This chapter describes maneuvers to access the internal system of the patient as well as means to accelerate or decelerate the work in that process of accessing the self-system. Eye movement desensitization and reprocessing (EMDR), ego state therapy, and somatic therapy fit together like hand and glove. An extended preparation phase is often necessary before trauma processing in complex traumatic stress presentations and attachment-related syndromes, particularly when dealing with the sequelae of chronic early trauma. Clinical practice suggests that the adjunctive use of body therapy and ego state interventions can be useful, during stabilization and later on in increasing the treatment response to EMDR. Traditional treatment of complex posttraumatic stress disorder (PTSD) and dissociative disorders has usually included hypnoanalytic interventions, during which abreaction is considered an important part of treatment.
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- Go to article: Adverse Childhood Experiences, Posttraumatic Stress Disorder Symptoms, and Emotional Intelligence in Partner Aggression
Adverse Childhood Experiences, Posttraumatic Stress Disorder Symptoms, and Emotional Intelligence in Partner Aggression
Intimate partner violence (IPV) has been linked to childhood abuse, posttraumatic stress disorder (PTSD), and low emotional intelligence (EI). Relationships among adverse childhood experiences (ACE), PTSD symptoms, and partner aggression (i.e., generalized tendency to aggress toward one’s partner) were assessed in 108 male IPV offenders. It was hypothesized that ACE is positively correlated with partner aggression, PTSD mediates the ACE-aggression relationship, and the ACE-PTSD-aggression mediation varies by selected EI facets. Results indicate that ACE has an indirect effect on partner aggression via PTSD and PTSD mediates the ACE–aggression link when emotional self-regulation is low and when intuition (vs. reason) is high. Trauma-exposed IPV offenders may benefit from comprehensive treatments focusing on PTSD symptoms, emotional control, and reasoning skills to reduce aggression.Source:
- Go to article: An Affective Cognitive Neuroscience-Based Approach to PTSD Psychotherapy: The TARGET Model
Adaptations or alternative versions of cognitive psychotherapy for posttraumatic stress disorder (PTSD) are needed because even the most efficacious cognitive or cognitive-behavioral psychotherapies for PTSD do not retain or achieve sustained clinically significant benefits for a majority of recipients. Cognitive affective neuroscience research is reviewed which suggests that it is not just memory (or memories) of traumatic events and related core beliefs about self, the world, and relationships that are altered in PTSD but also memory (and affective information) processing. A cognitive psychotherapy is described that was designed to systematically make explicit these otherwise implicit trauma-related alterations in cognitive emotion regulation and its application to the treatment of complex variants of PTSD—Trauma Affect Regulation: Guide for Education and Therapy (TARGET). TARGET provides therapists and clients with (a) a neurobiologically informed strengths-based meta-model of stress-related cognitive processing in the brain and how this is altered by PTSD and (b) a practical algorithm for restoring the executive functions that are necessary to make implicit trauma-related cognitions explicit (i.e., experiential awareness) and modifiable (i.e., planful refocusing). Results of randomized clinical trial studies and quasi-experimental effectiveness evaluations of TARGET with adolescents and adults are reviewed.
Emotional dysregulation is a key component of posttraumatic stress disorder (PTSD). It is important to understand the basic neurophysiology of stress and how it influences a survivor’s ability to cope. The mechanism involved in stress includes the connections among the hypothalamus, the pituitary gland, and the adrenal gland. Glucocorticoids influence metabolism and immune function, and send signals back to the brain about the stressor. Low cortisol levels immediately after a trauma may also be a risk factor for developing PTSD. The sympathetic nervous system (SNS) secretes catecholamines during stress, which help to consolidate memories. When military personnel have a history of childhood abuse and subsequent military sexual trauma (
MST), they may be particularly vulnerable to developing PTSD. Anticipatory anxiety is also one of the greatest barriers in engaging clients in treatment. Mindfulness can be described as any practice that brings clients back to the present moment.Source:
- Go to article: An Analysis of the Relationship Between Self-Compassion, Psychological Inflexibility, Psychological Health, and PTSD Severity in a Partial Hospitalization Program
An Analysis of the Relationship Between Self-Compassion, Psychological Inflexibility, Psychological Health, and PTSD Severity in a Partial Hospitalization Program
PTSD symptoms and psychological inflexibility have been linked to a lack of self-compassion and poor psychological health. Prior work has explored these relationships in a trauma-exposed undergraduate population and found that, while self-compassion was correlated with PTSD symptom severity at the bivariate level, this relationship was no longer significant when accounting for psychological inflexibility. Additionally, self-compassion and psychological inflexibility predicted psychological health. The present study sought to test these findings in PTSD patients enrolled in an exposure-based partial hospitalization program. Acceptance and Commitment Therapy (ACT)-consistent measures (i.e., Valued Living Questionnaire, Behavioral Activation for Depression Scale [Short Form], Quality of Life Enjoyment and Satisfaction Questionnaire [Short Form]) were used to assess psychological health. The PTSD checklist for DSM-5 and the Acceptance and Action Questionnaire (II) were used to measure PTSD symptoms and Psychological Inflexibility, respectively. Our results were largely consistent with previous investigations. We found a negative relationship between psychological inflexibility and psychological health, as well as a positive relationship between psychological inflexibility and PTSD symptom severity. Future research should measure these constructs across different time points to explore the benefit of viewing self-compassion and other related constructs (e.g., courage and love) as values in an ACT model for PTSD treatment.Source:
This chapter focuses on anxiety disorders and deals with a discussion of the physiology of anxiety, including the major structures involved in the creation of a fear memory. It considers the mechanisms for extinction of conditioned anxiety. The chapter discusses the basic physiology of fear conditioning, specific anxiety disorders namely generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD), and explains treatments. It then reviews the literature about how clients can talk about their fears to minimize them and how relabeling or reappraising of past events can be helpful. There is evidence suggesting that the basal ganglia, structures associated with the control of movement, are involved in the expression of OCD behaviors in subsets of those with OCD. Cognitive behavioral therapy is effective in the treatment of generalized anxiety. Selective serotonin reuptake inhibitors are also used in the treatment of anxiety disorders.
This chapter provides an overview of the neurophysiology underlying the innate human response of anxiety. Knowledge regarding the brain’s response to normal levels of stress and how it responds in a healthy manner will help clarify the various ways the brain can misfire and produce debilitating symptoms and outcomes. Posttraumatic stress disorder (PTSD) is an unhealthy emotional reaction to the experienced trauma. Inability to control stress can lead to release of neurochemicals and alterations in the hypothalamic-pituitary-adrenal (HPA) axis, which can result in both central nervous system (CNS) and parasympathetic nervous system (pNs) dysregulation. The mental health provider should be familiar with various anxiety disorders, so to diagnose more accurately, because treatment differs depending upon the specific anxiety disorder diagnosis. Generalized anxiety disorder (GAD) is the most frequently diagnosed anxiety disorder in general clinics, but it is one of the least frequently diagnosed anxiety disorders in specialized anxiety clinics.Source:
Meeting academic demands, getting along with roommates, dealing with new social pressures, questioning career choices, managing finances, and other new responsibilities of the college experience can give rise to unexpected and undesired stress and anxiety. While event-related stress does not cause anxiety disorders on its own, it can worsen symptoms of a preexisting anxiety disorder or trigger an anxiety disorder in someone who may be predisposed. The symptoms of anxiety disorders generally involve disturbances in mood, thinking, and behavior. This chapter assesses the different classifications of anxiety disorders. Types of anxiety disorder includes generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder, and specific phobias. The chapter evaluates effective treatment and intervention strategies for college student population. Among other psychotherapy approaches, cognitive-behavioral therapy (CBT), relaxation therapy (RT), and mindfulness-based stress reduction (MBSR) have received considerable empirical support in the treatment of anxiety disorders.
This chapter examines the experience of internalized oppression within the Asian American community. It provides an introduction to the theoretical and applied literature that addresses the critical issue of how to challenge the internalization of one’s oppression. The critical educational disparities continue to be mirrored in employment, occupational, and income disparities. Parallel to these educational and employment risks, Asian Americans have also been found to be at risk for health disparities. In terms of mental health, posttraumatic stress disorder and depression are common in Cambodian and Vietnamese American refugees. As a continuation of these colonial experiences, Asians who immigrated to the United States were also looked down upon, considered of lower status, and were thus discriminated against, exploited, and, at worst, violently attacked and murdered. Cultural racism occurs when the values, norms, and beliefs of a group encourage often leading to the oppression of racial groups deemed inferior.
This chapter lists and examines essential criteria to consider when assessing patient stability and readiness for the standard eye movement desensitization and reprocessing (
EMDR) procedural steps. In considering a patient’s suitability and readiness for standard reprocessing, five kinds of issues need to be considered: medical concerns; social and economic stability; behavioral stability; mood stability; and complex personality and dissociative disorders, life-threatening substance abuse, and severe mental illness. Depersonalization and derealization as expressions of primary structural dissociation are frequently the only dissociative symptoms in patients with posttraumatic stress disorder (PTSD). The chapter reviews standardized assessment tools that can assist clinicians in assessing symptom severity, screening for dissociative disorders, and monitoring treatment progress and outcomes. The trauma assessment packet includes four test instruments, along with three research and clinical articles, which together provide a comprehensive assessment of trauma histories at different ages.