Abstract
With the exception of the sudden death phenomenon, posttraumatic stress disorder (PTSD) represents the single most severe and recalcitrant variant of pathogenetic stress arousal known to modern medicine (Everly, 1989). Its symptomatology includes both psychiatric and somatic manifestations (Everly, 1989) which often prove to be enigmatic to traditional treatment approaches. In this chapter, I will offer a reconsideration of the neurophysiology of PTSD wherein PTSD is viewed within the context of the “disorders of arousal” nosological genre as formulated in earlier research (Everly & Benson, 1989). Such a reformulation will give rise to a neurophysiological rationale for the use of therapeutic interventions designed to lower the “state-and-trait” levels of neurophysiological arousal within the PTSD patient. Indeed, it may be argued that successful treatment of the PTSD patient is contingent upon the successful diminution of manifest arousal.
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References
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.
Arnold, M. (1984). Memory and the brain. Hillsdale, NJ: Lawrence Erlbaum.
Bandura, A. (1977). Self-efficacy. Psychological Review, 84, 191–215.
Bandura, A. (1982). Self-efficacy mechanisms in human agency. American Psychologist, 37, 122–147.
Barlow, D., & Beck, J. (1984). The psychosocial treatment of anxiety disorders. In J. B. Williams & R. Spitzer (Eds.), Psychotherapy research (pp. 29–69). New York: Guilford Press.
Benson, H. (1975). The relaxation response. New York: William Morrow.
Benson, H. (1983). The relaxation response. Trends in Neuroscience, 6, 281–284.
Carr, D., & Sheehan, D. (1984). Panic anxiety. Journal of Clinical Psychiatry, 45, 323–330.
Ciaranello, R. D. (1983). Neurochemical aspects of stress. In N. Garmezy & M. Rutter (Eds.), Stress, coping, and development in children. New York: McGraw-Hill.
Delanoy, R., Tucci, D., & Gold, P. (1983). Amphetamine effects on LTP in dendate granule cells. Pharmacology, Biochemistry, and Behavior, 18, 137–139.
Doane, B. (1986). Clinical psychiatry and physiodynamics of the limbic system. In B. Doane & K. Livingston (Eds.), The limbic system (pp. 285–315). New York: Raven Press.
Everly, G. S. (1984, December). A neurocognitive analysis of stress response syndromes associated with trauma. Paper presented to the FEMA/NIMH Conference on Role Conflict and Support for Emergency Workers, Washington, DC.
Everly, G. S. (1985, April). Neurocognitive therapy and rehabilitation of psychiatric syndromes in response to stress. Paper presented to the International Conference on Stress and Behavioral Emergencies, Balto.
Everly, G. S. (1989). A clinical guide to the treatment of the human stress response. New York: Plenum Press.
Everly, G. S. (1990). Post-traumatic stress disorder as a “disorder of arousal.” Psychology and Health: An International Journal, 4, 135–145.
Everly, G. S., & Benson, H. (1989). Disorders of arousal. International Journal of Psychosomatics, 36, 15–22.
Everly, G. S., & Horton, A. M. (1989). Neuropsychology of posttraumatic stress disorder: A pilot study. Perceptual and Motor Skills, 68, 807–810.
Fifkova, E., & Van Harreveld, A. (1977). Long-lasting morphological changes in dendritic spines. Journal of Neurocytology, 6, 211–230.
Foy, D., Lund, M., Sipprelle, C., & Strachan, A. (1984). The Combat Exposure Scale: A systematic assessment of trauma in the Vietnam War. Journal of Clinical Psychology, 40, 1323–1328.
Friedman, M. (1988). Toward a rational pharmacotherapy for PTSD. American Journal of Psychiatry, 145, 281–285.
Gellhorn, E. (1957). Autonomic imbalance and the hypothalamus. Minneapolis: University of Minnesota Press.
Gellhorn, E. (1965). Neurophysiological bases of anxiety. Perspectives in Biology and Medicine, 8, 488–515.
Gellhorn, E. (1967). Principles of autonomic-somatic integration. Minneapolis: University of Minnesota Press.
Gellhorn, E., & Loofbourrow, G. (1963). Emotions and emotional disorders. New York: Harper & Row.
Goddard, G., Mclntyre, D., & Leech, C. (1969). A permanent change in brain function resulting from daily electrical stimulation. Experimental Neurology, 25, 295–330.
Horowitz, M., Wilner, N., Kaltreider, N., & Alvarez, W. (1980). Signs and symptoms of PTSD. Archives of General Psychiatry, 37, 85–92.
Joy, R. (1985). The effects of neurotoxicants on kindling and kindled seizures. Fundamental and Applied Toxicology, 5, 41–65.
Kardiner, A. (1941). The traumatic neuroses of war. New York: Paul B. Hoeber.
Kolb, L. C. (1987). A neuropsychological hypothesis explaining post-traumatic stress disorders. American Journal of Psychiatry, 144, 989–995.
Kolb, L. C. (1988). A critical survey of hypotheses regarding PTSD in light of recent research. Journal of Traumatic Stress, 3, 291–304.
McGeer, E., & McGeer, P. (1988). Excitotoxins and animal models of disease. In C. Galli, L. Manzo, & P. Spencer (Eds.), Recent advances in nervous system toxicology (pp. 107–131). New York: Plenum Press.
Mason, J. W., Giller, E. L., Kosten, T. R., et al. (1986). Urinary free cortisol in PTSD. Journal of Nervous and Mental Disorders, 174, 145–149.
Nutt, D. (1989). Altered central a2 adrenoreceptor sensitivity in panic disorder. Archives of General Psychiatry, 46, 165–169.
Olney, J. W. (1978). Neurotoxicity of excitatory amino acids. In E. McGeer, J. Olney, & P. McGeer (Eds.), Kainic acid as a tool in neurobiology (pp. 95–122). New York: Raven Press.
Post, R. (1985). Stress, sensitization, kindling, and conditioning. Behavioral and Brain Sciences, 8, 372–373.
Post, R. (1986). Does limbic system dysfunction play a role in affective illness? In B. Doane & K. Livingston (Eds.), The limbic system. New York: Raven Press.
Post, R., & Ballenger, J. (1981). Kindling models for progressive development of psychopathology. In H. Van Pragg (Ed.), Handbook of biological psychiatry (pp. 609–651). New York: Marcel Dekker.
Post, R., & Kopanda, R. (1976). Cocaine, kindling, and psychosis. American Journal of Psychiatry, 133, 627–634.
Sapolsky, R., Krey, L., & McEwen, B. (1984). Stress downregulates corticosterone receptors in a site specific manner in the brain. Endocrinology, 114, 287–292.
Sheehan, D. (1983). The anxiety disease. New York: Scribner.
van der Kolk, B. (1988). The trauma spectrum. Journal of Traumatic Stress, 1, 273–290.
van der Kolk, B., Brown, P., & van der Hart, O. (1989). Pierre Janet on post-traumatic stress. Journal of Traumatic Stress, 2, 365–378.
van der Kolk, B., Greenberg, M., Boyd, H., & Krystal, J. (1985). Inescapable shock, neurotransmitters, and addiction to trauma. Biological Psychiatry, 20, 314–325.
Weil, J. (1974). A neurophysiological model of emotional and intentional behavior. Springfield, IL: Charles C Thomas.
Wilson, J. P. (1989). Trauma, transformation, and healing. New York: Brunner/Mazel.
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Everly, G.S. (1993). Neurophysiological Considerations in the Treatment of Posttraumatic Stress Disorder. In: Wilson, J.P., Raphael, B. (eds) International Handbook of Traumatic Stress Syndromes. The Plenum Series on Stress and Coping. Springer, Boston, MA. https://doi.org/10.1007/978-1-4615-2820-3_67
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DOI: https://doi.org/10.1007/978-1-4615-2820-3_67
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