Exposure therapy for post-traumatic stress disorder: four case studies

Article Abstract:

Post-traumatic stress disorder (PTSD) has been the subject of much research since it first appeared in psychiatric diagnostic manuals in 1980. The clinical criteria for describing the illness have been validated and factors have been identified which may predict the development of the disorder. Treatments have been offered from all facets of psychology and psychiatry. Direct therapeutic exposure to the memories surrounding the traumatic event (such as a wartime experience) precipitating the disorder is common to all theoretical models, although the type of imagery used differs. PTSD is characterized by avoidance of situations and objects that are connected with the original trauma. In the presence of the avoided stimuli, there are often physiological symptoms, and flashbacks, amnesia, and nightmares are frequently reported. Four cases of PTSD are described. Each was treated with exposure to the aversive event through audio tapes that helped patients imagine the scene of the event. Patients listened to the tapes at home at least four times per week. Outcome was measured by questionnaires that assessed mood, anxiety, social adjustment, and self-report of behavioral change. The four patients were treated successfully, suggesting that imaginal exposure may give greater access to the meaning elements of the memory, which have been hypothesized to be important to the understanding and treatment of PTSD. Controlled research is now needed to further assess the efficacy of this treatment. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Methods, Post-traumatic stress disorder, Psychotherapy

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Depression in autistic children

Article Abstract:

Social interaction, language, and play are severely impaired in patients with autism, a developmental disorder. At one time it was thought that autistic individuals were incapable of experiencing emotions and feelings, but more recent evidence disputes this. For instance, one report describes two autistic adolescents with mood swings, and another reports an autistic patient with manic-depressive illness. The present paper discusses the case of a 17-year-old boy with Down's syndrome and autism who suffered major depression. He was evaluated after uncharacteristic aggressive outbursts and frequent crying that began and worsened in the months after changing schools. There was no family history of psychiatric disorder. Based on symptoms of depressed mood, diminished interest in pleasurable activities, insomnia, decrease in appetite, and fatigue, the patient was diagnosed with major depression; treatment with 20 milligrams of fluoxetine per day was begun. Two months later, after some improvement, the dose was increased to 40 mg/day. The symptoms remitted after another month of treatment. Assessment and diagnosis of depression in autistic persons is difficult because many of the traditional rating scales are not accurate with this population and patients often cannot provide necessary information. Clinicians should be aware of the possibility of depression coexisting with autism or other developmental disorders. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Diagnosis, Complications and side effects, Depression, Mental, Depression (Mood disorder), Autism, Autistic children

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