How Effective Is Psychotherapy for PTSD?

Stress-related disorders are a group of functional mental disorders that are caused by the direct action of strong or persistent psychosocial factors. The characteristics of this group of diseases are: psychosocial factors are the direct cause; clinical manifestations are closely related to mental stimulus factors; after the cause is eliminated or the environment is changed, most patients' mental symptoms should disappear in succession; the prognosis is good, and there is no personality defect. Stress-related disorders are divided into three categories: acute stress disorder, post-traumatic stress disorder, and adaptation disorder. ^[1-2]

Susceptibility to stress-related disorders can be divided into individual intrinsic (such as genetic characteristics, age, gender,

Adjustment disorder (adjustment disorder) refers to short-term and mild distressed states and emotional disorders that occur when there is an obvious life change or environmental change, and there is often a certain degree of behavior change, but there are no psychotic symptoms. Typical life events are: bereavement, divorce, unemployment or changing positions, relocation, transfer to school, serious illness, economic crisis, retirement, etc. The incidence is often related to the severity of life events, individual psychological quality, and psychological coping styles. ^[1]

There was no significant difference between the sexes in men and women; the disease can occur at any age, but it is more common in adults. ^[4]

Clinical manifestations of stress mental disorders

The onset often occurs within 1 to 3 months after the occurrence of stressful life events, and the clinical manifestations are diverse, including depression, anxiety, or anxiety, feeling unable to cope with the current life or being unable to plan for the future, insomnia, stress-related Physical dysfunction (headache, abdominal discomfort, chest tightness, palpitation), impaired social functioning or work. Some patients may experience violent behaviors, while children show bedwetting, finger sucking, and so on. Depression is the main manifestation of low mood, loss of interest in daily life, self-blame, hopelessness, helplessness, changes in appetite, weight loss, and aggressive behavior. Those who are mainly anxious are manifested as anxiety, fear, nervousness, palpitation, shortness of breath, and suffocation. People with predominant conduct disorder are common in adolescents, manifested as truancy, fighting, theft, lying, substance abuse, running away from home, sexual promiscuity, etc. Adaptation disorders in children are mainly degenerative behaviors such as bedwetting, finger sucking, and vague physical symptoms such as unexplained abdominal discomfort. ^[1]

Diagnosis and Differentiation of Stress Psychological Disorder

The main points of diagnosis are as follows:

1. There are obvious life events as incentives, especially changes in living environment or social status (such as immigration, leaving the country, enlistment, retirement, etc.).

2. There is reason to infer that susceptible personality, life events and personality foundations all play an important role in causing mental disorders. Before the life event, the patient's mental state was normal. Many other people can handle such events without any abnormalities, but the patient has evidence of poor social adaptability.

3. Depression, anxiety, and fear are the main emotional symptoms, which are manifested as maladaptive behavioral disorders, such as withdrawal, inattention to health, and irregular life; physical dysfunctions, such as poor sleep and lack of appetite.

4. There are various symptoms found in affective mental disorders (excluding delusions and hallucinations), neurosis, stress disorders, somatic disorders, and conduct disorders, but they do not meet the diagnostic criteria for the above disorders.

5. Impaired social functions.

6. Mental disorders begin within 1 month of psychosocial stimulation (but not catastrophic or unusual) and meet diagnostic criteria for at least 1 month. After the stress factors are eliminated, the symptoms usually last no more than 6 months. ^[1]

Treatment of Stress Psychological Disorders

The duration of an adaptation disorder generally does not exceed 6 months. Over time, the adaptation disorder can resolve on its own, or it can be transformed into a specific and more severe other mental disorder. Therefore, the fundamental purpose of the treatment of adaptation disorders is to help patients improve their ability to deal with stressful situations, return to the level of pre-illumination as soon as possible, and prevent the course of disease from becoming worse or chronic. ^[1]

The treatment focuses on psychological treatment , and psychological treatment is mainly to solve the problem of patients' psychological coping style and emotional venting. Treatment should first assess the nature and severity of the patient's symptoms, understand the relative role of factors such as incentives, patient personality characteristics, and coping styles in the onset of the disease. Attention should be paid to the significance of the stressors to the patients. Individual guidance, family therapy and social support should be taken. And other ways. Supportive psychotherapy, brachytherapy, and cognitive behavioral therapy can be used as appropriate. ^[1]

It needs to be pointed out that, for young children, it is not mainly to treat the young children themselves, but to guide parents. ^[3]

Medication is only used in patients with more pronounced mood disorders. The role of drug treatment is to speed up the relief of symptoms and provide a suitable environment for psychological treatment. Anxiolytics and antidepressants can be used according to specific circumstances. It is advisable to take low doses and short courses of treatment. While medication is ongoing, psychotherapy should continue, especially for patients with slower recovery. ^[1]