term associations between them.
    Depression and Anxiety 07/2014; 32(1). DOI:10.1002/da.22267 · 4.29 Impact Factor