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However, Gist and Devilly (2002) worry that PTSD is being predicted
on such a wide scale for every tragedy that occurs that we've watered
down its usefulness as a diagnostic category, and they write, “Progressive
dilution of both stressor and duration criteria has so broadened applica-
tion that it can now prove difficult to diagnostically differentiate those
who have personally endured stark and prolonged threat from those
who have merely heard upsetting reports of calamities striking others”
(p. 741). The authors suggest that many early signs of PTSD are normal
responses to stress that are often overcome with time and distance from
the event. Victims often use natural healing processes to cope with trau-
matic events, and interference by professionals in natural healing could
make the problem more severe and prolonged. In determining whether
PTSD will actually develop, people must be given time to cope with the
trauma on their own before we diagnose and treat PTSD. To emphasize
this point, Gist and Devilly report that the immediate predictions of
PTSD in victims of the World Trade Center Bombings turned out to be
almost 70% higher than actually occurred 4 months after the event. Of
course, symptoms of PTSD may develop much later than 4 months after
a trauma. Still, the point is well taken. People often heal on their own,
and a premature diagnosis of PTSD may be counterproductive.
The following treatment approaches are used in treating PTSD and may
be useful to clinicians treating the victims of workplace violence.
Exposure Therapy
Rothbaum, Olasov, and Schwartz (2002) describe a type of treatment,
“Exposure Therapy,” based on emotional-processing theory which is
rooted in the belief that PTSD develops as a result of memories eliciting
fear that trigger escape and avoidance behaviors. Since the development
of a “fear network” functions as a type of obsessive condition, the client
continues to increase the number of stimuli that serve to increase his or
her fear. To reduce the number of stimuli that elicit fear, the client must
have his or her “fear network” activated so that new information can
be provided that rationally contradicts the obsessive network of emot-
ions reinforcing the PTSD symptoms. The authors believe that the fol-
lowing progression of treatment activities serves to reduce the client's fear
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