The first-line psychological treatment for PTSD should be trauma-focused (TFCBT or EMDR).

Post-traumatic stress disorder is currently classified as an anxiety disorder with fear as the predominant emotion. This has led to the development of treatment techniques such as exposure aimed at alleviating fear. This article highlights the need to address other emotional responses, in particular shame and guilt, when assessing and treating PTSD. Hence, it presents two clinical models of shame-based PTSD and guilt-based PTSD. These models are offered as aids to clinicians in assessing and formulating cases of PTSD where shame and guilt are salient issues. The models highlight the importance of assessing meaning in the context of pre-existing schemas and address two pathways to the development of shame and/or guilt: schema congruence and schema incongruence. Several treatment implications are drawn from the models.

Performance of the new measure was equivalent to agreement achieved between two full clinical interviews.

BackgroundBrief screening instruments appear to be a viable way of detecting post-traumatic stress disorder (PTSD) but none has yet been adequately validated.AimsTo test and cross-validate a brief instrumentthat is simple to administer and score.MethodForty-one survivors of a rai l crash were administered a questionnaire, followed by a structured clinical interview 1 week later.ResultsExcellent prediction of a PTSD diagnosis was provided by respondents endorsing at least six re-experiencing or arousal symptoms, in any combination. The findings were replicated on data from a previous study of 157 crime victims.ConclusionsPerformance of the new measure was equivalent to agreement achieved between two full clinical interviews.

A recent meta-analysis by Benish, Imel, and Wampold (2008, Clinical Psychology Review, 28, 746–758) concluded that all bona fide treatments are equally effective in posttraumatic stress disorder (PTSD). In contrast, seven other meta-analyses or systematic reviews concluded that there is good evidence that trauma-focused psychological treatments (trauma-focused cognitive behavior therapy and eye movement desensitization and reprocessing) are effective in PTSD; but that treatments that do not focus on the patients' trauma memories or their meanings are either less effective or not yet sufficiently studied. International treatment guidelines therefore recommend trauma-focused psychological treatments as first-line treatments for PTSD. We examine possible reasons for the discrepant conclusions and argue that (1) the selection procedure of the available evidence used in Benish et al.'s (2008)meta-analysis introduces bias, and (2) the analysis and conclusions fail to take into account the need to demonstrate that treatments for PTSD are more effective than natural recovery. Furthermore, significant increases in effect sizes of trauma-focused cognitive behavior therapies over the past two decades contradict the conclusion that content of treatment does not matter. To advance understanding of the optimal treatment for PTSD, we recommend further research into the active mechanisms of therapeutic change, including treatment elements commonly considered to be non-specific. We also recommend transparency in reporting exclusions in meta-analyses and suggest that bona fide treatments should be defined on empirical and theoretical grounds rather than by judgments of the investigators' intent.

This study describes a large series of BBAVFs and makes an extensive comparison between the one-stage and two-stage operations. Significantly improved overall functional patency is demonstrated for the two-stage operation.

The case notes documenting the psychological well-being of 100 survivors of torture and other forms of organised state violence were analysed retrospectively. The most common diagnoses were post-traumatic stress disorder (PTSD), major depression, and somatoform disorders. Of these, PTSD showed the strongest association with experience of torture. It is possible that PTSD has a dimensional nature, and that reactions to different stressors are heterogeneous.

When someone flees their country and seeks the protection of another state, they usually have to describe what happened to make them afraid to return. This task requires many psychological processes, a key one being autobiographical memory. Memory for events of a specific time and place in one's personal past is the subject of a huge literature, much of it showing that recall is vulnerable to distortions and biases. We review selected areas of this literature, shedding light on some of the processes at work when someone seeks to be recognised as a refugee-in particular, the effects of emotion, including emotional disorder. We then turn to the differing types of memory styles seen in different cultures. Crucial to this area, we briefly examine the current literature on deception. Finally, we draw on the reviewed literature to present conclusions about the reliance on autobiographical memories in the asylum process. The asylum processAsylum processes differ across countries, but the basic procedure, as it operates in the West, is the same-offering an account (i.e. making a claim), a first decision (often by the state) and an appeal process. Using the UK as an example, the first step in claiming asylum is to give basic details and an explanation as to how the individual believes