Recent developments in psychosocial treatment of PTSD

Abstract

Overview of treatments 1. Combined treatment medication + psychotherapy esp., if depression is moderate or severe

2. Psychotherapy > Medication esp., Cluster C

Overview of treatments 3. CBT(Cognitive Behavioral Therapy)

4. Limited evidence for effectiveness for many approaches * Randomized Clinical Trials (RCTs) Pharmacotherapy Strong Evidence SSRIs: Sertraline, Paroxetine TCAs: Imipramine, Amitriptyline, Desipramine Less Strong Evidence SSRIs: Fluoxetine MAOIs: Phenelzine

Psychological debriefing Psychological debriefing Critical Incident Stress Debriefing(CISD) - 사고 후 초기의 고통을 줄이고 PTSD같은 후유증을 줄이기 위함 - 환기, 반응의 정상화, 미래에 대한 준비

limited evidence for efficacy

Cognitive Behavioral Therapy Exposure Therapy* Systemic desensitization Stress Inoculation Training* Cognitive Processing Therapy Cognitive Therapy Biofeedback & Relaxation Training Assertiveness training Prolonged exposure Developed by Foa(1989) Including two established exposure therapy - Imaginal & In vivo Twelve session program with homework Group psychotherapy Three major forms 1) cognitive bahavioral 2) supportive 3) psychodynamic

Limited evidence Most studies reports favorable outcomes Others Psychodynamic therapy Interpersonal psychotherapy Supportive psychotherapy Hypnosis