International Society for Traumatic Stress Studies

Free Resources

 
  1. Trauma and Stress Related Disorders in DSM-5
  2. The Psycological Cost of Disasters
  3. Toward Informing a Developmentally Sensitive DSM-5: Empirical Validations of the Diagnostic Criteria for PTSD and ASD Among Preschool, School-Age, and Adolescent Samples
  4. World Health Organization Preparation of ICD-11: Clinical Utility of Diagnostic Criteria for Trauma Related Disorders, Part 1
  5. World Health Organization Preparation of ICD-11: Clinical Utility of Diagnostic Criteria for Trauma-Related Disorders, Part 2
  6. Public Mental Health as the Future Paradigm for our Trauma Societies?
  7. Mental Health for All-by-All
 
 

Trauma and Stress Related Disorders in DSM-5

with Matthew Friedman, MD, PhD
 
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Description

This recorded webinar will present the new "Trauma- and Stressor-Related Disorders" Category within DSM-5. In particular it reviews the diagnostic criteria for PTSD and its Dissociative and Pre-School Subtypes. In addition it discusses diagnostic criteria for Acute Stress Disorder, Adjustment Disorders, and other diagnoses within this DSM-5 chapter. Finally, briefly reviews Dissociative Disorders and Persistent Complex Bereavement Disorder.
 
 

The Psychological Cost of Disasters

with Richard Bryant, PhD

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Purchase CE credit for $25
 

Description

The session will provide an overview of interventions following large-scale disasters. It will commence with a description of expected mental health needs of disasters, and the usual trajectory of disaster responses. It will then describe recent developments in conceptualizing mental health response in a staged care framework. Commencing with Psychological First Aid in the immediate phase, followed by Skills for Psychological Recovery in the following period, and finally evidence-based interventions for people with persistent mental disorders. Examples of each of these approaches will be provided in the context of recent large-scale disasters.
 

Learning Objectives

  1. Evaluate the mental health needs of disaster survivors.
  2. Describe early interventions after disasters.
  3. Update developments in staged interventions after disasters.
 
 

Toward Informing a Developmentally Sensitive DSM-5: Empirical Validations of the Diagnostic Criteria for PTSD and ASD Among Preschool, School-Age, and Adolescent Samples

with Patricia Kerig, PhD, Michael Scheeringa, MD, Justin Kenardy, PhD, De Young, Margaret Charlton, Nancy Kassam-Adams, PhD, Patrick Palmieri, PhD, Kristen Kohser, LMSW, Meghan Marsac, PhD, Diana Bennett, Shannon Chaplo
 
Click here to listen to the recording - No CE Available
Click here to view the slides
 

Description

The developers of the DSM-5 only recently have begun turning their attention to the question of whether there is a need for developmentally-sensitive criteria for diagnosing disorders in the stress response spectrum, including Post-Traumatic Stress Disorder (PTSD) and Acute Stress Disorder (ASD). Increasing the accuracy and specificity of these diagnoses among young people is essential for ensuring that children in need of services are identified and referred for appropriate interventions. Although various alternative diagnostic algorithms have been proposed for young persons, there is a need for carefully designed research including ethnically diverse and culturally representative samples to help inform these decisions in the most empirically sound way. To that end, this international symposium brings together researchers from four independent laboratories who assess the associations between various proposed diagnostic criteria for PTSD and ASD and to investigate the clinical presentations and longitudinal outcomes associated with these diagnoses among preschool-age, school-age, and teenaged youth drawn from samples in Australia, Switzerland, the UK, and the US. The findings of these studies suggest both evidence for validity as well as the need for greater developmental specificity of the proposed DSM-5 diagnostic criteria for disorders in the stress response spectrum.
 

Learning Objectives

  1. Critique the limitations of the existing criteria set in DSM-IV for PTSD for children.
  2. Describe the links between PTSD and later disorders in children and explain the significance these relationships have for intervention.
  3. Describe the prevalence of acute stress symptoms in a large international sample of children and teenagers and explain the association of acute traumatic stress reactions and functional impairment in children.
  4. Demonstrate the link between types of trauma exposure and symptom clusters, and how symptom clusters relate to internalizing and externalizing symptoms.
 
 

World Health Organization Preparation of ICD-11: Clinical Utility of Diagnostic Criteria for Trauma Related Disorders, Part 1

with Andreas Maercker, PhD, MD, and Matthew Friedman, MD, PhD, Michael First, MD, Cécile Rousseau, MD, Chris Brewin, PhD, Marylène Cloitre, PhD

Click here to listen to the recording - No CE Available
Click here to view the slides - Section 1
Click here to view the slides - Section 2
 

Description

Stress-related disorders (such as PTSD, acute stress reaction) must be differentiated from other mental disorders and from normal, self-limited stress responses. WHO is aware of concern about an overuse of certain stress-related diagnoses, especially among populations that have been exposed to a natural or human-made disaster. A tendency to focus on stress-related diagnoses may be related to the appeal of the simple, external explanation for symptoms, which is suggested by names such as PTSD. There is also significant controversy in the field about some existing or proposed categories that are seen as ‘milder’, such as adjustment disorder or prolonged grief disorder. Some have challenged the validity and utility of these categories. At the same time, there is evidence that some clinical phenomena that have up to now been considered sub-threshold for diagnosis are associated with poor adjustment and a variety of negative mental health outcomes over time. In general, to help countries to reduce disease burden associated with mental disorders, the classification system must be usable and useful for health care workers around the world. With ICD-11, there appears to be a unique opportunity to produce such a system.
 

Learning Objectives

  1. Describe ICD-11 attachment-related categories and explain the relation between category cultural validity and clinical usefulness.
  2. Describe the approach to diagnosing PTSD in ICD-10, and differentiate the approaches of DSM-V and ICD-11.
  3. Distinguish the symptoms of PTSD from Complex PTSD and give examples of emotion regulation problems of complex PTSD.
 
 

World Health Organization Preparation of ICD-11: Clinical Utility of Diagnostic Criteria for Trauma-Related Disorders, Part 2

with Andreas Maercker, PhD, MD, Mark van Ommeren, Yuriko Suzuki, Ashraf Kagee, Asma Humayun

Click here to listen to the recording - No CE Available
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Description

See Description for Part 1 above.
 

Learning Objectives

  1. Cite current literature on the overview of philosophy for trauma and stress-related disorders.
  2. Cite current literature on major conceptual change of acute stress reaction.
  3. Differentiate adjustment disorder from other stress related disorders.
 
 

Public Mental Health as the Future Paradigm for our Trauma Societies?

with Joop de Jong, MD, PhD

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Description

How do we address the psychological needs of large populations exposed to severe traumatic stressors? To answer this question, a public mental health approach is quickly gaining popularity for trauma-exposed populations in international settings.
 
This presentation will address how this perspective may inform prevention and care with populations exposed to traumatic stressors both in high-income (e.g. in the aftermath of 9/11 or Katrina) and in developing countries (e.g. in the context of natural disasters and armed conflicts). 
 
Public mental health aims at protecting, promoting and restoring the mental health of a population rather than an individual. The paradigm of public mental health has several important implications for the trauma profession in the realms of prevention, resilience, research and competencies.
 
First, both origins and consequences of disasters play at different system levels. Hence, primary prevention can become more effective if it further develops interventions that address these multiple system levels. Universal primary prevention has much to win by distilling and addressing key predictors of ill health that show striking similarity with the determinants of disaster and war including poverty and marginalization.
 
Second, an ecological approach requires a shift from individual psychological resilience to ecological resilience involving diverse actors at the level of the community. An ecological approach also asks for a careful cultural critique of the salience of the neuroscience construct of post-traumatic stress disorder (PTSD) versus other expressions of distress across the globe.
 
Third, dealing with distress in resource-strained settings requires task sharing and task shifting by mental health professionals to locally trained paraprofessionals and lay people. It also requires a shift from specialized treatment to selective prevention involving local healers, local practitioners and a range of community interventionist from other disciplines.
 
Fourth, public mental health calls for a new research agenda. We need research on tipping points that convert inaction to cooperation and synergy in post-disaster areas and refugee camps. We need research on the transformation of stigma and helplessness into connectivity and remoralization of vulnerable populations. We need research to change cycles of violence (e.g. by the use of transitional justice mechanisms into peaceful coexistence). We also need research on differential susceptibility to traumatic stress transcending the macro-level of ecological resilience to the micro-level of epigenetics.
 
Finally, the public mental paradigm asks for a redefinition of psychological and other competencies in both high and low-income countries. It implies that psychologists and other mental health professionals become core team players liaising to other professionals involved in health and education, the economy, governance, the military, and human rights.
 

Learning Objectives

  1. Express the rationale of public mental health as a paradigm for traumatic stress beyond the individual cognitive-emotional level.
  2. Outline implications of public mental health for our profession in the realm of prevention, resilience and research.
  3. Redefine the professional competences in both high and low-income countries.
 
 

Mental Health for All-by-All

with Vikram Patel, MSc, MRCPsych, PhD, FMedSci
 
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Description

The scarcity of specialist mental health human resources in all countries, but especially in low income countries, is further compounded by their inequitable distribution and inefficient utilization. This human resource gap will remain large for the foreseeable future, and is likely to be worsened as populations grow in many countries and as specialists immigrate from poorer to richer areas.
 
In this context, this presentation considers ‘task-sharing’ as one of the most significant advances in improving access to affordable and effective mental health care. Task sharing, the strategy of rational redistribution of tasks among health workforce teams, has become a popular method to address specialist health human resource shortages in other areas of health care such as HIV/AIDS and maternal and child health. Specific tasks are moved, where appropriate, from highly qualified health workers to health workers with shorter training and fewer qualifications in order to make more efficient use of the available human resources for health.
 
This presentation will synthesize the growing, and compelling, body of evidence on the safety and effectiveness of task-sharing to improve access to care for a range of mental disorders, by unpacking complex psychological treatments and empowering community and lay health workers to deliver specific treatment strategies. Not only are such interventions more affordable and accessible, but they also empower individuals to better manage their own mental health and care for others who are affected, thereby reducing the large ‘treatment gaps’.
 
Such task-sharing interventions are also very relevant to better resourced settings which also face high levels of ‘treatment gaps’ (in particular for psychological treatments), and spiraling costs of mental health care (mostly driven by the high costs of specialist delivered care). The role of mental health specialists in such intervention programs needs to expand from providing direct clinical care to incorporate a number of additional roles, for example advocacy, training, consultation, evaluation and supervision. In doing so, the goal of ‘mental health for all’ may be realistically achieved, in partnership ‘with all’.
 

Learning Objectives

  1. Recognize the scale of the treatment gap globally, and the barrier posed by the shortage of skilled mental health human resources to reduce this gap.
  2. Identify the new evidence on task-shifting to lay and community health workers for a range of mental health conditions in low resource settings.
  3. Explain the role of mental health specialists in improving access to mental health care through the use of community and lay mental health workers.