Posttraumatic stress disorder following violence and aggression
Section snippets
Diagnostic Criteria For PTSD
The original diagnostic criteria were updated in the revised version of DSM-III and further minor revisions occurred in DSM-IV (American Psychiatric Association, 1994). The latest version of the International Classification of Diseases (ICD-10; World Health Organisation, 1992) also contains a category of PTSD.
Not surprisingly, the first criterion to be met for a diagnosis of PTSD is experience of a traumatic event. Considerable debate has focused on the importance of this criterion in an
The assessment of ptsd
The purpose of this section is to summarize the key areas to be covered in the clinical evaluation of a trauma survivor. Detailed reviews of PTSD assessment are well covered in other work, to which the interested reader is referred for further information (e.g., Allen 1994, Carlson 1996, Wilson & Keane 1996).
There has been considerable debate in recent years regarding the extent to which symptoms of PTSD may be fabricated or exaggerated, especially when issues of compensation are involved
Treatment options
Clearly, those victims who do not recover independently, and who go on to develop longer term problems as a result of their exposure to violence, may require formal treatment. The purpose of this section is to provide a brief overview of the common psychological interventions used in the treatment of PTSD following violent crime. More detailed discussion of these approaches has been provided by other authors (e.g., Foa and Meadows 1997, Foa & Rothbaum 1998, Shalev, Bonne, & Eth 1996). A
Early intervention and prevention
In recent years, there has been considerable debate as to the extent to which it may be possible to modify the course of traumatic stress reactions, and to facilitate recovery, by means of an early intervention. Much of this debate has revolved around the area of psychological debriefing as described by Mitchell and others Mitchell 1983, Mitchell & Bray 1990. As noted by several authors Bisson & Deahl 1994, Kenardy et al. 1996, Raphael, Meldrum, & McFarlane 1995, there is a paucity of adequate
Conclusions
This article has attempted to provide a broad overview of PTSD in victims of violence. Despite considerable interest, the field remains in its infancy in terms of rigorous empirical research, and much remains to be learned about human response to violent trauma. With regard to phenomenology, the relationship between active avoidance and numbing (or passive avoidance) requires clarification, perhaps with the aim of classifying them as distinct and separate clusters in forthcoming diagnostic
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