There are multiple evidence-based treatments for reducing acute and chronic Posttraumatic Stress Disorder (PTSD) and associated sleep disturbances. PTSD is considered chronic when the duration of symptoms extends beyond 3 months. Several treatment guidelines are available to assist clinicians with the selection and implementation of appropriate treatments. Treatment guidelines typically recommend cognitive behavioral therapy (CBT) interventions, such as prolonged exposure therapy, cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR). Additional treatment recommendations include stress inoculation treatment and pharmacotherapy. For acute traumatic stress reactions, a wait and see approach is recommended as a natural recovery process is believed to be activated posttrauma and should be respected. Overall, the establishment of a strong, positive therapeutic alliance is essential to providing a safe context in which clients can process their trauma experiences and regain a sense of psychological stability and empowerment.

Psychological trauma can occur when a person experiences an extreme stressor that negatively affects his or her emotional or physical well-being. Trauma can cause emotionally painful and distressing feelings that overwhelm a person’s capacity to cope and leave him or her with feelings of helplessness. Traumatic events can lead to Posttraumatic stress disorder (PTSD) and myriad other reactions, such as depression, substance abuse, sleep problems, and potentially chronic health problems, such as heart disease, diabetes, and cancer. Trauma exposure cuts across all walks of life, regardless of age, race, ethnicity, socioeconomic status, religion, and cultural background. The types of traumatic events includes child maltreatment, intimate partner violence/domestic violence, rape or sexual violence, military sexual trauma, sex trafficking, combat-related trauma, civilian war trauma and torture, disasters, serious accidents, and life-threatening medical illness. This book provides an overview of the rich and varied research conducted on psychological trauma over the past 3 decades.

This chapter examines the ways in which the experience, interpretation, and response to trauma may vary by gender, race or ethnicity, and culture. Findings from large-scale epidemiological surveys indicate significant gender differences in trauma exposure and Posttraumatic stress disorder (PTSD). Various theories have been put forth to explain the differential gender risk for developing PTSD, including the situational vulnerability theory and the female vulnerability theory. Another area that has been examined to help explain gender differences in PTSD is posttrauma cognitions and coping responses. Empirical studies on gender differences in PTSD treatment outcomes, however, have been limited. Gender differences in exposure to certain types of traumas may partly explain this difference, with women reporting greater exposure to high-impact traumas. Moreover, certain discriminatory practices may be traumatic events in and of themselves, which increases exposure to trauma among racial and ethnic minorities.

Psychological trauma can have long-term effects on health. When considering the impact of trauma on health, most people tend to focus on immediate consequences, such as injury. And these needs can be substantial. Patients who reported four or more types of childhood adversity, including sexual, physical, and emotional abuse; exposure to domestic violence; and parental mental illness, criminal activity, and substance abuse, were at significantly increased risk for such diverse conditions as ischemic heart disease, cancer, stroke, chronic bronchitis, emphysema, diabetes, and hepatitis. Human beings are meant to have social relationships with others. Unfortunately, trauma survivors often have difficulties in their relationships. Depression and Posttraumatic stress disorder (PTSD) are common sequelae of trauma. Depression is one of the most commonly occurring sequelae of trauma. Given the serious often life-threatening conditions that trauma survivors often have, an adequate health care system response is perhaps the most pressing need of survivors of traumatic events.

A relatively new and controversial psychiatric diagnostic category, posttraumatic stress disorder (PTSD) is the only psychiatric disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM) that requires exposure to a traumatic event to meet the diagnosis. According to the DSM-IV-TR, a person could be diagnosed with PTSD only if he or she experienced a criterion A stressor, which comprises two components: The person experienced, witnessed events that involved actual threatened death/serious injury, or a threat to the physical integrity of self/others, and the person’s response involved intense fear, helplessness, or horror. The PTSD symptom clusters include re-experiencing symptoms, such as intrusive thoughts, nightmares, and flashbacks about the traumatic event, avoidance of trauma-related stimuli, such as memories, thoughts, feelings, or places associated with the trauma, emotional numbing, and hyperarousal symptoms, including difficulty falling/staying asleep, irritability/anger, and increased startle response.

This chapter describes that posttraumatic stress disorder (PTSD) can have a significant negative effect on families. In spite of difficulties, it is possible for family members to band together and weather the storm of PTSD. When one member of a family suffers, it affects the entire family. They may not have experienced the traumatic event, but they live every day with the consequences. They are collateral damage. PTSD can affect all members of a survivor’s family: parents, spouses, and children. Divorce is twice as common in families with PTSD. Spouses are at increased risk for domestic violence. People with PTSD are easily startled; they have nightmares, which can interfere with their family members’ sleep; and they can’t handle many social situations, often isolating their families from contact with the outside world. PTSD can also significantly alter the personality, making an individual seem like a different person.

This chapter explores how memories for such traumatic experiences differ from memories for more mundane experiences, and what role the memories play in the development and maintenance of posttraumatic stress disorder (PTSD). When the memory refuses to fade and continues to intrude into daily experiences months or years later, PTSD may result. Those who have PTSD suffer through flashbacks, in which the memory for the event occurs without intention and feels like a reliving of the experience, and recurrent nightmares about the traumatic experience. Most people are convinced by their own experience that dramatic and traumatic events are better remembered than mundane or neutral ones. In fact, there is extensive evidence supporting this phenomenon of emotional enhancement of memory. People remember words on a list referring to emotional concepts better than neutral words and emotion-laden pictures better than neutral ones.

Complementary and alternative medicine (CAM) includes a range of therapies and health care systems, practices, and products that are outside of standard medical practice in the United States (U.S.). CAM treatments generally have fewer side effects and address the range of symptoms that patients with complex disorders, such as posttraumatic stress disorder (PTSD), experience. The U.S. Department of Veterans Affairs (VA) is committed to providing cutting-edge, evidence-based treatment for all Veterans, including those seeking PTSD-related services. Acupuncture is one of the most mainstream of the CAM treatments. It is based on traditional Chinese medicine (TCM) and involves inserting very thin needles along meridian points to stimulate the flow of energy. Mindfulness is another CAM modality that has been integrated into trauma treatment. Another CAM treatment for trauma is expressive writing. One mechanism by which expressive writing was thought to be effective was in helping trauma survivors.

This chapter explores some of the most commonly seen non-evidence-based treatments (non-EBTs) in psychology and counseling, from treatments for specific disorders, such as autism spectrum disorder (ASD), posttraumatic stress disorder (PTSD), and substance abuse, to psychological assessment measures. ASD is characterized by impairments in social interaction and communication, frequently accompanied by repetitive self-soothing behavior. Four of the most widespread pseudoscientific treatments for trauma-related problems are critical incident stress management (CISM), eye movement desensitization and retraining (EMDR), emotional freedom technique (EFT), and thought field therapy (TFT). The Thematic Apperception Test (TAT) manuals provide very clear and detailed procedures, but similar to what happened with the Rorschach, numerous other systems and methods of using the TAT developed. Given the preponderance of non-EBT for psychological problems, one must often be careful in choosing a provider of mental health services, whether that person is a psychologist, psychiatrist, professional counselor, or other kind of therapist.

This chapter discusses three key controversies in the trauma psychology field: whether posttraumatic stress disorder (PTSD) is a sufficient diagnostic category to capture the full range of reactions to severe and prolonged trauma, whether memories of traumatic events can be lost, and whether dissociative identity disorder is a real condition or a social construct. Another controversial and heavily debated topic in the field of trauma psychology is whether memories of childhood abuse can be lost and then later recovered. Research and debate on this issue have converged on several key questions: Do recovered memories of traumatic events exist?, How and why do individuals forget and then later remember a traumatic event?, Do false memories exist?, How and why do false memories occur, and Another key criticism of Complex PTSD (CPTSD) is its significant overlap with PTSD and Borderline Personality Disorder.