Dan J. Stein - Post-traumatic Stress Disorder

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Library of Congress Cataloging-in-Publication Data

Post-traumatic stress disorder / [edited by] Dan Stein, Matthew Friedman, and Carlos Blanco.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-470-68897-7 (cloth)

1. Post-traumatic stress disorder. I. Stein, Dan J. II. Friedman, Matthew J. III. Blanco, Carlos, 1962

[DNLM: 1. Stress Disorders, Post-Traumatic. WM 172]

RC552.P67P6616 2011

616.8521dc23

2011014924

A catalogue record for this book is available from the British Library.

This book is published in the following electronic format: ePDF 9781119998488; Wiley Online Library: 9781119998471; ePub 9781119971481; Mobi 9781119971498

Preface

Post-traumatic stress disorder (PTSD) is arguably the most controversial of all the psychiatric diagnoses. There are disagreements about the qualifying events that count as sufficiently traumatic to precipitate PTSD, disagreements about the nature of the typical symptoms that follow exposure to trauma, disagreements about how best to prevent and treat PTSD, and disagreements about what kind of compensation is owed to people with PTSD by society.

At the same time, there have been major advances in our understanding of many aspects of PTSD. The diagnostic classifications of both the World Health Organization (WHO) and the American Psychiatric Association (APA) include the same broad symptom categories (e.g. re-experiencing, avoidance/numbing and arousal) and emphasise that exposure to extremely stressful events can produce profound alterations in cognitions, emotions and behaviour that may persist for decades or a lifetime.

There is also a growing appreciation of the public health burden of PTSD. Trauma continues to be a pervasive aspect of life in the 21st century, in high-, middle- and low-income countries [1]. Furthermore, PTSD and other trauma-related disorders are highly prevalent and disabling, are often associated with other psychiatric and medical disorders, and lead to significant costs for society [2, 3].

We are gradually advancing our scientific understanding of how exposure to traumatic events can produce neurobiological and psychological alterations which, if untreated, may persist indefinitely [4]. Furthermore, although there is not complete consensus across different clinical guidelines [5], there is general agreement that cognitive behaviour therapy and certain medications are the most effective clinical approaches for PTSD.