Gonzalez 1

Annotated Bibliography

The psychological and pharmaceutical treatments of PTSD

William Gonzalez
Professor Malcolm Campbell
English 1103
March 15, 2016

Gonzalez 2

Annotated Bibliography
Jeffreys, Matt. Clinicians Guide to Medications for PTSD. U.S. Department of Veterans
Affairs. Web. 15 Mar. 2016.
This website is one of the main sources of information about PTSD that the VA has
available. It is aimed at other military medical providers, and attempts to give factual,
unbiased opinions on the many types of drugs that are used when dealing with PTSD. It
does admit that psychotherapy has more evidenced based success, but still lists the
possible ways that medication can be used to supplement the therapy. This website also
admits that medication can possibly do more harm to the patient and should be taken on a
case by case basis. Doctor Matt Jeffreys, the author of this article, does a great job
breaking down the different symptoms that the medication is trying to target. He does get
into the explanation of Selective Serotonin Reuptake Inhibitors (SSRIs), clearly stating
that they are the only drugs approved by the FDA for PTSD. Jeffreys also goes into the
many variables that affect the results in patients, from co-occurring disorders to
hereditary conditions. Another useful thing that he goes over is the dosage of the different
SSRIs, and lists the possible side effects. Overall the article is written at a very high level,
making it difficult to understand. It does a great job of avoiding bias and just stating facts
and figures. This website is a very reliable source that I will use for most of my
medication fact checking.
Kulkarni, Madhur, Katherine E. Porter, Sheila A.M. Rauch. Anger, dissociation, and PTSD
among male veterans entering into PTSD treatment Journal of Anxiety Disorders (2011):
271-278. ScienceDirect. Web. 15 Mar. 2016.

Gonzalez 3

This Journal describes the relationship between anger, disassociation, and PTSD. The
authors, all psychologists working for the VA, claim that anger and disassociation are the
key characteristics that cause veterans to have problems with PTSD late into their lives.
In their studies of combat veterans, they have found that the more angry and violent the
service members, the more severe the case of PTSD. They have also found that regardless
of the amount of combat a veteran has seen, the more severe cases were those that
showed high levels of disassociation, either during the trauma, or after. They claim that
the importance of this isnt just in knowing how to evaluate potential cases but to also
help with knowing where the problem comes from. This way we can better choose a
treatment that specifically targets the problem. I do not completely agree with the
statement about anger in veterans with PTSD, since it is entirely possible to be a calm
person who has PTSD. I do acknowledge that the anger could be repressed, and still be a
part of the problem that should be targeted. Disassociation on the other hand, is much
more probable. The veterans that I have known personally, have all had this same
problem. I think their research into this connection has some merit, but there are too
many assumptions being made without actual experience in the subject. Overall this
journal helps to understand a possible direction to take when treating PTSD, but lacks
more personal accounts and experiences.
Lawrence, Quil. Veterans kick the prescription pill habit, against doctors orders. National
Public Radio, 11 July 2014. NRP.org. Web. 15 Mar 2016.
This is an article in NPR about veterans who reject the prescription medications that the
military and pharmacies are giving them. It is written by Quil Lawrence, who is an
experienced correspondent for NPR, who has spent 10 years reporting in Iraq and now

Gonzalez 4

covers service members returning home from the war. In this article he gets many firsthand accounts of why some of these veterans have PTSD, and what drugs they have been
given to deal with it. He also has them describe how exactly it makes them feel. Most of
this article is against the use of drugs to deal with PTSD, saying that it makes them feel
like they barely even exist, or like a zombie. Some of the service members that he has
interviewed report having to take 20 or more pills a day, such as; escitalopram, Prozac,
Klonopin, Percocet, Vicodin, Seroquel, and lidocaine, just to name a few. Eventually
these service members decide to stop taking the prescribed drugs and reported an increase
in overall mood, saying things like, I felt like a totally different person. They complain
that the military just gives them medications to, keep troops sleeping, waking up and
functioning during wartime. Some of the medication such as Ritalin and Seroquel have
no direct effect on PTSD symptoms, which leads to a lack of trust in what they are
prescribed. To add fuel to their fire, a study by the Institute of Medicine in 2014
concluded that the VA does not do a good job in keeping track of the results of these
prescribed drugs. This cements in their mind that it is just a quick fix and not something
they believe will solve the problem. This article gives me an interesting perspective on
how some service members feel about their medication for PTSD, but I feel like it is very
one sided. There are many soldiers that I have met that are very happy with the
medications that they receive from the military. I will be using this article to show the
negative point of view of prescription medication for PTSD, but I will have to research
the positives of drug use to balance this bias.
Moore, Bret A., Walter E. Penk. Treating PTSD in Military Personnel: A Clinical Handbook.
The Guilford Press, 2011. Print

Gonzalez 5

This book is a complete, in depth, evaluation of PTSD from a clinical point of view. One
of the authors, Bret A. Moore, has served in the active duty Army as a psychologist, and
has deployed to Iraq twice. This gives him a unique view into the problems faced by
veterans coming home from the warzone. The book is directed towards others in the same
field, and looks to spread knowledge about what works, and to bring to light commonly
made mistakes. Moore even lists not understanding the military culture, as one of the
most common challenges face by practitioners. He states the importance of building trust
and rapport with soldiers as key to the success of psychological treatments. The authors
acknowledge large gaps in our understanding of PTSD, saying that we know much more
about how it is caused and how it is maintained, than we do about evidence based
treatments. They use factual studies done by the Institute of Medicine to show that there
is currently not enough evidence to support the use of pharmacological and some
psychotherapeutic treatments. They dedicate several chapters to the different therapies
that are being practiced today, with exposure therapy having the most evidence-based
success. This book has over 50 contributors, who are all experts in their field. The
combined knowledge and experience helps to make the book unbiased and instead
focuses on proof of success. It attempts to show what we do and do not know about
PTSD and challenges others in the field to fill in gaps of knowledge. This is a must have
book for anyone who either wants to get an understanding of the facts behind PTSD, or
professionals who will be working with veterans returning from war. I will be using this
book specifically for the detailed descriptions of the psychotherapeutic treatments.