TREATMENT OF PROLONGED POSTTRAUMATIC-STRESS-DISORDER - LEARNING FROM EXPERIENCE - DISCUSSION

Reports of limited treatment effect in Vietnam veterans with PTSD are discussed. Survivors of multiple traumata who suffer from complex PTSD and who live in poverty and distress may not properly represent the g eneral case of PTSD. Yet the lessons learned suggest that attempts to treat prolonged PTSD by rederessing causation are ineffective. The app ropriateness of targeting symptoms is also challenged. Previously hera lded rethorics of healing trauma should be replaced by careful assessm ent of residual disability in a social context. Recognizing treatment- resistance in PTSD could lead to favorably investigating interventions of modest effect to shifting from exploration to rehabilitation, and to redefining outcome measures such that changes in a variety of domai ns are appreciated.