創傷後壓力症(PTSD)，歷史上曾被稱為「砲彈休克症」或「戰爭精神官能症」，自1980年起被美國精神醫學會認可為一個正式診斷。PTSD是一個精神健康問題，出現在一些經歷過創傷（e.g., 嚴重受傷、暴力、重大意外、戰爭）的人身上。PTSD有四大症狀類別：(1) 再度體驗、(2) 逃避症狀、(3) 認知和情緒症狀，及 (4) 警醒及反應症狀(Lancaster, Teeters, Gros, & Back, 2016)。PTSD在一般人口的終生盛行率為1.9% 至 8.8%，在受創社群（e.g., 群眾衝突或性侵受害人）則更普遍 (Bisson, Cosgrove, Lewis, & Roberts, 2015)。新的診斷手冊DSM-5已承認PTSD解離亞型之效度。有些PTSD患者會同時出現其他症狀（e.g., 抑鬱、自殺傾向、幻覺、物質濫用）。以創傷為焦點的一些心理治療法，諸如延長暴露(PE)療法、認知處理療法(CPT)和眼動減敏與歷程更新治療法(EMDR)，是PTSD的一線治療方案。藥物治療也可能有幫助。有些學者長久以來認為，單一創傷和多重創傷（e.g., 家庭暴力、童年受虐）所帶來的後果，在病理和所需治療方面，可能有很大分別。他們建議，複合型PTSD應該是獨立於一般PTSD之外的一個診斷。經過長期的研究和倡導，複合型PTSD終於被近來的世界衛生組織診斷手冊(ICD-11)列為正式診斷。PTSD不僅是一個醫學和精神健康問題──這跟社會壓迫和政治力量也息息相關。
Posttraumatic stress disorder (PTSD), used to be known as "shell shock" or "combat neurosis" in history, has been recognized as an official diagnosis by the American Psychiatric Association since 1980. PTSD is a mental health problem which develops in some persons who have encountered a traumatic event (e.g. serious injury, violence, serious accident, war). There are four major PTSD symptom clusters: (1) re-experiencing symptoms, (2) avoidance symptoms, (3) cognitive and mood symptoms, and (4) arousal and reactivity symptoms (Lancaster, Teeters, Gros, & Back, 2016). The lifetime prevalence of PTSD is between 1.9% to 8.8% in the general population and PTSD is much more common in traumatized populations (e.g., mass conflict or sexual abuse victims) (Bisson, Cosgrove, Lewis, & Roberts, 2015). The validity of a dissociative subtype of PTSD has been recognized in the recent diagnostic manual DSM-5. Some patients with PTSD also suffer from other comorbid symptoms (e.g., depression, suicidality, hallucinations, substance abuse). Trauma-focused psychotherapies, such as prolonged exposure (PE) therapy, cognitive processing therapy (CPT) and eye movement desensitization and reprocessing (EMDR), are the first-line treatments for PTSD. Drug treatment may also be helpful. Some scholars have long suggested that the consequences of a single trauma and multiple traumas (e.g., family violence, child abuse) can be very different in terms of the psychopathology and treatment needed, and they proposed that complex PTSD should be a diagnosis separate from simple PTSD. After a long period of research and advocacy, complex PTSD has been eventually included as an official diagnosis in the recent World Health Organization (WHO) diagnostic manual (i.e., ICD-11). PTSD is not just a medical or mental health problem – it is also highly related to social oppression and political power.
Pilkington, E. (2013). US military struggling to stop suicide epidemic among war veterans. The Guardian.
It was reported that the number of US soldiers who killed themselves was greater than the number of those who was dead due to combat. Suicide has become a very common but serious issue in US military. This article provides some figures regarding this issue. Combat-related trauma could lead to serious mental health problems. 引文
彭仁郁. (2018, 2018-05-21, January 01). 《從創傷到復原》導讀：真相與正義——遺忘真的比較好？. 關鍵評論.
This movie is based on the memoir of Chris Kyle, who was the deadliest marksman in U.S. military history. Despite of his success in military, Kyle had a lot of troubles after he returned home. This movie describes his successful military career as well as his suffering of having PTSD as a result of war. 引文
Yglesias, R. (1993). Fearless.
This American movie describes an architect who suffered from PTSD after a plane crash. 引文
Cloitre, M. et al. (2012). The ISTSS expert consensus treatment guidelines for complex PTSD in adults.
This resource was developed by a group of experts in the field of trauma. It reviews the definition and clinical features of complex PTSD and describes the recommended treatment for complex PTSD. 引文
Fung, H. W. et al. (2019). Using the Post-traumatic Stress Disorder (PTSD) Checklist for DSM-5 to screen for PTSD in the Chinese context: A pilot study in a psychiatric sample. Journal of Evidence-Based Social Work, 16(6), 643–651.
This paper reports the reliability and validity of the Chinese version of the Post-traumatic Stress Disorder (PTSD) Checklist for DSM-5. 引文
Greene, T. et al. (2016). Prevalence, detection and correlates of PTSD in the primary care setting: A systematic review. Journal of Clinical Psychology in Medical Settings, 23(2), 160–180.
This paper reviews the prevalence and clinical correlates of PTSD in primary care settings. The authors suggested that early detection of PTSD in primary care settings are important and that indicated screening and professional education would be helpful. 引文
Lancaster, C. L. et al. (2016). Posttraumatic stress disorder: Overview of evidence-based assessment and treatment. Journal of Clinical Medicine, 5(11), 105–117.
Nemeroff, C. B. et al. (2006). Posttraumatic stress disorder: A state-of-the-science review. Journal of Psychiatric Research, 40(1), 1–21.
This article provides a review of the scientific findings regarding PTSD. Some specific issues have been discussed, such as gender differences, impact of early-life trauma and prolonged exposure therapy. 引文
Thomaes, K. et al. (2014). Can pharmacological and psychological treatment change brain structure and function in PTSD? A systematic review. Journal of Psychiatric Research, 50, 1–15.
This paper systematically reviews the neurophysiological effects of PTSD treatment. Both pharmacological and psychological treatment evaluation studies were reviewed. 引文
Van der Hart, O. et al. (2005). Dissociation: An insufficiently recognized major feature of complex posttraumatic stress disorder. Journal of Traumatic Stress, 18(5), 413–423.
Many scholars have suggested that dissociation is a key concept in the study of posttraumatic psychopathology. This conceptual paper discusses why dissociation should receive more attention in the context of complex PTSD. The theory of structural dissociation of the personality was introduced to explain the phenomenon of complex PTSD. 引文
American Psychological Association, . (2017). Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. Washington, D.C: American Psychological Association.
This clinical guideline was developed by the American Psychological Association in order to provide recommendations on psychological and medication treatments for adults who suffer from PTSD. However, complementary and alternative treatments were not included in this guideline. 引文
Friedman, M. J. et al. (2014). Handbook of PTSD: Science and practice . New York: The Guilford Press.
This comprehensive book includes contributions from leading experts in the field of PTSD. Readers could know more about the history, scientific foundations, theoretical perspectives, assessment and treatment of PTSD after reading this definitive reference. 引文
Herman, J. L. (1992). Trauma and recovery. New York: Basic Books.
This book is a classic in the field of psychological trauma. Dr. Judith Herman, a Professor of clinical psychiatry at Harvard University Medical School, brings us a new level of understanding of psychological trauma and its consequences. This book not only talks about the phenomenon of trauma and posttraumatic reactions (including PTSD and complex PTSD) and overviews the process of trauma recovery, but also emphasizes the social and political context. 引文
US Department of Veterans Affairs and Department of Defense, . (2010). VA/DoD clinical practice guideline for the management of post-traumatic stress. Washington, DC: US Department of Veterans Affairs and Department of Defense.
This resource provides practical guidelines for the management of PTSD and acute stress reaction. Helping professionals who work with traumatized clients would find this helpful. 引文
van der Kolk, B. A. (2014). The body keeps the score: Brain, mind and body in the healing of trauma. New York, NY: Viking.
This New York Times bestseller is written by Dr. Bessel van der Kolk, who is a renowned expert on trauma. This book introduces the neuroscience of trauma and discusses recent scientific advances in the field. It explains how psychological trauma affects our brain and body. Innovative approaches to the treatment of trauma (e.g., EMDR, sports, drama, yoga, neurofeedback) were also highlighted. 引文
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