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????????(PTSD)

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Title: ????????(PTSD)


1
????????(PTSD)
  • ??????
  • ?????
  • mywife_at_ms88.url.com.tw
  • 037-685569336

2
????
  • 1????????????????,???????????????????????????????
    ?
  • 2??????????????????,???1974????????????,?????????
    ????,????????????????
  • 3?1983????????????,??????????????????????????????
    ????????,???????????????????,?????????,?????????11
    .6 ??????????
  • 4????????????,??????????????????,????????????????
    ????????????????????????????,????????,????????????
    ?,?????????????????????????????,??????????????????
    ?,??????????????

3
????????
  • ??????????????????????????????????????????????????
    ?????????,?????????????????????,????????????,?????
    ???????????,??????????????????????????????????????
    ????????????????????????????????(????,2000)?
  • ???????????????????????????????????,??????????????
    ????????????????????????,????????????????????????
    ?????,?????????,???????????????????????????????,
    ?????????????????,??????,?????????????(???,2000),
    ????????????????????????????

4
??PTSD
  • ???????????(DSM-?) ????,???????????????????,??????
    ??????????,???????????????(????????????????),?????
    ???????????????,??????????,??????????????????(PTSD
    Posttraumatic Stress Disorder)
  • PTSD???????????????,?????????,???????????????????D
    elayed onset(????PTSD)
  • ???????????????Acute stress disorder(?????)?

5
???PTSD????????
  • 1????????????????????,???????????????????????
  • 2??????????, ???????????? ?????????????????
    ????
  • 3????????????????????????
  • 4????????????,????????????????

6
????
?? ??
???? ???????????????
???? ???????????????
???? ???????????,?????????
???? ??
??? ?????????
?????? ????????????????????
?????????????? ?????????????
???????? ?????????????????????????????????
?????? ?????????????????
7
??????
  • ??????????????????,??????????????????????????????
    ?????????,????????????????????
  • ???????????????????????????????  

8
PTSD?????
  • ?????? Dr. Peter Levine???,??????????????,????????
    ?????????(residual energy)???????,????????????????
    ?????,Levine ?????????????????????,????????????,??
    ??????????????????????????????,???????????????tr
    auma immunity????????????,???????????
  • ???????????????????????,????????????????????,?????
    ??????survival energies,??????????????????,???????
    ??

9
PTSD?????
  • ????????????????????????? ?????????????????????
    ??????????
  • ???????????survival energy ???? stuck
    ????????????????????????????,?????????,????????
  • ??????????????????????????
  • ???PTSD???????????????? ?????????????????????
  • ????????????????,???????????????????,???????(PTSD?
    ?)??????????????????????????

10
?????????????
???? ??
??????????? 1.????????? 2.????(Flashbacks) 3.?????????????? 4.??????????????????????
?? 1.????????????????????? 2.?????????
???? 1.???????(????????????) 2.???????(??????) 3.??????(????????) 4.???????????(???????)
?????  1.???? 2.???? 3.???? 4.???? 5.??????
11
PTSD?????
  • ????
  • ?????? (???????,??????????????????????)
  • ??????(??????????,??????,????,????????????????????
    ????)
  • ?????????????????,???????PTSD????(????????????????
    ????????????????????????)
  • ????
  • ??(??????????)
  • ???????(???????????)
  • ????
  • ????(????????splitting off,?????????)
  • ????(?????)

12
PTSD?????
  • ????
  • ??????
  • ???????
  • ???????
  • ????
  • ????
  • ????
  • ????
  • ????
  • ????
  • ????????????????????
  • ?????????
  • ????

13
??????PTSD
  • ?????????? ????????????????????? ???? PTSD
    ?????(complex)PTSD???PTSD?????????????????????????
    ????????????????????????(Borderline Personality
    Disorder)??????????????,????????complex PTSD?
  • ???Complex PTSD ???
  • ???????(????????,????,?????)
  • ???????????(?????????)
  • ??????(?????? ????????? splitting off parts
    of oneself)?

14
?????????????????
  • ??????????????????PTSD???,????????????????????????
    ???????,?????????????????,????????????????,???????
    ????,?????????????????,???????????????????????????
    ??????,???????????????
  • ???????????????????
  • ??????????????,???????????????????
  • ?????(????????????????)
  • ?????????????????
  • ???????????
  • ???????(???????????)
  • ???????(??????????)
  • ????????????
  • ?????????

15
PTSD???
  • ??????,??1.0-2.6???????????,?????????3.6,????30
    ,??????45,?????????50???????????(APA,
    1994),??????,??30?????????,40?????????,20??????
    ???,10?????????????(Kaplan Sodock, 1994)?
  • Lima??(1987)????,?????????,??55??????????,???????
    ?30????????(Lima et al, 1993)Shore??(1986)??,???
    ?????,?11???21????PTSD?????????

16
PTSD????
  • ??????,Yule (1991)????30 ?50?????????????????,Yu
    le (1990)??????????,?????????????????,?Winje??(199
    8)????????????????,????????????????????????,??????
    ??????,Nader(1990)?????????????,????????????74???
    ?PTSD???(??????????)
  • ???????????,30?????????????PTSD??(De La Fuente,
    1990),??74????,??????????????????PTSD,????????,??
    ???????????PTSD????(Goenjian, 1994),??????,???????
    ??????,???????????????????,???????????????????(50
    ??)?
  • Klipatric??(1987)??????,??17????????????????PTSD?
    ?Green??(1990)???????????,?????????????,??28????
    ???PTSD??,?????8,??????????????????,?????????????
    ????????

17
PTSD???????????
  • ????????????????,???PTSD????????????????????,?????
    ??PTSD????? ?????????????Dr.Yehuda??,???PTSD??????
    ??????PTSD?????,?????????????????????
  • PTSD????????????????,?????????????????????????????
    ???????,????PTSD?????????????????????????PTSD????
    ???????????????????,???????????????,PTSD??????????
    ???,??????????,??????????????????,??PTSD?????????,
    ????????,???????????????????????,?????????????????

18
PTSD???????????
  • ?????????????,?????????PTSD???????????????????????
    ????????????????10-20??????????,????????????????
    ,94???????????PTSD,?????,?????????,???10-20????P
    TSD??,??????????????????,???????????,?????,???????
    ?,???????????????
  • ??,??????PTSD??,???????????????????,??????????????
    ??????PTSD??????????,?????????????,????????????,?
    ???????????????

19
PTSD???????????
  • PTSD???????????,????????,????????????????,????????
    ??????????(magnetic resonance spectroscopy)???????
    ?????????????????????????,??????,????PTSD?????????
    ????,???????????????,??????????????,??????????????
    ????????????????,???PTSD????????13???????????,????
    ????,??????????????,PTSD????????????????(MRS)??,??
    ????????????,????PTSD?????????????????????,???????
    ?????PTSD??????????,?????????????,????????????????
    ???????????????????,????????????,??????,??????????
    ???????

20
??????
  • ????????????????,???????????,????????????????????
    ????????
  • ??????????????,????????????????,?????????????????
    ???????????????????????????????????,??????????
  • ?????????????????????????,???????????????????????
    ????????????????,????????????????????????(???????
    ????)??,???????????,????????,?????????

21
??????
  • ?????????????????????,??????,?????,???????????,??
    ??????????????,???????????,??????????????????,????
    ????,????????????????
  • ????????????????????,???????????????????????????,
    ???????????,???????,???????????,??????,???????????
    ??

22
??????????????????
  • ???????????????,??????????????,????????,?????????
    ?????????,????????????
  • ??????????????,????????????????????
  • ??????????????????,????????,????????
  • ?????????????????,??????,??????,?????????,???????
    ????????????,?????????????,??????,??????????,?????
    ????,?????????????????????
  • ???????????????????????,?????????,???????????????
    ?,????????????????????????????????,???????????????
    ??????????????????

23
??????????
  • ??????????,?????????????,?????????,??????????????,
    ???????,????????????,???????,?????????,???????????
    ???????????????,????????????????????,?????????????
    ?,??????????????????,??????????
  • ???????????,??????????????????????????????????????
    ?????????????????????????????????????????,?????
    ?????????????????????????????????????????????
    ?????????????????????,???????????

24
?????????????????
?? ????? ??? ??
    ?? ?? ?????????????????????????????????????????????? ????????????????????????????????????????????????????? ????????????????????????????????????
    ?? ????????????????????????????????????????????????? ????????????????????????????????????????????????????? ???????????????????????????????????????????????????????
25
????
  • Anxiety Management(????) ??????????       
    ????-       a.Relaxation Training(????)?????????
    ????????????????????     b.Breathing
    Retraining(????) ????????????????????,???????????
    ???????     c.Positive Thinking and
    self-talk(??????????) ?????????????????(????????
    ??)???????????(?????????) d.Assertiveness
    Training(??????) ???????????????????????,????????
         e.Thought Stopping(?????)
    ?????????????,???????????????????

26
????
  • Cognitive Therapy(????)???????????????,??????????
    ?????????????????????? ??????????????,???????????
    ?????????????????????????????????????????,??????,?
    ??????????????????

27
????
  • Exposure Therapy(?????)??????????????????????????
    ???,????????????????????,??????  
  • a.Imagine exposure(?????) ????????????????????,??
    ????????????????????,?????????????
  • b.In vivo Exposure(?????) ????????????????,??????
    ?????????? ,????????????????????,?????????????????
    ??????????,??????????????????,????????????????

28
??????????
  • Play Therapy(????)?????????????????????????,?????
    ???????????????????????????????
  • Psychoeducation(??????)?????????????PTSD?????????
    ???????,????????????????????????,????????????????
    ????????????????????????????
  • ????????????????????
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