The P's Flashcards
What is ‘PIE’?
form of ‘forward psychiatry’ designed to treat combat stress reaction using the three principles of proximity, immediacy and expectancy.
Who came up with ‘PIE’?
Although the treatment is often attributed to Thomas Salmon, the US army psychiatrist, he was responsible neither for the techniques nor the acronym, although he did publicise the method and recommended its introduction for US forces when they entered the war in April 1917.
The acronym ‘PIE’ was devised by Artiss (1963) and does not appear in any literature from World Wars One or Two.
Who first used forward psychiatric units?
Forward psychiatric units were first operated by the French Second Army at the beginning of 1916 following representations from the Société de Neurologie.
When did the British use forward psychiatric units?
The British, suffering from manpower shortages after the Somme offensive set up four forward psychiatric units in December 1916 at casualty clearing stations and stationary hospitals situated about ten miles from the front line. Officially termed ‘not yet diagnosed, nervous centres’ they continued to function until the end of the war (Jones and Wessely, 2003a).
What is post-combat disorder or post-war disorder?
terms coined to describe clusters of medically unexplained symptoms arising in servicemen after active service. These presentations are also known as ‘war syndromes’.
Why post-combat disorder is a misleading term?
Post-combat disorder is a misleading term in one respect as the same symptom clusters have been observed in soldiers who break down during training or service in the UK and have not been exposed to the stress of battle. Particular examples included: Soldier’s heart, DAH, shell shock, Gulf War Syndrome, and exposure to Agent Orange (Jones et al., 2002b).
Are post-combat disorders the same as combat stress reactions?
Post-combat disorders are not the same as combat stress reactions in that they are characterised by somatic and neurological symptoms usually of a chronic nature. Whether a diagnosis of CSR predisposes a veteran to subsequent post-combat disorders has not been tested.
What is posttraumatic illness (PTI) or posttraumatic disorder (PTD)?
O’Brien defined posttraumatic illness as ‘a recognisable mental disorder other than PTSD which follows a traumatic event and is postulated to have been caused or precipitated by it. Possible PTIs commonly include other anxiety disorders, affective disorders, adjustment reactions, substance abuse disorders, and a range of other axis 1 disorders (O’Brien, 1998, p. 2).
Hence PTI/PTD includes but is not limited to PTSD. It encompasses co-morbid, or cooccurring, conditions (such as depression or substance abuse disorder) as well as other manifestations of traumatic events such as ASD, ASR and CSR.
What is the criteria of posttraumatic stress disorder (PTSD)?
1 ‘existence of a recognisable stressor that would evoke significant symptoms of distress in almost anyone’
2 re-experiencing symptoms
3 avoidance behaviour and feelings
4 arousal symptoms and behaviour.
What was the original name of posttraumatic stress disorder (PTSD)?
originally termed Post-Vietnam Syndrome because the effects were considered specific to veterans who had served in that conflict. However, it soon became apparent that its symptoms could be identified in civilians who had been exposed to traumatic episodes such as road traffic accidents. It was not a phenomenon confined to members of the armed forces and exposed to combat.
When was posttraumatic stress disorder (PTSD) formally defined?
PTSD was formally defined in 1980 in the American Psychiatric Association’s diagnostic and statistical manual, DSM-III
What are the sub-categories of PTSD?
PTSD was divided into two sub-categories*: An acute variant (onset of symptoms within six months of the traumatic event or duration of symptoms less than six months) and a chronic/delayed type (when the symptoms last for six months or longer, and when the symptoms arise at least six months after the traumatic event).
The 2 sub-categories also appear as 3 sub types.
What are the DSM-IIIR revisions done to PTSD?
The criteria for PTSD were subject to revision in DSM-IIIR published in 1987 (see Table G.3). The traumatic event was more closely defined: ‘Experience of an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone, e.g. serious threat to one’s life or physical integrity…or seeing someone who has recently been, or is being, seriously injured or killed as a result of an accident or physical violence’. In addition, the acute subtype of PTSD, codified in DSM-III, was effectively removed by the requirement that symptoms in categories B, C and D had to be present for at least one month.
When was the next revision done to PTSD, after the DSM-IIIR one?
DSM-IV published by the American Psychiatric Association in 1994 introduced further significant changes to the criteria for PTSD.
What are the DSM-IV changes to the actual causes of PTSD?
Definition of the traumatic event was tightened to include:
- Actual or threatened death
- or serious injury,
- or other threat to one’s physical integrity;
- or witnessing an event that involves death, injury, or a threat to the physical integrity of another person;
- or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (p. 424).
