New Tools to Enhance Posttraumatic Stress Disorder Diagnosis and Treatment: Invisible Wounds of War by B.K. Wiederhold


1059d1a221a0b7f-261x361.jpg Author B.K. Wiederhold
Isbn 9781614991885
File size 4.76MB
Year 2013
Pages 232
Language English
File format PDF
Category psychology


 

NATO Science for Peace and Security Series This Series presents the results of scientific meetings supported under the NATO Programme: Science for Peace and Security (SPS). The NATO SPS Programme supports meetings in the following Key Priority areas: (1) Defence Against Terrorism; (2) Countering other Threats to Security and (3) NATO, Partner and Mediterranean Dialogue Country Priorities. The types of meeting supported are generally “Advanced Study Institutes” and “Advanced Research Workshops”. The NATO SPS Series collects together the results of these meetings. The meetings are co-organized by scientists from NATO countries and scientists from NATO’s “Partner” or “Mediterranean Dialogue” countries. The observations and recommendations made at the meetings, as well as the contents of the volumes in the Series, reflect those of participants and contributors only; they should not necessarily be regarded as reflecting NATO views or policy. Advanced Study Institutes (ASI) are high-level tutorial courses to convey the latest developments in a subject to an advanced-level audience. Advanced Research Workshops (ARW) are expert meetings where an intense but informal exchange of views at the frontiers of a subject aims at identifying directions for future action. Following a transformation of the programme in 2006 the Series has been re-named and reorganised. Recent volumes on topics not related to security, which result from meetings supported under the programme earlier, may be found in the NATO Science Series. The Series is published by IOS Press, Amsterdam, and Springer Science and Business Media, Dordrecht, in conjunction with the NATO Emerging Security Challenges Division. Sub-Series A. B. C. D. E. Chemistry and Biology Physics and Biophysics Environmental Security Information and Communication Security Human and Societal Dynamics http://www.nato.int/science http://www.springer.com http://www.iospress.nl Sub-Series E: Human and Societal Dynamics – Vol. 108 ISSN 1874-6276 (print) ISSN 1879-8268 (online) Springer Science and Business Media Springer Science and Business Media Springer Science and Business Media IOS Press IOS Press New Tools to Enhance Posttraumatic Stress Disorder Diagnosis and Treatment Invisible Wounds of War Edited by Brenda K. Wiederhold, Ph.D, MBA, BCIA Interactive Media Institute, San Diego, CA, USA Virtual Reality Medical Institute, Brussels, Belgium Published in cooperation with NATO Emerging Security Challenges Division Proceedings of the NATO Advanced Study Institute on Invisible Wounds: New Tools to Enhance Posttraumatic Stress Disorder Diagnosis and Treatment Ankara, Turkey 18-28 June 2012 © 2013 The authors and IOS Press. All rights reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without prior written permission from the publisher. ISBN 978-1-61499-188-5 (print) ISBN 978-1-61499-189-2 (online) Library of Congress Control Number: 2013946076 Publisher IOS Press BV Nieuwe Hemweg 6B 1013 BG Amsterdam Netherlands fax: +31 20 687 0019 e-mail: [email protected] Distributor in the USA and Canada IOS Press, Inc. 4502 Rachael Manor Drive Fairfax, VA 22032 USA fax: +1 703 323 3668 e-mail: [email protected] LEGAL NOTICE The publisher is not responsible for the use which might be made of the following information. PRINTED IN POLAND New Tools to Enhance Posttraumatic Stress Disorder Diagnosis and Treatment B.K. Wiederhold (Ed.) IOS Press, 2013 © 2013 The authors and IOS Press. All rights reserved v Preface The organizers and attendees of the NATO-funded “Wounds of War” Advanced Research Workshop series realized the need for the 2012 NATO Advanced Study Institute: Invisible Wounds – New Tools to Enhance PTSD Diagnosis and Treatment (IW2012) due to the increased rates of PTSD in combat veterans and survivors of armed conflict. Exposure to traumatic events have led to this increased risk of PTSD and often, the serious consequences of this disorder lead to impulsive and destructive behaviours such as drug abuse, uncontrollable anger, and even suicide. Combat-related PTSD is one of the strongest contributing factors to high suicide risk in returning troops. IW2012 disseminated knowledge, emboldened skill sets, fostered collaborations and trained attendees to help counter this aforementioned internal threat to our countries’ security. In comparison to a traditional conference, IW2012 allowed for greater collaboration among established and emerging research leaders in the field of PTSD, and provided an in depth presentation of this unique material. IW2012 afforded participants a solid grounding in the latest PTSD research; review of the latest science related to theoretical constructs and associated neuroscience; and presentation of the latest psychotherapy and pharmacotherapy for intervention, treatment, and management of this disorder. Brenda K. Wiederhold, 0h.D, MBA, BCIA This page intentionally left blank vii Editorial Brenda K. Wiederhold, Ph.D, MBA, BCIA Interactive Media Institute, San Diego, CA, United States Virtual Reality Medical Institute, Brussels, Belgium Introduction Fifty-six scientists and representatives from NATO and Partner countries met in Ankara, Turkey from June 18-28, 2012 for the ten-day NATO Advanced Study Institute (ASI) titled “Invisible Wounds New Tools To Enhance Posttraumatic Stress Disorder Diagnosis And Treatment. (IW2012)” Formal scientific presentations were delivered by experts from nine different countries who were invited to take part in the ASI. The meeting was divided into four scientific sessions: 1. 2. 3. 4. Session I - “Review of the Latest Science Related to Theoretical Constructs and Associated Neurosciences” Session II – “Screening” Session III – “Stress Inoculation Training” Session IV – “Co-morbid Issues: Considering the Whole Person in Treatment” Papers and Presentations In addition to their presentations, presenters submitted papers for publication in this volume in order to inform readers who were not in attendance at this year’s study institute about the latest research and rehabilitative techniques in the study of Combatrelated PTSD. The first section, “Review of the Latest Science Related to Theoretical Constructs and Associated Neurosciences,” discusses the latest PTSD research in “Brain Systems and Circuits in PTSD: Overview of Clinical Research Models.” The opening paper by Colonel Eric Vermetten and Dr. Ruth Lanius presents different methods that contributed to the working model of the neural circuitry of PTSD. The chapter focuses on the functional neuroimaging research conducted in PTSD by highlighting various techniques (SPECT, PET, and fMRI) and differing paradigms (resting, active tasks, stimulus presentation) which provides the reader a global overview of the current findings of these studies. The second paper, “Biomarkers as New Tools to Improve the Diagnosis and Treatment of PTSD” by Professor Nela Pivac et al., discusses their research which attempts to determine different neurobiological, genetic and environmental risk factors which might be involved in the vulnerability and/or resilience to PTSD using Croatian male war veterans. The results indicate that specific PTSD biomarkers, associated with viii the narrow clinical features, might be indicators of PTSD traits, state or progression, and might be used to improve the diagnosis and treatment of PTSD. The second section continues with a discussion on PTSD screening. In “Early Identification of Risk for Posttraumatic Stress Disorder after Military Deployment,” Colonel Michael Roy reports on his iterative effort to educate military family members to recognize symptoms and facilitate intervention. In addition, preliminary results are discussed from direct longitudinal assessment of returning service members for development of PTSD. Their direct assessment of service members is unique in its comprehensiveness, and holds great promise for risk stratification. Next, Professor Dragica Kozaric-Kovacic and Dr. Andrea Jambrosic Sakoman present results of previous PTSD studies as well as original research in search for psychophysiological indicators of PTSD in their paper “Psychophysiological Indicators and Biofeedback Treatment of Stress Related Disorders: Our Experience.” In addition, their promising experience with applied psychophysiology (biofeedback) as an add-on therapy is discussed. In “Multimodal Paradigm for Mental Readiness Training and PTSD Prevention”, Professor Krešimir osi’s et al. proposes that a multimodal paradigm for cognitiveemotional elicitation, estimation and regulation may strengthen military training and enhance selection process. The paradigm includes multiple sessions involving missionrelevant audio-visual stimulation and simultaneous measurement of the trainee’s multimodal physiological, facial and vocal response. Another paper led by Professor Krešimir osi’s et al.“Extreme Political Attitudes and Emotionally Based Strategic Communications” proposes using Emotionally Based Strategic Communications (EBSC) as a soft power for restoring political stability, security and prosperity in turbulent societies. The authors propose that emotional transformation based on the concept of dominant emotional maps may assist targeted groups or even entire societies to overcome their challenging political, social and security problems. The third section, “Stress Inoculation Training”, begins with “Our Experiences in the Use of VR Technology in Therapy and Prevention of Combat Related Stress Disorders in the Polish Army” By Stanislaw Ilnicki et. al. This paper is a report on 5year partnership between the Department of Psychiatry and Combat Stress (DP&CS) of the Military Institute of Medicine in Warsaw with the Virtual Reality Medical Center (VRMC) of San Diego, USA in implementation of VR technology in the area of protection of mental health of Polish Military Contingent’s (PMC) soldiers and veterans who participated in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). The next chapter, “VR Stress Inoculation Training Results for Polish ISAF Soldiers – A Study of 4 Cases” by Ludmila Kosinska et al. evaluated the results of VR Stress Inoculation Training (SIT) for four soldiers preparing for their first mission in Afghanistan (ISAF) and assessed if their temperamental structure was related to successful training. Justyna Maciolek’s et al. paper titled, “The Influence of Pre-Deployment VR Computer-Assisted Stress Inoculation Training on the Anxiety Level in the Polish ISAF Soldiers” evaluates the influence of Stress Inoculation Training (SIT) on the anxiety level measured by State-Trait Anxiety Inventory (STAI), both as temporary/emotional state anxiety (X1) and stable personality trait anxiety (X2) in soldiers preparing for their mission in Afghanistan (ISAF). It concludes that given the ix equivocal results of the experiment, there is a need for a further study or a deeper analysis. Next, in “Personality and Stress-Coping Factors in VR Computer-Assisted Stress Inoculation Training of Polish ISAF Soldiers” Maciej Zbyszewski et al. discuss a study that evaluated the impact of personality, temperament and stress coping factors in Stress Inoculation Training (SIT) in soldiers preparing for their first deployment to Afghanistan (ISAF). The results shown could be taken into account when analyzing individual susceptibility to SIT. The fourth and final section is called “Co-morbid Issues: Considering the Whole Person in Treatment”. “Recent Advances in the Treatment of Comorbid PTSD and Substance Use Disorder” by Professor Mehmet Sofuoglu et al. conducted two clinical trials testing the safety and efficacy of medication treatments for comorbid PTSD and alcohol dependence (AD). The study suggested that norepinephrine uptake inhibitors may have efficacy for the treatment of comorbid PTSD and AD. In “Secondary Traumatic Stress Among Wives of War Veterans”, Professor Tanja Franiškovi et al. present a study that compares the level of present psychological symptoms and perceived quality of life between the wives of veterans with PTSD, without PTSD, and wives of non-veterans. They conclude that when planning the future interventions for PTSD affected veterans, a systemic approach should be considered not only to prevent secondary traumatic stress in partners of war veterans but also to enhance individual functioning of each partner and functioning as a couple. The ultimate aim of IW2012 was to enhance attendees’ knowledge of the latest advances in assessment, diagnosis, prevention and treatment of posttraumatic stress disorder (PTSD) and related comorbid disorders in military populations. Overall, the conference was successful in increasing knowledge, disseminating information and communicating research results within the group of participants. We are also grateful to Chelsie Boyd from the Virtual Reality Medical Institute for collecting and coordinating the chapters for this volume. This page intentionally left blank xi Co-Chairs Professor Brenda K. Wiederhold PhD, MBA, BCIA Interactive Media Institute 9565 Waples Street, Suite 200 San Diego, CA 92121 Tel +1 858 642 0267 Fax +1 858 642 0285 Virtual Reality Medical Institute 30 Clos Chapelle aux Champs, Bte 1.3030 1200 Brussels, Belgium E-mail: [email protected] Professor Krešimir osi ,PhD University of Zagreb Faculty of Electrical Engineering & Computing, Unska 3 10000 Zagreb, Croatia E-mail: [email protected] xii Lectures/Presentations Given DAY 1 Theoretical Constructs and Associated Neuroscience Introduction to the 2012 NATO Advanced Study Institute Professor Dr. Brenda K. Wiederhold Introduction to the 2012 NATO Advanced Study Institute Professor Dr. Kresimir Cosic Introduction to the 2012 NATO Advanced Study Institute Captain U. Feyyaz Aydogdu Introduction to Posttraumatic Stress Disorder Professor Dr. Brenda K. Wiederhold Official Conference Photograph & Morning Coffee Break State of the Art: Pharmacotherapy Colonel Dr. Eric Vermetten Questions & Answers Colonel Dr. Eric Vermetten & Prof. Dr. Brenda K. Wiederhold State of the Art: Brain Imaging Colonel Dr. Eric Vermetten PTSD, PTSD-like Symptoms due to Mild Traumatic Brain Injury and Comorbidity: How QEEG is Helpful in Diagnosis and Personalized Treatment? Dr. Tanju Surmeli Questions & Answers Colonel Dr. Eric Vermetten & Dr. Tanju Surmeli DAY 2 Screening Review of Day 1 and Introduction of Day 2 Professor Dr. Brenda K. Wiederhold xiii Early Identification of Risk for Posttraumatic Stress Disorder after Military Deployment Professor Dr. Michael Roy Psychophysiological Indicators and Biofeedback Treatment of Stress-related Disorders: Our Experience Professor Dr. Dragica Kozaric-Kovacic Multimodal Paradigm for Mental Readiness Training and PTSD Prevention Dr. Sinisa Popovic Questions & Answers Professor Dr. Dragica Kozaric-Kovacic, Dr. Sinisa Popovic & Professor Dr. Michael Roy Extreme Political Attitudes and Emotionally Based Strategic Communications Professor Dr. Kresimir Cosic Questions & Answers Professor Dr. Kresimir Cosic iMAT – Mental Armor Training Discussion of Screening Issues and Demonstration Mr. James Stewart Cullen DAY 3 Stress Inoculation Training Review of Day 2 and Introduction of Day 3 Professor Dr. Brenda K. Wiederhold Introduction to Stress Inoculation Training Professor Dr. Brenda K. Wiederhold The Influence of Pre-Deployment VR Computer-Assisted Stress Inoculation Training on the Anxiety Level in the Polish ISAF Soldiers Justyna Maciolek, MA VR Stress Inoculation Training Results for Polish ISAF Soldiers – A Study of 4 Cases Ludmila Kosinka, MA VR Stress Inoculation Training Results for Polish ISAF Soldiers – A Case Study Maciej Zbyszewski, MA Secondary Traumatic Stress Among Wives of War Veterans Professor Dr. Tanja Franciskovic xiv Questions & Answers Justyna Maciolek, Ludmila Kosinka, & Maciej Zbyszewski Stress Inoculation Training Demonstrations (Combat Medic, Stress Training) Mr. James Stewart Cullen & Professor Dr. Stanislaw Ilnicki DAY 4 Treatment Review of Day 3 and Introduction of Training Day 4 Professor Dr. Brenda K. Wiederhold Understanding PTSD: Critiques and Challenges to Diagnosis and Therapeutic Approaches Professor Dr. Mehmet Sungur What Do We Know and What Needs to be Explored Further to Increase our Knowledge of PTSD? Professor Dr. Mehmet Sungur A Cognitive Model of PTSD: Implications for Treatment Professor Dr. Mehmet Sungur Establishing Treatment Algorithms in PTSD and Cognitive Behavioral Therapy in PTSD Professor Dr. Mehmet Sungur DAY 5 Review of Day 4 and Introduction of Day 5 Professor Dr. Brenda K. Wiederhold Pharmacotherapy of Substance Use Disorders Professor Dr. Mehmet Sofuoglu Recent Advances in the Treatment of Comorbid PTSD and Substance Use Disorders Professor Dr. Mehmet Sofuoglu Substance Abuse Professor Dr. Berna Ulug Questions & Answers Professor Dr. Mehmet Sofuoglu & Professor Dr. Berna Ulug Biomarkers as New Tools to Improve the Diagnosis and Treatment of PTSD Professor Dr. Nela Pivac xv Questions & Answers Professor Dr. Nela Pivac DAY 6 Virtual Reality Treatment Review of Days 1 - 5 and Introduction of Days 6 - 10 Professor Dr. Brenda K. Wiederhold Introduction to Virtual Reality Treatment - Civilian Professor Dr. Brenda K. Wiederhold Introduction to Virtual Reality Treatment - Military Professor Dr. James L. Spira Questions & Answers Professor Dr. James L. Spira & Professor Dr. Brenda K. Wiederhold Introduction of VR, Attentional Retraining and Physiological Monitoring and Feedback Professor Dr. James L. Spira DAY 7 Review of Day 6 and Introduction of Day 7 Professor Dr. James L. Spira Discussion of Advantages and Cautions of VR-Assisted Therapy Professor Dr. James L. Spira Psychological Effects of Trauma Professor Dr. Barbara Melamed Questions & Answers Professor Dr. Stanislaw Ilnicki, Professor Dr. Stanislaw Ilnick & Dr. Barbara Melamed Supervised Practice of Attentional Retraining, Psychophysiology and VR Professor Dr. James L. Spira Review of Supervised Practice Professor Dr. James L. Spira DAY 8 Review of Day 7 and Introduction of Day 8 Professor Dr. James L. Spira xvi PTSD and Pain Co-Morbidity and Demonstration Professor Dr. James L. Spira Supervised Practice of Attentional Retraining, Psychophysiology and VR Professor Dr. James L. Spira Supervised Practice of Attentional Retraining, Psychophysiology and VR Professor Dr. James L. Spira DAY 9 Review of Day 8 and Introduction of Day 9 Professor Dr. James L. Spira Supervised Practice of Attentional Retraining, Psychophysiology and VR Professor Dr. James L. Spira Supervised Practice of Attentional Retraining, Psychophysiology and VR Professor Dr. James L. Spira Participants in Pairs are Reviewed and Given Feedback Professor Dr. James L. Spira DAY 10 Review of Day 9 and Introduction of Day 10 Professor Dr. Brenda K. Wiederhold Our Experiences in the Use of VR Technology in Therapy, Diagnostics and Prophylaxy of Combat Related Stress Disorders in Polish Army Justyna Maciolek, MA Training Civilians to Treat the Military Professor Dr. Brenda K. Wiederhold Difficulties in Treatment and Individualizing Treatment Professor Dr. James L. Spira Final Questions & Answers Professor Dr. James L. Spira & Professor Dr. Brenda K. Wiederhold Wrap-Up and Certificate Ceremony Professor Dr. Brenda K. Wiederhold xvii Sponsors Workshop organizers Interactive Media Institute and Virtual Reality Medical Institute would like to thank the sponsors of this Advanced Study Institute listed below. Without their support, this event could not have taken place: • • • • • • • Centre of Excellence-Defence Against Terrorism Interactive Media Institute International Association of CyberPsychology, Training & Rehabilitation North Atlantic Treaty Organization (NATO) University of Zagreb Virtual Reality Medical Center Virtual Reality Medical Institute This page intentionally left blank xix Contents Preface v Editorial Brenda K. Wiederhold vii Co-Chairs xi Lectures/Presentations Given xii Sponsors xvii Section 1: Review of the Latest Science Related to Theoretical Constructs and Associated Neurosciences Brain Systems and Circuits in PTSD: Overview of Clinical Research Models Eric Vermetten 3 Biomarkers as New Tools To Improve the Diagnosis and Treatment of PTSD Nela Pivac, Gordana Nedic, Dragica Kozaric-Kovacic, Matea Nikolac, Mirjana Grubisic-Ilic, Maja Mustapic, Tihana Jendricko, Iva Rakos and Dorotea Muck-Seler 21 Section 2: Screening Early Identification of Risk for Posttraumatic Stress Disorder after Military Deployment Michael J. Roy 75 Psychophysiological Indicators and Biofeedback Treatment of Stress Related Disorders: Our Experience Dragica Kozaric-Kovacic and Andrea Jambrosic Sakoman 92 Multimodal Paradigm for Mental Readiness Training and PTSD Prevention Krešimir osi, Siniša Popovi, Marko Horvat, Davor Kukolja, Branimir Dropulji, Bernard Kova and Ivan Fabek 102 Extreme Political Attitudes and Emotionally Based Strategic Communications Krešimir osi, Siniša Popovi, Armano Srbljinovi, Bernard Kova and Ivan Fabek 117 xx Section 3: Stress Inoculation Training Our Experiences in the Use of VR Technology in Therapy and Prevention of Combat Related Stress Disorders in the Polish Army Stanislaw Ilnicki, Radosaw Tworus, Sylwia Szymanska, Agnieszka Laskowska, Maciej Zbyszewski, Ludmila Kosinska, Justyna Maciolek, Piotr Ilnicki, Andrzej K. Radzikowski, Dorota Wojtowska-Wiechetek, Anna Siatkowska, Monika Filarowska and Ana Petrovic VR Stress Inoculation Training Results for Polish ISAF Soldiers – A Study of 4 Cases Ludmila Kosinska, Stanislaw Ilnicki, Brenda K. Wiederhold, Justyna Maciolek, Sylwia Szymanska, Ewelina Opalko-Piotrkiewicz, Anna Siatkowska, Piotr Ilnicki, Maciej Zbyszewski and Anna Glibowska The Influence of Pre-Deployment VR Computer-Assisted Stress Inoculation Training on the Anxiety Level in the Polish ISAF Soldiers Justyna Maciolek, Stanislaw Ilnicki, Brenda K. Wiederhold, Ludmila Kosinska, Sylwia Szymanska, Maciej Zbyszewski, Ewelina Opalko-Piotrkiewicz, Anna Siatkowska, Anna Glibowska, Dorota Borzetka, Piotr Ilnicki, Monika Filarowska, Katarzyna Pleskacz and Piotr Murawski Personality and Stress-Coping Factors in VR Computer-Assisted Stress Inoculation Training of Polish ISAF Soldiers Maciej Zbyszewski, Stanislaw Ilnicki, Brenda K. Wiederhold, Justyna Maciolek, Ludmila Kosinska, Sylwia Szymanska, Ewelina Opalko-Piotrkiewicz, Anna Swierczynska, Monika Filarowska,, Anna Glibowska, Dorota Borzetka, Katarzyna Pleskacz and Piotr Murawski 139 149 161 172 Section 4: Co-Morbid Issues: Considering the Whole Person in Treatment Recent Advances in the Treatment of Comorbid PTSD and Substance Use Disorder Mehmet Sofuoglu, Robert Rosenheck and Ismene Petrakis 183 Secondary Traumatic Stress Among Wives of War Veterans 190 Aleksandra Stevanovi, Tanja Franiškovi and Gordana Kuterovac Jagodi Subject Index 207 Author Index 209

Author B.K. Wiederhold Isbn 9781614991885 File size 4.76MB Year 2013 Pages 232 Language English File format PDF Category Psychology Book Description: FacebookTwitterGoogle+TumblrDiggMySpaceShare The number of cases of post traumatic stress disorder (PTSD) affecting both combat veterans and survivors of armed conflict has increased in recent years. Exposure to traumatic events can cause PTSD, and the serious consequences of this disorder can often lead to impulsive and destructive behaviors such as drug abuse and uncontrollable anger. Combat related PTSD is also one of the strongest contributing factors to the high suicide risk in returning troops. This book presents the collected papers from the 2012 NATO Advanced Study Institute (ASI): Invisible Wounds New Tools to Enhance PTSD Diagnosis and Treatment (IW2012), held in Ankara, Turkey, in June 2012. This ASI was attended by 56 scientists and representatives from NATO and Partner countries, and expert contributors from nine different countries were invited to take part in the workshop. The aim of the ASI was to equip participants with an in-depth knowledge of the latest theoretical advances in neuroscience, psychotherapy and pharmacology, and thereby to assist them in the task of assessment, diagnosis, prevention and treatment of PTSD and related co-morbid disorders. The book is divided into four sections: a review of the latest science related to theoretical constructs and associated neurosciences; screening; stress inoculation training; and co-morbid issues: considering the whole person in treatment. This book will provide a valuable resource for all those whose work involves dealing with post traumatic stress disorder. IOS Press is an international science, technical and medical publisher of high-quality books for academics, scientists, and professionals in all fields. Some of the areas we publish in: -Biomedicine -Oncology -Artificial intelligence -Databases and information systems -Maritime engineering -Nanotechnology -Geoengineering -All aspects of physics -E-governance -E-commerce -The knowledge economy -Urban studies -Arms control -Understanding and responding to terrorism -Medical informatics -Computer Sciences     Download (4.76MB) It Wasn’t Your Fault : Freeing Yourself From the Shame of Childhood Abuse Mindfulness-Based Cognitive Therapy for Posttraumatic Stress Disorder Understanding Combat Related Post Traumatic Stress Disorder Play Therapy with Children and Adolescents in Crisis, Fourth Edition Addiction (Oxford Psychiatry Library Series) Load more posts

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