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Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (CPTSD)

Experiencing frightening or traumatic events can result in a wide range of difficult symptoms: some people may become very anxious, whereas others may experience depression. For the first month following a traumatic event experiences of heightened vigilance and avoidance are so common as to be almost expected. Repeated experiences of neglect or abuse have been linked with the development of a wide range of mental health conditions including anxiety and mood disorders, psychosis, and personality disorders. Post-traumatic stress disorder (PTSD) is one common sequelae of trauma. Patients with PTSD experience unwanted memories of the traumatic event in the form of flashbacks or nightmares, and they report higher levels of anxiety, and vigilance. Reminders of the trauma often act as triggers for intrusive memories or heightened emotion and are frequently avoided. Individuals who have experienced repeated, prolonged interpersonal trauma may develop complex post-traumatic stress disorder (CPTSD) which is characterized by the symptoms of PTSD as well as alterations in attention (such as dissociation), difficulties in managing relationships, and very strong negative beliefs about the self, world, or future. Read more

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Post-Traumatic Stress Disorder (PTSD) and Complex Post-Traumatic Stress Disorder (CPTSD)

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Grounding Techniques Menu

Dissociation can be described as a shift of a person’s attention away from the present moment. When working with traumatized clients, this shift oft ... https://www.psychologytools.com/resource/grounding-techniques-menu

Fight Or Flight Response

The fight or flight response is an automatic physiological reaction to an event that is perceived as stressful or frightening. The perception of threa ... https://www.psychologytools.com/resource/fight-or-flight-response

Failure To Achieve

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/failure-to-achieve

Therapy Blueprint (Universal)

A therapy blueprint is CBT tool which summarizes the work a therapist and patient have completed together. It represents the past (the problems, what ... https://www.psychologytools.com/resource/therapy-blueprint-universal

Grounding Techniques

Individuals who have experienced trama often find it difficult to stay within the 'window of tolerance'. Grounding techniques (which can be sensory/pe ... https://www.psychologytools.com/resource/grounding-techniques

Before I Blame Myself And Feel Guilty

Guilt is a common post-traumatic reaction and is often the result of cognitive bias. This CBT worksheet explores common cognitive biases that have bee ... https://www.psychologytools.com/resource/before-i-blame-myself-and-feel-guilty

Emotional Deprivation

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/emotional-deprivation

Behavioral Experiment

Behavioral experiments are planned experiential activities to test the validity of a belief. They are one of the most powerful techniques available to ... https://www.psychologytools.com/resource/behavioral-experiment

Responses To Threat: Freeze, Appease, Flight, Fight

Human beings are programmed to respond automatically in a variety of ways to a threat including freezing, escaping, and dissociation. Traumatized indi ... https://www.psychologytools.com/resource/responses-to-threat-freeze-appease-flight-fight

How Trauma Can Affect You (CYP)

Trauma can result in a wide variety of symptoms, experiences, and behaviors. As well as post-traumatic stress disorder (PTSD), prevalence rates of oth ... https://www.psychologytools.com/resource/how-trauma-can-affect-you-cyp

Behavioral Experiment (Portrait Format)

Behavioral experiments allow individuals to test the validity of their beliefs and assumptions. They are a core experiential technique for therapeutic ... https://www.psychologytools.com/resource/behavioral-experiment-portrait-format

Dependence / Incompetence

Schema therapy posits that psychological difficulties stem from early maladaptive schemas (EMS) and clients’ characteristic responses to them, refer ... https://www.psychologytools.com/resource/dependence-incompetence

Self-Blame

The Self-Blame information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively wi ... https://www.psychologytools.com/resource/self-blame

Reactions To Trauma

Traumatic events are shocking and it is normal to feel overwhelmed. Not everybody reacts in the same way though and there is no ‘right’ way to res ... https://www.psychologytools.com/resource/reactions-to-trauma

Properties Of Trauma Memories

Important properties of trauma memories include involuntary recall, 'nowness', vividness, and immutability. People who have experienced trauma report ... https://www.psychologytools.com/resource/properties-of-trauma-memories

Catastrophizing

The Catastrophizing information handout forms part of the cognitive distortions series. It is designed to help clients and therapists to work more eff ... https://www.psychologytools.com/resource/catastrophizing

Habituation

The Habituation information sheets are designed to help clinicians to explain the concept of habituation and its role in exposure therapy. The handout ... https://www.psychologytools.com/resource/habituation

Responsibility Pie Chart

The Responsibility Pie Chart exercise is designed to guide clients through the process of clarifying and re-evaluating their responsibility for negati ... https://www.psychologytools.com/resource/responsibility-pie-chart

PTSD And Memory

Alterations in the way the brain processes 'normal' vs. 'traumatic' material are thought to be responsible for the intrusive nature of memories in con ... https://www.psychologytools.com/resource/ptsd-and-memory

Autonomic Nervous System

The autonomic nervous system (ANS) automatically regulates the function of body systems outside of voluntary control. The Autonomic Nervous System han ... https://www.psychologytools.com/resource/autonomic-nervous-system

Nightmare Exposure And Rescripting

Imagery rescripting is an effective treatment for intrusive and unwanted memories. Nightmare Exposure And Rescripting employs similar techniques and c ... https://www.psychologytools.com/resource/nightmare-exposure-and-rescripting

Social Comparison

The Social Comparison information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effecti ... https://www.psychologytools.com/resource/social-comparison

PTSD Linen Cupboard Metaphor

Treatment for trauma often involves exposure to traumatic thoughts and memories, and many clients are understandably reluctant to attempt this. The PT ... https://www.psychologytools.com/resource/ptsd-linen-cupboard-metaphor

Understanding Post-Traumatic Stress Disorder (PTSD)

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-post-traumatic-stress-disorder-ptsd

Progressive Muscle Relaxation (Audio)

Progressive Muscle Relaxation is an audio exercise from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to help anyone exper ... https://www.psychologytools.com/resource/progressive-muscle-relaxation-audio

Trauma And Dissociation

Trauma and Dissociation is a guide written for clients who have experienced trauma and who are troubled by dissociation. It provides clear informatio ... https://www.psychologytools.com/resource/trauma-and-dissociation

Emotional Reasoning

The Emotional Reasoning information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effec ... https://www.psychologytools.com/resource/emotional-reasoning

Audio Collection: Psychology Tools For Overcoming PTSD

The Psychology Tools for Overcoming PTSD Audio Collection is designed for anyone with post-traumatic stress disorder (PTSD). This skills development p ... https://www.psychologytools.com/resource/psychology-tools-for-overcoming-ptsd-audio-collection

Reclaiming Your Life From A Traumatic Experience (Second Edition): Workbook

Prolonged Exposure Therapy For PTSD comes in two volumes. This page is for the Client Workbook. Click on the following link to access the accompanying ... https://www.psychologytools.com/resource/reclaiming-your-life-from-a-traumatic-experience-workbook

Cognitive Behavioral Model Of Post Traumatic Stress Disorder (PTSD: Ehlers & Clark, 2000)

Anke Ehlers' & David Clark's Cognitive Behavioral Model Of Post-Traumatic Stress Disorder (PTSD) is an influential account of the condition. The ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-post-traumatic-stress-disorder-ptsd-ehlers-clark-2000

Intrusive Memory Record

Intrusive (unwanted, involuntary) memories are a common feature of PTSD, but also depression and other conditions. This Intrusive Memory Record is des ... https://www.psychologytools.com/resource/intrusive-memory-record

EMDR Negative And Positive Cognitions

Eye movement desensitization and reprocessing (EMDR) is a therapeutic approach designed to alleviate the distress associated with traumatic memories. ... https://www.psychologytools.com/resource/emdr-negative-and-positive-cogntions

Hotspot Record

Enhanced 'reliving' in trauma-focused CBT for PTSD involves addressing the meaning associated with 'hot spots' of traumatic memory. This Hotspot Recor ... https://www.psychologytools.com/resource/hotspot-record

Maximizing The Effectiveness Of Exposure Therapy

Despite its position as the leading treatment technique for anxiety disorders, not all clients respond to exposure therapy and some individuals relaps ... https://www.psychologytools.com/resource/maximizing-the-effectiveness-of-exposure-therapy

Prolonged Exposure Therapy For PTSD (Second Edition): Therapist Guide

Prolonged Exposure Therapy For PTSD comes in two volumes. This page is for the Therapist Guide. Click on the following link to access the accompanying ... https://www.psychologytools.com/resource/prolonged-exposure-therapy-for-ptsd-therapist-guide

Therapy Blueprint For PTSD

A therapy blueprint represents the past (the problems, what maintained them), the present (the therapy itself, new knowledge learned and skills develo ... https://www.psychologytools.com/resource/therapy-blueprint-for-ptsd

Hindsight Bias

Hindsight bias describes the tendency that people have – once an outcome is known – to believe that they predicted (or could have predicted) an ou ... https://www.psychologytools.com/resource/hindsight-bias

Dissociation - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/dissociation-self-monitoring-record

Coercive Methods For Enforcing Compliance

Individuals who have experienced abuse often focus on their own actions (or inactions) and blame themselves for their own abuse. This client informati ... https://www.psychologytools.com/resource/coercive-methods-for-enforcing-compliance

PTSD Film Projection Metaphor

Treatment for trauma often involves exposure to traumatic thoughts and memories, and many clients are understandably reluctant to attempt this. The PT ... https://www.psychologytools.com/resource/ptsd-film-projection-metaphor

EMDR Protocol (With Interweave Guidance)

Cognitive interweaves are commonly used in Eye Movement Desensitization and Reprocessing (EMDR) to 'unblock' processing which has become 'stuck'. This ... https://www.psychologytools.com/resource/emdr-protocol-with-interweave-guidance

Barriers Abusers Overcome In Order To Abuse

Individuals who have experienced abuse often focus on their own actions (or inactions) and blame themselves for their own abuse. This client informati ... https://www.psychologytools.com/resource/barriers-abusers-overcome-in-order-to-abuse

EMDR Protocol (Standard)

The standard protocol in Eye Movement Desensitization and Reprocessing (EMDR) outlines information required to start processing and identifies a seque ... https://www.psychologytools.com/resource/emdr-protocol-standard

Pie Charts (Archived)

NOTE: An improved version of this resource is available here: Responsibility Pie Chart. Older versions of a resource may be archived in the event ... https://www.psychologytools.com/resource/pie-charts-archived

Externalizing

The Externalizing information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/externalizing

Critical Care And PTSD

The Critical Care And PTSD information handout is designed to help clients to learn about the properties of critical care that can increase the likeli ... https://www.psychologytools.com/resource/critical-care-and-ptsd

Recognizing Complex Post Traumatic Stress Disorder

Complex Post Traumatic Stress Disorder (Complex PTSD) may develop after exposure to an event (or series of events) of an extremely threatening or horr ... https://www.psychologytools.com/resource/recognizing-complex-post-traumatic-stress-disorder

Arbitrary Inference

Arbitrary inference is one of the earliest and broadest cognitive disotortions described in CBT. Beck defines it as "the process of forming an interpr ... https://www.psychologytools.com/resource/arbitrary-inference

Am I Experiencing Post-Traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a condition characterized by unwanted memories of trauma, high levels of arousal, and avoidance. Am I Experie ... https://www.psychologytools.com/resource/am-i-experiencing-post-traumatic-stress-disorder-ptsd

Fortune Telling

The Fortune Telling information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effective ... https://www.psychologytools.com/resource/fortune-telling

Disqualifying Others

This Disqualifying Others information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more eff ... https://www.psychologytools.com/resource/disqualifying-others

Trauma, Dissociation, And Grounding (Archived)

NOTE: An improved version of this resource is available here: Trauma And Dissociation. Older versions of a resource may be archived in the event that ... https://www.psychologytools.com/resource/trauma-dissociation-and-grounding

Personalizing

The Personalizing information handout forms part of the cognitive distortions series, designed to help clients and therapists to work more effectively ... https://www.psychologytools.com/resource/personalizing

Understanding Depersonalization And Derealization

Our ‘Understanding…’ series is a collection of psychoeducation guides for common mental health conditions. Friendly and explanatory, they are co ... https://www.psychologytools.com/resource/understanding-depersonalization-and-derealization

Am I Experiencing Depersonalization And Derealization?

Depersonalization-derealization disorder is a condition characterized by feelings of unreality and detachment from your self (your emotions, thoughts, ... https://www.psychologytools.com/resource/am-i-experiencing-depersonalization-and-derealization

Sensory Grounding Using Your Five Senses (Audio)

The Sensory Grounding Using Your Five Senses exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed ... https://www.psychologytools.com/resource/sensory-grounding-using-your-five-senses-audio

Nightmare Rescripting (Audio)

Nightmare rescripting is an evidence based treatment for nightmares, with medium to large effect sizes on nightmare frequency, distress, intensity, an ... https://www.psychologytools.com/resource/nightmare-rescripting-audio

Grounding Statements (Audio)

The Grounding Statements exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. This audio track is designed for p ... https://www.psychologytools.com/resource/grounding-statements-audio

Rewind Technique

The Rewind Technique is a simple technique for processing traumatic memories and involves an element of exposure. It is best practiced within a formul ... https://www.psychologytools.com/resource/rewind-technique

Critical Illness Intensive Care And Post-Traumatic Stress Disorder (PTSD)

This is a free guide designed for people who have spent time in an intensive care unit and are experiencing symptoms of post-traumatic stress disorder ... https://www.psychologytools.com/resource/critical-illness-intensive-care-and-post-traumatic-stress-disorder-ptsd

Flashbacks - Self-Monitoring Record

Developing self-monitoring skills teaches clients to systematically observe and record specific targets such as their own thoughts, body feelings, emo ... https://www.psychologytools.com/resource/flashbacks-self-monitoring-record

Hindsight Bias (Archived)

Survivors of loss or trauma often think "If only …". Hindsight Bias is a cognitive bias / cognitive illusion which makes events seem more predictabl ... https://www.psychologytools.com/resource/hindsight-bias-archived

Grounding Objects (Audio)

The Grounding Objects exercise is a simple technique which teaches people with PTSD or dissociative disorders how to use objects with particular senso ... https://www.psychologytools.com/resource/grounding-objects-audio

Cognitive Behavioral Model Of Depersonalization (Hunter, Phillips, Chalder, Sierra, David, 2003)

Depersonalization is an experience where an individual feels a sense of detachment from themselves, or estrangement from their perceptions, actions, a ... https://www.psychologytools.com/resource/cognitive-behavioral-model-of-depersonalization-hunter-phillips-chalder-sierra-david-2003

Sensory Grounding Using Smells (Audio)

The Sensory Grounding Using Smells exercise is an audio track from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to teach ... https://www.psychologytools.com/resource/sensory-grounding-using-smells-audio

Stimulus Discrimination (Audio)

The Stimulus Discrimination audio exercise is taken from the Psychology Tools For Overcoming PTSD Audio Collection. It is designed to help people with ... https://www.psychologytools.com/resource/stimulus-discrimination-audio

Links to external resources

Psychology Tools makes every effort to check external links and review their content. However, we are not responsible for the quality or content of external links and cannot guarantee that these links will work all of the time.

Assessment

  • Brief Dissociative Experiences Scale (DES-B) | Dalenberg, Carlson | 2010
    • Scale
    • DES-B (Dalenberg C, Carlson E, 2010) modified for DSM-5 by C. Dalenberg and E. Carlson.

Resources related to the assessment of post-traumatic stress disorder (PTSD)

  • Wilson, J.P., & Keane, T.M. (Eds.). (2004). Assessing psychological trauma and PTSD: A practitioner’s handbook (2nd ed.). New York, NY: Guilford Press.
  • Shutdown Dissociation Scale (Shut-D) | Schauer, Schalinski, Elbert | 2015
  • Dissociative Experiences Scale – II (DES-II) | Carlson, Putnam | 1993
    • Scale
    • Carlson, E.B. & Putnam, F.W. (1993). An update on the Dissociative Experience Scale. Dissociation 6(1), p. 16-27.

Screening, diagnostic, and outcome-measurement tools for post-traumatic stress disorder (PTSD)

  • Trauma Screening Questionnaire (TSQ) | Brewin, Rose, Andrews, Green, Tata, McEvedy, Turner, Foa | 2002
    • Brewin, C. R, Rose, S., Andrews, B., Green, J., Tata, P., McEvedy, C. Turner, S, Foa, E. B. (2002). Brief screening instrument for post-traumatic stress disorder. British Journal of Psychiatry, 181, 158-162.
    • Scale
  • Trauma Appraisal Questionnaire (TAQ) | DePrince, Zurbruggen, Chu, Smart | 2010
    • DePrince, A. P., Zurbriggen, E. L., Chu, A. T., & Smart, L. (2010). Development of the trauma appraisal questionnaire.Journal of Aggression, Maltreatment & Trauma,19(3), 275-299.
    • Scale
  • Severity Of Posttraumatic Stress Symptoms | Kilpatrick, Resnick, Friedman | 2013
  • PTSD Symptom Scale – Interview Version for DSM-5 (PSS-I-5) | Foa, McLean, Zang, Zhong, Rauch, Porter, Knowles, Powers, Kauffman | 2016
    • Foa, Edna B.,McLean, Carmen P.,Zang, Yinyin,Zhong, Jody,Rauch, Sheila,Porter, Katherine,Knowles, Kelly,Powers, Mark B.,Kauffman, Brooke Y. (2016) Psychological Assessment, Vol 28(10), 1159-1165
    • Scale
  • PTSD Checklist for DSM-5 (PCL-5) | Weathers, Litz, Keane, Palmieri, Marz, Schnurr | 2013
    • Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K., & Domino, J. L. (2015). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and initial psychometric evaluation. Journal of Traumatic Stress, 28, 489-498. doi: 10.1002/jts.22059
    • Weathers, F. W., Litz, B. T., Keane, T. M., Palmieri, P. A., Marx, B. P., & Schnurr, P. P. (2013). The PTSD Checklist for DSM-5 (PCL-5) – Standard. [Measurement instrument].
    • Manual
    • Scale (Standard)
    • Scale with criterion A
    • Scale with life events checklist and criterion A
  • Life Events Checklist for DSM-5 (LEC-5) | Weathers, Blake, Schnurr, Kaloupek, Marx, Keane | 2013
    • Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2013). The Life Events Checklist for DSM-5 (LEC-5) – Standard. [Measurement instrument].
    • Scale
  • Impact Of Events Scale – Revised (IES-R) | Weiss, Marmar | 1996
    • Weiss, D. S., & Marmar, C. R. (1996). The Impact of Event Scale – Revised. In J. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399-411). New York: Guilford.
    • Scale
  • Clinician Administered PTSD Scale for DSM-5 (CAPS-5) (Past week version) | Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. | 2015
    • Scale archived version
    • Weathers, F. W., Blake, D. D., Schnurr, P. P., Kaloupek, D. G., Marx, B. P., & Keane, T. M. (2015). The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) – Past Week [Measurement instrument].

Guides and workbooks

  • Your very own TF-CBT workbook | Alison Hendricks, Judith A. Cohen, Anthony P. Mannarino, Esther Deblinger
  • Posttraumatic stress disorder: patient treatment manual | Clinical Research Unit for Anxiety and Depression (CRUfAD)
  • Trauma And Substance Use | NDARC: Mills, Ewer, Marel, Baker, Teesson, Dore, Kay-Lambkin, Manns, Trimmingham | 2011
  • Abuse – Information For Adults Physically, Emotionally, Or Sexually Abused As Children (An NHS Self-Help Guide) | Lesley Maunder, Lorna Cameron | 2020

Information Handouts

  • A collection of soothing activities wwu.edu
  • Grounding techniques list
  • Detaching from emotional pain e-tmf.org
  • Grounding Techniques
  • Coping with trauma | Dr Jim White | 2006
  • Was it my fault? Self-blame and survivors | PANDYS / Shannon | 2007
  • The Power and Control Wheel diagram: for understanding abusive and violent behaviors | National Centre on Domestic and Sexual Violence
  • After the event: supporting children after a frightening event | Trickey, Bailie, Serpell | 2010
  • Explaining the rationale for trauma focused work: why it’s good to talk (children & young people) | Trickey | 2012
  • Processing trauma: the factory metaphor | Hawkins
  • Surviving torture: understanding the nature and purpose of torture | Christian Peacemaker Teams
  • Post-traumatic stress disorder (PTSD) patient handout | Royal College Of Psychiatrists | 2005
  • Coping with trauma (workbook) | Good Thinking

Information (Professional)

  • Understanding traumatic intrusions (OCTC Practical Guides) | Helen Kennerley | 2016
  • Prolonged Exposure (PE) | Edna Foa
  • Narrative Exposure Therapy (NET) | Shauer, Neuner, Elpert

Presentations

  • PTSD as a shame disorder | Judith Herman | 2014
  • A trauma-focused cognitive behavioral therapy case conceptualization: from assessment to termination | Alison Hendricks
  • Using exposure to treat PTSD: why, when, and how? | Fyvie
  • Introduction to traumatic stress | Kitchiner & Roberts
  • Using compassionate imagery in shame based flashbacks in PTSD | Deborah Lee | 2009
  • Dissociation and PTSD | Fiona Kennedy | 2010
  • Beyond reliving in PTSD treatment: advanced skills for overcoming common obstacles in memory work | Hannah Murray, Sharif El-Leithy
  • Cognitive therapy for PTSD | Nick Grey | 2016
  • Dissociative phenomena in the everyday lives of trauma survivors | Janina Fischer | 2001
  • Modulation, mindfulness, and movement in the treatment of trauma-related depression (window of tolerance) | Pat Ogden | 2009

Treatment Guide

  • CBT-3M (Meanings, Memories and Management) - A trauma- based cognitive therapy protocol for young children aged 3-8 years | Based on the treatment developed by Smith, Yule, Perrin, & Clark (2006)
  • Trauma focused CBT for chronic whiplash
  • Canadian clinical practice guidelines for the management of anxiety, posttraumatic stress and obsessive-compulsive disorders (2014) | Katzman et al | 2014
  • Guideline for the treatment and planning of services for complex post-traumatic stress disorder in adults | UKPTS: McFetridge, Hauenstein Swan, Here, Karatzias, Greenberg, Kitchiner, Morley | 2017
  • Guidelines for the Evaluation and Treatment of Dissociative Symptoms in Children and Adolescents | International Society for the Study of Trauma and Dissociation (ISST-D) | 2003
  • Guidelines for Treating Dissociative Identity Disorder in Adults | International Society for the Study of Trauma and Dissociation (ISST-D) | 2011
  • Clinical practice guideline for the treatment of PTSD | American Psychological Association (APA) | 2017
  • Post-traumatic stress disorder (PTSD) | National Institute for Health and Care Excellence (NICE) guidelines | 2018
  • Cognitive Processing Therapy (CPT) Veteran/Military Version | Patricia Resick, Candice Monson, Kathleen Chard | 2006

Video

  • Absolutely not: an other thoughts you might have about mental health support (Animation) | UK Trauma Council | 2023
  • Coping with scary and distressing memories (Animation) | UK Trauma Council | 2023
  • What is trauma-focused CBT? (Animation) | UK Trauma Council | 2023
  • What is post-traumatic stress disorder? (Animation) | UK Trauma Council | 2023

Recommended Reading

  • Grey, N., Young, K., & Holmes, E. (2002). Cognitive restructuring within reliving: a treatment for peritraumatic emotional “hotspots” in posttraumatic stress disorder. Behavioural and Cognitive Psychotherapy, 30, 37-56
  • Ehlers, A., Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38, 319-345 (The canonical reference for the treatment of PTSD: Trauma-Focused Cognitive Behavioural Therapy [TF-CBT]. This model is suitable even for more complex PTSD, within a phased approach)
  • Brewin, C. R., Gregory, J. D., Lipton, M., Burgess, N. (2010). Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment. Psychological Review, 117(1), 210-232
  • Brewin, C. R., Dalgleish, T., Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103, 670-686 (Useful for understanding the neural basis of memory in PTSD)
  • Schauer, M., Elbert, T. (2010). Dissociation following traumatic stress. Journal of Psychology, 218(2), 109-127

Other papers

  • Medford, N., Sierra, M., Baker, D., David, A. S. (2005). Understanding and treating depersonalisation disorder. Advances in Psychiatric Treatment, 11, 92-100
  • Read, J., Hammersley, P., Rudegeair, T. (2007). Why, when and how to ask about childhood abuse. Advances in Psychiatric Treatment, 13, 101-110
  • Levin, R. J., & van Berlo, W. (2004). Sexual arousal and orgasm in subjects who experience forced or non-consensual sexual stimulation–a review.Journal of Clinical Forensic Medicine,11(2), 82-88.
  • Chessell, Z. J., Brady, F., Akbar, S., Stevens, A., & Young, K. (2019). A protocol for managing dissociative symptoms in refugee populations. The Cognitive Behaviour Therapist, 12.
  • Arntz, A., & Weertman, A. (1999). Treatment of childhood memories: Theory and practice. Behaviour Research and Therapy, 37(8), 715-740

Complex PTSD

  • Terr, L. C. (1991). Childhood traumas: An outline and overview. American journal of psychiatry, 148(1), 10-20
  • Herman, J. L. (1992). Complex PTSD: A syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5(3), 377-391
  • Finalizing PTSD in DSM-5: Getting here from there and where to go next. Journal of Traumatic Stress, 26, 548-556 | Friedman, M. J. | 2013

Complex PTSD

  • ISTSS guidelines position paper on complex PTSD in adults | ISTSS | 2017

What Is Post-Traumatic Stress Disorder?

Symptoms of PTSD

The DSM criteria for PTSD require that an individual has experienced a traumatic event and include symptoms in four categories:

  • re-experiencing memories of the trauma
  • heightened anxiety and hypervigilance
  • avoidance of reminders of the trauma
  • negative beliefs or feelings

People who develop complex PTSD have typically experienced prolonged and repeated trauma and may experience symptoms in addition to PTSD including:

Incidence, Prevalence, and Predictors of PTSD

Depending upon the type of trauma experienced, approximately 10% to 30% of trauma survivors will develop PTSD (Santiago et al., 2013). Some of the strongest predictors of whether an individual will develop PTSD is how severe they perceived the trauma to be, and levels of social support post-trauma (Brewin, Andrews & Valentine, 2000).

Psychological Models and Theory of PTSD

One of the most influential models of PTSD is the cognitive model published by Anke Ehlers and David Clark in 2000. They propose that distress in PTSD is maintained by:

  • A disturbance of autobiographical memory characterized by poor elaboration and contextualization, strong associative memory, and strong perceptual priming. (The ‘unprocessed’ qualities of trauma memories makes them particularly intrusive.)
  • Excessively negative appraisals of the trauma and events surrounding it. (The thoughts and beliefs that survivors of trauma hold about themselves, others, and the world may be inaccurate or counterproductive.)
  • Problematic behavioral and cognitive strategies. (The avoidance and safety behaviors which people with PTSD engage in can act to perpetuate distress in PTSD.)

Other theories of particular relevance to PTSD include:

  • Emotional processing theory (Foa & Kozak, 1986) which proposes that emotions are information structures in memory (i.e., fear is associated with a ‘fear structure’). Changes in a structure require the integration of information that is incompatible with some elements of the fear structure.
  • The dual-processing model of memory in PTSD (Brewin, Dalgleish, & Joseph, 1996) which helps to explain some of the important and unusual properties of memory in PTSD such as ‘nowness’ and sensory vividness.

Evidence-Based Psychological Approaches for Working with PTSD

A variety of different therapeutic approaches have demonstrated effectiveness in the treatment of PTSD. A common factor in all of these approaches is that they are trauma-focused: at least some of the work in therapy addresses what happened to the patient. Evidence-based treatments for PTSD include:

  • cognitive behavioral therapy (CBT) / trauma-focused CBT
  • cognitive processing therapy (CPT)
  • eye movement desensitization and reprocessing (EMDR)
  • narrative exposure therapy (NET)
  • prolonged exposure therapy (PE)

Resources for Working with PTSD

Psychology Tools has an extensive library of therapy resources devoted to the effective treatment of PTSD. Many patients report finding the Psychology Tools for Overcoming PTSD Audio Collection helpful in teaching a set of skills that can help them to feel more stable and to approach subsequent phases of trauma treatment. There are also a range of information handouts, exercises, and worksheets for working with PTSD. Psychology Tools resources available for working therapeutically with PTSD may include:

References

  • Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748–766.
  • Brewin, C. R., Dalgleish, T., & Joseph, S. (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review, 103(4), 670.
  • Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. BehaviourResearch and Therapy, 38(4), 319–345.
  • Foa, E. B., & Kozak, M. J. (1986). Emotional processing of fear: Exposure to corrective information. Psychological Bulletin, 99(1), 20–35.
  • Santiago, P. N., Ursano, R. J., Gray, C. L., Pynoos, R. S., Spiegel, D., Lewis-Fernandez, R., … & Fullerton, C. S. (2013). A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: Intentional and non-intentional traumatic events. PloS one, 8(4), e59236. doi: 10.1371/journal.pone.0059236