Which of the following is the most effective treatment modality for Post-Traumatic Stress Disorder (PTSD)?
Ans. a. Cognitive behavioral therapyPost Traumatic Stress Disorder (PTSD)It is an intense, prolonged and sometimes protracted or delayed response to exceptionally intense stressful eventse.Etiology:Events involving actual or threatened serious injury or death of the person or otherNatural disasters, man made calamities and serious physical assault or rapePredisposing Factors for PTSDFemale genderQ neuroticismPrevious history of traumaLower intelligence and lack of suppoQPersonal history of mood and anxiety disorderQNeurobiological Factors:Monoamine neurotransmitters and HPA axis mediate defensive response to stressful eventsSmall hippocampus leads to dysfunctional and inadequate memory processing while increased noradrenergic activity of amygdala, increases arousal and facilitates automatic recall and encoding of traumatic events.Clinical Presentation:May begin very soon after stressors or after an interval of days (usually), months (occasionally) or rarely more than 6 months.Symptoms must be present for at least 1 month, until then it is called acute stress disorder.Must leads to significant distress or impaired social functioning.Flash backs, nightmares and intrusive images collectively known, as painful re-experiencing symptoms along with avoidance, emotional numbing and fairly constant hyper arousal are most characteristic feature.Treatment:Structured psychotherapy is more effective than drug treatments.Counseling is TOC for sho term PTSDQCognitive behaviour therapy is TOC for severe long standing PTSDQDrug treatment: Antidepressants and benzodiazepines (in low doses for sho periods) are useful in treatment, if anxiety and/or depression are impoant components of the clinical picture.Rational and Enotive TherapyIt is a specialized type of CBT, proved to be useful for PTSD.Eye movement desensitization and reprocessing (EMDR)Relatively new treatment, found to reduce the symptoms of PTSD. EMDR involves making side- to-side eye movements, usually by follow?ing the movement of therapist's finger, while recalling the traumatic
Cognitive behavioral therapy
Eye movement desensitization and reprocessing
Hypnosis
Rational and emotive therapy