Consult the second edition of this authoritative, comprehensive, in-depth medical guide for information on more than 1,700 medical topics in language accessible to adult laypersons. Presented in a single alphabetical sequence, articles range in length from one or two paragraphs for minor topics, to several pages or more for major topics. Disease/disorder articles typically cover definition; description; causes and symptoms; diagnosis; treatments; prevention; and more. Test/treatment articles typically cover definition; purposes; precautions; preparation; risks; normal and abnormal results; and much more. This second edition includes more than 200 new entries, 300 updated entries, approximately 650 color images and illustrations, and a comprehensive subject index. New features include biographical and historical sidebars throughout the text.

Disease/disorder articles contain some or all of the following sections:

Test/treatment articles contain some or all of the following sections:

Published/Released: December 2001

The “Gale Encyclopedia of Mental Disorders” is a comprehensive two-volume set providing detailed information on mental disorders and conditions, in an easy-to-use format. It includes entries for all 150 disorders classified in the “Diagnostic and Statistical Manual of Mental Disorders,” and also features entries for prescription, alternative and over-the-counter drugs, as well as the various therapies used to treat mental disorders.

While some books about police psychology contain a chapter on the fitness-for-duty question, this is the first comprehensive publication focused exclusively on psychological fitness-for-duty evaluations (FFDEs) for law enforcement personnel. This handbook is ideal for professionals and for coursework designed to prepare individuals for careers as police or municipal officials, psychologists, students, behavioral science specialists, human rights advocates, and attorneys. A helpful glossary makes the book even more useful for students and those who do not have extensive academic or formal training in psychology or public administration.

A Handbook for Psychological Fitness-for-Duty Evaluations in Law Enforcement describes in detail the mechanics of setting up a fitness-for-duty methodology and examines the effectiveness of FFDEs in law enforcement. You’ll find clear instructions for developing a FFDE system from the law enforcement executive’s viewpoint (valuable for attorneys, police psychologists, and civil service board members as well), and an extensive bibliography with particular emphasis on laws and cases that provide guidance to psychological and law enforcement professionals. Several appendices provide examples of documentation that can be used in the evaluation process.

This book brings you reliable information on:

In addition, this book contains a succinct review of psychological testing (psychometrics), and the technicalities of employing a professional psychologist to determine the fitness of commissioned officers. A Handbook for Psychological Fitness-for-Duty Evaluations in Law Enforcement proposes a model law that could be used to improve the utility and effectiveness of FFDEs, and presents a forward-looking discussion of FFDE issues that may become controversial in the near future.

Clinical Guide to the Diagnosis and Treatment of Mental Disorders - Second Edition combines clinically-relevant information about each of theDSM-IV-TR diagnoses with clear, detailed information on treatment options, giving full clinical management advice. Once again, the editors, both leading psychiatrists, have condensed the chapters on Disorders from Tasman et al’s acclaimed two volume textbook of Psychiatry (now in its Third Edition), retaining only the content they deem particularly relevant to the clinician for ease of use.

Each disorder is discussed under the headings of Diagnosis (including Assessment Issues, Comorbidity, Course, and Differential Diagnosis, giving diagnostic decision trees where relevant) and Treatment (listing all therapeutic options, giving practical advice for patient management, summarising treatment specifics with tables and treatment flowcharts).

The original edition established itself as the first point of reference for any clinician or mental health practitioner needing expert advice on therapeutic options for any psychiatric disorder. This edition features an additional chapter on the psychiatric interview and assessment of mental status to increase its utility.

It echoes the progress in psychiatry regarding the establishment of an evidenced-based model of taxonomy, diagnosis, etiology, and treatment. Indeed, from a psychologist's perspective, the equal consideration provided to empirically supported psychosocial treatments versus somatic treatment is a significant development in the field of psychiatry.

Jonathan Weinand in PsycCritiques, the American Psychological Association Review of Books

Author: Michael B. First, Allan Tasman
Paperback: 558 pages
Company: Wiley (2010-03-16)
ISBN: 0470745207
List Price: $104.95
Amazon Price: $87.11
Used Price: $83.99

Acceptance and commitment therapy (ACT) offers a promising, empirically validated approach to the treatment of post-traumatic stress disorder (PTSD) and other trauma related problems. In this volume, you'll find a complete theoretical and practical guide to making this revolutionary new model work in your practice.

After a quick overview of PTSD, the first part of the book explains the problem of experiential avoidance as it relates to trauma and explores the verbal nature of post-traumatic stress. You'll learn the importance of mindfulness and acceptance in the ACT model, find out how to structure sessions with your clients, and examine the problem of control. The section concludes by introducing you to the idea of creative hopelessness as the starting point for creating a new, workable life after trauma.

The book's second section offers a practical, step-by-step clinical guide to the six core ACT components in chronological order: Creative hopelessness The problem of control Willingness and defusion Self-as-context Valued living Committed action

Each chapter explains how to introduce these topics to clients suffering from PTSD, illustrates each with case examples, and offers homework for your clients to use between sessions.

Author: Robyn D., Ph.D. Walser, Darrah, Ph.D. Westrup
Hardcover: 255 pages Bargain Price
Company: New Harbinger Publications (2007-06)
List Price: $58.95
Amazon Price: $489.96
Used Price: $95.22

Many people experience traumatic events and whilst some gradually recover from such experiences, others find it more difficult and may seek professional help for a range of problems. A Casebook of Cognitive Therapy for Traumatic Stress Reactions aims to help therapists who may not have an extensive range of clinical experience.

The book includes descriptions and case studies of clinical cases of cognitive behavioural treatments involving people who have experienced traumatic events, including:

people with phobias, depression and paranoid delusions following traumatic experiences people with Posttraumatic Stress Disorder (PTSD) people who have experienced multiple and prolonged traumatizations people who are refugees or asylum-seekers.

All chapters are written by experts in the field and consider what may be learned from such cases. In addition it is considered how these cases can be applied more generally in cognitive behavioural treatments for traumatic stress reactions.

This book will be invaluable to all mental health professionals and in particular to therapists wanting to treat people who have experienced traumatic events, allowing them to creatively apply their existing knowledge to new clinical cases.

There is controversy as to whether psychological interventions in the aftermath of disaster are helpful or not. This book addresses these controversies and describes the responses that psychologists have made in different parts of the world to disaster.

Allen Rubin & David W. Springer, Editors

Treatment of Traumatized Adults and Children

Clinician's Guide to Evidence-Based Practice

Praise for Treatment of Traumatized Adults and Children

"A major stumbling block to adoption of evidence-based practice in the real world of clinical practice has been the absence of clinician-friendly guides. Such guides need to be understandable, free of technical research jargon, infused with clinical expertise, and rich with real-life examples. ?Rubin and Springer have hit a home run with this series, which has all of these characteristics and more."
—Edward J. Mullen Willma & Albert Musher Chair and Professor, Columbia University

"Rubin and Springer have assembled the wisdom of leading practitioners of evidence-based practice interventions, enhancing the likelihood that these practices will be adopted by helping professionals. ?Written in the language of practitioners, this book represents an exemplar for dissemination of evidence-based practice information."
—Joanne Yaffe Associate Professor, University of Utah College of Social Work

Evidence-based interventions for treating traumatized adults and children

Part of the Clinician's Guide to Evidence-Based Practice Series, Treatment of Traumatized Adults and Children provides busy mental health practitioners with detailed, step-by-step guidance for implementing clinical interventions that are supported by the latest scientific evidence.

Edited by renowned educators Allen Rubin and David W. Springer, this thoroughly useful reference draws on a roster of experts and researchers in the field who have assembled state-of-the-art knowledge into this well-rounded guide, and covers the following interventions that have the best empirical support for treating posttraumatic stress disorder:

Prolonged exposure therapy

Trauma-focused cognitive behavior therapy

Eye Movement Desensitization and Reprocessing (EMDR)

Easy-to-use and accessible in tone, this indispensable resource is for practitioners who would like to implement evidence-based, compassionate, and effective interventions in their care of traumatized clients.

Also in the Clinician's Guide to Evidence-Based Practice Series

Substance Abuse Treatment for Youth and Adults

Hardcover: 480 pages
Company: Wiley (2009-08-17)
ISBN: 0470228466
List Price: $55.00
Amazon Price: $40.00
Used Price: $40.99

These volumes by a team of internationally recognized experts reflect and highlight both recognized and under-recognized events that cause trauma. They also examine current and emerging research on effective interventions to minimize and heal the effects of the trauma. Special attention is also given to culture and context, because what is considered healthy or problematic may vary widely across cultures, and culture can influence people's coping styles. Sources of trauma discussed include stalking, killing, terrorism, torture, kidnap, workplace violence, domestic violence, children and war, fires, floods, AIDS, pain, burns, spinal cord injury, children and medical illness, homelessness, and more. Case examples, treatment recommendations, and public policy recommendations are included in each of the chapters.

The growing field of trauma psychology has been spurred recently by natural events from Hurricane Katrina to the Tsunami, and by terrorist events worldwide, as well as chronic health and social issues—from persistent pain to homelessness—that are mounting. The experts offer a gripping overview of the most traumatic and widespread events causing trauma and of the symptoms and health impairment that may result. Most important, they explain how we can best recognize, understand, and treat the sufferers and develop intervention policies.

Stress produces numerous symptoms which vary according to persons, situations, and severity. These can include physical health decline as well as depression. According to the St. Louis Psychologists and Counseling Information and Referral, the process of stress management is one of the keys to a happy and successful life in modern society. Although life provides numerous demands that can prove difficult to handle, stress management is the best way to manage anxiety and maintain overall well-being.

This book is your one-stop, ultimate resource for Stress Management. Here you will find the most up-to-date information, analysis, background and everything you need to know.

In easy to read chapters, with extensive references and links covering all aspects of Stress Management: Stress management, Stress (biology), Abiotic stress, Acute stress reaction, Allostasis, Allostatic load, Amygdala hijack, Biotic stress, Body-centred countertransference, Breaking point (psychology), Burnout (psychology), Chronic stress, Combat stress reaction, Compassion fatigue, Complex post-traumatic stress disorder, Coping (psychology), Cortisol, Cortisol awakening response, Defense physiology, Diathesis–stress model, Effects of stress on memory, Emotional exhaustion, Emotional labor, Epinephrine, Eustress, Eutonology, Fight-or-flight response, Flashback (psychology), Freezing behavior, Grief counseling, Historical trauma, Holmes and Rahe stress scale, Hypothalamic–pituitary–adrenal axis, Jury stress, Karo¯shi, Lateral strain, Life-Events and Difficulties Schedule, Mental breakdown, Mental distress, Military sexual trauma, Psychoneuroimmunology, Occupational burnout, Occupational stress, Perceived Stress Scale, Posttraumatic stress disorder, Prenatal stress, Procrastination, Psychological trauma, Psychosomatic medicine, Self-medication, SIDD, Somatopsychic, Stress (physiology), Stress ball, Stress-related disorders, Stressor, Sugar addiction, Technostress, Tend and befriend, Thousand-yard stare, Transmarginal inhibition, Traumatic stress, Victimization Symptoms, Work–life balance, Workplace stress, Work–life balance (United States), Worry.

This book explains in-depth the real drivers and workings of Stress Management. It reduces the risk of your time and resources investment decisions by enabling you to compare your understanding of Stress Management with the objectivity of experienced professionals.

Unique, authoritative, and wide-ranging, it offers practical and strategic advice for managers, business owners and students worldwide.

Author: James Smith
Paperback: 226 pages
Company: Tebbo (2011-07-29)
ISBN: 1743047886
List Price: $49.97
Amazon Price: $45.77
Used Price: $127.31

An exploration of the ways in which people skills can be acquired and developed, this book discusses new career development tools, the role of professional commitment statements, psychological contracts, and how to work with difficult people. Each chapter elucidates the development of a specific skill and includes examples, sets benchmarks, and examines how the particular skill’s relationship to the other skills presented in the book. The author covers how to improve interpersonal relationships, communications, job performance, and dealing with people of different ages, gender, and backgrounds.

Winner of an AJN Book of the Year Award for 2010!

"[This book] is a wonderful guide to adult and elder forensics, and an important reference for all health care providers who care for adults and the elderely...Highly recommended."

--CHOICE

"It's about time this book was written! While excellent instructional texts exist, this book fills a niche for the nonspecialty health professional encountering victims of violence in the routine course of care This book should not only be on the shelf in every ED, but also in the armamentarium of providers working in the outpatient setting; public health clinics; residential facilities and student health clinics."

--AJN

Nurses and other health care professionals who work with victims and perpetrators of violence are often confronted with issues that they may not have prior training in, such as identifying and managing victims of violent crime. This book is designed to serve as a quick resource for practicing health care providers treating adults and older adults, as well as students or practitioners new to the field.

The book not only has full descriptions of principles of evidence, but also offers detailed guidelines on how to conduct a forensic assessment of adults and older adults. Additionally, the authors examine the concepts of competency and guardianship, and provide guidelines for navigating the justice system. The authors provide current, concise, and easy-to-use information in short chapters that assist practitioners with the prevention of crimes and the identification and management of both victims and offenders.

Presents general principles of forensics, such as assessment and documentation, principles of evidence, and expert witness testimony

Also available:

Borderline Personality Disorder: The NICE Guideline on Treatment and Management - ISBN 1854334778
Dementia: The NICE-SCIE Guideline on Supporting People with Dementia and Their Carers in Health and Social Care (National Clinical Practice Guideline) - ISBN 1854334514

RCPsych Publications is the publishing arm of the Royal College of Psychiatrists (based in London, United Kingdom), which has been promoting excellence in mental health care since 1841. Produced by the same editorial team who publish The British Journal of Psychiatry, they sell books for both psychiatrists and other mental health professionals; and also many written for the general public. Their popular series include the College Seminars Series, the NICE mental health guidelines and the Books Beyond Words series for people with intellectual disabilities.

RCPsych publishes in all areas of psychiatry and mental health, including but not limited to:
Clinical psychiatric practice
Intellectual disability
Mental health services for children, adolescents, adults and the elderly
Psychopharmacology
Psychotherapy
Rehabilitation psychiatry
Family mental health
Service provision

RCPsych Publications books can help with the following disorders:
Addictions
Affective disorders
Attention deficit hyperactivity disorder (ADHD)
Bereavement
Borderline personality disorder
Cognitive-behavioral therapy (CBT)
Dementia
Depression
Eating disorders
Perinatal psychiatric disorder
Post-traumatic stress disorder (PTSD)
Psychosis
Schizophrenia
Sleep problems

Author: National Collaborating Centre for Mental Health
Paperback: 168 pages
Company: British Psychological Society and RCPsych Publications (2005-01-01)
ISBN: 190467125X
List Price: $70.00
Amazon Price: $27.99
Used Price: $50.95

Clinical Guide to the Diagnosis and Treatment of Mental Disorders - Second Edition combines clinically-relevant information about each of theDSM-IV-TR diagnoses with clear, detailed information on treatment options, giving full clinical management advice. Once again, the editors, both leading psychiatrists, have condensed the chapters on Disorders from Tasman et al’s acclaimed two volume textbook of Psychiatry (now in its Third Edition), retaining only the content they deem particularly relevant to the clinician for ease of use.

Each disorder is discussed under the headings of Diagnosis (including Assessment Issues, Comorbidity, Course, and Differential Diagnosis, giving diagnostic decision trees where relevant) and Treatment (listing all therapeutic options, giving practical advice for patient management, summarising treatment specifics with tables and treatment flowcharts).

The original edition established itself as the first point of reference for any clinician or mental health practitioner needing expert advice on therapeutic options for any psychiatric disorder. This edition features an additional chapter on the psychiatric interview and assessment of mental status to increase its utility.

It echoes the progress in psychiatry regarding the establishment of an evidenced-based model of taxonomy, diagnosis, etiology, and treatment. Indeed, from a psychologist's perspective, the equal consideration provided to empirically supported psychosocial treatments versus somatic treatment is a significant development in the field of psychiatry.

Jonathan Weinand in PsycCritiques, the American Psychological Association Review of Books

Author: Michael B. First, Allan Tasman
Paperback: 558 pages
Company: Wiley (2010-03-16)
ISBN: 0470745207
List Price: $104.95
Amazon Price: $87.11
Used Price: $83.99

Acceptance and commitment therapy (ACT) offers a promising, empirically validated approach to the treatment of post-traumatic stress disorder (PTSD) and other trauma related problems. In this volume, you'll find a complete theoretical and practical guide to making this revolutionary new model work in your practice.

After a quick overview of PTSD, the first part of the book explains the problem of experiential avoidance as it relates to trauma and explores the verbal nature of post-traumatic stress. You'll learn the importance of mindfulness and acceptance in the ACT model, find out how to structure sessions with your clients, and examine the problem of control. The section concludes by introducing you to the idea of creative hopelessness as the starting point for creating a new, workable life after trauma.

The book's second section offers a practical, step-by-step clinical guide to the six core ACT components in chronological order: Creative hopelessness The problem of control Willingness and defusion Self-as-context Valued living Committed action

Each chapter explains how to introduce these topics to clients suffering from PTSD, illustrates each with case examples, and offers homework for your clients to use between sessions.

Author: Robyn D., Ph.D. Walser, Darrah, Ph.D. Westrup
Hardcover: 255 pages Bargain Price
Company: New Harbinger Publications (2007-06)
List Price: $58.95
Amazon Price: $489.96
Used Price: $95.22

Parents, teachers, and mental health workers will find the answersto these- and many other-questions in this forthright yet compassionate guide to helping your adolescent through the tumultuous teen years. From peer pressure and self-esteem to experimentation with sex, alcohol, and drugs, this invaluable resource covers a wide range of pratical issues. Here as well is information on more serious obstacles to a teen's development that may require professional intervention, such as depression, eating disorders, substance abuse, and disruptive behavorial disorders. As surely as every child will become a teen, every person that must relate to a teen will find this book a reliable, indespensable guide to the ups and downs of adolecence.

What does a typical three-year-old think about and feel? What can you anticipate from your five-year-old about to begin school? What does it mean that your eight-year-old seems to lie regularly?

"Your Child" takes you step-by-step through the developmental milestones of childhood, discussing specific questions and concerns and examining more troublesome problems. From choosing your baby's doctor to dealing with steep problems, from helping a child develop selfesteem to discerning when certain behaviors call for professional help -- and how to find it -- this book offers comprehensive and accessible information for parents on the emotional, behavioral, and cognitive development of children from infancy through the preadolescent years. Expertly and definitively offering practical advice and invaluable information, "Your Child" will guide you through every stage of your child's growth and help you meet the daily challenges of parenting.

Author: AACAP, David Pruitt
Paperback: 496 pages
Company: William Morrow Paperbacks (2000-03-22) (2000-03-22)
ISBN: 0062737309
List Price: $22.99
Amazon Price: $15.69
Used Price: $0.30

Psychol Assess. 2011 Dec 12;
Griffith JW, Kleim B, Sumner JA, Ehlers A

The objective of this study was to examine the psychometric properties of the Autobiographical Memory Test (AMT), which is widely used to measure overgeneral autobiographical memory in individuals with depression and a trauma history. Its factor structure and internal consistency have not been explored in a clinical sample. This study examined the psychometric properties of the AMT in a sample of recent trauma survivors (N = 194), who completed the AMT 2 weeks after a trauma. Participants were also assessed with structured clinical interviews for current acute stress disorder and current and past major depressive disorder. Confirmatory factor analysis and item response theory were used to analyze the AMT in the whole sample. The factor structure of the AMT was also compared for (a) individuals with and without lifetime major depressive disorder and (b) individuals with current (posttrauma) major depressive disorder and/or acute stress disorder versus those with neither disorder. In all of these analyses, the AMT with cues of positive and negative valence had a 1-factor structure, which replicates work in nonclinical samples. Based on analyses of the whole sample, scores from the AMT had a reliability estimate of .72, and standard error of measurement was lowest for people who scored low on memory specificity. In conclusion, the AMT measures 1 factor of memory specificity in a clinical sample and can yield reliable scores for memory specificity. More psychometric studies of the AMT are needed to replicate these results with similar and other clinical populations. (PsycINFO Database Record (c) 2011 APA, all rights reserved).

J Psychiatr Res. 2012 Feb; 46(2): 168-73
Bryant RA, Creamer M, O'Donnell M, Silove D, McFarlane AC

One rationale for establishing the acute stress disorder diagnosis was to identify recently trauma-exposed people who may develop later posttraumatic stress disorder (PTSD). This study conducted a multi-site assessment of the extent to which ASD predicts subsequent PTSD, and also major depressive disorder, panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, and substance use disorder, 12 months after trauma.Consecutive admissions to 5 major trauma hospitals across Australia (N = 1084) were assessed during hospital admission and within one month of trauma exposure and subsequently re-assessed for psychiatric disorder 12 months after the initial assessment (N = 859).Whereas 120 (10%) patients met criteria for ASD in the initial month after trauma, 83 (10%) met criteria for PTSD, and 268 (31%) had any psychiatric disorder at 12 months. In terms of those diagnosed with ASD, 28 (36%) subsequently met criteria for PTSD and 50 (65%) subsequently developed any psychiatric disorder.Whereas the majority of people with ASD subsequently develop a psychiatric disorder, most people with a disorder at 12 months do not initially display ASD.

Psychooncology. 2011 Nov 13;
Rodin G, Yuen D, Mischitelle A, Minden MD, Brandwein J, Schimmer A, Marmar C, Gagliese L, Lo C, Rydall A, Zimmermann C

OBJECTIVE: Acute leukemia is a condition with an acute onset that is associated with considerable morbidity and mortality. However, the psychological impact of this life-threatening condition and its intensive treatment has not been systematically examined. In the present study, we investigate the prevalence and correlates of post-traumatic stress symptoms in this population. METHODS: Patients with acute myeloid, lymphocytic, and promyelocytic leukemia who were newly diagnosed, recently relapsed, or treatment failures were recruited at a comprehensive cancer center in Toronto, Canada. Participants completed the Stanford Acute Stress Reaction Questionnaire, Memorial Symptom Assessment Scale, CARES Medical Interaction Subscale, and other psychosocial measures. A multivariate regression analysis was used to assess independent predictors of post-traumatic stress symptoms. RESULTS: Of the 205 participants, 58% were male, mean age was 50.1 ± 15.4 years, 86% were recently diagnosed, and 94% were receiving active treatment. The mean Stanford Acute Stress Reaction Questionnaire score was 30.2 ± 22.5, with 27 of 200 (14%) patients meeting criteria for acute stress disorder and 36 (18%) for subsyndromal acute stress disorder. Post-traumatic stress symptoms were associated with more physical symptoms, physical symptom distress, attachment anxiety, and perceived difficulty communicating with health-care providers, and poorer spiritual well-being (all p 

Crit Care Med. 2012 Feb; 40(2): 618-24
Davidson JE, Jones C, Bienvenu OJ

: The family response to critical illness includes development of adverse psychological outcomes such as anxiety, acute stress disorder, posttraumatic stress, depression, and complicated grief. This cluster of complications from exposure to critical care is now entitled postintensive care syndrome-family. Adverse psychological outcomes occur in parents of neonatal and pediatric patients and in family members of adult patients, and may be present for >4 yrs after intensive care unit discharge. Psychological repercussions of critical illness affect the family member's ability to fully engage in necessary care-giving functions after hospitalization.: It has been suggested that the manner in which healthcare workers communicate with family members and the way in which families are included in care and decision-making, may affect long-term outcomes. Preventive strategies for optimal communication and inclusion in care are reviewed.: Many tools are available to assess the risk for and to diagnose postintensive care syndrome-family conditions during hospitalization and at intervals after discharge.: Visits after discharge, support groups, and clinics have been proposed for assessing the need for professional referrals as well as for treating family members when psychological illness persists. Studies evaluating these measures are reviewed.

Arch Gen Psychiatry. 2012 Feb; 69(2): 166-76
Shalev AY, Ankri Y, Israeli-Shalev Y, Peleg T, Adessky R, Freedman S

Preventing posttraumatic stress disorder (PTSD) is a pressing public health need.To compare early and delayed exposure-based, cognitive, and pharmacological interventions for preventing PTSD.Equipoise-stratified randomized controlled study.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Consecutively admitted survivors of traumatic events were assessed by use of structured telephone interviews a mean (SD) 9.61 (3.91) days after the traumatic event. Survivors with symptoms of acute stress disorder were referred for clinical assessment. Survivors who met PTSD symptom criteria during the clinical assessment were invited to receive treatment.Twelve weekly sessions of prolonged exposure (PE; n = 63), or cognitive therapy (CT; n = 40), or double blind treatment with 2 daily tablets of either escitalopram (10 mg) or placebo (selective serotonin reuptake inhibitor/placebo; n = 46), or 12 weeks in a waiting list group (n = 93). Treatment started a mean (SD) 29.8 (5.7) days after the traumatic event. Waiting list participants with PTSD after 12 weeks received PE a mean (SD) 151.8 (42.4) days after the traumatic event (delayed PE). Main Outcome Measure  Proportion of participants with PTSD after treatment, as determined by the use of the Clinician-Administered PTSD Scale (CAPS) 5 and 9 months after the traumatic event. Treatment assignment and attendance were concealed from the clinicians who used the CAPS.At 5 months, 21.6% of participants who received PE and 57.1% of comparable participants on the waiting list had PTSD (odds ratio [OR], 0.21 [95% CI, 0.09-0.46]). At 5 months, 20.0% of participants who received CT and 58.7% of comparable participants on the waiting list had PTSD (OR, 0.18 [CI, 0.06-0.48]). The PE group did not differ from the CT group with regard to PTSD outcome (OR, 0.87 [95% CI, 0.29-2.62]). The PTSD prevalence rates did not differ between the escitalopram and placebo subgroups (61.9% vs 55.6%; OR, 0.77 [95% CI, 0.21-2.77]). At 9 months, 20.8% of participants who received PE and 21.4% of participants on the waiting list had PTSD (OR, 1.04 [95% CI, 0.40-2.67]). Participants with partial PTSD before treatment onset did similarly well with and without treatment.Prolonged exposure, CT, and delayed PE effectively prevent chronic PTSD in recent survivors. The lack of improvement from treatment with escitalopram requires further evaluation. Trauma-focused clinical interventions have no added benefit to survivors with subthreshold PTSD symptoms. Trial Registration  clinicaltrials.gov Identifier: NCT00146900.

Gen Hosp Psychiatry. 2011 Nov; 33(6): 565-71
Ginzburg K, Ein-Dor T

This study examines the implications of acute stress disorder (ASD), following myocardial infraction (MI), in predicting subsequent posttraumatic stress disorder (PTSD) and impaired quality of life (QoL) 8 years post-MI.MI patients, who were assessed within a week of the MI (Time 1; n=173), were followed up 7 months (Time 2; n=116) and 8 years (Time 3; n=90) post-MI. ASD was assessed at Time 1 and PTSD at Time 2 and Time 3. Health-related QoL was assessed at Time 3.Unconditional latent class growth models revealed two distinct subpopulations: the recovered/resilient group (94%) demonstrated a decrease from 12.4% of ASD at Time 1 to 6.1% of PTSD at Time 3. Rates of posttraumatic stress syndromes in the chronic group (6%) were 85.3% at Time 1 and 75.7% at Time 3. The two groups differed in pre-MI life events, length of hospitalization, likelihood to have anterior MI, and perceived threat of death. The chronic group reported lower levels of QoL at Time 3.Although most ASD patients demonstrate a trend of recovery, ASD in the immediate aftermath of MI remains a marker of long term adjustment difficulties.

J Clin Psychol Med Settings. 2011 Dec; 18(4): 416-22
Cline GD, Schwartz DD, Axelrad ME, Anderson B

The primary aims of this exploratory study were to determine the rate of occurrence of acute stress disorder (ASD) in children newly diagnosed with Type 1 diabetes and their parents, to examine relationships with demographic and psychosocial factors, and to examine the relationships between ASD symptom clusters and early adherence behavior (clinic attendance). The sample consisted of 102 parents of children ages 0-17 years and 40 youth ages 11-17 who were evaluated within three days of diabetes diagnosis. Eighteen percent of parents and 17% of youth reported subthreshold symptoms of ASD. Acute stress symptoms and demographic variables predicted clinic attendance, with a differential pattern evident in the responses of youth and their parents. These findings reinforce the importance of screening symptoms of ASD in youth with newly diagnosed diabetes and their parents to assist in identifying families who may be in need of additional support.

Pediatr Crit Care Med. 2011 Sep 15;
Stowman S, Kearney CA, Daphtary K

OBJECTIVES:: Youths in a pediatric intensive care unit and their parents may experience initial symptoms of acute stress disorder and later symptoms of posttraumatic stress disorder. The objective of this study was to examine potential mediators of these conditions, including youth anxiety, depression, negative affect, and hospital fear, as well as parent anxiety and depression. DESIGN:: This study involved a short longitudinal design that encompassed initial assessments in a pediatric intensive care unit setting and later assessments 4-7 wks after discharge. SETTING:: Youths and their parents completed dependent measures in the hospital and at follow-up at the youth's home or an outpatient clinic setting. PATIENTS:: Fifty youths aged 9-17 yrs were admitted to a pediatric intensive care unit for respiratory illness/asthma (30.0%), trauma (26.0%), surgery and after surgery recovery (20.0%), infections/viral illness (8.0%), neurologic disorder (6.0%), or other (10.0%). Parents (n = 50) were also assessed. MEASUREMENTS AND MAIN RESULTS:: Measures were utilized for youth anxiety, acute stress, depression, negative affect, posttraumatic stress, and hospital fear, as well as parent anxiety, acute stress, depression, and posttraumatic stress. Some youths (26%) and parents (24%) had substantial posttraumatic stress disorder symptoms develop. Youth acute stress disorder symptoms in the pediatric intensive care unit predicted later youth posttraumatic stress disorder symptoms, parent acute stress disorder symptoms in the pediatric intensive care unit predicted later parent posttraumatic stress disorder symptoms, and youth acute stress disorder symptoms in the pediatric intensive care unit predicted later parent posttraumatic stress disorder symptoms. Youth anxiety, negative affect, and hospital fear mediated initial youth acute stress disorder symptoms and later youth posttraumatic stress disorder symptoms. CONCLUSIONS:: Youths in a pediatric intensive care unit are at increased risk for posttraumatic stress disorder and should be screened for acute stress disorder.

Depress Anxiety. 2011 Sep; 28(9): 802-17
Bryant RA, Friedman MJ, Spiegel D, Ursano R, Strain J

Acute stress disorder (ASD) was introduced into DSM-IV to describe acute stress reactions (ASRs) that occur in the initial month after exposure to a traumatic event and before the possibility of diagnosing posttraumatic stress disorder (PTSD), and to identify trauma survivors in the acute phase who are high risk for PTSD. This review considers ASD in relation to other diagnostic approaches to acute stress responses, critiques the evidence of the predictive power of ASD, and discusses ASD in relation to Adjustment Disorder. The evidence suggests that ASD does not adequately identify most people who develop PTSD. This review presents a number of options and preliminary considerations to be considered for DSM-5. It is proposed that ASD be limited to describing severe ASRs (that are not necessarily precursors of PTSD). The evidence suggests that the current emphasis on dissociation may be overly restrictive and does not recognize the heterogeneity of early posttraumatic stress responses. It is proposed that ASD may be better conceptualized as the severity of acute stress responses that does not require specific clusters to be present.

Biol Psychiatry. 2011 Dec 1; 70(11): 1055-62
Inslicht SS, Otte C, McCaslin SE, Apfel BA, Henn-Haase C, Metzler T, Yehuda R, Neylan TC, Marmar CR

The hypothalamic-pituitary-adrenal axis is a major stress response system hypothesized to be involved in the pathogenesis of posttraumatic stress disorder (PTSD). However, few studies have prospectively examined the relationships among pre-exposure hypothalamic-pituitary-adrenal activity, acute stress reactions and PTSD.Two hundred ninety-six police recruits were assessed during academy training before critical incident exposure and provided salivary cortisol at first awakening and after 30 minutes. A measure of cortisol awakening response (CAR) was computed as the change in cortisol level from the first to the second collection. At 12, 24, and 36 months following the start of active police service, officers were assessed for peritraumatic distress, peritraumatic dissociation, acute stress disorder (ASD) symptoms, and PTSD symptoms to their self-identified worst duty-related critical incident. Mixed models for repeated measures were used to analyze the effects of CAR on the outcome variables pooled across the three follow-up assessments.After controlling for time of awakening, first awakening cortisol levels, and cumulative critical incident stress exposure, CAR during academy training was associated with greater peritraumatic dissociation, β = .14, z = 3.49, p < .0001, and greater ASD symptoms during police service assessed at 12, 24, and 36 months, β = .09, Z = 2.03, p < .05, but not with peritraumatic distress, β = .03, z = .81, p = .42, or PTSD symptoms, β = -.004, z = -.09, p = .93.These findings suggest that greater cortisol response to awakening is a pre-exposure risk factor for peritraumatic dissociation and ASD symptoms during police service.

Arch Gen Psychiatry. 2012 Jan; 69(1): 89-97
Mercer KB, Orcutt HK, Quinn JF, Fitzgerald CA, Conneely KN, Barfield RT, Gillespie CF, Ressler KJ

The serotonin transporter (SLC6A4) has been associated with several stress-related syndromes including posttraumatic stress disorder (PTSD). The ability to detect meaningful associations is largely dependent on reliable measures of preexisting trauma.To study the association of genetic variants within SLC6A4 with acute and posttraumatic stress symptoms in a civilian cohort with known levels of preexisting trauma and PTSD symptoms collected prior to a shared index traumatic event.Ongoing longitudinal study.On February 14, 2008, a lone gunman shot multiple people on the campus of Northern Illinois University in DeKalb, Illinois, killing 5 and wounding 21. As part of an ongoing longitudinal study on that campus, a cohort of female undergraduate students, interviewed prior to the shooting, completed follow-up trauma-related measures including PTSD symptom severity (follow-up survey was launched 17 days postshooting; n = 691). To obtain DNA, salivary samples were collected from a subset of the original study population based on willingness to participate (n = 276).Two hundred four undergraduate women.SLC6A4 polymorphisms STin2, 5-HTTLPR, and rs25531 were genotyped in 235 individuals.We found that although the STin2 variant and 5-HTTLPR alone did not associate with increased PTSD symptoms, rs25531 and the 5-HTTLPR multimarker genotype (combined 5-HTTLPR and rs25531) were associated with significantly increased acute stress disorder symptoms at 2 to 4 weeks postshooting (n = 161; P 

Z Kinder Jugendpsychiatr Psychother. 2011 Sep; 39(5): 323-40
Tagay S, Düllmann S, Hermans E, Repic N, Hiller R, Senf W

In light of the clinical and scientific relevance of traumatic events and posttraumatic disorders our study aimed to develop and validate the Essen Trauma-Inventory for Children and Adolescents (ETI-CA). The new instrument should assess various aspects of traumatic events and both posttraumatic disorders, namely Posttraumatic Stress Disorder and Acute Stress Disorder according to the criteria provided in DSM-IV.ETI-CA was administered to a sample consisting of 276 children and adolescents aged between 12 and 17 years with regard to psychometric properties on clinical and non-clinical groups.The ETI-CA subscales as well as the total score proved to have high internal consistency. The 4-factorial structure (intrusion, avoidance, hyperarousal, dissociation) was in line with the theoretical assumptions. Associations between ETI-CA and other trauma instruments as well as instruments for psychological distress and protective factors provided empirical evidence for the construct validity of ETI-CA.In German-speaking regions, the ETI-CA represents the first economic, reliable and valid screening instrument that assesses exposure to a broad range of potential traumatic events as well as posttraumatic disorders. The ETI-CA can be recommended for use in research as well as in clinical settings.

AIDS Care. 2011 Nov; 23(11): 1351-9
Soller M, Kharrazi N, Prentiss D, Cummings S, Balmas G, Koopman C, Israelski D

HIV-infected individuals face a tremendous burden of psychiatric comorbidity. This study evaluates a community health care system's effort to screen for psychiatric disorders among patients at an HIV clinic and evaluate adherence to psychiatric service utilization.Standardized screening measures were used to identify participants who met diagnostic symptom criteria for post-traumatic stress disorder (PTSD), acute stress disorder (ASD) and depression. All participants who screened positive were referred for psychiatric follow-up. Rates of utilization were measured and barriers to adherence were investigated.Of the 210 participants, 118 patients met screening criteria for PTSD, ASD, and/or depression, and 116 of these had medical records available for review. Of the 116 patients with psychiatric comorbidity, 46.6% saw a psychiatrist and/or were prescribed a psychiatric medication. Thirty-two percent of Latinos, 40.5% of African Americans, and 38.5% of heterosexuals utilized referred psychiatric services, and these rates were significantly less than their counterparts. One hundred patients were seen by a social worker.While a large burden of psychiatric comorbidity exists among this population of HIV-positive patients, only half adhered to recommended psychiatric services referrals. Further research is warranted to examine cost-effective interventions to maximize psychiatric screening, referral, and follow-up with mental health services in this vulnerable population.

Psychol Med. 2012 Jan; 42(1): 173-81
Kleim B, Ehring T, Ehlers A

Intrusive re-experiencing in post-traumatic stress disorder (PTSD) comprises distressing sensory impressions from the trauma that seem to occur 'out of the blue'. A key question is how intrusions are triggered. One possibility is that PTSD is characterized by a processing advantage for stimuli that resemble those that accompanied the trauma, which would lead to increased detection of such cues in the environment.We used a blurred picture identification task in a cross-sectional (n=99) and a prospective study (n=221) of trauma survivors.Participants with acute stress disorder (ASD) or PTSD, but not trauma survivors without these disorders, identified trauma-related pictures, but not general threat pictures, better than neutral pictures. There were no group differences in the rate of trauma-related answers to other picture categories. The relative processing advantage for trauma-related pictures correlated with re-experiencing and dissociation, and predicted PTSD at follow-up.A perceptual processing bias for trauma-related stimuli may contribute to the involuntary triggering of intrusive trauma memories in PTSD.

Psychiatr Serv. 2011 Jul; 62(7): 765-73
Shalev AY, Ankri YL, Peleg T, Israeli-Shalev Y, Freedman S

Preventing posttraumatic stress disorder (PTSD) is a pressing public health need. Studies have shown significant barriers to obtaining early care. This study prospectively evaluated the acceptance of early assessment and treatment, the accuracy of recommending care, and the consequences of declining it.Researchers undertook systematic outreach to survivors of traumatic events consecutively seen in a general hospital emergency department. Structured telephone interviews were conducted 9.5±3.2 days after the emergency visit. Persons with acute stress disorder symptoms were invited for clinical assessment. Those clinically assessed as having acute PTSD symptoms were offered treatment. Telephone interviews, conducted 224.9±39.1 days from the traumatic event, evaluated those included in the initial assessment and a random sample of 10% of those not included because they were deemed not to have experienced a traumatic event.Telephone calls were made to 5,286 individuals, and 5,053 were reached (96%). Of these, 4,743 (94%) agreed to a telephone interview, 1,502 were invited for a clinical assessment, 756 (50%) attended the assessment, 397 were eligible for treatment, and 296 (75%) started treatment. Declining clinical assessments and treatment were associated with less symptom reduction over time. The prevalence of PTSD among those deemed not to have experienced a traumatic event, not to need clinical assessment, and not to need treatment were, respectively, 4%, 11%, and 3%.Despite successful outreach, many symptomatic participants declined clinical care and subsequently recovered less well. Screening for DSM-IV PTSD criterion A effectively identified survivors at low risk for PTSD. Systematic outreach is costly and might be reserved for exceptionally traumatic events.

Support Care Cancer. 2011 Jun 30;
Goebel S, Strenge H, Mehdorn HM

PURPOSE: This study investigated whether diagnosis and neurosurgical removal of a brain tumour induced Acute Stress Disorder (ASD) in adults. We also aimed to identify factors associated with the development of ASD in this specific patient group and setting. METHODS: Forty-seven consecutive patients with intracranial neoplasms completed a variety of self-report questionnaires and underwent a structured clinical interview (SCID) within the first 4 weeks after tumour detection on average 1 week after neurosurgical treatment. Moreover, the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), A1 and A2 criterion and thus the characteristics of the traumatic event were explored in detail. RESULTS: ASD symptoms were common. Twenty-three percent of the patients met stringent criteria of ASD and another 4% suffered from subsyndromal ASD. Predisposing factors previously reported in literature with the exception of previous trauma could not be identified in this study (e.g., sex, age, intelligence). CONCLUSION: It has been critically discussed whether the diagnosis of ASD is appropriate in cancer patients due to the often future-related nature of cancer-related traumatic events. The diagnosis of ASD was justified in the vast majority of affected patients due to the specific, acute and past traumatic experiences in concordance with the DSM and International Statistical Classification of Diseases and Related Health Problems (ICD) trauma definitions. Thus, ASD is a common and relevant psychiatric comorbidity in patients with brain tumours. Our data highlight both the need for the routine psychological assessment as well as of psychosocial support in this early treatment phase.

Stud Health Technol Inform. 2011; 167: 194-8
Kozarić-Kovačić D, Jambrošić-Sakoman A, Jovanovic T

The aim of this study is to prospectively examine electromyographic (EMG) responses in patients diagnosed with acute stress disorder (ASD) after experiencing a traffic accident or violent attack, within one month after the traumatic event and six months later. Half of the participants met criteria for posttraumatic stress disorder (PTSD) after six months. Psychophysiological parameters can provide a better clarification between ASD and PTSD patients. Heightened startle magnitude in the immediate aftermath of trauma may be a good predictor of PTSD; moreover, a lack of startle habituation appears to be a more stable marker of PTSD, which persists for six months after trauma exposure.

Depress Anxiety. 2011 Sep; 28(9): 737-49
Friedman MJ, Resick PA, Bryant RA, Strain J, Horowitz M, Spiegel D

This review examines the question of whether there should be a cluster of disorders, including the adjustment disorders (ADs), acute stress disorder (ASD), posttraumatic stress disorder (PTSD), and the dissociative disorders (DDs), in a section devoted to abnormal responses to stress and trauma in the DSM-5. Environmental risk factors, including the individual's developmental experience, would thus become a major diagnostic consideration. The relationship of these disorders to one another is examined and also their relationship to other anxiety disorders to determine whether they are better grouped with anxiety disorders or a new specific grouping of trauma and stressor-related disorders. First how stress responses have been classified since DSM-III is reviewed. The major focus is on PTSD because it has received the most attention, regarding its proper placement among the psychiatric diagnoses. It is discussed whether PTSD should be considered an anxiety disorder, a stress-induced fear circuitry disorder, an internalizing disorder, or a trauma and stressor-related disorder. Then, ASD, AD, and DD are considered from a similar perspective. Evidence is examined pro and con, and a conclsion is offered recommending inclusion of this cluster of disorders in a section entitled "Trauma and Stressor-Related Disorders." The recommendation to shift ASD and PTSD out of the anxiety disorders section reflects increased recognition of trauma as a precipitant, emphasizing common etiology over common phenomenology. Similar considerations are addressed with regard to AD and DD.

J Trauma. 2011 Apr; 70(4): 923-30
Han PP, Holbrook TL, Sise MJ, Sack DI, Sise CB, Hoyt DB, Coimbra R, Potenza B, Anderson JP

Little is known about the impact of postinjury depression after major trauma in adolescents. A prospective epidemiologic study was conducted to examine depression in injured adolescents. Specific objectives of this report are to identify risk factors for depression onset and the impact of depression on quality of life (QoL) outcomes.Four hundred one trauma patients were enrolled in this study (age, 12-19 years; injury severity score [ISS] ≥4). Depression diagnosis was based on the Children's Depression Inventory. QoL outcomes were measured using the Quality of Well-being Scale at 3-, 6-, 12-, 18-, and 24-month follow-up.Depression at discharge was diagnosed in 41% of 399 adolescent trauma survivors with complete Children's Depression Inventory data. Multivariate logistic regression identified ISS, >3 body regions injured, low socioeconomic status, family members injured at the scene, and suicidal ideology or attempted suicide before injury as strong and independent predictors of depression risk. ISS and three or more body regions injured predicted depression risk. Patients with severe injury (ISS ≥17) were twice more likely to have depressive symptoms than patients with moderate injury (ISS

Int Marit Health. 2011; 62(1): 77-81
Korzeniewski K, Pieniuta S

This article presents the results of the authors' own studies concerning the evacuation of Polish soldiers serving in the Centre South Zone in Iraq during the Iraqi Freedom Operation.Analysis was based on the medical and personnel documents of 4800 soldiers of the Multinational Division Centre South in the period August 2003-July 2004.Medical evacuations and rotations at the soldier's own request dominated in the analysed period in the group. The main reasons for medical evacuation (67 persons) were psychiatric disorders (acute stress disorder) requiring pharmacological treatment, followed by battle injuries (gunshot/shrapnel wounds), and non-battle injuries (sports injuries, traffic accidents). Evacuations at the soldier's own request (47 persons) were dominated by non-medical adaptation disorders and family-related problems.Polish soldiers evacuated to their home country before the scheduled termination of duty accounted for 2.5% of the total number of military personnel assigned to Iraq in the analysed period.