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Chapter 6

Chapter 6. Posttraumatic Stress Disorder (PTSD) in Veterans. DSM Diagnostic Criteria for PTSD*. (According to the DSM-IV-TR; APA, 2000) Exposure to an actual or perceived threat provoking intense fear or helplessness. Three symptom clusters At least one reexperiencing symptom

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Chapter 6

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  1. Chapter 6 Posttraumatic Stress Disorder (PTSD) in Veterans

  2. DSM Diagnostic Criteria for PTSD* • (According to the DSM-IV-TR; APA, 2000) Exposure to an actual or perceived threat provoking intense fear or helplessness. • Three symptom clusters • At least one reexperiencing symptom • At least three avoidance or emotional numbing symptoms • At least two hyperarousal symptoms • Symptoms last more than one month. • Significant distress or impairment in social, occupational, of other functioning. ----------- *Changes being proposed in upcoming revision (DSM-V)

  3. Early Conceptions of PTSD • Nineteenth century: “traumatic neurosis” • Freud: Hysteria based on actual or fantasized sexual trauma • World War I: “shell shock”

  4. Models to Explain PTSD • Psychodynamic Model • Early childhood trauma and psychological conflicts • General Adaptation Syndrome • Physiological response to stress • Biological Model • Chronic or potentially permanent physiological changes • Transactional Theories of Stress • Contextual and environmental factors emphasized • Diathesis-Stress Model • Amalgam of the above models • Genetic vulnerabilities, early childhood experiences or brain abnormalities

  5. Current, More Empirically Supported Models of PTSD • Behavioral Models • Feared stimuli overgeneralized • Avoidance of overgeneralized stimuli is reinforced • Cognitive Models • Traumatic event reinforces negative beliefs about one’s safety and competence • Cognitive distortion that the world is a dangerous place • Biological Models

  6. Discussion Questions Regarding Case Study • Discuss what you know about the case and possible resources. • What are the societal, cultural, and community contexts of the case? • What are elements of SSG Brown’s world that could serve to maintain his problems? • How would you address the maintenance of problems? • What else would you want to know about the case and about SSG Brown’s situation to develop a better understanding of him? • How would you locate resources for SSG Brown and for yourself as a social worker? • What beliefs and perceptions did you have about PTSD and about veterans before reading this chapter, and how did they change after reading this chapter? • How does the veteran experience compare and contrast to the civilian experience in general and with trauma?

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