Front Cover	1
	Posttraumatic Stress Disorder	4
	Copyright Page	5
	Contents	6
	Preface	10
	1 Understanding psychological trauma and posttraumatic stress disorder (PTSD)	16
	“Is there a life after trauma?”: The case of Marian M.	18
	History of popular and scientific conceptions of psychological trauma and PTSD	20
	From stress reactions to traumatic stressors and posttraumatic disorders	33
	Complex PTSD: can traumatic stress affect a person’s core self?	36
	PTSD becomes complex in the DSM-5	39
	Complex PTSD emerges as a (proposed) subtype of PTSD in the ICD-11	46
	From trauma exposure to developing (and recovery from) traumatic stress disorders	46
	Epidemiology of PTSD: how often (and to whom) does PTSD occur?	47
	Etiology of PTSD: potential causes and risk factors for developing PTSD	48
	Biology of PTSD: alterations in the body and in physical health associated with PTSD	49
	Research and clinical assessment of psychological trauma and PTSD	49
	Treatment and prevention of PTSD	50
	Forensic issues in the PTSD field	51
	Social, cultural, and ethical issues in the PTSD field	52
	Careers in the PTSD field and impact of psychological trauma on the professional	52
	References	53
	2 The impact of psychological trauma	58
	When the other shoe falls: What makes stressful events traumatic?	58
	In the beginning: acute traumatic stress reactions and acute stress disorder	67
	Acute traumatic stress reactions	67
	Acute stress disorder	69
	Life after trauma: Positive and problematic trajectories of adaptation	73
	Positive posttraumatic life trajectories	74
	Problematic posttraumatic life trajectories	80
	Research on the impact of traumatic stress on the course of people’s lives	83
	References	89
	3 Etiology of PTSD: What causes PTSD?	96
	Understanding etiology: causes? Or risk and protective factors?	102
	Causal risk factors for PTSD	107
	Degree or severity of exposure to traumatic stressor(s)	108
	Preexisting psychiatric disorders	116
	Potential genetic or biological causal risk factors	120
	Cognitive processing capacities	123
	Potential risk factors for exposure to traumatic stressors	127
	Vulnerability factors for PTSD	128
	Outcome risk factors	133
	Protective factors	134
	Conclusion	136
	References	137
	4 Epidemiology of PTSD	148
	Epidemiology of exposure to traumatic stressors	151
	Traumatic stressor exposure in early childhood	152
	Traumatic stressor exposure among school-age children	153
	Traumatic stressor exposure in adolescence	154
	Traumatic stressor exposure in adulthood	156
	Traumatic stressor exposure among older adults	158
	Poly-victimization	158
	Epidemiology of PTSD	163
	Criterion A: evidence of trauma exposure	163
	PTSD in early childhood	165
	PTSD in school-age children and adolescents	166
	PTSD among adults	167
	PTSD among older adults	168
	Comorbid psychiatric and medical disorders	168
	Gender and the epidemiology of PTSD	176
	Ethnocultural and socioeconomic background and the epidemiology of PTSD	184
	References	187
	5 Neurobiology of traumatic stress disorders and their impact on physical health	198
	Alterations in the body’s stress response systems in PTSD	200
	ANS reactivity in PTSD	201
	Stress hormones and PTSD	204
	Alterations in brain structure, functioning, and chemistry in PTSD	212
	Brain structure and PTSD	212
	Brain functioning and PTSD	220
	Brain chemistry and PTSD	226
	Putting it all together: the learning brain versus the survival brain in PTSD	227
	Genetics and PTSD	228
	PTSD and physical health problems and medical illness	231
	PTSD and medical illness	231
	Exposure to traumatic stressors, PTSD, and health risk behaviors	233
	Exposure to traumatic stressors, PTSD, and somatic dissociation	234
	Somatic complaints and medical illness as precipitants for PTSD	235
	Conclusion	236
	References	237
	6 Assessment of psychological trauma and PTSD	248
	Scientific criteria for PTSD assessment	248
	Clinical issues in PTSD assessment: 1. Assessing trauma history	252
	Assessing past exposure to traumatic stressors (trauma history)	255
	Trauma history measures	256
	Assessment of PTSD: identifying symptoms and confirming the diagnosis	260
	PTSD assessment with children	265
	PTSD symptom and diagnosis measures	266
	Assessment of psychiatric problems commonly comorbid with PTSD	273
	Assessment of posttraumatic dysregulation	274
	Screening for PTSD	275
	Conclusion	307
	References	308
	7 Treatment of adults with PTSD	314
	Best practice principles in the treatment of PTSD	316
	Phases of therapy for PTSD	319
	PTSD treatment: practical issues	335
	Evidence-based treatments for PTSD	337
	CBT for PTSD	340
	CBT interventions for special populations of adults with PTSD	346
	Psychotherapies for Affect and Interpersonal Regulation (PAIR)	349
	Hypnosis and hypnotherapy for PTSD	354
	Psychodynamic therapies for PTSD	355
	Integration of experiential and psychodynamic psychotherapies for PTSD	356
	Body-focused psychotherapy for PTSD	357
	Family and couples therapies for PTSD	358
	Group therapies for PTSD	359
	Pharmacological therapies (medication) for PTSD	360
	Conclusion	360
	References	370
	8 Treatment of children and adolescents with PTSD	382
	Evidence-based and empirically informed psychotherapy models for children with PTSD	382
	Trauma-focused Cognitive Behavioral Therapy	384
	Trauma Affect Regulation: Guide for Education and Therapy	394
	Emerging evidence-based psychotherapies for children and youth with PTSD	395
	Prolonged Exposure Therapy	396
	Cognitive Processing Therapy	396
	Eye Movement Desensitization and Reprocessing	397
	Trauma and Grief Components Therapy for Adolescents	397
	KID Narrative Exposure Therapy	398
	Seeking Safety	399
	Cognitive Behavioral Intervention for Trauma In Schools	399
	ERASE-Stress	400
	Child-Parent Psychotherapy	400
	Other empirically based psychotherapy models for adolescents with PTSD	401
	Pharmacotherapy for children with PTSD	402
	Creative arts therapies	404
	Real-world challenges in treating children with PTSD	410
	Conclusion	420
	References	421
	9 Prevention of PTSD	428
	Overview of biopsychosocial approaches to prevention	431
	Theoretical foundations and principles of PTSD prevention	442
	PTSD prevention interventions	445
	Conclusion	467
	References	467
	10 Forensic issues in the traumatic stress field	474
	Forensic mental health roles for traumatic stress professionals	475
	Child welfare service and CPS	483
	Family law courts	487
	Juvenile justice system	489
	Adult criminal justice system	492
	Forensic challenges for PTSD clinicians and researchers	494
	Forensic mental health standards of care and standards of practice	509
	References	512
	11 Social, cultural, and other diversity issues in the traumatic stress field	518
	The role of gender, ethnicity, culture, and social resources in PTSD	521
	Discrimination due to gender or sexual orientation and PTSD	527
	Physical and developmental disabilities and PTSD	530
	Poverty, psychological trauma, and PTSD	532
	Victims of political repression, genocide (“ethnic cleansing”), and torture	535
	Refugee survivors of political violence and catastrophic disasters	545
	Programs addressing the social and political aspects of catastrophic traumatic stressors	553
	Conclusion	556
	References	556
	12 Careers and ethical issues in the traumatic stress field	562
	Careers in the traumatic stress field: 1. The research scientist	565
	Careers in the traumatic stress field: 2. The clinician practitioner	568
	Careers in the traumatic stress field: 3. The scientist practitioner	573
	Careers in the traumatic stress field: 4. The health services researcher	576
	Careers in the traumatic stress field: 5. The educator	579
	Careers in the traumatic stress field: 6. The program director	580
	Ethical issues in PTSD research and treatment	584
	References	590
	Afterword	600
	Index	604