The Mental Cure - Complete & Unabridged

Books by Warren Felt Evans

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Recent research on contextually based third-generation behavior therapies suggests that they may produce results comparable to some of the better validated therapies. Exposure therapy is a type of cognitive behavioral therapy [] that involves assisting trauma survivors to re-experience distressing trauma-related memories and reminders in order to facilitate habituation and successful emotional processing of the trauma memory. Most exposure therapy programs include both imaginal confrontation with the traumatic memories and real-life exposure to trauma reminders; this therapy modality is well supported by clinical evidence.

Department of Veterans Affairs has been actively training mental health treatment staff in prolonged exposure therapy [] and Cognitive Processing Therapy [] in an effort to better treat U. Eye movement desensitization and reprocessing EMDR is a form of psychotherapy developed and studied by Francine Shapiro. When she brought her eye movements under control while thinking, the thoughts were less distressing. In , Shapiro and Maxfield published a theory of why this might work, called adaptive information processing.

There have been multiple small controlled trials of four to eight weeks of EMDR in adults [] as well as children and adolescents. The eye movement component of the therapy may not be critical for benefit. Secondly we found that that in laboratory studies the evidence concludes that thinking of upsetting memories and simultaneously doing a task that facilitates eye movements reduces the vividness and distress associated with the upsetting memories. Other approaches, in particular involving social supports, [] [] may also be important.

An open trial of interpersonal psychotherapy [] reported high rates of remission from PTSD symptoms without using exposure. While many medications do not have enough evidence to support their use, three fluoxetine, paroxetine, and venlafaxine have been shown to have a small benefit over placebo. For those who already have PTSD, benzodiazepines may worsen and prolong the course of illness, by worsening psychotherapy outcomes, and causing or exacerbating aggression, depression including suicidality , and substance use.

Glucocorticoids may be useful for short-term therapy to protect against neurodegeneration caused by the extended stress response that characterizes PTSD, but long-term use may actually promote neurodegeneration. Evidence as of is insufficient to determine if medical cannabis is useful for PTSD. The cannabinoid nabilone is sometimes used off-label for nightmares in PTSD. Although some short-term benefit was shown, adverse effects are common and it has not been adequately studied to determine efficacy.

The use of medical marijuana for PTSD is controversial, with only a handful of states permitting its use for that purpose. Physical activity can influence people's psychological [] and physical health. National Center for PTSD recommends moderate exercise as a way to distract from disturbing emotions, build self-esteem and increase feelings of being in control again. They recommend a discussion with a doctor before starting an exercise program.

Play is thought to help children link their inner thoughts with their outer world, connecting real experiences with abstract thought. Many veterans of the wars in Iraq and Afghanistan have faced significant physical, emotional, and relational disruptions. In response, the United States Marine Corps has instituted programs to assist them in re-adjusting to civilian life, especially in their relationships with spouses and loved ones, to help them communicate better and understand what the other has gone through. There is debate over the rates of PTSD found in populations, but, despite changes in diagnosis and the criteria used to define PTSD between and , epidemiological rates have not changed significantly.

The most frequently reported traumatic events by men are rape, combat, and childhood neglect or physical abuse. Women most frequently report instances of rape, sexual molestation, physical attack, being threatened with a weapon and childhood physical abuse. Four out of five reported recent symptoms when interviewed 20—25 years after Vietnam. A study from Georgia State University and San Diego State University found that rates of PTSD diagnosis increased significantly when troops were stationed in combat zones, had tours of longer than a year, experienced combat, or were injured.

Military personnel serving in combat zones were Those serving more than 12 months in a combat zone were Experiencing an enemy firefight was associated a The September 11 attacks took the lives of nearly 3, people, leaving 6, injured. The prevalence of probable PTSD in these highly exposed populations was estimated across multiple studies utilizing in-person, telephone, and online interviews and questionnaires. However, disparities were found among the different types of recovery workers. Alcohol consumption was assessed in a cohort of World Trade Center workers using the cut-annoyed-guilty-eye CAGE questionnaire for alcohol abuse.

Defined by the disruption of family, work, and social life, the risk of developing social disability increased fold when categorized as having probable PTSD. The United States provides a range of benefits for veterans that the VA has determined have PTSD, which developed during, or as a result of, their military service. These benefits may include tax-free cash payments, [] free or low-cost mental health treatment and other healthcare, [] vocational rehabilitation services, [] employment assistance, [] and independent living support. In the UK, there are various charities and service organisations dedicated to aiding veterans in readjusting to civilian life.

The Royal British Legion and the more recently established Help for Heroes are two of Britain's more high-profile veterans' organisations which have actively advocated for veterans over the years. There has been some controversy that the NHS has not done enough in tackling mental health issues and is instead "dumping" veterans on charities such as Combat Stress. Veterans Affairs Canada offers a new program that includes rehabilitation, financial benefits, job placement, health benefits program, disability awards, peer support [] [] [] and family support.

The edition of the DSM-I includes a diagnosis of "gross stress reaction", which has similarities to the modern definition and understanding of PTSD. Early in , the term was used in a working group finding presented to the Committee of Reactive Disorders. In a similar vein, psychiatrist Jonathan Shay has proposed that Lady Percy 's soliloquy in the William Shakespeare play Henry IV, Part 1 act 2, scene 3, lines 40—62 [] , written around , represents an unusually accurate description of the symptom constellation of PTSD.

A study based on personal letters from soldiers of the 18th-century Prussian Army concludes that combatants may have had PTSD. These Assyrian soldiers would undergo a three-year rotation of combat before being allowed to return home, and were purported to have faced immense challenges in reconciling their past actions in war with their civilian lives. This is misleading when it comes to understanding the implications and extent of PTSD as a neurological disorder. Dating back to the definition of Gross stress reaction in the DSM-I, civilian experience of catastrophic or high stress events is included as a cause of PTSD in medical literature.

The National Comorbidity Survey reports that "the traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. However, triers of fact judges and juries often regarded the PTSD diagnostic criteria as imprecise, a view shared by legal scholars, trauma specialists, forensic psychologists , and forensic psychiatrists.

Cretinism: The past, present and future of diagnosis and cure

Professional discussions and debates in academic journals, at conferences, and between thought leaders, led to a more clearly-defined set of diagnostic criteria in DSM-IV, particularly the definition of a "traumatic event". The Diagnostic and Statistical Manual of Mental Disorders does not hyphenate 'post' and 'traumatic', thus, the DSM-5 lists the disorder as posttraumatic stress disorder.

However, many scientific journal articles and other scholarly publications do hyphenate the name of the disorder, viz. Most knowledge regarding PTSD comes from studies in high-income countries. In this study, PTSD animals demonstrated recall of traumatic memories, anxiety, and an impaired social behavior, while animals subject to both mTBI and PTSD had a pattern of disinhibitory-like behavior. In comparison with other animal studies, [] [] examination of neuroendocrine and neuroimmune responses in plasma revealed a trend toward increase in corticosterone in PTSD and combination groups.

MDMA was used for psychedelic therapy for a variety of indications before its criminalization in the U. In response to its criminalization, the Multidisciplinary Association for Psychedelic Studies was founded as a nonprofit drug-development organization to develop MDMA into a legal prescription drug for use as an adjunct in psychotherapy.

In this treatment, people participate in an extended psychotherapy session during the acute activity of the drug, and then spend the night at the treatment facility. In the sessions with the drug, therapists are not directive and support the patients in exploring their inner experiences. People participate in standard psychotherapy sessions before the drug-assisted sessions, as well as after the drug-assisted psychotherapy to help them integrate their experiences with the drug.

Research is also investigating using D-cycloserine , hydrocortisone , and propranolol as add on therapy to more conventional exposure therapy. From Wikipedia, the free encyclopedia. For other uses, see PTSD disambiguation. For the album, see Post Traumatic. Veteran and Refugee health. Childbirth-related posttraumatic stress disorder. Genetics of posttraumatic stress disorder. For one such method, see trauma risk management. Treatments for combat-related PTSD.

Eye movement desensitization and reprocessing. Diagnostic and Statistical Manual of Mental Disorders 5th ed. BMJ Clinical research ed. National Institute of Mental Health. Archived from the original on 9 March Retrieved 10 March American Psychiatric Association 5th ed.

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Social Psychiatry and Psychiatric Epidemiology. A search for clarity in a conflicting literature". Neuroscience and Biobehavioral Reviews. Gaskell Royal College of Psychiatrists. Archived from the original on Lay summary — Pubmed Health plain English.

Medical treatment - definition of Medical treatment by The Free Dictionary

The Cochrane Database of Systematic Reviews 7: A Systematic Review and Meta-Analysis". Journal of Psychiatric Practice. Clinical child psychiatry 3. Chichester, West Sussex, UK: Journal of Traumatic Stress. Diagnostic and statistical manual of mental disorders: The Psychophysiology of Trauma and Trauma Treatment. Kaplan and Sadock's synopsis of psychiatry: Behavioral sciences, clinical psychiatry 7th ed. A Report of the Surgeon General.

Surgeon General of the United States. J R Soc Med. The Behavior Analyst Today. Archived from the original PDF on 23 June Proceedings of the National Academy of Sciences. Clinical Features, Pathophysiology, and Treatment". The American Journal of Medicine. Massachusetts General Hospital comprehensive clinical psychiatry. European Journal of Psychotraumatology. The British Journal of Psychiatry. International journal of adolescent medicine and health. New pathways and new thinking". A developmental perspective on risk-modifying factors".

Toward a New Psychology of Trauma. Williams Gynecology 3rd ed. Archived PDF from the original on The New England Journal of Medicine. A meta-analysis of psychological consequences and their moderators". Cross-national findings from the world mental health surveys". A multiple mediation model". Dialogues in Clinical Neuroscience. Archives of Women's Mental Health. J Psychosom Obstet Gynaecol.

Journal de gynecologie, obstetrique et biologie de la reproduction. American Journal of Psychiatry. Current Opinion in Psychiatry. J Nerv Ment Dis. Progress in Brain Research. Neuroplasticity epigenetics and endophenotypes". National Institutes of Health. Expert Review of Neurotherapeutics. The American Journal of Psychiatry. Neurobiology of Mental Illness 5th ed. Physiology of Behavior 9 ed. Journal of Affective Disorders. Development and initial psychometric evaluation".

International Society for Traumatic Stress Studies. Journal of Clinical Child Psychology. Retrieved 8 April A syndrome in survivors of prolonged and repeated trauma". Trauma and Recovery 2nd ed. A field study of the impact of debriefing". Three-year follow-up of a randomised controlled trial".

The Cochrane Database of Systematic Reviews 3: The Cochrane Database of Systematic Reviews. The Cochrane Database of Systematic Reviews 2: Society of Clinical Psychology: Division 12 of The American Psychological Association. Retrieved 9 September Retrieved 4 October Advances in the Treatment of Posttraumatic Stress Disorder: Department of Veterans Affairs.

by Patricia Carlisle

Archived from the original on December 1, Defense Centers of Excellence. Archived from the original on November 30, International Journal of Behavioral Consultation and Therapy. Journal of Behavior Analysis of Offender and Victim: Archived from the original PDF on Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence.

Department of Veteran Affairs. Journal of clinical psychology. Department of Veterans Affairs, Department of Defense.

Archived from the original on 30 May Retrieved 2 June Cochrane Database Syst Rev. Behavioural and cognitive psychotherapy. J Consult Clin Psychol. Review with clinical applications" PDF.

The Journal of Rehabilitation Research and Development. Archived PDF from the original on 4 March Retrieved 26 November While evidence-based, trauma-focused psychotherapy is the preferred treatment for PTSD, pharmacotherapy is also an important treatment option. First-line pharmacotherapy agents include selective serotonin reuptake inhibitors and the selective serotonin-norepinephrine reuptake inhibitor venlafaxine.

Archived from the original on 17 December The cumulative evidence summarized in this review indicates that pharmacotherapy significantly reduces PTSD, anxiety, and depressive symptom severity among combat veterans with PTSD. Focus on pharmacological treatment" PDF. Prog Neuropsychopharmacol Biol Psychiatry.

Posttraumatic stress disorder

F, published by Epocrates. Annals of Internal Medicine. A Review of the Clinical Effectiveness and Safety". Goitre is a disease which, when once acquired and not cured, can be transmitted even to the third and fourth generation of posterity, therefore people with this disease should not be permitted to indulge in parenthood. Understanding the pathogenesis of congenital hypothyroidism has led to prevention, treatment and proper counselling.

Congenital hypothyroidism due to other causes occurs in one of live births. Before the introduction of neonatal screening, the diagnosis was often delayed until the second or third month of life, although greater delays in recognition were not unusual. Brain development is absolutely dependent on normal thyroid hormone levels. The fetus and the infant are neurologically vulnerable due to the incomplete brain development in humans at birth. A progressive intellectual deterioration occurs with each passing week in the absence of appropriate thyroxine replacement.

Severe developmental and physical delays occur by six months of age. Treatment in infancy will reverse the physical changes, but not the neurological damage. Dr Jean Dussault 4 , in the s, then a young investigator from Quebec, saw some colleagues using filter paper spots to screen for phenylketonuria and tyrosinemia. He decided to see if thyroxine could be assayed from the same neonatal filter paper heel prick blood collection spots.

He was enormously successful, and published the first report of preliminary mass screening in 5. He is credited with initiating what is now accepted as standard practice at birth as a means of the prevention of mental retardation secondary to congenital hypothyroidism 4. If congenital hypothyroidism is recognized at birth and treated immediately there is a very favourable therapeutic outcome. Many screening programs now use thyroid stimulating hormone eluted from the filter paper blood spots, but the principle is the same. Fortunately, in the clinic, we can no longer demonstrate to students the classic clinical signs of cretinism that were known to every paediatrician in the years before the onset of thyroid screening.

A small percentage of cases can be attributed to the transplacental passage of maternal blocking antibodies from mothers with autoimmune thyroiditis. The explosion of research in genetics and molecular endocrinology has given us some understanding of the factors controlling morphogenesis and migration of the thyroid in fetal life to the normal position in the anterior neck.

A few defects are now known to be due to errors in fetal transcription factors controlling descent and configuration of the thyroid. Future research will complete our understanding of the development of the gland and thyroid hormone production 6 , 7.

The tablets are sweet, and the taste is not unpleasant. In the past, the onset of treatment was often delayed longer than the current standard of 11 to 15 days, and the dose of thyroxine was lower 8. Normal short term developmental outcomes in even severely affected infants have recently been reported, with the early initiation of thyroxine at a dose of 9.

However, modifications in treatment recommendations may still be needed after further long term outcome analyses of screening and treatment schedules 8. Modern early discharge practices present a challenge, because the physiological surge of thyroid stimulating hormone in the first 24 h can cause false positive results, necessitating a recall of the infant for testing if the blood spot is taken too early. There are logistical difficulties with screening infants after discharge or following home birth, and these special situations need a careful solution. The neonatal diagnosis and treatment of congenital hypothyroidism prevents severe intellectual delay, a significant contribution by many in the past century.

The present century must address the needs of the millions of infants in nonaffluent parts of the world where congenital hypothyroidism of all etiologies, including iodine deficiency, is still a major health problem. Sometimes parents, physicians and the general public forget or take for granted how far paediatric medicine has come, particularly in areas such as childhood immunization and infectious diseases. Canadians need to remember the legacy of the gifts of health and longevity given to us by previous generations of physicians and scientists.

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