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Sample records for ptsd treatment proclivity

  1. PTSD Treatment Options

    Science.gov (United States)

    ... Elements of Cognitive Behavioral Therapies Cognitive behavioral therapies (CBTs) for PTSD involve a relatively structured, short-term treatment that ... time does it take? A usual course of CBT for PTSD lasts about eight to 20 sessions but can ...

  2. PTSD: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table of Contents ... version of this page please turn Javascript on. Symptoms As with mild traumatic brain injury (TBI), PTSD ...

  3. Examining PTSD Treatment Choice Among Individuals with Subthreshold PTSD

    OpenAIRE

    Bergman, Hannah E.; Kline, Alexander C.; Feeny, Norah C.; Zoellner, Lori A.

    2015-01-01

    Subthreshold posttraumatic stress disorder (PTSD) is associated with impairment and has a prevalence rate comparable to full PTSD. Yet, little is known regarding treatment preferences among individuals with subthreshold PTSD, even though they seek trauma-related treatment at a similar rate to those with full PTSD. This study explored subthreshold diagnostic PTSD diagnostic category and treatment preference in undergraduate (N = 439) and trauma-exposed community (N = 203) samples. Participants...

  4. PTSD Treatment Options

    Science.gov (United States)

    ... Force photo by Staff Sgt. Timothy Chacon Posttraumatic stress disorder (PTSD) is a mental health condition that can significantly affect a person’s thoughts, feelings, behaviors and relationships. The ...

  5. Review of group treatment for PTSD

    Directory of Open Access Journals (Sweden)

    Denise M. Sloan, PhD

    2012-06-01

    Full Text Available The purpose of this article is to provide a brief review of group treatment for posttraumatic stress disorder (PTSD. This review includes a description of group-based treatments for PTSD and the available data on the efficacy of group treatment for PTSD. The literature review indicates that group treatment for PTSD is efficacious compared with no treatment. However, specific types of group treatment are not efficacious when compared with a nonspecific group treatment, such as psychoeducation or supportive counseling. Recommendations for practice and research are made in light of the available literature.

  6. Beyond Exposure for Posttraumatic Stress Disorder (PTSD) Symptoms: Broad-Spectrum PTSD Treatment Strategies

    Science.gov (United States)

    Lombardo, Thomas W.; Gray, Matt J.

    2005-01-01

    Although cases of posttraumatic stress disorder (PTSD) with comorbid disorders are common, the first generation of PTSD treatment approaches, including exposure and cognitive-behavioral therapy, generally ignore symptoms beyond those specific to PTSD. Optimum PTSD treatment outcome requires more comprehensive strategies, and the development and…

  7. Pharmacotherapy treatment of PTSD and comorbid disorders.

    Science.gov (United States)

    Kozarić-Kovacić, Dragica

    2009-09-01

    Comorbity is very high in posttraumatic stress disorder (PTSD) patients. PTSD is very often complicated with depressive disorder, substance abuse, other anxiety disorders, personality disorders, psychotic features, etc. There have been few pharmacotherapy studies in this complicated field. In the past few years the literature on pharmacotherapy treatment for PTSD and comorbidity has arisen. From empirical evidence (level A) exist three sertraline studies in PTSD comorbid with: 1) anxiety, 2) depression, and 3) anxiety and depression, and one risperidone study in PTSD comorbid with psychotic symptoms. From empirical evidence (level B) exist two disulfiram, naltrexone, and their combination studies in patients with PTSD comorbid with alcohol dependence and one paroxetine or bupropion versus cognitive behavioral therapy (CBT) versus community mental health referral study in PTSD women outpatients with major depressive disorder. The results from our label trials in the Croatian war veterans with chronic PTSD comorbid with psychotic features treated with novel antipsychotics (olanzapine, risperidone, or quetiapine) are promising. In the future more rigorously designed, comparative studies are needed to determine the usefulness, efficacy, tolerability, and safety of particular psychopharmaceutical drugs in the treatment of this therapeutically and functionally challenging disorder, especially the trials from level A.

  8. Complex PTSD and phased treatment in refugees: a debate piece.

    Science.gov (United States)

    Ter Heide, F Jackie June; Mooren, Trudy M; Kleber, Rolf J

    2016-01-01

    Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD. The aim of this debate piece is to defend two theses: (1) that complex trauma leads to complex PTSD in a minority of refugees only and (2) that trauma-focused treatment should be offered to all refugees who seek treatment for PTSD. The first thesis is defended by comparing data on the prevalence of complex PTSD in refugees to those in other trauma-exposed populations, using studies derived from a systematic review. The second thesis is defended using conclusions of systematic reviews and a meta-analysis of the efficacy of psychotherapeutic treatment in refugees. Research shows that refugees are more likely to meet a regular PTSD diagnosis or no diagnosis than a complex PTSD diagnosis and that prevalence of complex PTSD in refugees is relatively low compared to that in survivors of childhood trauma. Effect sizes for trauma-focused treatment in refugees, especially narrative exposure therapy (NET) and culturally adapted cognitive-behaviour therapy (CA-CBT), have consistently been found to be high. Complex PTSD in refugees should not be assumed to be present on the basis of complex traumatic experiences but should be carefully diagnosed using a validated interview. In line with treatment guidelines for PTSD, a course of trauma-focused treatment should be offered to all refugees seeking treatment for PTSD, including asylum seekers.

  9. Complex PTSD and phased treatment in refugees: a debate piece

    Directory of Open Access Journals (Sweden)

    F. Jackie June ter Heide

    2016-02-01

    Full Text Available Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD. Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD. Objective: The aim of this debate piece is to defend two theses: (1 that complex trauma leads to complex PTSD in a minority of refugees only and (2 that trauma-focused treatment should be offered to all refugees who seek treatment for PTSD. Methods: The first thesis is defended by comparing data on the prevalence of complex PTSD in refugees to those in other trauma-exposed populations, using studies derived from a systematic review. The second thesis is defended using conclusions of systematic reviews and a meta-analysis of the efficacy of psychotherapeutic treatment in refugees. Results: Research shows that refugees are more likely to meet a regular PTSD diagnosis or no diagnosis than a complex PTSD diagnosis and that prevalence of complex PTSD in refugees is relatively low compared to that in survivors of childhood trauma. Effect sizes for trauma-focused treatment in refugees, especially narrative exposure therapy (NET and culturally adapted cognitive-behaviour therapy (CA-CBT, have consistently been found to be high. Conclusions: Complex PTSD in refugees should not be assumed to be present on the basis of complex traumatic experiences but should be carefully diagnosed using a validated interview. In line with treatment guidelines for PTSD, a course of trauma-focused treatment should be offered to all refugees seeking treatment for PTSD, including asylum seekers.

  10. PTSD among a treatment sample of repeat DUI offenders.

    Science.gov (United States)

    Peller, Allyson J; Najavits, Lisa M; Nelson, Sarah E; LaBrie, Richard A; Shaffer, Howard J

    2010-08-01

    Recent studies indicate that posttraumatic stress disorder (PTSD) is one of the most common psychiatric comorbidities among driving-under-the-influence (DUI) offenders in treatment. Investigation of DUI offenders' PTSD and clinical characteristics could have important implications for prevention and treatment. This prospective study examined the demographic and clinical characteristics of repeat DUI offenders with PTSD symptoms at baseline and 1-year follow-up. Seven hundred twenty-nine DUI offenders admitted to a 2-week inpatient program participated in the study. Participants with PTSD evidenced more severe psychiatric comorbidity and reported a higher DUI recidivism rate at 1-year than those without PTSD. This study suggests a need to address PTSD among DUI offenders, as well as to further develop methodologies for accurately reporting DUI recidivism.

  11. Psychological Mechanisms of PTSD and Its Treatment.

    Science.gov (United States)

    Sripada, Rebecca K; Rauch, Sheila A M; Liberzon, Israel

    2016-11-01

    Psychological mechanisms can be defined as processes or events that are responsible for specific changes in psychological outcomes. In psychotherapy research, mechanisms are the factors through which interventions produce change. In this article, we explain the importance of identifying psychological mechanisms, describe methods for identifying them, and analyze recent literature on the psychological mechanisms underlying the development and treatment of posttraumatic stress disorder (PTSD). Based on the findings of recent investigations (from 2013 to present), we focus on four putative mechanisms: emotional engagement, extinction and contextualization, distress tolerance, and negative posttraumatic cognitions. Future directions for psychological mechanism research are also outlined, including possible opportunities for capitalizing on the most promising mechanisms identified to date.

  12. Using qualitative evidence to optimize child PTSD treatment guidelines.

    NARCIS (Netherlands)

    Wesel, F. van; Alisic, E.; Boeije, H.

    2014-01-01

    The importance of patients’ perspectives in the treatment of posttraumatic stress disorder (PTSD) is increasingly emphasized in recent years. However, qualitative evidence regarding these perspectives, is not systematically included in treatment guidelines. The possibilities of adding systematically

  13. Complex PTSD and phased treatment in refugees: a debate piece

    OpenAIRE

    ter Heide, F. Jackie June; Trudy M. Mooren; Kleber, Rolf J.

    2016-01-01

    Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD.Objective: The aim of this debate piece is to defend two theses:...

  14. Complex PTSD and phased treatment in refugees : a debate piece

    OpenAIRE

    ter Heide, F. Jackie June; Mooren, Trudy M.; Kleber, Rolf J.

    2016-01-01

    Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD.Objective: The aim of this debate piece is to defend two theses:...

  15. Treatment of residual insomnia after CBT for PTSD: case studies.

    Science.gov (United States)

    DeViva, Jason C; Zayfert, Claudia; Pigeon, Wilfred R; Mellman, Thomas A

    2005-04-01

    Insomnia is one of the most common symptoms of posttraumatic stress disorder (PTSD). Evidence suggests that insomnia may persist for many PTSD patients after other symptoms have responded to cognitive-behavioral therapy (CBT). The present article reports the effects of administering a five-session cognitive-behavioral insomnia treatment to 5 patients who responded to CBT for PTSD yet continued to report insomnia. Insomnia treatment was associated with improvements on subjective sleep measures (Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Beliefs and Attitudes about Sleep Scale) and self-monitored sleep efficiency and related measures in 4 of 5 cases. Results highlight issues specific to treating insomnia in trauma populations and future directions for examining treatment of insomnia associated with PTSD.

  16. Integrated Treatment of PTSD and Substance Use Disorders: The Mediating Role of PTSD Improvement in the Reduction of Depression

    Directory of Open Access Journals (Sweden)

    Kristina J. Korte

    2017-01-01

    Full Text Available Posttraumatic stress disorder (PTSD represents one of the most common mental health disorders, particularly among veterans, and is associated with significant distress and impairment. This highly debilitating disorder is further complicated by common comorbid psychiatric disorders, such as substance use disorders (SUD. Individuals with PTSD and co-occurring SUD also commonly present with secondary symptoms, such as elevated depression. Little is known, however, about how these secondary symptoms are related to treatment outcome. The aim of the present study, therefore, was to examine (1 the effects of treatment of comorbid PTSD/SUD on depressive symptoms; and (2 whether this effect was mediated by changes in PTSD severity or changes in SUD severity. Participants were 81 U.S. military veterans (90.1% male with PTSD and SUD enrolled in a randomized controlled trial examining the efficacy of an integrated, exposure-based treatment (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure; n = 54 versus relapse prevention (n = 27. Results revealed significantly lower depressive symptoms at post-treatment in the COPE group, as compared to the relapse prevention group. Examination of the mechanisms associated with change in depression revealed that reduction in PTSD severity, but not substance use severity, mediated the association between the treatment group and post-treatment depression. The findings underscore the importance of treating PTSD symptoms in order to help reduce co-occurring symptoms of depression in individuals with PTSD/SUD. Clinical implications and avenues for future research are discussed.

  17. MDMA and PTSD treatment: "PTSD: From novel pathophysiology to innovative therapeutics".

    Science.gov (United States)

    Sessa, Ben

    2017-05-10

    There is a range of therapies to treat Post Traumatic Stress Disorder (PTSD) but treatment resistance remains high, with many sufferers experiencing the chronic condition. Engagement in trauma-focused psychotherapy is difficult for some patients with PTSD, especially those with extreme affect dysregulation associated with recall of traumatic memories. In recent years there have been a number of neuroscientific and clinical studies examining the potential role for adjunctive drug-assisted psychotherapy using 3,4,-methylenedioxmethamphetamine (MDMA) as a treatment for PTSD. re-visiting of a novel approach to trauma-focused psychotherapy with Used just two or three times, under careful medical supervision and specialised psychotherapy support MDMA appears to facilitate the recall of traumatic memories without the user feeling overwhelmed by the negative affect that usually accompanies such memories. This therapeutic approach began in the 1980s and was subsequently shelved in the midst of public health concerns surrounding the recreational use of the drug ecstasy. When pharmaceutical grade MDMA is used in a clinical setting it does not share the same risk profiles as ecstasy. Recent phase one neurophysiological studies and phase two clinical studies are showing promise as a potential new approach to managing treatment-resistant PTSD. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  18. Vintage treatments for PTSD: a reconsideration of tricyclic drugs.

    Science.gov (United States)

    Davidson, Jonathan

    2015-03-01

    Serotonin (SSRI) and serotonin-norepinephrine (SNRI) reuptake inhibitors (SSRI) are the first-line recommended drug treatments for post-traumatic stress disorder (PTSD); but despite their benefits, much residual pathology remains and no new drugs have yet emerged with a clearly demonstrated benefit for treating the disorder. A case is made that tricyclic drugs deserve a closer look, based on their ability to affect several of the main neurotransmitters that are relevant to PTSD. Their promising efficacy, which was shown 30 years ago, had not been followed up, until a recent trial of desipramine found advantages over a SSRI in PTSD with comorbid alcohol dependence. Opportunities exist for studying newer and purportedly safer tricyclic formulations, as well as further the work with older, established compounds. A reappraisal of their risk:benefit ratio seems in order, when treating PTSD.

  19. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request ... Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right ...

  20. PTSD: National Center for PTSD

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    Full Text Available ... and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ... Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What ...

  1. Sleep Disturbances, TBI and PTSD: Implications for Treatment and Recovery

    Science.gov (United States)

    Gilbert, Karina Stavitsky; Kark, Sarah M.; Gehrman, Philip; Bogdanova, Yelena

    2015-01-01

    Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties. PMID:26164549

  2. Sleep disturbances, TBI and PTSD: Implications for treatment and recovery.

    Science.gov (United States)

    Gilbert, Karina Stavitsky; Kark, Sarah M; Gehrman, Philip; Bogdanova, Yelena

    2015-08-01

    Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties.

  3. Contextual Behavior Therapies in the Treatment of PTSD: A Review

    Science.gov (United States)

    Mulick, Patrick S.; Landers, Sara J.; Kanter, Jonathan W.

    2005-01-01

    Empirical evidence supports cognitive-behavioral interventions for the treatment Posttraumatic Stress Disorder (PTSD), with exposure therapy typically being the most frequently utilized. While the success of exposure treatments is well established there are factors which may hinder their use in "real-world" settings (e.g., poor treatment…

  4. Treatment of a Case Example with PTSD and Chronic Pain

    Science.gov (United States)

    Shipherd, Jillian C.

    2006-01-01

    This commentary reviews the case of GH, a survivor of a road traffic collision, who has chronic pain and posttraumatic stress disorder (PTSD). The case formulation, assessment strategy, and treatment plan are informed by the relevant experimental literature and empirically supported treatments using a cognitive behavioral perspective. Given this…

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click ... download "PTSD Treatment: Know Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click ...

  6. Complex PTSD and phased treatment in refugees : a debate piece

    NARCIS (Netherlands)

    Ter Heide, F Jackie June; Mooren, Trudy M; Kleber, Rolf J

    2016-01-01

    BACKGROUND: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused

  7. Complex PTSD and phased treatment in refugees : a debate piece

    NARCIS (Netherlands)

    Ter Heide, F Jackie June; Mooren, Trudy M; Kleber, Rolf J

    2016-01-01

    BACKGROUND: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatme

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Section: Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know ... Help page. Date this content was last updated is at the bottom of the page. Share this ...

  9. The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD

    NARCIS (Netherlands)

    Hagenaars, M.A.; Minnen, A. van; Hoogduin, C.A.L.

    2010-01-01

    This study investigates the impact of dissociative phenomena and depression on the efficacy of prolonged exposure treatment in 71 patients with posttraumatic stress disorder (PTSD). Diagnoses, comorbidity, pretreatment depressive symptoms, PTSD symptom severity, and dissociative phenomena (trait dis

  10. EMDR therapy for PTSD after motor vehicle accidents: meta-analytic evidence for specific treatment

    OpenAIRE

    Maddalena eBoccia; Laura ePiccardi; Pierluigi eCordellieri; Cecilia eGuariglia; Anna Maria eGiannini

    2015-01-01

    Motor vehicle accident (MVA) victims may suffer both acute and post-traumatic stress disorders (PTSD). With PTSD affecting social, interpersonal and occupational functioning, clinicians as well as the National Institute of Health are very interested in identifying the most effective psychological treatment to reduce PTSD. From research findings, eye movement desensitization and reprocessing (EMDR) therapy is considered as one of the effective treatment of PTSD. In this paper, we present the r...

  11. Adaptive Disclosure: A Combat-Specific PTSD Treatment

    Science.gov (United States)

    2014-10-01

    based interventions for treating PTSD, however, were not developed for military trauma and thus may be suboptimal for this population. This study...in conducting pre- and post-treatment psychosocial assessments that will be used to determine treatment efficacy. 15. SUBJECT TERMS Active-duty...behavioral therapy strategies packaged and sequenced to target the three high base-rate combat and operational traumas , namely, life-threat trauma

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment ... Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment ... Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Disasters Is it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get ... other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment Self- ... Home PTSD Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment ...

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Overview PTSD Basics Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse ... Treatment Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation ...

  17. Critical analysis of the current treatment guidelines for complex ptsd in adults

    NARCIS (Netherlands)

    de Jongh, A.; Resick, P.A.; Zoelner, L.A.; van Minnen, A.; Lee, C.W.; Monson, C.M.; Foa, E.B.; Wheeler, K.; ten Broeke, E.; Feeny, N.; Rauch, S.A.M.; Chard, K.M.; Mueser, K.T.; Sloan, D.M.; van der Gaag, M.; Rothbaum, B.O.; Neuner, F.; de Roos, C.; Hehenkamp, L.M.J.; Rosner, R.; Bicanic, I.A.E.

    2016-01-01

    According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a “stabilization phase.” This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused

  18. CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS

    NARCIS (Netherlands)

    De Jongh, Ad; Resick, Patricia A.; Zoellner, Lori A.; Van Minnen, Agnes; Lee, Christopher W.; Monson, Candice M.; Foa, Edna B.; Wheeler, Kathleen; Broeke, Erik Ten; Feeny, Norah; Rauch, Sheila A M; Chard, Kathleen M.; Mueser, Kim T.; Sloan, Denise M.; Van Der Gaag, Mark; Rothbaum, Barbara Olasov; Neuner, Frank; De Roos, Carlijn; Hehenkamp, Lieve M J; Rosner, Rita; Bicanic, Iva A E

    2016-01-01

    According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a "stabilization phase." This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused

  19. Review of exposure therapy: A gold standard for PTSD treatment

    Directory of Open Access Journals (Sweden)

    Sheila A. M. Rauch, PhD

    2012-06-01

    Full Text Available Prolonged exposure (PE is an effective first-line treatment for posttraumatic stress disorder (PTSD, regardless of the type of trauma, for Veterans and military personnel. Extensive research and clinical practice guidelines from various organizations support this conclusion. PE is effective in reducing PTSD symptoms and has also demonstrated efficacy in reducing comorbid issues such as anger, guilt, negative health perceptions, and depression. PE has demonstrated efficacy in diagnostically complex populations and survivors of single- and multiple-incident traumas. The PE protocol includes four main therapeutic components (i.e., psychoeducation, in vivo exposure, imaginal exposure, and emotional processing. In light of PE’s efficacy, the Veterans Health Administration designed and supported a PE training program for mental health professionals that has trained over 1,300 providers. Research examining the mechanisms involved in PE and working to improve its acceptability, efficacy, and efficiency is underway with promising results.

  20. PTSD: National Center for PTSD

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    Full Text Available ... Treatment: Know Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens ... Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For ...

  2. PTSD: National Center for PTSD

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    Full Text Available ... Performance VA Plans, Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget Submission Recovery ... and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ...

  3. PTSD: National Center for PTSD

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    Full Text Available ... What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here to download " ... for PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to ...

  4. Role and treatment of early maladaptive schemas in Vietnam Veterans with PTSD.

    Science.gov (United States)

    Cockram, David M; Drummond, Peter D; Lee, Christopher W

    2010-01-01

    The role of early maladaptive schemas in understanding and treating post-traumatic stress disorder (PTSD) was investigated. The first study examined the role of perceived adverse parenting and early maladaptive schemas in the development of PTSD in Australian and New Zealand Vietnam war veterans (n = 220). Veterans diagnosed with PTSD scored higher on the Young Schema Questionnaire (L3) and had higher scores on the Measure of Parental Style than veterans not diagnosed with PTSD. The results suggest that early maladaptive schemas have an important role in the development or maintenance of PTSD in Vietnam veterans. The second study measured at baseline, termination and 3 months the early maladaptive schemas, PTSD, anxiety and depression of war veterans (n = 54) participating in a PTSD group treatment programme that included schema-focused therapy. Scores on the PTSD Checklist, the Hospital Anxiety and Depression Scale, and 17 schemas decreased significantly after treatment. Change scores for the schema treatment were compared with change scores of war veterans (n = 127) who had completed a manualized cognitive-behavioural therapy programme without schema-focused therapy. Pre-treatment measures were similar in both groups. Nevertheless, PTSD and anxiety improved more significantly for the schema-focused therapy group. Together, these findings support the feasibility of schema-focused therapy to assist veterans with PTSD.

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here to download " ... Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive ...

  6. Emotion Regulatory Brain Function and SSRI Treatment in PTSD: Neural Correlates and Predictors of Change.

    Science.gov (United States)

    MacNamara, Annmarie; Rabinak, Christine A; Kennedy, Amy E; Fitzgerald, Daniel A; Liberzon, Israel; Stein, Murray B; Phan, K Luan

    2016-01-01

    Posttraumatic stress disorder (PTSD)-a chronic, debilitating condition, broadly characterized by emotion dysregulation-is prevalent among US military personnel who have returned from Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF). Selective serotonin reuptake inhibitors (SSRIs) are a first-line treatment for PTSD, but treatment mechanisms are unknown and patient response varies. SSRIs may exert their effects by remediating emotion regulatory brain activity and individual differences in patient response might be explained, in part, by pre-treatment differences in neural systems supporting the downregulation of negative affect. Thirty-four OEF/OIF veterans, 17 with PTSD and 17 without PTSD underwent 2 functional magnetic resonance imaging scans 12 weeks apart. At each scan, they performed an emotion regulation task; in the interim, veterans with PTSD were treated with the SSRI, paroxetine. SSRI treatment increased activation in both the left dorsolateral prefrontal cortex (PFC) and supplementary motor area (SMA) during emotion regulation, although only change in the SMA over time occurred in veterans with PTSD and not those without PTSD. Less activation of the right ventrolateral PFC/inferior frontal gyrus during pre-treatment emotion regulation was associated with greater reduction in PTSD symptoms with SSRI treatment, irrespective of pre-treatment severity. Patients with the least recruitment of prefrontal emotion regulatory brain regions may benefit most from treatment with SSRIs, which appear to augment activity in these regions.

  7. Neural correlates of inhibition and contextual cue processing related to treatment response in PTSD

    NARCIS (Netherlands)

    van Rooij, Sanne J H; Geuze, Elbert; Kennis, Mitzy; Rademaker, Arthur R; Vink, Matthijs

    2015-01-01

    Thirty to fifty percent of posttraumatic stress disorder (PTSD) patients do not respond to treatment. Understanding the neural mechanisms underlying treatment response could contribute to improve response rates. PTSD is often associated with decreased inhibition of fear responses in a safe environme

  8. Prazosin for Treatment With PTSD And Comorbid Alcohol Dependence

    Science.gov (United States)

    2010-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD and alcohol dependence . The objective of this study is to evaluate the efficacy of prazosis (16mg

  9. Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Lesia M. Ruglass

    2017-02-01

    Full Text Available Background: Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD and substance use disorders (SUDs in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed.

  10. Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders

    Science.gov (United States)

    Ruglass, Lesia M.; Shevorykin, Alina; Radoncic, Vanja; Smith, Kathryn M. Z.; Smith, Philip H.; Galatzer-Levy, Isaac R.; Papini, Santiago; Hien, Denise A.

    2017-01-01

    Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed. PMID:28178207

  11. PTSD: National Center for PTSD

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    Full Text Available ... Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation ...

  12. Integrated and Holistic Treatment Approach to PTSD and SUD: A Synergy

    Science.gov (United States)

    Weis, Melanie

    2010-01-01

    Individuals living with posttraumatic stress disorder (PTSD) and addiction experience a complex and dynamic interaction of symptoms from both diagnoses. However, heretofore, each diagnosis has been approached as if it were a separate treatment consideration. Therefore, an individual may be treated for either a substance use disorder (SUD) or PTSD,…

  13. Compensation and treatment: disability benefits and outcomes of U.S. veterans receiving residential PTSD treatment.

    Science.gov (United States)

    Belsher, Bradley E; Tiet, Quyen Q; Garvert, Donn W; Rosen, Craig S

    2012-10-01

    The U.S. Department of Veterans Affairs (VA) provides specialized intensive posttraumatic stress disorder (PTSD) programs to treat trauma-related symptoms in addition to providing service-connected disability to compensate veterans for injury sustained while serving in the military. Given the percentage of veterans who are receiving treatment for PTSD, in addition to seeking compensation for PTSD, a debate has emerged about the impact of compensation on symptom recovery. This study examined the associations among status of compensation, treatment expectations, military cohort, length of stay, and outcomes for 776 veterans who were enrolled in 5 VA residential PTSD programs between the years of 2005 and 2010. Mixed model longitudinal analyses, with age, gender, and baseline symptoms nested within treatment site in the model, found that treatment expectations were modestly predictive of treatment outcomes. Veterans seeking increased compensation reported marginally lower treatment expectations (d = .008), and did not experience poorer outcomes compared to veterans not seeking increased compensation with the effect of baseline symptoms partialled out. Veterans from the era of the Iraq and Afghanistan conflicts reported lower treatment expectations (d = .020) and slightly higher symptoms at intake (d = .021), but had outcomes at discharge equivalent to veterans from other eras with baseline symptoms partialled out. These findings help further inform the debate concerning disability benefits and symptom changes across time. Published 2012. This article is a US Government work and is in the public domain in the USA.

  14. PTSD: National Center for PTSD

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    Full Text Available ... The following short animated videos use hand-drawn images to help you learn about PTSD and effective treatments. What is PTSD? Treatment: Know Your Options "Evidence-based" Treatment Cognitive Processing Therapy Prolonged Exposure Watch our whiteboard video for ...

  15. Spirituality factors in the prediction of outcomes of PTSD treatment for U.S. military veterans.

    Science.gov (United States)

    Currier, Joseph M; Holland, Jason M; Drescher, Kent D

    2015-02-01

    Spirituality is a multifaceted construct that might affect veterans' recovery from posttraumatic stress disorder (PTSD) in adaptive and maladaptive ways. Using a cross-lagged panel design, this study examined longitudinal associations between spirituality and PTSD symptom severity among 532 U.S. veterans in a residential treatment program for combat-related PTSD. Results indicated that spirituality factors at the start of treatment were uniquely predictive of PTSD symptom severity at discharge, when accounting for combat exposure and both synchronous and autoregressive associations between the study variables, βs = .10 to .16. Specifically, veterans who scored higher on adaptive dimensions of spirituality (daily spiritual experiences, forgiveness, spiritual practices, positive religious coping, and organizational religiousness) at intake fared significantly better in this program. In addition, possible spiritual struggles (operationalized as negative religious coping) at baseline were predictive of poorer PTSD outcomes, β = .11. In contrast to these results, PTSD symptomatology at baseline did not predict any of the spirituality variables at posttreatment. In keeping with a spiritually integrative approach to treating combat-related PTSD, these results suggest that understanding the possible spiritual context of veterans' trauma-related concerns might add prognostic value and equip clinicians to alleviate PTSD symptomatology among those veterans who possess spiritual resources or are somehow struggling in this domain.

  16. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    OpenAIRE

    Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.

    2014-01-01

    Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown.Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates.Results: Only six studies with...

  17. Group Cognitive Behavioral Treatment for PTSD: Treatment of Motor Vehicle Accident Survivors

    Science.gov (United States)

    Beck, J. Gayle; Coffey, Scott F.

    2005-01-01

    Individual cognitive behavioral therapies (CBT) are now considered the first-line treatment for posttraumatic stress disorder (PTSD; Foa, Keane, & Friedman, 2000). As mental health reimbursement becomes more restricted, it is imperative that we adapt individual-format therapies for use in a small group format. Group therapies have a number of…

  18. PTSD and comorbid AUD: a review of pharmacological and alternative treatment options

    Directory of Open Access Journals (Sweden)

    Ralevski E

    2014-03-01

    Full Text Available Elizabeth Ralevski, Lening A Olivera-Figueroa, Ismene Petrakis Yale University School of Medicine, Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA Background: Although posttraumatic stress disorder (PTSD and alcohol use disorders (AUD frequently co-occur there are no specific treatments for individuals diagnosed with these comorbid conditions. The main objectives of this paper are to review the literature on pharmacological options for PTSD and comorbid AUD, and to summarize promising behavioral and alternative interventions for those with these dual diagnoses. Methods: We conducted a comprehensive search on PsycINFO and MEDLINE/PubMed databases using Medical Subject Headings terms in various combinations to identify articles that used pharmacotherapy for individuals with dual diagnoses of PTSD and AUD. Similar strategies were used to identify articles on behavioral and alternative treatments for AUD and PTSD. We identified and reviewed six studies that tested pharmacological treatments for patients with PTSD and comorbid AUD. Results: The literature on treatment with US Food and Drug Administration approved medications for patients with dual diagnosis of PTSD and AUD is very limited and inconclusive. Promising evidence indicates that topiramate and prazosin may be effective in reducing PTSD and AUD symptoms in individuals with comorbidity. Seeking safety has had mixed efficacy in clinical trials. The efficacy of other behavioral and alternative treatments (mindfulness-based, yoga, and acupuncture is more difficult to evaluate since the evidence comes from small, single studies without comparison groups. Conclusion: There is a clear need for more systematic and rigorous study of pharmacological, behavioral, and alternative treatments for patients with dual diagnoses of PTSD and AUD. Keywords: dual diagnosis, PTSD, AUD, pharmacotherapy

  19. Effect of virtual reality PTSD treatment on mood and neurocognitive outcomes.

    Science.gov (United States)

    McLay, Robert; Ram, Vasudha; Murphy, Jennifer; Spira, James; Wood, Dennis P; Wiederhold, Mark D; Wiederhold, Brenda K; Johnston, Scott; Reeves, Dennis

    2014-07-01

    Virtual reality (VR) is an emerging tool to help treat posttraumatic stress disorder (PTSD). Previously published studies have shown that VR graded exposure therapy (VR-GET) treatment can result in improvements in PTSD symptoms. Less is known about the impact on depression, general anxiety, and neuropsychological functioning in patients with PTSD. This study examined changes in self-reports of PTSD, depression, and anxiety before and after treatment, and also examined neuropsychological functioning as assessed by a computerized test of simple reaction time, procedural reaction time, and performance on the congruent, incongruent, emotional, and neutral (match the color of the "nonsense word") Stroop tests. Results showed that subjects treated with VR-GET showed significant reductions in PTSD and anxiety severity and significant improvements on the emotional Stroop test. Changes in depression and other measures of neuropsychological function were not significant. Change scores on the emotional Stroop test did not correlate with changes in self-report measures of PTSD. Overall, these findings support the use of VR-GET as a treatment for PTSD but indicate that benefits may be narrowly focused. Additional treatments may be needed after or alongside VR-GET for service members with neuropsychological impairments.

  20. Effectiveness of Group-Delivered Cognitive Therapy and Treatment Length in Women Veterans with PTSD

    Directory of Open Access Journals (Sweden)

    Diane T. Castillo

    2014-01-01

    Full Text Available The effectiveness and length of group-delivered cognitive treatment for Posttraumatic Stress Disorder (PTSD was examined in a sample of women veterans. The sample included 271 primarily non-Hispanic white (61% and Hispanic (25% women veterans treated in 8-, 10-, or 12-group length sessions with manualized cognitive therapy for PTSD. Outcome was measured with the PTSD Symptom Checklist (PCL in an intention-to-treat analysis (N = 271, in completer subjects (n = 172, and with group as the unit of analysis (n = 47 groups. Significant decreases in PTSD were found in the full sample (effect size [ES] range = 0.27 to 0.38, completers (ES range = 0.37 to 0.54, and group as the unit of analysis (ES range = 0.71 to 0.92, suggesting effectiveness of cognitive group treatment for PTSD. PCL scores significantly improved in the 8, 10, and 12 group lengths, with no differences between each. Clinical improvement showed a third decreasing 10 or more PCL points and 22% no longer meeting PTSD diagnostic criteria, with the best results in the 10-session group. The results suggest group-delivered cognitive therapy is an effective, efficient, time-limited treatment for PTSD.

  1. Borderline Personality Characteristics and Treatment Outcome in Cognitive-Behavioral Treatments for PTSD in Female Rape Victims

    Science.gov (United States)

    Clarke, Stephanie B.; Rizvi, Shireen L.; Resick, Patricia A.

    2008-01-01

    Many studies report that comorbid borderline personality pathology is associated with poorer outcomes in the treatment of Axis I disorders. Given the high rates of comorbidity between borderline personality pathology and posttraumatic stress disorder (PTSD), it is essential to determine whether borderline symptomatology affects PTSD treatment…

  2. Pharmacological enhancement of exposure-based treatment in PTSD: a qualitative review

    Directory of Open Access Journals (Sweden)

    Rianne A. de Kleine

    2013-10-01

    Full Text Available There is a good amount of evidence that exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD. Notwithstanding its efficacy, there is room for improvement, since a large proportion of patients does not benefit from treatment. Recently, an interesting new direction in the improvement of exposure therapy efficacy for PTSD emerged. Basic research found evidence of the pharmacological enhancement of the underlying learning and memory processes of exposure therapy. The current review aims to give an overview of clinical studies on pharmacological enhancement of exposure-based treatment for PTSD. The working mechanisms, efficacy studies in PTSD patients, and clinical utility of four different pharmacological enhancers will be discussed: D-cycloserine, MDMA, hydrocortisone, and propranolol.

  3. Differences in relationship conflict, attachment, and depression in treatment-seeking veterans with hazardous substance use, PTSD, or PTSD and hazardous substance use.

    Science.gov (United States)

    Owens, Gina P; Held, Philip; Blackburn, Laura; Auerbach, John S; Clark, Allison A; Herrera, Catherine J; Cook, Jerome; Stuart, Gregory L

    2014-05-01

    Veterans (N = 133) who were seeking treatment in either the Posttraumatic Stress Program or Substance Use Disorders Program at a Veterans Affairs Medical Center (VAMC) and, based on self-report of symptoms, met clinical norms for posttraumatic stress disorder (PTSD) or hazardous substance use (HSU) completed a survey related to relationship conflict behaviors, attachment styles, and depression severity. Participants were grouped into one of three categories on the basis of clinical norm criteria: PTSD only, HSU only, and PTSD + HSU. Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, Center for Epidemiologic Studies-Depression scale, Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test, and Psychological Aggression and Physical Violence subscales of the Conflict Tactics Scale. Most participants were male and Caucasian. Significant differences were found between groups on depression, avoidant attachment, psychological aggression perpetration and victimization, and physical violence perpetration and victimization. Post hoc analyses revealed that the PTSD + HSU group had significantly higher levels of depression, avoidant attachment, and psychological aggression than the HSU only group. The PTSD + HSU group had significantly higher levels of physical violence than did the PTSD only group, but both groups had similar mean scores on all other variables. Potential treatment implications are discussed.

  4. PTSD in Latino patients: illness beliefs, treatment preferences, and implications for care.

    Science.gov (United States)

    Eisenman, David P; Meredith, Lisa S; Rhodes, Hilary; Green, Bonnie L; Kaltman, Stacey; Cassells, Andrea; Tobin, Jonathan N

    2008-09-01

    Little is known about how Latinos with post-traumatic stress disorder (PTSD) understand their illness and their preferences for mental health treatment. To understand the illness beliefs and treatment preferences of Latino immigrants with PTSD. Semi-structured, face-to-face interviews. Sixty foreign-born, Latino adults recruited from five primary care centers in New York and New Jersey and screened for PTSD. Content analytic methods identified common themes, their range, and most frequent or typical responses. Participants identified their primary feelings as sadness, anxiety, nervousness, and fear. The most common feeling was "sad" (triste). Other words frequently volunteered were "angry" (enojada), "nervous" (nerviosa), and "scared" (miedo). Participants viewed their PTSD as impairing health and functioning. They ascribed their somatic symptoms and their general medical problems to the "stress" from the trauma and its consequences on their lives. The most common reason participants volunteered for their work and school functioning being impaired was their poor concentration, often due to intrusive thoughts. Most expressed their desire to receive mental health treatment, to receive it within their primary care center, and preferred psychotherapy over psychotropic medications. Among participants who did not report wanting treatment, most said it was because the trauma was "in the past." Clinicians may consider enquiring about PTSD in Latino patients who report feeling sad, anxious, nervous, or fearful. Our study suggests topics clinicians may include in the psychoeducation of patients with PTSD.

  5. PTSD: National Center for PTSD

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    Full Text Available ... 5 Measures PTSD Screens Trauma Exposure Measures Assessment Request Form List of All Measures Treatment Treatment Overview ... up windows? See our alternate video page. For information on video formats, and to download an appropriate ...

  6. PTSD: National Center for PTSD

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    Full Text Available ... Frequently Asked Questions Conditions & Treatments See All Conditions & Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation ...

  7. PTSD: National Center for PTSD

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    Full Text Available ... Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures ... DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request Form List of All Measures Treatment Treatment ...

  8. PTSD: National Center for PTSD

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    Full Text Available ... MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to download "Evidence-based Treatment: What Does It Mean?" (22.7 MB) Close × Prolonged Exposure for PTSD ...

  9. SAFE for PTSD: noncontact psychophysiological measure based on high-resolution thermal imaging to aid in PTSD diagnosis and assessment of treatment

    Science.gov (United States)

    Familoni, Babajide O.; Ma, Lein; Hutchinson, J. Andrew; Morgan, C. Andrew, III; Rasmusson, Ann; O'Kane, Barbara L.

    2012-06-01

    Post Traumatic Stress Disorder (PTSD) sometimes develops following exposure to very stressful or traumatic events such as motor vehicle accidents, rape, and war. It is arguably the signature injury of the conflicts in Iraq and Afghanistan. Previous studies have demonstrated that PTSD sufferers exhibit autonomic hyper-responsiveness to both neutral and trauma-related stimuli. In this study, we propose using high resolution thermal imaging of sweat-pores to obtain a noncontact, remote, and quantifiable measure of the sympathetic autonomic nervous reactivity to guide diagnosis, assess response to treatment, and tease out important cues to suicidality as a PTSD comorbidity.

  10. Same-Day Integrated Mental Health Care and PTSD Diagnosis and Treatment Among VHA Primary Care Patients With Positive PTSD Screens.

    Science.gov (United States)

    Bohnert, Kipling M; Sripada, Rebecca K; Mach, Jennifer; McCarthy, John F

    2016-01-01

    The study examined whether same-day integrated mental health services are associated with increased diagnosis and treatment initiation among primary care patients with positive posttraumatic stress disorder (PTSD) screens. Data were from a national sample of Veterans Health Administration (VHA) primary care patients with a positive PTSD screen (N=21,427). Patients were assessed for PTSD diagnosis and treatment initiation on the screening day and ≤ 7 days, ≤ 12 weeks, ≤ 6 months, and ≤ 1 year after screening positive. The service setting on screening day was categorized as primary care only, same-day primary care-mental health integration (PC-MHI), or same-day specialty mental health care. Multivariable generalized estimating equations logistic regression was used to estimate associations between category of screening day services and diagnosis and treatment initiation, with adjustment for demographic characteristics, prior psychiatric diagnoses, prior VHA service utilization, and PTSD screen score. Of the 21,427 patients with positive PTSD screens, 10,809 (50.4%) received a diagnosis within one year of screening positive. Same-day PC-MHI services were associated with greater odds of PTSD diagnosis, both on the same day as (odds ratio [OR]=2.23) and one year (OR=1.67) after screening positive compared with primary care-only services (p<.001). Among those who received a diagnosis on the same day as their positive screen, same-day PC-MHI services were associated with increased odds of initiating PTSD treatment (OR=3.39) within 12 weeks of diagnosis, compared with primary care only (p<.001). Same-day integrated mental health services may help facilitate PTSD diagnosis and treatment initiation after a positive screen.

  11. PTSD: National Center for PTSD

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    Full Text Available ... Menu PTSD PTSD Home For the Public Public Section Home PTSD Overview PTSD Basics Return from War ... Web Links PTSD Site Search For Professionals Professional Section Home PTSD Overview Types of Trauma Trauma Basics ...

  12. EMDR therapy for PTSD after motor vehicle accidents: meta-analytic evidence for specific treatment

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    Maddalena eBoccia

    2015-04-01

    Full Text Available Motor vehicle accident (MVA victims may suffer both acute and post-traumatic stress disorders (PTSD. With PTSD affecting social, interpersonal and occupational functioning, clinicians as well as the National Institute of Health are very interested in identifying the most effective psychological treatment to reduce PTSD. From research findings, eye movement desensitization and reprocessing (EMDR therapy is considered as one of the effective treatment of PTSD. In this paper, we present the results of a meta-analysis of fMRI studies on PTSD after MVA through activation likelihood estimation. We found that PTSD following MVA is characterized by neural modifications in the anterior cingulate cortex (ACC, a cerebral structure involved in fear-conditioning mechanisms. Basing on previous findings in both humans and animals, which demonstrate that desensitization techniques and extinction protocols act on the limbic system, the effectiveness of EMDR and of cognitive behavioral therapies (CBT may be related to the fact that during these therapies the ACC is stimulated by desensitization.

  13. EMDR therapy for PTSD after motor vehicle accidents: meta-analytic evidence for specific treatment.

    Science.gov (United States)

    Boccia, Maddalena; Piccardi, Laura; Cordellieri, Pierluigi; Guariglia, Cecilia; Giannini, Anna Maria

    2015-01-01

    Motor vehicle accident (MVA) victims may suffer both acute and post-traumatic stress disorders (PTSD). With PTSD affecting social, interpersonal and occupational functioning, clinicians as well as the National Institute of Health are very interested in identifying the most effective psychological treatment to reduce PTSD. From research findings, eye movement desensitization and reprocessing (EMDR) therapy is considered as one of the effective treatment of PTSD. In this paper, we present the results of a meta-analysis of fMRI studies on PTSD after MVA through activation likelihood estimation. We found that PTSD following MVA is characterized by neural modifications in the anterior cingulate cortex (ACC), a cerebral structure involved in fear-conditioning mechanisms. Basing on previous findings in both humans and animals, which demonstrate that desensitization techniques and extinction protocols act on the limbic system, the effectiveness of EMDR and of cognitive behavioral therapies (CBT) may be related to the fact that during these therapies the ACC is stimulated by desensitization.

  14. Imagery rescripting and exposure group treatment of posttraumatic nightmares in Veterans with PTSD.

    Science.gov (United States)

    Long, Mary E; Hammons, Mary E; Davis, Joanne L; Frueh, B Christopher; Khan, Myrna M; Elhai, Jon D; Teng, Ellen J

    2011-05-01

    This study details results of an open trial of a group psychological treatment for Veterans with posttraumatic stress disorder (PTSD) and chronic posttraumatic nightmares called "Imagery Rescripting and Exposure Therapy" (IRET). IRET is a variant of a successful imagery rescripting treatment for civilian trauma-related nightmares that was modified to address the needs of the Veteran population. Thirty-seven male U.S. Veterans with PTSD and nightmares attended 6 multicomponent group sessions. Findings indicated that the intervention significantly reduced frequency of nightmares and PTSD severity, as well as increased hours of sleep. Unlike the few open trials examining treatment of nightmares in Veterans, effect sizes in this study were similar to those that have been found in the civilian randomized controlled trial. These preliminary findings suggest that a nightmares treatment can be adapted to successfully reduce distress associated with combat Veterans' chronic nightmares. Clinical and research implications are discussed.

  15. Online PTSD Diagnosis and Treatment Training for Primary Care Physicians

    Science.gov (United States)

    2013-03-01

    care capacity,9 there are also other well-described patient-level barriers to mental health care such as stigma , cultural attitudes, negative...including hypothesized underlying mechanisms, their knowledge and understanding of these psychotherapies were not maintained after 30 days. Having...a trusted PCP explain in plain language the rationale for evidence-based trauma-focused psychotherapies to a patient suffering from PTSD can be

  16. PTSD: National Center for PTSD

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    Full Text Available ... Whistleblower Rights & Protections Transparency Media Room Inside the Media Room Public Affairs News Releases Speeches Videos Publications ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and ...

  17. PTSD: National Center for PTSD

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    Full Text Available ... War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment ... Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview ...

  18. PTSD: National Center for PTSD

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    Full Text Available ... Health Benefits Home Apply for VA Care Apply Online Application Process Veteran Eligibility Active Duty Families of ... Treatment can turn your life around. PTSD Coach Online Tools to help you manage stress. Search Pilots ...

  19. PTSD: National Center for PTSD

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    Full Text Available ... 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option ( ... to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It ...

  20. PTSD: National Center for PTSD

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    Full Text Available ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and ... Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult ...

  1. PTSD: National Center for PTSD

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    Full Text Available ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and ... Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult ...

  2. PTSD: National Center for PTSD

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    Full Text Available ... Organizations Whistleblower Rights & Protections Media Room Inside the Media Room Public Affairs News Releases Speeches Videos Publications ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and ...

  3. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    Directory of Open Access Journals (Sweden)

    Ethy Dorrepaal

    2014-10-01

    Full Text Available Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD are well established, but their generalizability to child abuse (CA-related Complex PTSD is largely unknown. Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates. Results: Only six studies with one or more cognitive behavior therapy (CBT treatment conditions and one with a present centered therapy condition could be meta-analyzed. Results indicate that CA-related PTSD patients profit with large effect sizes and modest recovery and improvement rates. Treatments which include exposure showed greater effect sizes especially in completers’ analyses, although no differential results were found in recovery and improvement rates. However, results in the subgroup of CA-related Complex PTSD studies were least favorable. Within the Complex PTSD subgroup, no superior effect size was found for exposure, and affect management resulted in more favorable recovery and improvement rates and less drop-out, as compared to exposure, especially in intention-to-treat analyses. Conclusion: Limited evidence suggests that predominantly CBT treatments are effective, but do not suffice to achieve satisfactory end states, especially in Complex PTSD populations. Moreover, we propose that future research should focus on direct comparisons between types of treatment for Complex PTSD patients, thereby increasing generalizability of results.

  4. Discrepancy in diagnosis and treatment of post-traumatic stress disorder (PTSD): treatment for the wrong reason.

    Science.gov (United States)

    Meltzer, Ellen C; Averbuch, Tali; Samet, Jeffrey H; Saitz, Richard; Jabbar, Khelda; Lloyd-Travaglini, Christine; Liebschutz, Jane M

    2012-04-01

    In primary care (PC), patients with post-traumatic stress disorder (PTSD) are often undiagnosed. To determine variables associated with treatment, this cross-sectional study assessed 592 adult patients for PTSD. Electronic medical record (EMR) review of the prior 12 months assessed mental health (MH) diagnoses and MH treatments [selective serotonin reuptake inhibitor (SSRI) and/or ≥1 visit with MH professional]. Of 133 adults with PTSD, half (49%; 66/133) received an SSRI (18%), a visit with MH professional (14%), or both (17%). Of those treated, 88% (58/66) had an EMR MH diagnosis, the majority (71%; 47/66) depression and (18%; 12/66) PTSD. The odds of receiving MH treatment were increased 8.2 times (95% CI 3.1-21.5) for patients with an EMR MH diagnosis. Nearly 50% of patients with PTSD received MH treatment, yet few had this diagnosis documented. Treatment was likely due to overlap in the management of PTSD and other mental illnesses.

  5. The Moderating Effect of State Anger on Treatment Outcome in Female Adolescents With PTSD.

    Science.gov (United States)

    Kaczkurkin, Antonia N; Asnaani, Anu; Zhong, Jody; Foa, Edna B

    2016-08-01

    Trauma experienced in childhood and adolescence negatively affects the development of adaptive regulation of emotions and is associated with greater symptoms of anger. Prior research has suggested that high levels of anger may impede the outcome of treatment in adults with posttraumatic stress disorder (PTSD). The current study investigated whether high levels of anger resulted in poorer treatment outcomes in adolescent girls with PTSD. Participants included 61 female adolescent survivors of sexual abuse or assault who were randomized to either prolonged exposure for adolescents (PE-A) or client-centered therapy (CCT) for traumatized children for 8-14 weekly sessions. Participants were followed for 12 months posttreatment. High levels of state anger at baseline were associated with less improvement in PTSD symptoms in the CCT group than the PE-A group (d = 0.62). The moderating effects of state anger on improvement in PTSD symptoms was significant with emotion regulation difficulties, which may underlie anger symptoms (d = 0.58) in the model. The results of this study suggessted that high state anger was less of an impediment to treatment of PTSD for those receiving PE-A than those receiving less differentiated approaches such as CCT. Copyright © 2016 International Society for Traumatic Stress Studies.

  6. Posttraumatic stress disorder (PTSD in children after paediatric intensive care treatment compared to children who survived a major fire disaster

    Directory of Open Access Journals (Sweden)

    Last Bob F

    2008-05-01

    Full Text Available Abstract Background The goals were to determine the presence of posttraumatic stress disorder (PTSD in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands. Methods Children completed the Dutch Children's Responses to Trauma Inventory at three and nine months after discharge from the paediatric intensive care unit (PICU. Comparison data were available from 355 children survivors who completed the same questionnaire 10 months after a major fire disaster. Results Thirty-six children aged eight to 17 years completed questionnaires at three month follow-up, nine month follow-up, or both. More than one third (34.5% of the children had subclinical PTSD, while 13.8% were likely to meet criteria for PTSD. Maternal PTSD was the strongest predictor for child PTSD. There were no significant differences in (subclinical PTSD symptoms either over time or compared to symptoms of survivors from the fire disaster. Conclusion This study shows that a considerable number of children have persistent PTSD after PICU treatment. Prevention of PTSD is important to minimize the profound adverse effects that PTSD can have on children's well-being and future development.

  7. Gender and offender status predicting treatment success in refugees and asylum seekers with PTSD

    Directory of Open Access Journals (Sweden)

    Håkon Stenmark

    2014-01-01

    Full Text Available Background: Current knowledge is limited regarding patient characteristics related to treatment outcome of posttraumatic stress disorders (PTSD in refugees and asylum seekers. Objective: Gender, torture status, offender status, level of anger, and level of depression were investigated for possible effects on the treatment outcome. Method: Patient characteristics were explored in 54 refugees and asylum seekers who had completed a treatment program for PTSD. Non-responders (10, those who had the same or higher levels of symptom severity after treatment, were compared with responders, those who had lower symptom severity after treatment (44. Symptom severity was measured by Clinician-Administered PTSD Scale. The non-responders and responders constituted the dichotomous, dependent variable. The independent variables were gender, torture status, offender status, level of anger, and level of depression. T-tests and Exact Unconditional Homogeneity/Independence Tests for 2X2 Tables were used to study the relationship to treatment outcome. Results: Being male and reporting to have been a violent offender were significantly more frequent characteristics among the non-responders compared to the responders. The levels of pretreatment anger, depression and torture status did not affect the treatment outcome. Conclusions: The study adds support to findings that females benefit more from treatment of PTSD than males and that violent offenders are difficult to treat within the standard treatment programs.

  8. Pharmacological enhancement of exposure-based treatment in PTSD: a qualitative review

    NARCIS (Netherlands)

    Kleine, R.A. de; Rothbaum, B.O.; Minnen, A. van

    2013-01-01

    There is a good amount of evidence that exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD). Notwithstanding its efficacy, there is room for improvement, since a large proportion of patients does not benefit from treatment. Recently, an interesting new direction in

  9. Trauma-focused treatment in PTSD patients with psychosis : symptom exacerbation, adverse events, and revictimization

    NARCIS (Netherlands)

    van den Berg, D.P.G.; de Bont, P.A.J.M.; van der Vleugel, B.M.; de Roos, C.; de Jongh, A.; van Minnen, A.; van der Gaag, M.

    2016-01-01

    Objectives: Most clinicians refrain from trauma treatment for patients with psychosis because they fear symptom exacerbation and relapse. This study examined the negative side effects of trauma-focused (TF) treatment in patients with psychosis and posttraumatic stress disorder (PTSD). Methods: Analy

  10. Trauma-focused treatment in PTSD patients with psychosis: Symptom exacerbation, adverse events, and revictimization

    NARCIS (Netherlands)

    Berg, D.P.G. van den; Bont, P.A.J.M. de; Vleugel, B.M. van der; Roos, C.J.A.M. de; Jongh, A. de; Minnen, A. van; Gaag, M. van der

    2016-01-01

    Objectives: Most clinicians refrain from trauma treatment for patients with psychosis because they fear symptom exacerbation and relapse. This study examined the negative side effects of trauma-focused (TF) treatment in patients with psychosis and posttraumatic stress disorder (PTSD). Methods:

  11. Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.

    Science.gov (United States)

    Cloitre, Marylene; Courtois, Christine A; Charuvastra, Anthony; Carapezza, Richard; Stolbach, Bradley C; Green, Bonnie L

    2011-12-01

    This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances. Agreement was not obtained on either the expected course of improvement or on duration of treatment. The survey results provide a strong rationale for conducting research focusing on the relative merits of traditional trauma-focused therapies and sequenced multicomponent approaches applied to different patient populations with a range of symptom profiles. Sustained symptom monitoring during the course of treatment and during extended follow-up would advance knowledge about both the speed and durability of treatment effects. Copyright © 2011 International Society for Traumatic Stress Studies.

  12. Prazosin Augmentation of Outpatient Treatment of Alcohol Use Disorders in Active Duty Soldiers with and without PTSD

    Science.gov (United States)

    2016-10-01

    treatment and 2) to determine if the presence of PTSD affects prazosin efficacy for AUD. AUD are major causes of behavioral, medical, family , and...debilitating problem in active duty Service Members and is a frequent comorbidity of posttraumatic stress disorder (PTSD). Our pilot placebo...durability of prazosin effect on AUD in those randomized to prazosin in the RCT. 2. KEYWORDS: alcohol use disorder, prazosin, Service Member , PTSD

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Service Organizations Whistleblower Rights & Protections Media Room Inside the Media Room Public Affairs News Releases Speeches Videos ... for PTSD Menu Menu PTSD PTSD Home For the Public Public Section Home PTSD Overview PTSD Basics ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Organizations Whistleblower Rights & Protections Transparency Media Room Inside the Media Room Public Affairs News Releases Speeches Videos ... for PTSD Menu Menu PTSD PTSD Home For the Public Public Section Home PTSD Overview PTSD Basics ...

  15. Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study

    OpenAIRE

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H; Veltman, Dick J.; Hoogendoorn, Adriaan W.; van Balkom, Anton J. L. M.; Draijer, Nel

    2013-01-01

    Background: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment.Objective: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method: In a randomized controlled trial on a 20-week stabilizing group cognitive ...

  16. Chronic pain and PTSD: the Perpetual Avoidance Model and its treatment implications.

    Science.gov (United States)

    Liedl, Alexandra; Knaevelsrud, Christine

    2008-01-01

    Posttraumatic Stress Disorder (PTSD) and chronic pain are frequently seen in the aftermath of a traumatic experience. Torture survivors have an increased risk to suffer from these two disorders. Although many studies report high comorbidity,there is still insufficient knowledge on the mechanisms of the development and maintenance of PTSD and chronic pain. After providing an overview of the current literature concerning the comorbidity of these two disorders, we will present the "Perpetual Avoidance Model" (PAM). This model provides an explanation of the reciprocal maintenance of both disorders and offers treatment implications.

  17. Contributions of psychodynamic approaches to treatment of PTSD and trauma: a review of the empirical treatment and psychopathology literature.

    Science.gov (United States)

    Schottenbauer, Michele A; Glass, Carol R; Arnkoff, Diane B; Gray, Sheila Hafter

    2008-01-01

    Reviews of currently empirically supported treatments for post-traumatic stress disorder (PTSD) show that despite their efficacy for many patients, these treatments have high nonresponse and dropout rates. This article develops arguments for the value of psychodynamic approaches for PTSD, based on a review of the empirical psychopathology and treatment literature. Psychodynamic approaches may help address crucial areas in the clinical presentation of PTSD and the sequelae of trauma that are not targeted by currently empirically supported treatments. They may be particularly helpful when treating complex PTSD. Empirical and clinical evidence suggests that psychodynamic approaches may result in improved self-esteem, increased ability to resolve reactions to trauma through improved reflective functioning, increased reliance on mature defenses with concomitant decreased reliance on immature defenses, the internalization of more secure working models of relationships, and improved social functioning. Additionally, psychodynamic psychotherapy tends to result in continued improvement after treatment ends. Additional empirical studies of psychodynamic psychotherapy for PTSD are needed, including randomized controlled outcome studies.

  18. Divalproex Sodium for the Treatment of PTSD and Conduct Disordered Youth: A Pilot Randomized Controlled Clinical Trial

    Science.gov (United States)

    Steiner, Hans; Saxena, Kirti S.; Carrion, Victor; Khanzode, Leena A.; Silverman, Melissa; Chang, Kiki

    2007-01-01

    We examined the efficacy of divalproex sodium (DVP) for the treatment of PTSD in conduct disorder, utilizing a previous study in which 71 youth were enrolled in a randomized controlled clinical trial. Twelve had PTSD. Subjects (all males, mean age 16, SD 1.0) were randomized into high and low dose conditions. Clinical Global Impression (CGI)…

  19. Does Reintegration Stress Contribute to Suicidal Ideation Among Returning Veterans Seeking PTSD Treatment?

    Science.gov (United States)

    Haller, Moira; Angkaw, Abigail C; Hendricks, Brittany A; Norman, Sonya B

    2016-04-01

    Although posttraumatic stress disorder (PTSD) and other psychiatric symptoms are well-established risk factors for suicidal ideation among returning veterans, less attention has been paid to whether the stress of reintegrating into civilian society contributes to suicidal ideation. Utilizing a sample of 232 returning veterans (95% male, mean age = 33.63 years) seeking PTSD treatment, this study tested whether reintegration difficulties contribute to suicidal ideation over and above the influence of PTSD symptoms, depression symptoms, and potential substance misuse. Logistic regressions indicated that reintegration stress had a unique effect on suicidal ideation over and above PTSD and depression symptoms. Reintegration stress interacted with substance misuse to predict suicidal ideation, such that the effect of reintegration stress on suicidal ideation was much larger for those with potential substance misuse. Exploratory analyses also examined which types of reintegration difficulties were associated with suicidal ideation, and found that difficulty maintaining military friendships, difficulty getting along with relatives, difficulty feeling like you belong in civilian society, and difficulty finding meaning/purpose in life were all significantly associated with suicidal ideation, beyond the effects of psychiatric symptoms and potential substance misuse. Findings highlight the importance of addressing reintegration stress for the prevention of suicide among returning veterans. Implications for treatment are discussed.

  20. Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder.

    Science.gov (United States)

    Harned, Melanie S; Jackson, Safia C; Comtois, Katherine A; Linehan, Marsha M

    2010-08-01

    This study examined the efficacy of dialectical behavior therapy (DBT) in reducing behaviors commonly used as exclusion criteria for posttraumatic stress disorder (PTSD) treatment. The sample included 51 suicidal and/or self-injuring women with borderline personality disorder (BPD), 26 (51%) of whom met criteria for PTSD. BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT. By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment. Borderline personality disorder clients with PTSD who began treatment with a greater number of recent suicide attempts and more severe PTSD were significantly less likely to become eligible for PTSD treatment.

  1. Dresden PTSD treatment study: randomized controlled trial of motor vehicle accident survivors

    Directory of Open Access Journals (Sweden)

    Menning Hans

    2006-07-01

    Full Text Available Abstract Background We translated, modified, and extended a cognitive behavioral treatment (CBT protocol by Blanchard and Hickling (2003 for the purpose of treating survivors of MVA with full or subsyndromal posttraumatic stress disorder (PTSD whose native language is German. The treatment manual included some additional elements, e. g. cognitive procedures, imaginal reliving, and facilitating of posttraumatic growth. The current study was conducted in order to test the efficacy of the modified manual by administering randomized controlled trial in which a CBT was compared to a wait-list control condition. Methods Forty-two motor vehicle accident survivors with chronic or severe subsyndromal posttraumatic stress disorder (PTSD completed the treatment trial with two or three detailed assessments (pre, post, and 3-month follow-up. Results CAPS-scores showed significantly greater improvement in the CBT condition as compared to the wait list condition (group × time interaction effect size d = 1.61. Intent-to-treat analysis supported the outcome (d = 1.34. Categorical diagnostic data indicated clinical recovery of 67% (post-treatment and 76% (3 months FU in the treatment group. Additionally, patients of the CBT condition showed significantly greater reductions in co-morbid major depression than the control condition. At follow-up the improvements were stable in the active treatment condition. Conclusion The degree of improvement in our treatment group was comparable to that in previously reported treatment trials of PTSD with cognitive behavioral therapy. Trial registration ISRCTN66456536

  2. The application of virtual reality to the treatment of PTSD following the WTC attack.

    Science.gov (United States)

    Difede, Joann; Cukor, Judith; Patt, Ivy; Giosan, Cezar; Hoffman, Hunter

    2006-07-01

    Recent research suggests that virtual reality (VR) enhanced exposure therapy may enhance the efficacy of treatment through increasing patient engagement in the exposure. This study evaluated the use of VR in the treatment of PTSD following the WTC attack of September 11, 2001. Individuals in a 14 session VR-enhanced treatment (n=9) were compared to a waitlist (WL) control group (n=8). ANOVA showed a significant interaction of time by group (p<.01) with a large effect size of 1.53. The VR group showed significantly greater post-treatment decline in CAPS scores compared to the WL. Our preliminary data suggests that VR is an effective tool for enhancing exposure therapy for both civilians and disaster workers who suffer from PTSD.

  3. Comparing Virtual Reality Exposure Therapy to Prolonged Exposure in the Treatment of Soldiers with PTSD

    Science.gov (United States)

    2014-06-01

    Hodges LF: The use of virtual reality exposure in the treatment of anxiety disorders . Behav Modif 1999; 23(4):507-25 4. Difede J, Cukor J, Ivy P, Giosan C...RD: Virtual reality exposure therapy for Vietnam veterans with posttraumatic stress disorder . J Clin Psychiatry 2001; 62(8):617-22 3. Rothbaum BO...Hoffman H: The Application of Virtual Reality to the Treatment of PTSD Following the WTC Attack, in Psychobiology of Posttraumatic Stress Disorders

  4. Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): A Pilot Study in Alcohol-dependent Women.

    Science.gov (United States)

    Persson, Anna; Back, Sudie E; Killeen, Therese K; Brady, Kathleen T; Schwandt, Melanie L; Heilig, Markus; Magnusson, Åsa

    Posttraumatic stress disorder (PTSD) and substance use disorders are highly comorbid. Effective treatments are largely lacking. This pilot study evaluated the safety and feasibility of a novel intervention, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), in preparation for a randomized controlled trial. Twenty-two treatment-seeking women with current DSM-IV-TR PTSD and alcohol dependence (AD) were recruited. Participants received COPE. Safety and feasibility were evaluated, as were efficacy-related outcomes: PTSD and depression symptom severity, alcohol use, craving, and dependence severity. No adverse events occurred. COPE was implemented in routine clinical practice. Among the assessed women, 95.8% were eligible to participate. Treatment attendance and completion were higher than in previous studies. Post treatment, all efficacy-related outcomes, including PTSD and depression symptom severity, alcohol use, craving, and dependence severity, were significantly reduced. COPE was safe and feasible to use. Concerns that trauma-focused, exposure-based therapy might promote relapse in this population appear unwarranted. Our findings provide initial evidence suggestive of COPE efficacy for comorbid PTSD and AD in women. These results provide a strong rationale for investigating the efficacy of COPE for comorbid PTSD and AD in women in a randomized controlled trial.

  5. Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse

    Directory of Open Access Journals (Sweden)

    Antje Krüger

    2014-09-01

    Full Text Available Background: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD. However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD. Objective: The goal of the present study was to explore the frequency of sudden losses and sudden gains in the course of an exposure-based treatment programme for female patients suffering from PTSD related to childhood sexual abuse who also show severe comorbidity. In addition, the relationship between sudden changes and treatment outcome was examined. Methods: Female participants (N=74 were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. The pattern of symptom change was assessed via weekly assessments using the Posttraumatic Diagnostic Scale (PDS. Sudden changes were computed as suggested by the literature on sudden gains. Results: During treatment, only one participant (3% experienced a sudden loss, whereas 25% of participants experienced sudden gains. In the waiting condition, 8% of the participants experienced sudden losses and 5% experienced sudden gains during the same time period. No symptom worsening was observed in response to exposure sessions. However, sudden gains occurred during exposure and non-exposure treatment weeks. Patients with sudden gains showed better treatment outcome in the post-treatment and follow-up assessments. Conclusions: Exposure-based treatment did not lead to PTSD symptom worsening in the study sample. Results show that sudden gains occur frequently during PTSD treatment and have a prognostic value for treatment outcome.

  6. Comorbid antisocial and substance misuse proclivity and mental health service utilization by female inmates: testing the worst of both worlds hypothesis with the PAI.

    Science.gov (United States)

    Walters, Glenn D; Magaletta, Philip R

    2015-02-01

    The primary purpose of this study was to establish whether female inmates with comorbid proclivity for antisocial behavior and substance misuse, as measured by the Personality Assessment Inventory (PAI; Morey, 2007), use more mental health-related services than female inmates with either antisocial or substance misuse proclivity alone. A second purpose was to determine whether the effect of comorbid antisocial and substance misuse proclivity on mental health service utilization is cumulative or interactive. In a survey of 421 female federal prison inmates, it was noted that proclivity for both antisocial behavior and substance misuse was associated with significantly greater subsequent use of mental health services in female inmates than either proclivity alone, even after preexisting mental health diagnoses and treatment were controlled. In addition, the effect was additive rather than interactive. These findings provide further support for the "worst of both worlds" hypothesis, which holds that comorbid antisocial and substance involvement/proclivity portend poorer future outcomes than either antisocial or substance involvement/proclivity alone. The implications of these results for development of a comprehensive training model that provides mental health professionals with the skills to properly screen and effectively treat female inmates are discussed, along with the need to clarify the theory behind the "worst of both worlds" hypothesis.

  7. [Efficacy of HRV-biofeedback as additional treatment of depression and PTSD].

    Science.gov (United States)

    Blase, K L; van Dijke, A; Cluitmans, P J M; Vermetten, E

    2016-01-01

    Heartrate variability biofeedback (HRVB) is a non-invasive treatment in which patients are assumed to self-regulate a physiological dysregulated vagal nerve. Although the therapeutic approach of HRVB is promising in various stress-related disorders, it has only been offered on a regular basis in a few mental health treatment settings. To analyse the efficacy of HRV biofeedback as an additional psychophysiological treatment for depression and PTSD. Systematic review with search terms HRV, biofeedback, PTSD, depression, panic disorder and anxiety disorder. Our search of the literature yielded 789 studies. After critical appraisal using the GRADE method, we selected 6 randomised controlled trials (RCTs) and 4 relevant studies. The RCTs with control groups 'treatment as usual' and muscle relaxation training revealed significant clinical efficacy and better results than control conditions after 4 to 8 weeks training. Although this systematic review shows the popularity of HRV in literature, it does not indicate that HRVB really has been reviewed systematically. Significant outcomes of this limited number of randomised studies indicate there may be a clinical improvement when HRVB training is integrated into treatment of PTSD and depression, particularly when this integration procedure is combined with psychotherapy. More research needs to be done with larger groups and further efforts are needed to integrate HRVB into treatment of stress-related disorders in psychiatry. Future research also needs to focus on the psychophysiological mechanisms involved.

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... for PTSD What We Do Mission and Overview Goals and Objectives Looking Ahead Annual Reports Research Initiatives Education Initiatives ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

  9. Initial evaluation of an integrated treatment for comorbid PTSD and smoking using a nonconcurrent, multiple-baseline design.

    Science.gov (United States)

    Feldner, Matthew T; Smith, Rose C; Monson, Candice M; Zvolensky, Michael J

    2013-09-01

    The present study examined an integrated treatment for comorbid posttraumatic stress disorder (PTSD) and smoking entitled "Smoke-Free to Overcome PTSD: An Integrated Treatment" (STOP IT program). A nonconcurrent multiple-baseline design was used with six community-recruited adult smokers with PTSD to investigate both patient acceptance of the treatment and its initial efficacy on both PTSD and smoking. Potential order effects of exposure-based and affect management components were also examined. A gold-standard assessment strategy that included the Clinician Administered PTSD Scale (Blake et al., 1995) and biochemical verification of self-reported smoking status was employed to measure primary targets of treatment. Results suggested that the STOP IT program was well tolerated. There were clinically significant improvements in PTSD outcomes, but only temporary reductions in smoking. Participants' relatively low posttreatment smoking levels increased by the follow-up assessment, although not to baseline levels. Treatment component order did not appear to affect treatment outcomes, but those who were assigned to the exposure-focused writing prior to affect management training condition appeared more likely to discontinue treatment before beginning exposure. These preliminary data support the safety, acceptability, and potential efficacy of the STOP IT program. Future investigation of the STOP IT program should include testing the incremental efficacy of increasing the dose of smoking-focused intervention, as well as randomized controlled tests of the treatment that employ gold standards for treatment outcome research.

  10. Treatment of PTSD by eye movement desensitization reprocessing (EMDR) improves sleep quality, quality of life, and perception of stress.

    Science.gov (United States)

    Raboni, Mara Regina; Tufik, Sergio; Suchecki, Deborah

    2006-07-01

    The impact of posttraumatic stress disorder (PTSD) on the sleep of patients is widely reported. However, the parameters that can be altered are not the same for all patients. Some studies report an impairment of sleep maintenance and recurrent nightmares, while others failed to find such alterations. Among the many treatments, the eye movement desensitization reprocessing (EMDR) is a therapy used specifically to treat PTSD and general trauma. The purpose of this study was to examine whether EMDR treatment can improve PTSD symptoms, such as sleep, depression, anxiety, and poor quality of life.

  11. Glucocorticoid-induced reduction of traumatic memories: implications for the treatment of PTSD.

    Science.gov (United States)

    de Quervain, Dominique J-F

    2008-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that can occur after a traumatic event such as military combat, terrorist attacks, or accidents. The disorder is characterized by traumatic memories that manifest as reexperiencing symptoms including daytime recollections, traumatic nightmares, or flashbacks in which components of the event are relived. These symptoms result from excessive retrieval of traumatic memories that often retain their vividness and power to evoke distress for decades or even a lifetime. We have reported previously that elevated glucocorticoid levels inhibit memory retrieval in animals and healthy human subjects. We therefore hypothesized that the administration of cortisol might also inhibit the retrieval of traumatic memories in patients with PTSD. In a recent pilot study we found the first evidence to support this hypothesis. During a 3-month observation period, low-dose cortisol (10 mg per day) was administered orally for 1 month to three patients with chronic PTSD using a double-blind, placebo-controlled, crossover design. In each patient investigated, there was a significant treatment effect with cortisol-related reductions in one of the daily-rated symptoms of traumatic memories without causing adverse side effects. Furthermore, we have reported evidence for a prolonged effect of the cortisol treatment. Persistent retrieval and reconsolidation of traumatic memories is a process that keeps these memories vivid and thereby the disorder alive. By inhibiting memory retrieval, cortisol may weaken the traumatic memory trace and thus reduce symptoms even beyond the treatment period. Future studies with more patients and longer treatment periods are required to evaluate the efficacy of cortisol treatment for PTSD.

  12. Disseminating evidence-based treatments for PTSD in organizational settings: A high priority focus area.

    Science.gov (United States)

    Ruzek, Josef I; Rosen, Raymond C

    2009-11-01

    Dissemination of evidence-based treatments for PTSD has become an important focus of activity in the aftermath of recent terrorist attacks (e.g., London underground and U.S. 9/11 attacks), natural disasters (e.g., Indian Ocean tsunami and Hurricane Katrina), and wars (e.g., in Iraq and Afghanistan). This has become a high priority need for all mental health training and service delivery organizations. Researchers and educators have begun to examine clinician and client perceptions and preferences regarding PTSD treatment processes, and health care systems are organizing more comprehensive efforts at training and system change. As this evolution of services moves forward, effective dissemination should be a major focus of health policy research for the next decade or more. This review critically evaluates the PTSD-related research and emerging theory related to four major sets of variables that affect dissemination: (1) Practitioner factors, (2) Training methods, (3) The practice innovation(s) being disseminated; and (4) Organization or system factors. We evaluate findings from recent studies in light of emerging models of dissemination, and in the final section of the paper, we consider five broad topics with particular implications for dissemination of PTSD-specific treatments. They are: (1) The content of dissemination (i.e., which treatment protocols or intervention methods should be prioritized); (2) Strict adherence versus flexibility in the use of treatment manuals and the role of fidelity assessment; (3) The need for collaboration with user audiences; (4) The potential role of web-based technologies in increasing the effectiveness and efficiency of dissemination; and (5) Development of dissemination infrastructures within organizations.

  13. Treatment outcomes for women with substance abuse and PTSD who have experienced complex trauma.

    Science.gov (United States)

    Cohen, Lisa R; Hien, Denise A

    2006-01-01

    This study assessed the effect of cognitive-behavioral therapy on a range of problems associated with complex trauma in a sample of women with comorbid substance use disorders and posttraumatic stress disorder (PTSD). A total of 107 women with current or subthreshold PTSD and a current substance use disorder from an urban, low-income area were recruited from both community and clinical populations. Participants were recruited between 1997 and 2000. A quasi-experimental design was used, and participants who received cognitive-behavioral therapy (N=75) were compared with those in a control group who received no active study treatment (N=32). All participants were given the same list of community treatment resources and told that they could pursue services while participating in the study if they wished. At the end of treatment (three months postbaseline), compared with participants in the control group, those in the active treatment group showed significant reductions in symptoms of PTSD and alcohol use disorders, with a trend toward reductions in symptoms of drug use disorders. No significant differences were found between the groups on depression, dissociation, and social and sexual functioning outcomes. These findings underscore the challenge and necessity of addressing the unique and wide-ranging needs of women with substance use disorder who have been exposed to early and multiple interpersonal traumas.

  14. Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD

    Science.gov (United States)

    2015-10-01

    physically healthy and without mental health conditions  Sleep regulated 1 week prior to entering lab  Restricted from caffeine /alcohol 48 hours prior to...Award Number: W81XWH-11-2-0001 TITLE: “Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD...Annual 3. DATES COVERED (From - To) 1 OCT 2014- 30 SEP 2015 4. TITLE AND SUBTITLE Role of Sleep Deprivation in Fear Conditioning and Extinction

  15. Building a Family Systems Model to Promote Adherence to PTSD Treatment

    Science.gov (United States)

    2015-10-01

    also be delayed. We have begun presenting preliminary findings at scientific meetings and in recent MOMRP In Progress Review. 7 What was...alliance, and disclosure of CPT/PE engagement are important predictors of commitment to evidence based treatments for PTSD. In Progress Review...information that supplements, clarifies or supports the text . Examples include original copies of journal articles, reprints of manuscripts and

  16. The Impact of PTSD on Functioning in Patients Seeking Treatment for Chronic Pain and Validation of the Posttraumatic Diagnostic Scale.

    Science.gov (United States)

    Åkerblom, Sophia; Perrin, Sean; Rivano Fischer, Marcelo; McCracken, Lance M

    2017-04-01

    The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status. Participants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital. The translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events with 28.9% fulfilling criteria for a current PTSD diagnosis. The patients with PTSD also reported significantly higher levels of pain interference, kinesiophobia, anxiety, and depression and significantly lower levels of life control, compared to patients exposed to trauma and not fulfilling criteria for PTSD and patients with no history of traumatic exposure. Consistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for PTSD according to a standardized self-report measure. The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted. Self-report measures like the PDS appear to be valid for use in chronic pain samples and offer a relative low-cost method for screening for PTSD.

  17. Efficacy of virtual reality exposure therapy in the treatment of PTSD: a systematic review.

    Directory of Open Access Journals (Sweden)

    Raquel Gonçalves

    Full Text Available The use of Information and Communication Technologies, such as virtual reality, has been employed in the treatment of anxiety disorders with the goal of augmenting exposure treatment, which is already considered to be the first-line treatment for Post-traumatic Stress Disorder (PTSD. To evaluate the efficacy of virtual reality exposure therapy (VRET in the treatment of PTSD, we performed a systematic review of published articles using the following electronic databases: Web of Science, PubMed, PsycINFO, and PILOTS. Eligibility criteria included the use of patients diagnosed with PTSD according to DSM-IV, the use of cognitive behavioral therapy (CBT and the use of virtual reality for performing exposure. 10 articles were selected, seven of which showed that VRET produced statistically significant results in comparison to the waiting list. However, no difference was found between VRET and exposure treatment. Of these 10, four were randomized, two were controlled but not randomized and four were non-controlled. The majority of the articles used head-mounted display virtual reality (VR equipment and VR systems specific for the population that was being treated. Dropout rates do not seem to be lower than in traditional exposure treatment. However, there are a few limitations. Because this is a new field of research, there are few studies in the literature. There is also a need to standardize the number of sessions used. The randomized studies were analyzed to assess the quality of the methodology, and important deficiencies were noted, such as the non-use of intent-to- treat-analysis and the absence of description of possible concomitant treatments and comorbidities. Preliminary data suggest that VRET is as efficacious as traditional exposure treatment and can be especially useful in the treatment of patients who are resistant to traditional exposure.

  18. Efficacy of virtual reality exposure therapy in the treatment of PTSD: a systematic review.

    Science.gov (United States)

    Gonçalves, Raquel; Pedrozo, Ana Lúcia; Coutinho, Evandro Silva Freire; Figueira, Ivan; Ventura, Paula

    2012-01-01

    The use of Information and Communication Technologies, such as virtual reality, has been employed in the treatment of anxiety disorders with the goal of augmenting exposure treatment, which is already considered to be the first-line treatment for Post-traumatic Stress Disorder (PTSD). To evaluate the efficacy of virtual reality exposure therapy (VRET) in the treatment of PTSD, we performed a systematic review of published articles using the following electronic databases: Web of Science, PubMed, PsycINFO, and PILOTS. Eligibility criteria included the use of patients diagnosed with PTSD according to DSM-IV, the use of cognitive behavioral therapy (CBT) and the use of virtual reality for performing exposure. 10 articles were selected, seven of which showed that VRET produced statistically significant results in comparison to the waiting list. However, no difference was found between VRET and exposure treatment. Of these 10, four were randomized, two were controlled but not randomized and four were non-controlled. The majority of the articles used head-mounted display virtual reality (VR) equipment and VR systems specific for the population that was being treated. Dropout rates do not seem to be lower than in traditional exposure treatment. However, there are a few limitations. Because this is a new field of research, there are few studies in the literature. There is also a need to standardize the number of sessions used. The randomized studies were analyzed to assess the quality of the methodology, and important deficiencies were noted, such as the non-use of intent-to- treat-analysis and the absence of description of possible concomitant treatments and comorbidities. Preliminary data suggest that VRET is as efficacious as traditional exposure treatment and can be especially useful in the treatment of patients who are resistant to traditional exposure.

  19. Measurement and documentation of complex PTSD in treatment seeking traumatized refugees

    DEFF Research Database (Denmark)

    Palic, Sabina

    and personality dysfunction following extreme traumatization. Importantly, patterns of severe traumatic exposure in refugees may represent a group vulnerable to complex PTSD. However, there are currently only a few validated psychiatric measures for the assessment of traumatized refugees, which are limited...... to measuring symptoms of PTSD, anxiety, and depression. This renders documentation, measurement, and treatment of possible complex traumatic adaptations in traumatized refugees very difficult. The thesis comprises two studies using different measures and different samples. The first study investigated complex...... traumatization as Disorders of Extreme Stress Not Otherwise Specified (DESNOS). The first article from this study demonstrated that DESNOS in a clinical sample of refugees, primarily resembled the Schizotypal, and Paranoid personality disorders (PD), when compared to Axis I and Axis II syndromes on self...

  20. Measurement and documentation of complex PTSD in treatment seeking traumatized refugees

    DEFF Research Database (Denmark)

    Palic, Sabina

    The aim of the thesis is to study complex traumatization and its measurement in treatment seeking traumatized refugees. Historically there have been repeated attempts to create a diagnosis for complex posttraumatic stress disorder (complex PTSD) to capture the more diverse, trauma related symptoms...... traumatization as Disorders of Extreme Stress Not Otherwise Specified (DESNOS). The first article from this study demonstrated that DESNOS in a clinical sample of refugees, primarily resembled the Schizotypal, and Paranoid personality disorders (PD), when compared to Axis I and Axis II syndromes on self...... is considered a predominant risk factor for DESNOS and PD). However, there was also overlap between DESNOS and Axis I syndromes – specifically, depression, dissociation, somatization and PTSD. It was therefore concluded, that categorization of DESNOS in refugees under either Axis I or Axis II depends...

  1. Response to "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study"

    NARCIS (Netherlands)

    de Jongh, A.; ten Broeke, E.

    2014-01-01

    Last November, the European Journal of Psychotraumatology published an interesting paper entitled "Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study". This article

  2. Identifying Molecular Targets for PTSD Treatment Using Single Prolonged Stress

    Science.gov (United States)

    2015-10-01

    Neurobiological Mechanisms 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NO. OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC a...to changes in protein transcription that modulates glutamatergic and GABAergic function. In turn this could lead to aberrant excitatory and/or...will test novel pharmacological treatment strategies to prevent and reverse stress-induced change, and explore mechanisms of vulnerability and

  3. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2015-03-01

    Full Text Available Background: Three intrinsic connectivity networks in the brain, namely the central executive, salience, and default mode networks, have been identified as crucial to the understanding of higher cognitive functioning, and the functioning of these networks has been suggested to be impaired in psychopathology, including posttraumatic stress disorder (PTSD. Objective: 1 To describe three main large-scale networks of the human brain; 2 to discuss the functioning of these neural networks in PTSD and related symptoms; and 3 to offer hypotheses for neuroscientifically-informed interventions based on treating the abnormalities observed in these neural networks in PTSD and related disorders. Method: Literature relevant to this commentary was reviewed. Results: Increasing evidence for altered functioning of the central executive, salience, and default mode networks in PTSD has been demonstrated. We suggest that each network is associated with specific clinical symptoms observed in PTSD, including cognitive dysfunction (central executive network, increased and decreased arousal/interoception (salience network, and an altered sense of self (default mode network. Specific testable neuroscientifically-informed treatments aimed to restore each of these neural networks and related clinical dysfunction are proposed. Conclusions: Neuroscientifically-informed treatment interventions will be essential to future research agendas aimed at targeting specific PTSD and related symptoms.

  4. PTSD: National Center for PTSD

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    Full Text Available ... Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site Map Content Inventory Accessibility ... Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health Care Veterans Health Administration ...

  5. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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    Full Text Available ... Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & Protections Media Room Inside the Media Room Public ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

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  8. PTSD: National Center for PTSD

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    Full Text Available ... Search How to Obtain Articles Alerts User Guide Purpose and Scope Find Assessment Measures Instrument Authority List ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

  9. PTSD: National Center for PTSD

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    Full Text Available ... Directory Grants Management Services Veterans Service Organizations Whistleblower Rights & Protections Transparency Media Room Inside the Media Room ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30. ...

  10. PTSD: National Center for PTSD

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    Full Text Available ... VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ... Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers VA Providers and ...

  11. PTSD: National Center for PTSD

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    Full Text Available ... Accessibility Privacy and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health ...

  12. Aripiprazole Augmentation in the Treatment of Military-Related PTSD with Major Depression: a retrospective chart review

    Directory of Open Access Journals (Sweden)

    Fikretoglu Deniz

    2011-05-01

    Full Text Available Abstract Background In this chart review, we attempted to evaluate the benefits of adding aripiprazole in veterans with military-related PTSD and comorbid depression, who had been minimally or partially responsive to their existing medications. Methods A retrospective chart review of patients who received an open-label, flexible-dose, 12- week course of adjunctive aripiprazole was conducted in 27 military veterans meeting DSM-IV criteria for PTSD and comorbid major depression. Concomitant psychiatric medications continued unchanged, except for other antipsychotics which were discontinued prior to initiating aripiprazole. The primary outcome variable was a change from baseline in the PTSD checklist-military version (PCL-M and the Beck Depression Inventory (BDI-II. Results PTSD severity (Total PCL scores decreased from 56.11 at baseline to 46.85 at 12-weeks (p Conclusions The addition of aripiprazole contributed to a reduction in both PTSD and depression symptomatology in a population that has traditionally demonstrated poor pharmacological response. Further investigations, including double-blind, placebo-controlled studies, are essential to confirm and further demonstrate the benefit of aripiprazole augmentation in the treatment of military related PTSD.

  13. Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study.

    Science.gov (United States)

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H; Veltman, Dick J; Hoogendoorn, Adriaan W; van Balkom, Anton J L M; Draijer, Nel

    2013-01-01

    In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT) for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive) (N=14) with the non-adaptive patients (N=24) as revealed by a cluster analysis. We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles "withdrawn" and "aggressive," were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

  14. Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study

    Directory of Open Access Journals (Sweden)

    Ethy Dorrepaal

    2013-11-01

    Full Text Available Background: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD and personality disorders (PDs are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. Objective: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method: In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive (N=14 with the non-adaptive patients (N=24 as revealed by a cluster analysis. Results: We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles “withdrawn” and “aggressive,” were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Conclusion: Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

  15. Narrative exposure therapy for PTSD increases top-down processing of aversive stimuli - evidence from a randomized controlled treatment trial

    Directory of Open Access Journals (Sweden)

    Adenauer Hannah

    2011-12-01

    Full Text Available Abstract Background Little is known about the neurobiological foundations of psychotherapy for Posttraumatic Stress Disorder (PTSD. Prior studies have shown that PTSD is associated with altered processing of threatening and aversive stimuli. It remains unclear whether this functional abnormality can be changed by psychotherapy. This is the first randomized controlled treatment trial that examines whether narrative exposure therapy (NET causes changes in affective stimulus processing in patients with chronic PTSD. Methods 34 refugees with PTSD were randomly assigned to a NET group or to a waitlist control (WLC group. At pre-test and at four-months follow-up, the diagnostics included the assessment of clinical variables and measurements of neuromagnetic oscillatory brain activity (steady-state visual evoked fields, ssVEF resulting from exposure to aversive pictures compared to neutral pictures. Results PTSD as well as depressive symptom severity scores declined in the NET group, whereas symptoms persisted in the WLC group. Only in the NET group, parietal and occipital activity towards threatening pictures increased significantly after therapy. Conclusions Our results indicate that NET causes an increase of activity associated with cortical top-down regulation of attention towards aversive pictures. The increase of attention allocation to potential threat cues might allow treated patients to re-appraise the actual danger of the current situation and, thereby, reducing PTSD symptoms. Registration of the clinical trial Number: NCT00563888 Name: "Change of Neural Network Indicators Through Narrative Treatment of PTSD in Torture Victims" ULR: http://www.clinicaltrials.gov/ct2/show/NCT00563888

  16. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD.

    Science.gov (United States)

    Armour, Cherie; Karstoft, Karen-Inge; Richardson, J Don

    2014-08-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD. The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group. In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.

  17. Comparing Treatment Outcome of Guided Imagery and Music and Psychodynamic Imaginative Trauma Therapy for Women with Complex PTSD

    DEFF Research Database (Denmark)

    Maack, Carola

    2013-01-01

    To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery...... of Complex PTSD, structural and somatoform dissociation, interpersonal problems, and factors promoting health before treatment and after 50 therapy hours or before and after waiting. Results showed significant differences in all scores when either of the treatment conditions was compared to the control group....... Participants treated with GIM showed significantly better outcome in all measurements than participants treated with PITT. This indicates that the use of music is beneficial for women with Complex PTSD treated with psychodynamic trauma therapy....

  18. Tones inferior to eye movements in the EMDR treatment of PTSD.

    Science.gov (United States)

    van den Hout, Marcel A; Rijkeboer, Marleen M; Engelhard, Iris M; Klugkist, Irene; Hornsveld, Hellen; Toffolo, Marieke J B; Cath, Danielle C

    2012-05-01

    Eye Movement Desensitization and Reprocessing (EMDR) is an effective treatment for posttraumatic stress disorder (PTSD). During EMDR, patients make eye movements (EMs) while recalling traumatic memories, but recently therapists have replaced EMs by alternating beep tones. There are no outcome studies on the effects of tones. In an earlier analogue study, tones were inferior to EMs in the reduction of vividness of aversive memories. In a first EMDR session, 12 PTSD patients recalled trauma memories in three conditions: recall only, recall + tones, and recall + EMs. Three competing hypotheses were tested: 1) EMs are as effective as tones and better than recall only, 2) EMs are better than tones and tones are as effective as recall only, and 3) EMs are better than tones and tones are better than recall only. The order of conditions was balanced, each condition was delivered twice, and decline in memory vividness and emotionality served as outcome measures. The data strongly support hypothesis 2 and 3 over 1: EMs outperformed tones while it remained unclear if tones add to recall only. The findings add to earlier considerations and earlier analogue findings suggesting that EMs are superior to tones and that replacing the former by the latter was premature.

  19. Long-term responses to treatment in UK veterans with military-related PTSD: an observational study

    Science.gov (United States)

    Murphy, Dominic; Spencer-Harper, Lucy; Carson, Carron; Palmer, Emily; Hill, Kate; Sorfleet, Nicola; Wessely, Simon; Busuttil, Walter

    2016-01-01

    Objectives Military-related trauma can be difficult to treat. Evaluating longer term responses to treatment and identifying which individuals may need additional support could inform clinical practice. We assessed 1-year outcomes in UK veterans treated for post-traumatic stress disorder (PTSD). Design Within-participant design. Setting The intervention was offered by Combat Stress, a mental health charity for veterans in the UK. Participants The sample included 401 veterans who completed a standardised 6-week residential treatment. Of these, 268 (67%) were successfully followed up a year after the end of treatment. Methods A range of health outcomes were collected pretreatment and repeated at standard intervals post-treatment. The primary outcome was severity of PTSD symptoms, and secondary outcomes included measures of other mental health difficulties (depression, anxiety and anger), problems with alcohol, and social and occupational functioning. Results Significant reductions in PTSD severity were observed a year after treatment (PSS-I: −11.9, 95% CI −13.1 to −10.7). Reductions in the secondary outcomes were also reported. Higher levels of post-treatment functional impairment (0.24, 95% CI 0.08 to 0.41) and alcohol problems (0.18, 95% CI 0.03 to 0.32) were associated with poorer PTSD treatment response at 12 months. Conclusions This uncontrolled study suggests the longer term benefits of a structured programme to treat UK veterans with PTSD. Our findings point to the importance of continued support targeted for particular individuals post-treatment to improve longer term outcomes. PMID:27638494

  20. The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving.

    Science.gov (United States)

    Kaczkurkin, Antonia N; Asnaani, Anu; Alpert, Elizabeth; Foa, Edna B

    2016-04-01

    Given the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), we investigated an integrated treatment for these disorders. Individuals with comorbid PTSD and alcohol dependence were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants also received BRENDA (supportive counseling). The naltrexone plus PE group showed a greater decline in alcohol craving symptoms than those in the placebo with no PE group. The PE plus placebo and the naltrexone without PE groups did not differ significantly from the placebo with no PE group in terms of alcohol craving. No treatment group differences were found for percentage of drinking days. Alcohol craving was moderated by PTSD severity, with those with higher PTSD symptoms showing faster decreases in alcohol craving. Both PTSD and alcohol use had a lagged effect on alcohol craving, with changes in PTSD symptoms and percentage of days drinking being associated with subsequent changes in craving. These results support the relationship between greater PTSD symptoms leading to greater alcohol craving and suggest that reducing PTSD symptoms may be beneficial to reducing craving in those with co-occurring PTSD/SUD.

  1. Prazosin for Treatment of Patients With PTSD and Comorbid Alcohol Dependence

    Science.gov (United States)

    2013-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD, and alcohol dependence . Objective: The objective of this study is to evaluate the efficacy of

  2. Neural changes in extinction recall following prolonged exposure treatment for PTSD: A longitudinal fMRI study

    Directory of Open Access Journals (Sweden)

    Liat Helpman, PhD

    2016-01-01

    Conclusions: Prolonged exposure treatment appears to alter neural activation in PTSD patients during recall of fear extinction, and change in extinction recall (measured by SCR is associated with symptom reduction. We discuss results in the context of neural systems involved in response to affective stimuli.

  3. Baseline psychophysiological and cortisol reactivity as a predictor of PTSD treatment outcome in virtual reality exposure therapy.

    Science.gov (United States)

    Norrholm, Seth Davin; Jovanovic, Tanja; Gerardi, Maryrose; Breazeale, Kathryn G; Price, Matthew; Davis, Michael; Duncan, Erica; Ressler, Kerry J; Bradley, Bekh; Rizzo, Albert; Tuerk, Peter W; Rothbaum, Barbara O

    2016-07-01

    Baseline cue-dependent physiological reactivity may serve as an objective measure of posttraumatic stress disorder (PTSD) symptoms. Additionally, prior animal model and psychological studies would suggest that subjects with greatest symptoms at baseline may have the greatest violation of expectancy to danger when undergoing exposure based psychotherapy; thus treatment approaches which enhanced the learning under these conditions would be optimal for those with maximal baseline cue-dependent reactivity. However methods to study this hypothesis objectively are lacking. Virtual reality (VR) methodologies have been successfully employed as an enhanced form of imaginal prolonged exposure therapy for the treatment of PTSD. Our goal was to examine the predictive nature of initial psychophysiological (e.g., startle, skin conductance, heart rate) and stress hormone responses (e.g., cortisol) during presentation of VR-based combat-related stimuli on PTSD treatment outcome. Combat veterans with PTSD underwent 6 weeks of VR exposure therapy combined with either d-cycloserine (DCS), alprazolam (ALP), or placebo (PBO). In the DCS group, startle response to VR scenes prior to initiation of treatment accounted for 76% of the variance in CAPS change scores, p therapy, in particular in the presence of enhancement (e.g., DCS). Published by Elsevier Ltd.

  4. Prazosin Augmentation of Outpatient Treatment of Alcohol Use Disorders in Active Duty Soldiers with and without PTSD

    Science.gov (United States)

    2014-10-01

    State Psychiatric Institute, 1996 17. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ: The Pittsburgh Sleep Quality Index: a new instrument...Clin Psychiatry 2001; 62:860–868 31. Marshall RD, Beebe KL, Oldham M, Zaninelli R: Efficacy and safety of paroxetine treatment for chronic PTSD: a fixed

  5. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD

    DEFF Research Database (Denmark)

    Armour, C.; Karstoft, K. I.; Richardson, J. D.

    2014-01-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative......-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants...... were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity...

  6. PTSD: National Center for PTSD

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  7. PTSD: National Center for PTSD

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    Full Text Available ... not provide direct clinical care, individual referrals or benefits information. For help please see: Where to Get ... PTSD or Get Help with VA PTSD Care, Benefits, or Claims For Web site help: Web Policies ...

  8. PTSD: National Center for PTSD

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  9. PTSD: National Center for PTSD

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    Full Text Available ... PTSD Research Quarterly Publications Search Using the PILOTS Database What is PILOTS? Quick Search Tips Modify Your ... stress. Search Pilots Search PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign up ...

  10. PTSD: National Center for PTSD

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    Full Text Available ... Common Problems Family and Friends PTSD and Communities Paginas en Espanol Apps, Videos and More Mobile Apps Videos Web Links PTSD Site Search For Professionals Professional Section ...

  11. PTSD: National Center for PTSD

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    Full Text Available ... Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based ...

  12. PTSD: National Center for PTSD

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  13. PTSD: National Center for PTSD

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  14. PTSD: National Center for PTSD

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  15. PTSD: National Center for PTSD

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  16. PTSD: National Center for PTSD

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  17. PTSD: National Center for PTSD

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  18. PTSD: National Center for PTSD

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  19. Prazosin for Treatment of Patients with PTSD and Comorbid Alcohol Dependence

    Science.gov (United States)

    2014-12-01

    as high as those in the general population. In addition, alcohol dependence is the most ommon comorbid condition in men with PTSD. Despite this...participants with a current iagnosis of AD and PTSD will be enrolled in a 13-week trial. They will be assigned, in a double-blind fashion , to either

  20. A Controlled Trial of Topiramate Treatment for Alcohol Dependence in Veterans with PTSD

    Science.gov (United States)

    2015-10-01

    APPENDICES: Attach all appendices that contain information that supplements, clarifies or supports the text. Examples include original copies of journal...symptom severity. However, AUD is also a potential consequence of PTSD. AUD and PTSD share some common neurobiological mechanisms, e.g. elevations

  1. Assessment and Treatment of Combat-Related PTSD in Returning War Veterans

    Science.gov (United States)

    2011-01-01

    severity of symptoms (Falsetti, Resick, Resnick, & Kilpatrick, 1993 as cited in Coffey, Dansky, Falsetti, Saladin , & Brady, 1998). PTSD Checklist-Military...S. A., Saladin , M. E., & Brady, K. T. (1998). Screening for PTSD in a substance abuse sample: Psychometric properties of a modified version of the

  2. University Counseling Center Use of Prolonged Exposure Therapy: In-Clinic Treatment for Students with PTSD

    Science.gov (United States)

    Bonar, Ted C.

    2015-01-01

    Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including…

  3. PTSD: National Center for PTSD

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  4. PTSD: National Center for PTSD

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  5. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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    Full Text Available ... and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation ... Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 Contact ...

  7. Precursors to rape: pressuring behaviors and rape proclivity.

    Science.gov (United States)

    Strain, Megan L; Hockett, Jericho M; Saucier, Donald A

    2015-01-01

    We developed measures assessing personal and normative attitudes toward two types of behaviors that are symptomatic of rape culture. We conceptualize sexual violence as existing on a continuum and argue that two types of behaviors may be potential antecedents to (and consequences of) sexual violence: attempts to pressure, which mimic the power dynamics of rape in a less aggressive fashion, and benevolent dating behaviors, which are accepted dating scripts in which men initiate action. We examined individuals' acceptance of these behaviors in relation to their attitudes toward rape victims and among men to rape proclivity. This initial work suggests that these constructs and measures may be useful to investigate in future research.

  8. Changes in social adjustment with cognitive processing therapy: effects of treatment and association with PTSD symptom change.

    Science.gov (United States)

    Monson, Candice M; Macdonald, Alexandra; Vorstenbosch, Valerie; Shnaider, Philippe; Goldstein, Elizabeth S R; Ferrier-Auerbach, Amanda G; Mocciola, Katharine E

    2012-10-01

    The current study sought to determine if different spheres of social adjustment, social and leisure, family, and work and income improved immediately following a course of cognitive processing therapy (CPT) when compared with those on a waiting list in a sample of 46 U.S. veterans diagnosed with posttraumatic stress disorder (PTSD). We also sought to determine whether changes in different PTSD symptom clusters were associated with changes in these spheres of social adjustment. Overall social adjustment, extended family relationships, and housework completion significantly improved in the CPT versus waiting-list condition, η(2) = .08 to .11. Hierarchical multiple regression analyses revealed that improvements in total clinician-rated PTSD symptoms were associated with improvements in overall social and housework adjustment. When changes in reexperiencing, avoidance, emotional numbing, and hyperarousal were all in the model accounting for changes in total social adjustment, improvements in emotional numbing symptoms were associated with improvements in overall social, extended family, and housework adjustment (β = .38 to .55). In addition, improvements in avoidance symptoms were associated with improvements in housework adjustment (β = .30), but associated with declines in extended family adjustment (β = -.34). Results suggest that it is important to consider the extent to which PTSD treatments effectively reduce specific types of symptoms, particularly emotional numbing and avoidance, to generally improve social adjustment.

  9. Evaluation of the effectiveness of a novel brain and vestibular rehabilitation treatment modality in PTSD patients who have suffered combat related traumatic brain injuries

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-02-01

    Full Text Available Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a signature injury. Vestibular complaints are the most frequent sequelae of mTBI and vestibular rehabilitation (VR has been established as the most important treatment modality for this group of patients. Material and Methods:We studied the effectiveness of a novel brain and VR treatment PTSD in subjects who had suffered combat related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6. We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS scores pre and post treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%. Results:Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. 41 subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment we observed a large reduction in CAPS severity scores with both statistical and substantive significance. Discussion:Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family and society.

  10. Treatment Outcomes for Women With Substance Abuse and PTSD Who Have Experienced Complex Trauma

    National Research Council Canada - National Science Library

    Cohen, Lisa R; Hien, Denise A

    2006-01-01

    OBJECTIVE: This study assessed the effect of cognitive-behavioral therapy on a range of problems associated with complex trauma in a sample of women with comorbid substance use disorders and posttraumatic stress disorder (PTSD). METHODS...

  11. Responding to the need for sleep among survivors of interpersonal violence: A randomized controlled trial of a cognitive-behavioral insomnia intervention followed by PTSD treatment.

    Science.gov (United States)

    Pigeon, Wilfred R; Heffner, Kathi L; Crean, Hugh; Gallegos, Autumn M; Walsh, Patrick; Seehuus, Martin; Cerulli, Catherine

    2015-11-01

    Sleep disturbance is a common feature of posttraumatic stress disorder (PTSD), but is not a focus of standard PTSD treatments. Psychological trauma exposure is associated with considerable physical and mental health morbidity, possibly due to the alterations in neuroendocrine function and inflammation observed in trauma exposed individuals. Although PTSD treatments are efficacious, they are associated with high drop-out rates in clinical trials and clinical practice. Finally, individuals with PTSD stemming from exposure to interpersonal violence represent an especially under-treated population with significant sleep disturbance. Community-based participatory research was utilized to design and prepare a clinical trial that randomizes recent survivors of interpersonal violence who have PTSD, depression, and insomnia to receive either: (1) Cognitive Behavioral Therapy for Insomnia (CBTi) followed by Cognitive Processing Therapy (CPT) for trauma, or (2) attention control followed by CPT. Outcome measures include subjective and objective measures of sleep, clinician-administered PTSD and depression scales, inflammatory cytokines, and salivary cortisol. Assessments are conducted at baseline, following the sleep or control intervention, and again following CPT. The design allows for: (1) the first test of a sleep intervention in this population; (2) the comparison of sequenced CBTi and CPT to attention control followed by CPT, and (3) assessing the roles of neuroendocrine function, inflammatory processes, and objective sleep markers in mediating treatment outcomes. The study's overarching hypothesis is that treating insomnia will produce reduction in insomnia, PTSD, and depression severity, allowing patients to more fully engage in, and derive optimal benefits from, cognitive processing therapy.

  12. Development of a guided self-help (GSH) program for the treatment of mild-to-moderate posttraumatic stress disorder (PTSD).

    Science.gov (United States)

    Lewis, Catrin; Roberts, Neil; Vick, Tracey; Bisson, Jonathan I

    2013-11-01

    There is a shortage of suitably qualified therapists able to deliver evidence-based treatment for posttraumatic stress disorder (PTSD), precluding timely access to intervention. This work aimed to develop an optimally effective, feasible, and acceptable guided self-help (GSH) program for treatment of the disorder. The study followed Medical Research Council (MRC) guidance for the development of a complex intervention. A prototype GSH program was developed through an initial modeling phase. Systematic reviews of the literature informed a portfolio of up-to-date information for key stakeholders to consider and discuss in a series of focus groups and semistructured interviews, which included 10 mental health professionals with expertise in the fields of GSH and/or PTSD, and seven former PTSD sufferers. Data were analyzed through a process of Inductive Thematic Analysis and used to inform the content, delivery, and guidance of a GSH program for PTSD. The prototype was piloted with 19 PTSD sufferers in two pilot studies, and refined on the basis of their quantitative results and qualitative feedback. The final version was available online and in hardcopy. It included 11 modules, some being mandatory and others optional, allowing tailoring of the intervention to meet an individual's specific needs. Qualitative and quantitative results of the pilot studies supported its efficacy in terms of reducing traumatic stress symptoms and its acceptability to PTSD sufferers. Delivering psychological treatment in a GSH format shows promise as an effective and acceptable way of treating mild-to-moderate PTSD. © 2013 Wiley Periodicals, Inc.

  13. Demonstrating the Efficacy of Group Prolonged Exposure Treatment of PTSD in OEF/OIF/OND Male Veterans

    Science.gov (United States)

    2015-12-01

    other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a...behaviors. PCT is a non-trauma focused treatment for PTSD, where the mechanisms of change include altering current maladaptive relational patterns and...RESPONSIBLE PERSON USAMRMC a. REPORT Unclassified b. ABSTRACT Unclassified c. THIS PAGE Unclassified Unclassified 19b. TELEPHONE NUMBER (include

  14. Biomarkers for PTSD

    Science.gov (United States)

    2013-07-01

    anxiety disorders. Ressler hopes that by understanding how fear works in the mammalian brain in the laboratory, it will improve understanding of and...provide translational treatments and possibly prevention for fear-based disorders, such as PTSD, phobic disorders and panic disorder. Dr. Ressler...PROVE (Project for Return and Opportunity in Veterans Education) Queens Vet Center Rutgers Anxiety Disorders Clinic Veteran PTSD Support Group

  15. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART(®)).

    Science.gov (United States)

    Kip, Kevin E; Elk, Carrie A; Sullivan, Kelly L; Kadel, Rajendra; Lengacher, Cecile A; Long, Christopher J; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F; Street, Jennifer D; Girling, Sue Ann; Diamond, David M

    2012-06-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART(®)) that incorporates the use of eye movements administered in a brief treatment period (1-5 one-hour sessions within three weeks). Eighty adults aged 21-60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants' mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD.

  16. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD by Use of Accelerated Resolution Therapy (ART®

    Directory of Open Access Journals (Sweden)

    Kevin E. Kip

    2012-06-01

    Full Text Available Post-Traumatic Stress Disorder (PTSD is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART® that incorporates the use of eye movements administered in a brief treatment period (1–5 one-hour sessions within three weeks. Eighty adults aged 21–60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants’ mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5% completed treatment, and 54 of 66 (81.8% provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p < 0.0001 for all pre-ART vs. post-ART and 2-month comparisons. No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD.

  17. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®)

    Science.gov (United States)

    Kip, Kevin E.; Elk, Carrie A.; Sullivan, Kelly L.; Kadel, Rajendra; Lengacher, Cecile A.; Long, Christopher J.; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F.; Street, Jennifer D.; Girling, Sue Ann; Diamond, David M.

    2012-01-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART®) that incorporates the use of eye movements administered in a brief treatment period (1–5 one-hour sessions within three weeks). Eighty adults aged 21–60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants’ mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD. PMID:25379218

  18. 76 FR 22145 - In the Matter of Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products...

    Science.gov (United States)

    2011-04-20

    ... COMMISSION Inv. No. 337-TA-756 In the Matter of Certain Reduced Ignition Proclivity Cigarette Paper Wrappers...'s electronic docket (EDIS) at http://edis.usitc.gov . SUPPLEMENTARY INFORMATION: On January 13, 2011... the United States after importation of certain reduced ignition proclivity cigarette paper wrappers...

  19. 77 FR 34407 - Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products Containing Same...

    Science.gov (United States)

    2012-06-11

    ... COMMISSION Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products Containing Same... record for this investigation may be viewed on the Commission's electronic docket (EDIS) at http://edis... importation, importation, or sale after importation of certain reduced ignition proclivity cigarette paper...

  20. Exposure to Sexist Humor and Rape Proclivity: The Moderator Effect of Aversiveness Ratings

    Science.gov (United States)

    Romero-Sanchez, Monica; Duran, Mercedes; Carretero-Dios, Hugo; Megias, Jesus L.; Moya, Miguel

    2010-01-01

    The aim of this study is to explore the effect of exposure to sexist humor about women on men's self-reported rape proclivity. Earlier studies have shown that exposure to this type of humor increases rape proclivity and that funniness responses to jokes are a key element to consider. However, the role of aversiveness responses has not been…

  1. PTSD: National Center for PTSD

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    Full Text Available ... Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation Spinal Cord Injury ...

  2. PTSD in the military: special considerations for understanding prevalence, pathophysiology and treatment following deployment

    Directory of Open Access Journals (Sweden)

    Rachel Yehuda

    2014-08-01

    Full Text Available Given the unique context of warzone engagement, which may include chronic threat, multiple and lengthy deployments, and loss, there is a need to understand whether and to what extent knowledge about PTSD derived from studies of civilian trauma exposure is generalizeable to the military. This special issue on PTSD in the military addresses a range of issues and debates related to mental health in military personnel and combat veterans. This article provides an overview of the issues covered in selected contributions that have been assembled for a special volume to consider issues unique to the military. Several leading scholars and military experts have contributed papers regarding: 1 prevalence rates of PTSD and other post-deployment mental health problems in different NATO countries, 2 the search for biomarkers of PTSD and the potential applications of such findings, and 3 prevention and intervention approaches for service members and veterans. The volume includes studies that highlight the divergence in prevalence rates of PTSD and other post-deployment mental health problems across nations and that discuss potential causes and implications. Included studies also provide an overview of research conducted in military or Veteran's Affairs settings, and overarching reviews of military-wide approaches to research, promotion of resilience, and mental health interventions in the Unites States and across NATO and allied ISAF partners.

  3. PTSD: National Center for PTSD

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    Full Text Available ... Inventory Accessibility Privacy and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business ... VA PTSD Care, Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 ...

  4. Brief, Early Treatment for ASD/PTSD Following Motor Vehicle Accidents

    Science.gov (United States)

    Hickling, Edward J.; Blanchard, Edward B.; Kuhn, Eric

    2005-01-01

    Early, brief interventions for posttraumatic stress disorder (PTSD) secondary to motor vehicle accidents (MVAs) have historically been, with few exceptions, unsuccessful with single session or even very brief (3 to 6 sessions) interventions. In contrast, very intensive cognitive behavioral therapy (CBT) applied over the first 6 to 8 weeks…

  5. PTSD and its treatment in people with intellectual disabilities: a review of the literature

    NARCIS (Netherlands)

    Mevissen-Renckens, E.H.M.; de Jongh, A.

    2010-01-01

    Although there is evidence to suggest that people with intellectual disabilities (ID) are likely to suffer from Post-Traumatic Stress Disorder (PTSD), reviews of the evidence base, and the potential consequences of this contention are absent. The purpose of this article is to present a comprehensive

  6. Culturally adapted CBT (CA-CBT) for Latino women with treatment-resistant PTSD: a pilot study comparing CA-CBT to applied muscle relaxation.

    Science.gov (United States)

    Hinton, Devon E; Hofmann, Stefan G; Rivera, Edwin; Otto, Michael W; Pollack, Mark H

    2011-04-01

    We examined the therapeutic efficacy of a culturally adapted form of CBT (CA-CBT) for PTSD as compared to applied muscle relaxation (AMR) for female Latino patients with treatment-resistant PTSD. Participants were randomized to receive either CA-CBT (n = 12) or AMR (n = 12), and were assessed before treatment, after treatment, and at a 12-week follow-up. The treatments were manualized and delivered in the form of group therapy across 14 weekly sessions. Assessments included a measure of PTSD, anxiety, culturally relevant idioms of distress (nervios and ataque de nervios), and emotion regulation ability. Patients receiving CA-CBT improved significantly more than in the AMR condition. Effect size estimates showed very large reductions in PTSD symptoms from pretreatment to posttreatment in the CA-CBT group (Cohen's d = 2.6) but only modest improvements in the AMR group (0.8). These results suggest that CA-CBT can be beneficial for previously treatment-resistant PTSD in Latino women.

  7. PTSD: National Center for PTSD

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  11. Adjunctive risperidone treatment for antidepressant-resistant symptoms of chronic military service-related PTSD: a randomized trial.

    Science.gov (United States)

    Krystal, John H; Rosenheck, Robert A; Cramer, Joyce A; Vessicchio, Jennifer C; Jones, Karen M; Vertrees, Julia E; Horney, Rebecca A; Huang, Grant D; Stock, Christopher

    2011-08-03

    Serotonin reuptake-inhibiting (SRI) antidepressants are the only FDA-approved pharmacotherapies for the treatment of posttraumatic stress disorder (PTSD). To determine efficacy of the second-generation antipsychotic risperidone as an adjunct to ongoing pharmacologic and psychosocial treatments for veterans with chronic military-related PTSD. A 6-month, randomized, double-blind, placebo-controlled multicenter trial conducted between February 2007 and February 2010 at 23 Veterans Administration outpatient medical centers. Of the 367 patients screened, 296 were diagnosed with military-related PTSD and had ongoing symptoms despite at least 2 adequate SRI treatments, and 247 contributed to analysis of the primary outcome measure. Risperidone (up to 4 mg once daily) or placebo. The Clinician-Administered PTSD Scale (CAPS) (range, 0-136). Other measures included the Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Scale (HAMA), Clinical Global Impression scale (CGI), and Veterans RAND 36-Item Health Survey (SF-36V). Change in CAPS scores from baseline to 24 weeks in the risperidone group was -16.3 (95% CI, -19.7 to -12.9) and in the placebo group, -12.5 (95% CI, -15.7 to -9.4); the mean difference was 3.74 (95% CI, -0.86 to 8.35; t = 1.6; P = .11). Mixed model analysis of all time points also showed no significant difference in CAPS score (risperidone: mean, 64.43; 95% CI, 61.98 to 66.89, vs placebo: mean, 67.16; 95% CI, 64.71 to 69.62; mean difference, 2.73; 95% CI, -0.74 to 6.20; P = .12). Risperidone did not reduce symptoms of depression (MADRS mean difference, 1.19; 95% CI, -0.29 to 2.68; P = .11) or anxiety (HAMA mean difference, 1.16; 95% CI, -0.18 to 2.51; P = .09; patient-rated CGI mean difference, 0.20; 95% CI, -0.06 to 0.45; P = .14; observer-rated CGI mean difference, 0.18; 95% CI, 0.01 to 0.34; P = .04), or increase quality of life (SF-36V physical component mean difference, -1.13, 95% CI, -2.58 to 0.32; P = .13; SF-36V mental component mean

  12. Higher FKBP5, COMT, CHRNA5, and CRHR1 allele burdens are associated with PTSD and interact with trauma exposure: implications for neuropsychiatric research and treatment

    Directory of Open Access Journals (Sweden)

    Boscarino JA

    2012-03-01

    interacts with risk allele count, such that PTSD is increased in those with higher risk allele counts and higher trauma exposures. Since the single nucleotide polymorphisms studied encompass stress circuitry and addiction biology, these findings may have implications for neuropsychiatric research and treatment.Keywords: posttraumatic stress disorder, genetic association study, single nucleotide polymorphism, risk alleles, trauma exposure, neuroticism, childhood adversity

  13. A Controlled Trial of Topiramate Treatment for Alcohol Dependence in Veterans with PTSD

    Science.gov (United States)

    2014-10-01

    due to myocardial infarction , judged to be unrelated to the study. DISCUSSION The study described here is the first prospective trial of to- piramate...Use Disorders sections of the Structured Clinical Interview for DSM-IV-TR (First et al., 2001). PTSD diagnosis was assessed with the Clinician...participant withdrew due to lack of time, and 1 PLA participant died of myo- cardial infarction , judged to be unrelated to the study. No participants dropped

  14. Role of Sleep Deprivation in Fear Conditioning and Extinction: Implications for Treatment of PTSD

    Science.gov (United States)

    2015-12-01

    and distressing symptoms of PTSD are insomnia and nightmares. The resultant sleep deprivation may actually serve to perpetuate the disorder by... accounted for by safety signal learning. Overnight REM sleep was, in turn, related to overnight retention of fear and safety learning, with 6 22.5% of the...variance in startle retention accounted for by REM sleep. These data suggest sleep difficulties, specifically REM sleep fragmentation, may play a

  15. Short and long term effectiveness of a subject's specific novel brain and vestibular rehabilitation treatment modality in combat veterans suffering from PTSD

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-06-01

    Full Text Available AbstractIntroduction: Treatment for post-traumatic stress disorder (PTSD in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS scores after a two week trial of a subject's particular novel brain and vestibular rehabilitation (VR program. The long-term maintenance of PTSD severity reduction was the subject of this study.Material and Methods:We studied the short and long term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre and post treatment (one week and three months using our subjects as their matched controls. Results:The generalized least squares (GLS technique demonstrated that with our 26 subjects in the 3 timed groups the R2 within groups was 0.000, R2 between groups was 0.000 and overall the R2 was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests.Discussion:Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (two weeks is less that other currently available treatments and has profound implications for cost, duration of disability and outcomes in the treatment of PTSD in combat veterans.

  16. Errors in the 2017 APA Clinical Practice Guideline for the Treatment of PTSD: What the Data Actually Says

    Directory of Open Access Journals (Sweden)

    Sarah K. Dominguez

    2017-08-01

    Full Text Available The American Psychological Association (APA Practice Guidelines for the Treatment of Posttraumatic Stress Disorder (PTSD concluded that there was strong evidence for cognitive behavioral therapy (CBT, cognitive processing therapy (CPT, cognitive therapy (CT, and exposure therapy yet weak evidence for eye movement desensitization and reprocessing (EMDR. This is despite the findings from an associated systematic review which concluded that EMDR leads to loss of PTSD diagnosis and symptom reduction. Depression symptoms were also found to improve more with EMDR than control conditions. In that review, EMDR was marked down on strength of evidence (SOE for symptom reduction for PTSD. However, there were several problems with the conclusions of that review. Firstly, in assessing the evidence in one of the studies, the reviewers chose an incorrect measure that skewed the data. We recalculated a meta-analysis with a more appropriate measure and found the SOE improved. The resulting effect size for EMDR on PTSD symptom reduction compared to a control condition was large for studies that meet the APA inclusion criteria (SMD = 1.28 and the heterogeneity was low (I2= 43%. Secondly, even if the original measure was chosen, we highlight inconsistencies with the way SOE was assessed for EMDR, CT, and CPT. Thirdly, we highlight two papers that were omitted from the analysis. One of these was omitted without any apparent reason. It found EMDR superior to a placebo control. The other study was published in 2015 and should have been part of APA guidelines since they were published in 2017. The inclusion of either study would have resulted in an improvement in SOE. Including both studies results in standard mean difference and confidence intervals that were better for EMDR than for CPT or CT. Therefore, the SOE should have been rated as moderate and EMDR assessed as at least equivalent to these CBT approaches in the APA guidelines. This would bring the APA

  17. Errors in the 2017 APA Clinical Practice Guideline for the Treatment of PTSD: What the Data Actually Says.

    Science.gov (United States)

    Dominguez, Sarah K; Lee, Christopher W

    2017-01-01

    The American Psychological Association (APA) Practice Guidelines for the Treatment of Posttraumatic Stress Disorder (PTSD) concluded that there was strong evidence for cognitive behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CT), and exposure therapy yet weak evidence for eye movement desensitization and reprocessing (EMDR). This is despite the findings from an associated systematic review which concluded that EMDR leads to loss of PTSD diagnosis and symptom reduction. Depression symptoms were also found to improve more with EMDR than control conditions. In that review, EMDR was marked down on strength of evidence (SOE) for symptom reduction for PTSD. However, there were several problems with the conclusions of that review. Firstly, in assessing the evidence in one of the studies, the reviewers chose an incorrect measure that skewed the data. We recalculated a meta-analysis with a more appropriate measure and found the SOE improved. The resulting effect size for EMDR on PTSD symptom reduction compared to a control condition was large for studies that meet the APA inclusion criteria (SMD = 1.28) and the heterogeneity was low (I(2)= 43%). Secondly, even if the original measure was chosen, we highlight inconsistencies with the way SOE was assessed for EMDR, CT, and CPT. Thirdly, we highlight two papers that were omitted from the analysis. One of these was omitted without any apparent reason. It found EMDR superior to a placebo control. The other study was published in 2015 and should have been part of APA guidelines since they were published in 2017. The inclusion of either study would have resulted in an improvement in SOE. Including both studies results in standard mean difference and confidence intervals that were better for EMDR than for CPT or CT. Therefore, the SOE should have been rated as moderate and EMDR assessed as at least equivalent to these CBT approaches in the APA guidelines. This would bring the APA guidelines in line

  18. Cognitive-behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial.

    Science.gov (United States)

    Macdonald, Alexandra; Pukay-Martin, Nicole D; Wagner, Anne C; Fredman, Steffany J; Monson, Candice M

    2016-02-01

    Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD.

  19. Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2014-09-01

    Full Text Available Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD is distinct from Borderline Personality Disorder (BPD when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.

  20. Cognitive-behavioral therapy versus other PTSD psychotherapies as treatment for women victims of war-related violence: a systematic review.

    Science.gov (United States)

    Dossa, N Inès; Hatem, Marie

    2012-01-01

    Although war-trauma victims are at a higher risk of developing PTSD, there is no consensus on the effective treatments for this condition among civilians who experienced war/conflict-related trauma. This paper assessed the effectiveness of the various forms of cognitive-behavioral therapy (CBT) at lowering PTSD and depression severity. All published and unpublished randomized controlled trials studying the effectiveness of CBT at reducing PTSD and/or depression severity in the population of interest were searched. Out of 738 trials identified, 33 analysed a form of CBTs effectiveness, and ten were included in the paper. The subgroup analysis shows that cognitive processing therapy (CPT), culturally adapted CPT, and narrative exposure therapy (NET) contribute to the reduction of PTSD and depression severity in the population of interest. The effect size was also significant at a level of 0.01 with the exception of the effect of NET on depression score. The test of subgroup differences was also significant, suggesting CPT is more effective than NET in our population of interest. CPT as well as its culturallyadapted form and NET seem effective in helping war/conflict traumatised civilians cope with their PTSD symptoms. However, more studies are required if one wishes to recommend one of these therapies above the other.

  1. Exposure and non-fear emotions: A randomized controlled study of exposure-based and rescripting-based imagery in PTSD treatment.

    Science.gov (United States)

    Langkaas, Tomas Formo; Hoffart, Asle; Øktedalen, Tuva; Ulvenes, Pål G; Hembree, Elizabeth A; Smucker, Mervin

    2017-10-01

    Interventions involving rescripting-based imagery have been proposed as a better approach than exposure-based imagery when posttraumatic stress disorder (PTSD) is associated with emotions other than fear. Prior research led to the study's hypotheses that (a) higher pretreatment non-fear emotions would predict relatively better response to rescripting as compared to exposure, (b) rescripting would be associated with greater reduction in non-fear emotions, and (c) pretreatment non-fear emotions would predict poor response to exposure. A clinically representative sample of 65 patients presenting a wide range of traumas was recruited from patients seeking and being offered PTSD treatment in an inpatient setting. Subjects were randomly assigned to 10 weeks of treatment involving either rescripting-based imagery (Imagery Rescripting; IR) or exposure-based imagery (Prolonged Exposure; PE). Patients were assessed on outcome and emotion measures at pretreatment, posttreatment and 12 months follow-up. Comparison to control benchmarks indicated that both treatments were effective, but no outcome differences between them appeared. None of the initial hypotheses were supported. The results from this study challenge previous observations and hypotheses about exposure mainly being effective for fear-based PTSD and strengthen the notion that exposure-based treatment is a generally effective treatment for all types of PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: Design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Polak A

    2012-10-01

    Full Text Available Abstract Background The two most common interventions for Posttraumatic Stress Disorder (PTSD are pharmacological treatment with SSRIs such as paroxetine and psychological treatment such as Trauma-Focused Cognitive Behavioral Therapy (TF-CBT. International guidelines recommend trauma-focused psychological interventions for all PTSD patients as first-line treatment (NICE. However, no clear-cut evidence is available to support this recommendation. Methods/design In order to compare pharmacological treatment (paroxetine and psychological treatment (TF-CBT in (cost- effectiveness on the short and the long term, we will randomize 90 patients with chronic PTSD to either paroxetine (24 weeks or TF-CBT (10–12 weeks. We will assess symptom severity and costs before and after the intervention with the Clinician Administered PTSD Scale (CAPS, the Clinical Global Impression Scale (CGI and the Trimbos/iMTA questionnaire for Costs associated with Psychiatric Illness (TiC-P. Discussion This study is unique for its direct comparison of the most commonly used psychological intervention (TF-CBT and pharmacological intervention (paroxetine on (cost- effectiveness on the short and the long term. The anticipated results will provide relevant evidence concerning long-term effects and relapse rates and will be beneficial in reducing societal costs. It may also provide information on who may benefit most from which type of intervention. Some methodological issues will be discussed. Trial Registration Dutch Trial registration: NTR2235

  3. PTSD: National Center for PTSD

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    Full Text Available ... Divisions Executive Behavioral Science Clinical Neurosciences Dissemination & Training Evaluation Pacific Islands Women’s Health Sciences Positions Available Press & Promotion Contacts for the Media AboutFace Media Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site ...

  4. PTSD: National Center for PTSD

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    Full Text Available ... map [a-z] More VA More VA Health Health Care Information A-Z Health Topic Finder My Health e Vet Prescriptions Refills Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act ... Compensation Pension GI Bill ® Vocational Rehabilitation & Employment ...

  5. PTSD: National Center for PTSD

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    Full Text Available ... menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, ... Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens ...

  6. Complex PTSD: research directions for nosology/assessment, treatment, and public health

    Directory of Open Access Journals (Sweden)

    Julian D. Ford

    2015-05-01

    Full Text Available Complex posttraumatic stress disorder (CPTSD in children and adolescents extends beyond the core PTSD symptoms to dysregulation in three psychobiological domains: (1 emotion processing, (2 self-organization (including bodily integrity, and (3 relational functioning. CPTSD research directions for the next decade and beyond are identified in three areas: (1 diagnostic classification (establishing the empirical integrity of CPTSD as a distinct form of psychopathology and psychometric assessment [validation and refinement of measures of childhood polyvictimization and developmental trauma disorder (DTD], (2 rigorous evaluation and refinement of interventions (and algorithms for their delivery developed or adapted for CPTSD and DTD, and (3 the epidemiology of CPTSD and DTD, and their public health and safety impact, across the lifespan and intergenerationally, for populations, nations, and cultures.

  7. Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: a randomized controlled clinical trial

    Directory of Open Access Journals (Sweden)

    Maercker Andreas

    2007-04-01

    Full Text Available Abstract Background The present study was designed to evaluate the efficacy of an internet-based therapy (Interapy for Posttraumatic Stress Disorder (PTSD in a German speaking population. Also, the quality of the online therapeutic relationship, its development and its relevance as potential moderator of the treatment effects was investigated. Method Ninety-six patients with posttraumatic stress reactions were allocated at random to ten sessions of Internet-based cognitive behavioural therapy (CBT conducted over a 5-week period or a waiting list control group. Severity of PTSD was the primary outcome. Secondary outcome variables were depression, anxiety, dissociation and physical health. Follow-up assessments were conducted at the end of treatment and 3 months after treatment. Results From baseline to post-treatment assessment, PTSD severity and other psychopathological symptoms were significantly improved for the treatment group (intent-to-treat group × time interaction effect size d = 1.40. Additionally, patients of the treatment condition showed significantly greater reduction of co-morbid depression and anxiety as compared to the waiting list condition. These effects were sustained during the 3-months follow-up period. High ratings of the therapeutic alliance and low drop-out rates indicated that a positive and stable therapeutic relationship could be established online. Significant improvement of the online working alliance in the course of treatment and a substantial correlation between the quality of the online relationship at the end of treatment and treatment outcome emerged. Conclusion Interapy proved to be a viable treatment alternative for PTSD with large effect sizes and sustained treatment effects. A stable and positive online therapeutic relationship can be established through the Internet which improved during the treatment process. Trial registration Australian Clinical Trials Registry ACTRN012606000401550

  8. The Effects of PTSD on Treatment Adherence, Drug Relapse, and Criminal Recidivism in a Sample of Incarcerated Men and Women

    Science.gov (United States)

    Kubiak, Sheryl Pimlott

    2004-01-01

    Objective/Method: Given the relationship between post-traumatic stress disorder (PTSD) and substance use disorders (SUD), and the prevalence of SUD among offenders, the inattention to trauma before, during, and after incarceration is troubling. This exploratory study compared those with and without co-occurring PTSD among men (n = 139) and women…

  9. The Efficacy and Safety of Add-on Ginko TD (Ginkgo Biloba Treatment for PTSD: Results of a 12-Week Double-Blind Placebo-Controlled Study

    Directory of Open Access Journals (Sweden)

    Laleh Koohi Habibi

    2007-06-01

    Full Text Available "nObjective: Exposure to traumatic stressors lead to activation of arousal responses mediated by serotonergic and noradrenergic systems and it may cause a change in numerous neurotransmitters and neuroendocrine systems. There is ample experimental and clinical evidence to suggest that Ginkgo biloba extract is neuroprotective and has antioxidant properties and can restore stress-induced elevation in brain levels of catecholamines, 5-HT and plasma corticosterone to normal level. "nMethod: In a 12-week, double-blind, placebo-controlled study, the efficacy and safety of adding-on a fixed-dose (200mg of Ginkgo TD to the previous treatment regime of adults with PTSD were examined. Subjects were forty male and female outpatients from a public-owned psychiatric clinic who met criteria for PTSD seven month after a 6.3 Richter earthquake in Bam city on December 26, 2003. The changes in five symptom domains including posttraumatic stress, anxiety and affective symptoms, general health and subjective stress after trauma were ssessed at weeks 0, 12 and 16 to examine effectiveness of the added-on Ginkgo TD and stability of its effects. "nResults: Ginkgo TD was associated with a significantly greater improvement than placebo in PTSD patients as measured by five symptom domain scales including: GHQ-28; Watson PTSD Scale; HAM-D; HAM-A and IES (p= 0.02, 0.01, 0.001, 0.01, 0.02 respectively Four weeks after the discontinuation of intervention, no significant difference was determined between the two groups in the five outcome measures (p= 0.005, 0.01, 0.004, 0.005, 0.01 respectively. No significant difference was observed between the two groups in terms of side effects. "nConclusions: We found Ginkgo TD to be superior to placebo as an adding-on in the treatment of PTSD. Although we did not examine the comparative efficacy of Ginkgo TD on the three main elements of PTSD, beneficial effects both on specific PTSD symptomatology and general conditions including

  10. Community-based PTSD treatment for ethnically diverse women who experienced intimate partner violence: a feasibility study.

    Science.gov (United States)

    Kelly, Ursula A; Pich, Kourou

    2014-12-01

    The objectives of this study were to: (1) Determine the feasibility of a community-based intervention for Latinas with PTSD who experienced IPV; (2) Explore the intervention effectiveness in reducing PTSD and improving quality of life, social support and self-efficacy. This was a feasibility study, using intervention pre-test/post-test qualitative and quantitative data. The experience of living through and surviving IPV was far more important than ethnicity in cultural identity. Significant reductions in PTSD and MDD and increased self-efficacy were sustained 6-months post-intervention. Culturally relevant mental health IPV interventions can be feasible and appropriate across ethnic groups.

  11. Effects of extinction treatments on the reduction of conditioned responding and conditioned hyperarousal in a rabbit model of posttraumatic stress disorder (PTSD).

    Science.gov (United States)

    Burhans, Lauren B; Smith-Bell, Carrie A; Schreurs, Bernard G

    2015-10-01

    We have previously characterized a model of posttraumatic stress disorder (PTSD), based on classical conditioning of the rabbit nictitating membrane response (NMR), that focuses on 2 key PTSD-like features: conditioned responses to trauma-associated cues and hyperarousal. In addition to the development of conditioned NMRs (CRs) to a tone conditioned stimulus (CS) associated with a periorbital shock unconditioned stimulus (US), we have observed that rabbits also exhibit a conditioning-specific reflex modification (CRM) of the NMR that manifests as an exaggerated and more complex reflexive NMR to presentations of the US by itself, particularly to intensities that elicited little response prior to conditioning. Previous work has demonstrated that unpaired presentations of the CS and US are successful at extinguishing CRs and CRM simultaneously, even when a significantly weakened version of the US is utilized. In the current study, additional extinction treatments were tested, including continued pairings of the CS with a weakened US and exposure to the training context alone, and these treatments were contrasted with the effects of unpaired extinction with a weakened US and remaining in home cages with no further treatment. Results showed that continued pairings only slightly decreased CRs and CRM, while context exposure had no effect on CRs and marginal effects on reducing CRM. Unpaired extinction was still the most effective treatment for reducing both. Findings are discussed in terms of applications to cognitive-behavioral therapies for treatment of PTSD, such as incorporating mild, innately stressful stimuli into virtual reality therapy.

  12. The Development of a Sexual Harassment Proclivity Scale: Construct Validation and Relationship to Communication Competence.

    Science.gov (United States)

    Bingham, Shereen G.; Burleson, Brant R.

    1996-01-01

    Develops and assesses the validity of a self-report measure of sexual harassment proclivities in men. Demonstrates the validity of the scale by its moderate correlations with attitude measures relevant to sexual harassment, its nonsignificant correlation with the need to provide socially desirable responses, and by showing that potential victims…

  13. 77 FR 6821 - Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products Containing Same...

    Science.gov (United States)

    2012-02-09

    ... COMMISSION Certain Reduced Ignition Proclivity Cigarette Paper Wrappers and Products Containing Same; Request... accessible on the Commission's electronic docket (EDIS) at http://edis.usitc.gov , and will be available for....gov ). The public record for this investigation may be viewed on the Commission's electronic...

  14. Early PTSD symptom trajectories: persistence, recovery, and response to treatment: results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS.

    Directory of Open Access Journals (Sweden)

    Isaac R Galatzer-Levy

    Full Text Available CONTEXT: Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis. OBJECTIVES: To describe discrete symptom trajectories and examine their relevance for preventive interventions. DESIGN: Latent Growth Mixture Modeling (LGMM of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data. SETTING: Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity. PARTICIPANTS: Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957 were included; 125 received cognitive behavioral therapy (CBT between one and nine months. APPROACH: We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41 or prolonged exposure (PE, n = 49, starting 29.8±5.7 days after ED admission, or delayed PE (n = 35 starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample. MAIN OUTCOME MEASURE: Latent trajectories of PTSD symptoms; effects of CBT on these trajectories. RESULTS: THREE TRAJECTORIES WERE IDENTIFIED: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample, Slow Remitting (progressive decrease in symptoms over 15 months; 27% and Non-Remitting (persistently elevated symptoms; 17%. CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes. CONCLUSIONS: The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to

  15. Early PTSD Symptom Trajectories: Persistence, Recovery, and Response to Treatment: Results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS)

    Science.gov (United States)

    Galatzer-Levy, Isaac R.; Ankri, Yael; Freedman, Sara; Israeli-Shalev, Yossi; Roitman, Pablo; Gilad, Moran; Shalev, Arieh Y.

    2013-01-01

    Context Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis. Objectives To describe discrete symptom trajectories and examine their relevance for preventive interventions. Design Latent Growth Mixture Modeling (LGMM) of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data. Setting Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity. Participants Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED) were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957) were included; 125 received cognitive behavioral therapy (CBT) between one and nine months. Approach We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41) or prolonged exposure (PE, n = 49), starting 29.8±5.7 days after ED admission, or delayed PE (n = 35) starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample. Main Outcome Measure Latent trajectories of PTSD symptoms; effects of CBT on these trajectories. Results Three trajectories were identified: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample), Slow Remitting (progressive decrease in symptoms over 15 months; 27%) and Non-Remitting (persistently elevated symptoms; 17%). CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes. Conclusions The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder

  16. Post Traumatic Stress Disorder (PTSD): NIH Research to Results

    Science.gov (United States)

    ... virtual reality" (VR) exposure therapy. The VR therapy combines traditional therapy and exposure via VR technology that ... families. Read More "Post Traumatic Stress Disorder (PTSD)" Articles PTSD: A Growing Epidemic / Symptoms, Diagnosis, Treatment / NIH ...

  17. Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2013-05-01

    Full Text Available Background: The WHO International Classification of Diseases, 11th version (ICD-11, has proposed two related diagnoses, posttraumatic stress disorder (PTSD and complex PTSD within the spectrum of trauma and stress-related disorders. Objective: To use latent profile analysis (LPA to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile. Method: An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse to single-incident events (e.g., exposure to 9/11 attacks. Results: The LPA revealed three classes of individuals: (1 a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2 a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3 a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity. Conclusion: Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  18. Sleep disturbance in pediatric PTSD: current findings and future directions.

    Science.gov (United States)

    Kovachy, Ben; O'Hara, Ruth; Hawkins, Nate; Gershon, Anda; Primeau, Michelle M; Madej, Jessica; Carrion, Victor

    2013-05-15

    Many studies have provided strong evidence of a fundamental and complex role for sleep disturbances in adult posttraumatic stress disorder (PTSD). Investigations of adult PTSD using subjective and objective measures document sleep architecture abnormalities and high prevalence of sleep disordered breathing, periodic limb movement disorder, nightmares, and insomnia. PTSD treatment methods do appear to significantly improve sleep disturbance, and also studies suggest that treatments for sleep disorders often result in improvements in PTSD symptoms. Further, the most recent evidence suggests sleep abnormalities may precede the development of PTSD. Given the importance of sleep disorders to the onset, course, and treatment of adult PTSD, examination of sleep disturbances far earlier in the life course is imperative. Here we review the literature on what we know about sleep disturbances and disorders in pediatric PTSD. Our review indicates that the extant, empirical data examining sleep disturbance and disorders in pediatric PTSD is limited. Yet, this literature suggests there are significantly higher reports of sleep disturbances and nightmares in children and adolescents exposed to trauma and/or diagnosed with PTSD than in non-trauma-exposed samples. Sleep questionnaires are predominantly employed to assess sleep disorders in pediatric PTSD, with few studies utilizing objective measures. Given the important, complex relationship being uncovered between adult PTSD and sleep, this review calls for further research of sleep in children with PTSD using more specific subjective measures and also objective measures, such as polysomnography and eventually treatment trial studies.

  19. Examining potential contraindications for prolonged exposure therapy for PTSD

    NARCIS (Netherlands)

    Minnen, A. van; Harned, M.S.; Zöllner, L.; Mills, K.

    2012-01-01

    Although prolonged exposure (PE) has received the most empirical support of any treatment for posttraumatic stress disorder (PTSD), clinicians are often hesitant to use PE due to beliefs that it is contraindicated for many patients with PTSD. This is especially true for PTSD patients with comorbid p

  20. The relationship between traumatic childhood experiences and proclivities towards substance abuse, self-esteem and coping strategies

    National Research Council Canada - National Science Library

    Psk. Timur TOKER; Ahmet TIRYAKI; Gamze ÖZÇÜRÜMEZ; Baykal ISKENDER

    2011-01-01

      The aim of this study was to compare people with substance use disorder with healthy controls in terms of childhood abuse, proclivity towards substance abuse, coping skills and self-esteem as well...

  1. Inherited proclivity: When should neurogenetics mitigate moral culpability for purposes of sentencing?

    Science.gov (United States)

    Segal, J Bradley

    2016-01-01

    Certain genes and neurobiology (‘neurogenetics’) may predispose some people to violent behavior. Increasingly, defendants introduce neurogenetic evidence as a mitigating factor during criminal sentencing. Identifying the cause of a criminal act, biological or otherwise, does not necessarily preclude moral or legal liability. However, valid scientific evidence of an inherited proclivity sometimes should be considered when evaluating whether a defendant is less morally culpable for a crime and perhaps less deserving of punishment. This Note proposes a two-pronged test to understand whether and when neurogenetic evidence should be considered to potentially mitigate an individual's culpability for criminal behavior. The first prong normatively assesses whether a defendant meets a threshold of having meaningfully managed his risk of harming others based on what he knew, or should have known, about his own proclivities to violence. The second prong considers the admissibility of the evidence based on whether the specific neurogenetic proclivity claimed by the defendant is relevant and adequately supported by science so as to be reliable. This proposed two-pronged test, beginning with an ethical threshold and followed by a scientific hurdle, can help judges and juries establish when to accept arguments for neurogenetic mitigation at sentencing, and when to reject them. PMID:27774246

  2. PTSD as a criminal defense: a review of case law.

    Science.gov (United States)

    Berger, Omri; McNiel, Dale E; Binder, Renée L

    2012-01-01

    Posttraumatic stress disorder (PTSD) has been offered as a basis for criminal defenses, including insanity, unconsciousness, self-defense, diminished capacity, and sentencing mitigation. Examination of case law (e.g., appellate decisions) involving PTSD reveals that when offered as a criminal defense, PTSD has received mixed treatment in the judicial system. Courts have often recognized testimony about PTSD as scientifically reliable. In addition, PTSD has been recognized by appellate courts in U.S. jurisdictions as a valid basis for insanity, unconsciousness, and self-defense. However, the courts have not always found the presentation of PTSD testimony to be relevant, admissible, or compelling in such cases, particularly when expert testimony failed to show how PTSD met the standard for the given defense. In cases that did not meet the standard for one of the complete defenses, PTSD has been presented as a partial defense or mitigating circumstance, again with mixed success.

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Trauma Exposure Measures Assessment Request Form List of All Measures Treatment Treatment Overview Early Intervention Veterans Cultural ... Family Members Frequently Asked Questions Conditions & Treatments See All Conditions & Treatments (A-Z) Hepatitis HIV Mental Health ...

  4. Project VALOR: Trajectories of Change in PTSD in Combat-Exposed Veterans

    Science.gov (United States)

    2015-10-01

    suicidal ideation. 2. KEYWORDS: Post-traumatic stress disorder (PTSD), military sexual trauma (MST), suicide , combat-exposed veterans, PTSD... affects employment in our sample longitudinally; how different types of combat affect rates of PTSD; factors that influence treatment seeking behaviors...to better understand how PTSD affects other outcomes across time. For example, our interim analyses have provided insight into how psychopathology

  5. A randomized, controlled pilot study of MDMA (± 3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Oehen, Peter; Traber, Rafael; Widmer, Verena; Schnyder, Ulrich

    2013-01-01

    Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988-1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results. Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups. We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores (p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement (p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two (p = 0.016).

  6. Comparing Treatment Outcome of Guided Imagery and Music and Psychodynamic Imaginative Trauma Therapy for Women with Complex PTSD

    DEFF Research Database (Denmark)

    Maack, Carola

    2013-01-01

    To investigate whether the use of recorded music enhances therapy outcome in psychodynamic trauma therapy for women with Complex PTSD, outcome measures of three groups of patients were compared. One group received 50 hours of outpatient trauma therapy with the Bonny Method of Guided Imagery...... and Music (GIM), another group received 50 hours of outpatient trauma therapy with Psychodynamic Imaginative Trauma Therapy (PITT). The third group was a waiting-list control group of women who had to wait at least nine months for therapy. The participants filled out questionnaires measuring symptoms....... Participants treated with GIM showed significantly better outcome in all measurements than participants treated with PITT. This indicates that the use of music is beneficial for women with Complex PTSD treated with psychodynamic trauma therapy....

  7. Simple versus complex PTSD: a cluster analytic investigation.

    Science.gov (United States)

    Taylor, Steven; Asmundson, Gordon J G; Carleton, R Nicholas

    2006-01-01

    A cluster analytic investigation was conducted on measures of PTSD associated features (e.g., personality pathology, dissociative tendencies) to investigate whether empirically-defined clusters correspond to Herman's [1992, Complex PTSD: a syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377-391; 1997, Trauma and recovery (Rev. ed.). New York: Basic Books] distinction between simple and complex PTSD. Results from a sample of 60 PTSD patients were broadly consistent with this distinction, although some inconsistencies were observed. Treatment outcome generally did not differ between the two clusters. Implications for classifying and treating PTSD are discussed.

  8. PTSD and Problems with Alcohol Use

    Science.gov (United States)

    ... drinking on your PTSD symptoms. As noted above, alcohol can affect sleep, anger and irritability, anxiety, depression, and work or relationship problems. Treatment should include education, therapy, and support ...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... All Measures Treatment Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families ... and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business POC Subscribe ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... All Measures Treatment Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families ... No FEAR Act Whistleblower Rights & Protections Site Index USA.gov White House Inspector General QUICK LIST Apply ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... 2 MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to download "Evidence-based Treatment: What Does It Mean?" (22.7 MB) Close × Prolonged Exposure for ...

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... 2 MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to download "Evidence-based Treatment: What Does It Mean?" (22.7 MB) Close × Prolonged Exposure for ...

  13. [Complex PTSD following early-childhood trauma: emotion-regulation training as addition to the PTSD guideline].

    Science.gov (United States)

    Thomaes, K; Dorrepaal, E; van Balkom, A J L M; Veltman, D J; Smit, J H; Hoogendoorn, A W; Draijer, N

    2015-01-01

    Posttraumatic stress disorder (PTSD) symptoms in individuals who have experienced repeated trauma (sexual and/or physical) in early childhood can lead to problems associated with emotion regulation, interpersonal functioning and self-image. This so-called complex PTSD is often accompanied by a comorbid personality disorder. Although ptsd is associated with structural and functional abnormalities in emotion-regulation areas in the brain, it is not known whether complex PTSD shows similar abnormalities. Experts take the view that before individuals with complex PTSD are given appropriate therapy they should receive a course of emotion-regulation therapy such as the one tested by Zlotnick e.a. (1997) in a randomised controlled trial (RCT).   To replicate Zlotnick's RCT in the Netherlands and to find out whether complex PTSD patients show specific structural and functional brain abnormalities and whether psychological recovery is linked to the 'normalisation' of these abnormalities. In a RCT with complex PTSD patients (n = 71) who had experienced trauma in early childhood, we compared normal individual treatment with treatment supported by 'Before and beyond', which consists of emotion-regulation therapy combined with cognitive group therapy. In a subsample (n= 33) we also performed an mri (repeated, n = 9) in which individuals were required to execute an emotional memory and attention task. In complex PTSD, structural abnormalities in the brain seemed to be more extensive than in PTSD and brain activity in complex PTSD seemed to be strikingly different from the brain activity seen in PTSD patients who had experienced only single trauma. The results of the RCT indicate that 'Before and beyond' is a clinically meaningful treatment (with minimal drop-out) for complex PTSD patients with a variety of personality disorders. The psychological recovery of patients who received the emotion regulation and cognitive group treatment was associated with normalisation of brain

  14. Effect of sexual coercion proclivity, insult and fantasy on emotional reactivity and appeal of sexual aggression.

    Science.gov (United States)

    Thomas, Lindsey A; Gorzalka, Boris B

    2012-08-01

    Fifty-nine heterosexual university males were assessed for Sexual Coercion Proclivity (SCP) and randomly assigned to one of three conditions: Insult/nonsexually coercive fantasy material; no insult/sexually coercive fantasy material; or, insult/sexually coercive fantasy material. Although not differing in terms of anger or anxiety, the high SCP became more frustrated than the low group, particularly when exposed to both insult and sexually coercive (SC) fantasy material. Changes in negative affect predicted anticipated likelihood of engaging in SC among the low SCP group and anticipated enjoyment of SC in the high SCP group. Acculturation accounted for differences observed between Caucasian and Chinese men.

  15. Cognitive behavioral therapy for PTSD and somatization: an open trial.

    Science.gov (United States)

    Pérez Benítez, Carlos I; Zlotnick, Caron; Gomez, Judelysse; Rendón, Maria J; Swanson, Amelia

    2013-06-01

    No treatment, to date, has been developed to improve both posttraumatic stress disorder (PTSD) and medically unexplained physical symptoms (MUPS), despite mounting evidence of high comorbidity between PTSD and MUPS. This study assessed the feasibility, acceptability, and treatment outcomes of an adapted cognitive behavioral therapy for PTSD and abridged somatization in a sample of eight participants. Fifteen percent of completers did not meet PTSD criteria after treatment completion and 62.5% improved their somatic symptoms. There was a significant difference between pre- and post-treatment depression symptoms, as well as in psychological and physical functioning measures. Results indicated a small to moderate effect size (d = 0.27-0.78) in PTSD severity scores, and moderate to large effect size in depression symptoms and psychosocial and physical functioning variables (d = 0.39-1.12). Preliminary evidence of acceptability indicates that the current CBT intervention may be suitable for Latinos individuals with PTSD and MUPS.

  16. Stress Detection for PTSD via the StartleMart Game

    DEFF Research Database (Denmark)

    Holmgård, Christoffer; Yannakakis, Georgios; Karstoft, Karen-Inge

    2013-01-01

    Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the positive impact of affect detection and advanced game technology on the treatment of mental diagnoses such as Post Traumatic Stress Disorder (PTSD). For that purpose......, we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while...... a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD...

  17. PTSD in Depressed Mothers in Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Chard, Kathleen M.; Stevens, Jack; Van Ginkel, Judith B.

    2013-01-01

    Recent research has suggested that mothers participating in home visitation programs have a high incidence of mental health problems, particularly depression. Posttraumatic stress disorder (PTSD) is a common comorbidity with depression, yet its prevalence among home visiting populations and implications for parenting and maternal functioning have not been examined. This study contrasted depressed mothers with (n = 35) and without PTSD (n = 55) who were enrolled in a home visitation program. Results indicated that depressed mothers with comorbid PTSD were more likely to have experienced childhood sexual abuse, had greater severity of depressive symptoms, increased social isolation, and lower overall functioning than their counterparts without PTSD. Among PTSD mothers, greater severity of PTSD symptoms, in particular avoidance and emotional numbness, were associated with increased maternal psychopathology and parenting deficits even after controlling for depression severity. These findings add to the literature documenting the negative impacts of PTSD on maternal functioning and parenting. Implications for screening and treatment in the context of home visitation are discussed. PMID:24307928

  18. Community males show multiple-perpetrator rape proclivity: development and preliminary validation of an interest scale.

    Science.gov (United States)

    Alleyne, Emma; Gannon, Theresa A; Ó Ciardha, Caoilte; Wood, Jane L

    2014-02-01

    The literature on Multiple Perpetrator Rape (MPR) is scant; however, a significant proportion of sexual offending involves multiple perpetrators. In addition to the need for research with apprehended offenders of MPR, there is also a need to conduct research with members of the general public. Recent advances in the forensic literature have led to the development of self-report proclivity scales. These scales have enabled researchers to conduct evaluative studies sampling from members of the general public who may be perpetrators of sexual offenses and have remained undetected, or at highest risk of engaging in sexual offending. The current study describes the development and preliminary validation of the Multiple-Perpetrator Rape Interest Scale (M-PRIS), a vignette-based measure assessing community males' sexual arousal to MPR, behavioral propensity toward MPR and enjoyment of MPR. The findings show that the M-PRIS is a reliable measure of community males' sexual interest in MPR with high internal reliability and temporal stability. In a sample of university males we found that a large proportion (66%) did not emphatically reject an interest in MPR. We also found that rape-supportive cognitive distortions, antisocial attitudes, and high-risk sexual fantasies were predictors of sexual interest in MPR. We discuss these findings and the implications for further research employing proclivity measures referencing theory development and clinical practice.

  19. Stress Detection for PTSD via the StartleMart Game

    DEFF Research Database (Denmark)

    Holmgard, C.; Yannakakis, Georgios; Karstoft, K.I.

    2013-01-01

    , we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while...... a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD...... for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools. I....

  20. On the role of noradrenergic system in PTSD and related sleep disturbances. The use of terazosin in PTSD related nightmares: a case report.

    Science.gov (United States)

    Salviati, M; Pallagrosi, M; Valeriani, G; Carlone, C; Todini, L; Biondi, M

    2013-01-01

    In PTSD, sleep disorders represent an important symptoms dimension which is associated with more severe PTSD and increased risk of relapse. The basic treatment for PTSD is not always associated to an improvement of sleep disturbances and nightmares. Alpha-blockers, and more specifically Prazosin, have shown a specific action on sleep disorders in PTSD. We report the clinical case of a young women with PTSD, who was suffering from severe sleep disorder and distressing nightmare. The patient was treated with Terazosin, a conger of Prazosin, and has shown symptom remission. Further studies on the use of alpha-blokers might reveal new therapeutic options in PTSD.

  1. More Than a Magazine: Exploring the Links Between Lads' Mags, Rape Myth Acceptance, and Rape Proclivity.

    Science.gov (United States)

    Romero-Sánchez, Mónica; Toro-García, Virginia; Horvath, Miranda A H; Megías, Jesús L

    2015-06-03

    Exposure to some magazines aimed at young male readers-lads' mags-has recently been associated with behaviors and attitudes that are derogatory toward women, including sexual violence. In the present study, a group of Spanish adult men was exposed to the covers of a lads' mag while a second group was exposed to the covers of a neutral magazine. Results showed that, compared with participants in the second group, participants who were exposed to covers of lads' mags who also showed high rape myth acceptance and legitimized the consumption of such magazines reported higher rape proclivity in a hypothetical situation. These findings suggest the need to further explore the possible detrimental effects of some sexualized media that are widely accepted in many Western countries. © The Author(s) 2015.

  2. Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): a pilot study.

    Science.gov (United States)

    Tan, Gabriel; Dao, Tam K; Farmer, Lorie; Sutherland, Roy John; Gevirtz, Richard

    2011-03-01

    Exposure to combat experiences is associated with increased risk of developing Post Traumatic Stress Disorder. Prolonged exposure therapy and cognitive processing therapy have garnered a significant amount of empirical support for PTSD treatment; however, they are not universally effective with some patients continuing to struggle with residual PTSD symptoms. Heart rate variability (HRV) is a measure of the autonomic nervous system functioning and reflects an individual's ability to adaptively cope with stress. A pilot study was undertaken to determine if veterans with PTSD (as measured by the Clinician-Administered PTSD Scale and the PTSD Checklist) would show significantly different HRV prior to an intervention at baseline compared to controls; specifically, to determine whether the HRV among veterans with PTSD is more depressed than that among veterans without PTSD. The study also aimed at assessing the feasibility, acceptability, and potential efficacy of providing HRV biofeedback as a treatment for PTSD. The findings suggest that implementing an HRV biofeedback as a treatment for PTSD is effective, feasible, and acceptable for veterans. Veterans with combat-related PTSD displayed significantly depressed HRV as compared to subjects without PTSD. When the veterans with PTSD were randomly assigned to receive either HRV biofeedback plus treatment as usual (TAU) or just TAU, the results indicated that HRV biofeedback significantly increased the HRV while reducing symptoms of PTSD. However, the TAU had no significant effect on either HRV or symptom reduction. A larger randomized control trial to validate these findings appears warranted.

  3. Prazosin for military combat-related PTSD nightmares: a critical review.

    Science.gov (United States)

    Writer, Brian W; Meyer, Eric G; Schillerstrom, Jason E

    2014-01-01

    Military combat is a common trauma experience associated with posttraumatic stress disorder (PTSD). Trauma-related nightmares are a hallmark symptom of PTSD. They can be resistant to label-pharmacological PTSD treatment, and they are associated with a variety of adverse health outcomes. The purpose of this article is to review and evaluate prazosin therapy for combat-related PTSD nightmares. Consistent with available literature for all-causes PTSD nightmares, prazosin is an effective off-label option for combat-related PTSD nightmares. Future trials may further instruct use in specific combat-exposure profiles.

  4. Exploring positive pathways to care for members of the UK Armed Forces receiving treatment for PTSD: a qualitative study

    Directory of Open Access Journals (Sweden)

    Dominic Murphy

    2014-02-01

    Full Text Available Objective: To examine the factors which facilitate UK military personnel with post-traumatic stress disorder (PTSD to engage in help-seeking behaviours. Methods: The study recruited active service personnel who were attending mental health services, employed a qualitative design, used semi-structured interview schedules to collect data, and explored these data using interpretative phenomenological analysis (IPA. Results: Five themes emerged about how participants were able to access help; having to reach a crisis point before accepting the need for help, overcoming feelings of shame, the importance of having an internal locus of control, finding a psychological explanation for their symptoms and having strong social support. Conclusions: This study reported that for military personnel who accessed mental health services, there were a number of factors that supported them to do so. In particular, factors that combated internal stigma, such as being supported to develop an internal locus of control, appeared to be critical in supporting military personnel to engage in help-seeking behaviour.

  5. Deep brain stimulation of the basolateral amygdala for treatment-refractory combat post-traumatic stress disorder (PTSD): study protocol for a pilot randomized controlled trial with blinded, staggered onset of stimulation.

    Science.gov (United States)

    Koek, Ralph J; Langevin, Jean-Philippe; Krahl, Scott E; Kosoyan, Hovsep J; Schwartz, Holly N; Chen, James W Y; Melrose, Rebecca; Mandelkern, Mark J; Sultzer, David

    2014-09-10

    Combat post-traumatic stress disorder (PTSD) involves significant suffering, impairments in social and occupational functioning, substance use and medical comorbidity, and increased mortality from suicide and other causes. Many veterans continue to suffer despite current treatments. Deep brain stimulation (DBS) has shown promise in refractory movement disorders, depression and obsessive-compulsive disorder, with deep brain targets chosen by integration of clinical and neuroimaging literature. The basolateral amygdala (BLn) is an optimal target for high-frequency DBS in PTSD based on neurocircuitry findings from a variety of perspectives. DBS of the BLn was validated in a rat model of PTSD by our group, and limited data from humans support the potential safety and effectiveness of BLn DBS. We describe the protocol design for a first-ever Phase I pilot study of bilateral BLn high-frequency DBS for six severely ill, functionally impaired combat veterans with PTSD refractory to conventional treatments. After implantation, patients are monitored for a month with stimulators off. An electroencephalographic (EEG) telemetry session will test safety of stimulation before randomization to staggered-onset, double-blind sham versus active stimulation for two months. Thereafter, patients will undergo an open-label stimulation for a total of 24 months. Primary efficacy outcome is a 30% decrease in the Clinician Administered PTSD Scale (CAPS) total score. Safety outcomes include extensive assessments of psychiatric and neurologic symptoms, psychosocial function, amygdala-specific and general neuropsychological functions, and EEG changes. The protocol requires the veteran to have a cohabiting significant other who is willing to assist in monitoring safety and effect on social functioning. At baseline and after approximately one year of stimulation, trauma script-provoked 18FDG PET metabolic changes in limbic circuitry will also be evaluated. While the rationale for studying DBS

  6. Women's experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal.

    Science.gov (United States)

    James, Stella

    2015-12-01

    This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that women following traumatic childbirth do experience postnatal PTSD; postnatal PTSD symptoms are similar to PTSD symptoms of other events and that CBT for PTSD of other events is just as effective for postnatal PTSD. Future recommendations include more qualitative studies with interpretative phenomenological approach in order to establish evidence-based CBT treatment for this client group, and more referrals need to be sent to the psychological services for CBT intervention.

  7. PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.

    Science.gov (United States)

    Contractor, Ateka A; Weiss, Nicole H; Dranger, Paula; Ruggero, Camilo; Armour, Cherie

    2017-06-01

    A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder's (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD's symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Dichromatic vision in a fruit bat with diurnal proclivities: the Samoan flying fox (Pteropus samoensis).

    Science.gov (United States)

    Melin, Amanda D; Danosi, Christina F; McCracken, Gary F; Dominy, Nathaniel J

    2014-12-01

    A nocturnal bottleneck during mammalian evolution left a majority of species with two cone opsins, or dichromatic color vision. Primate trichromatic vision arose from the duplication and divergence of an X-linked opsin gene, and is long attributed to tandem shifts from nocturnality to diurnality and from insectivory to frugivory. Opsin gene variation and at least one duplication event exist in the order Chiroptera, suggesting that trichromatic vision could evolve under favorable ecological conditions. The natural history of the Samoan flying fox (Pteropus samoensis) meets these conditions--it is a large bat that consumes nectar and fruit and demonstrates strong diurnal proclivities. It also possesses a visual system that is strikingly similar to that of primates. To explore the potential for opsin gene duplication and divergence in this species, we sequenced the opsin genes of 11 individuals (19 X-chromosomes) from three South Pacific islands. Our results indicate the uniform presence of two opsins with predicted peak sensitivities of ca. 360 and 553 nm. This result fails to support a causal link between diurnal frugivory and trichromatic vision, although it remains plausible that the diurnal activities of P. samoensis have insufficient antiquity to favor opsin gene renovation.

  9. The relationship between traumatic childhood experiences and proclivities towards substance abuse, self-esteem and coping strategies.

    Science.gov (United States)

    Toker, Timur; Tiryaki, Ahmet; Özçürümez, Gamze; Iskender, Baykal

    2011-01-01

    The aim of this study was to compare people with substance use disorder with healthy controls in terms of childhood abuse, proclivity towards substance abuse, coping skills and self-esteem as well as the correlation between experiences of abuse in childhood and these variables. The study group included 41 subjects diagnosed with substance use disorder, who had been sentenced under the respective laws as a result of crimes relating to substance use and possession, and the control group. A sociodemographic Data Form, SCID-I, Childhood Trauma Questionnaire, COPE, Substance Abuse Proclivity Scale and Rosenberg Self-Esteem Scale were applied to all participants. Childhood trauma history was observed to be more common in the study group than in the control group. When the childhood trauma questionnaire was evaluated, the scores for physical abuse were found to be significantly higher in the study group. COPE subscale scores for mental disengagement, focusing on problems and expressing emotions, active coping, coping through religion and emotional social support usage were significantly lower in the study group. The study group's results on the Substance Abuse Proclivity Scale were found to be higher than those of the control group. On the Rosenberg Self Respect Scale, the study group's scores were higher while the control group was more likely to have high self respect. People with substance use disorder are more likely to have a childhood history of physical abuse, higher proclivity towards substance abuse and lower self esteem. The level of abuse increases the level of emotion-based coping while decreasing levels of problem-based coping. There is support for the view that that traumatic childhood experiences are one of the psychosocial risk factors related to, although not specific to substance use.

  10. Revisiting propranolol and PTSD: Memory erasure or extinction enhancement?

    Science.gov (United States)

    Giustino, Thomas F; Fitzgerald, Paul J; Maren, Stephen

    2016-04-01

    Posttraumatic stress disorder (PTSD) has been described as the only neuropsychiatric disorder with a known cause, yet effective behavioral and pharmacotherapies remain elusive for many afflicted individuals. PTSD is characterized by heightened noradrenergic signaling, as well as a resistance to extinction learning. Research aimed at promoting more effective treatment of PTSD has focused on memory erasure (disrupting reconsolidation) and/or enhancing extinction retention through pharmacological manipulations. Propranolol, a β-adrenoceptor antagonist, has received considerable attention for its therapeutic potential in PTSD, although its impact on patients is not always effective. In this review, we briefly examine the consequences of β-noradrenergic manipulations on both reconsolidation and extinction learning in rodents and in humans. We suggest that propranolol is effective as a fear-reducing agent when paired with behavioral therapy soon after trauma when psychological stress is high, possibly preventing or dampening the later development of PTSD. In individuals who have already suffered from PTSD for a significant period of time, propranolol may be less effective at disrupting reconsolidation of strong fear memories. Also, when PTSD has already developed, chronic treatment with propranolol may be more effective than acute intervention, given that individuals with PTSD tend to experience long-term, elevated noradrenergic hyperarousal.

  11. The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims?

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Lauterbach, Dean; Elhai, Jon D

    2014-05-01

    The DSM-5 currently includes a dissociative-PTSD subtype within its nomenclature. Several studies have confirmed the dissociative-PTSD subtype in both American Veteran and American civilian samples. Studies have begun to assess specific factors which differentiate between dissociative vs. non-dissociative PTSD. The current study takes a novel approach to investigating the presence of a dissociative-PTSD subtype in its use of European victims of sexual assault and rape (N=351). Utilizing Latent Profile Analyses, we hypothesized that a discrete group of individuals would represent a dissociative-PTSD subtype. We additionally hypothesized that levels of depression, anger, hostility, and sleeping difficulties would differentiate dissociative-PTSD from a similarly severe form of PTSD in the absence of dissociation. Results concluded that there were four discrete groups termed baseline, moderate PTSD, high PTSD, and dissociative-PTSD. The dissociative-PTSD group encompassed 13.1% of the sample and evidenced significantly higher mean scores on measures of depression, anxiety, hostility, and sleeping difficulties. Implications are discussed in relation to both treatment planning and the newly published DSM-5. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Augmenting CPT to Improve Sleep Impairment in PTSD: A Randomized Clinical Trial

    Science.gov (United States)

    Galovski, Tara E.; Mott, Juliette; Blain, Leah M.; Elwood, Lisa; Gloth, Chelsea; Fletcher, Thomas

    2015-01-01

    Objective Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory following treatment for PTSD. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy; CPT). Method Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. Results After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Conclusion Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. Public Health Significance: This study suggests that hypnosis may be a viable treatment option in a stepped-care approach for treating sleep impairment in individuals suffering from PTSD. PMID:26689303

  13. [Development and Validation of a Screening Instrument for Complex PTSD].

    Science.gov (United States)

    Dorr, Florence; Firus, Christian; Kramer, Rolf; Bengel, Jürgen

    2016-11-01

    Chronic interpersonal traumata systematically result in psychological impairments referred to as complex post-traumatic stress disorder (cPTSD or DESNOS). This diagnosis will be newly established in the ICD-11 system. However, there is need for diagnostic instruments to assess cPTSD. The aim was to develop a screening form to identify patients at risk for cPTSD. The Screening for complex PTSD (SkPTBS) tests a) experience of potential traumatic events, b) related influential features and risk factors, and c) symptoms of cPTSD. 325 patients (mean age 51.5±8.7 years; 62.1% female) filled out the screening instrument at the beginning of their inpatient psychotherapy. The primary criterion for testing SkPTBS validity was the diagnosis of complex PTSD at the end of the inpatient treatment. The proportion of patients with cPTSD was 8.9% (n=29). SkPTBS items were selective, and the scale showed very good reliability (α=0.91). Factor analysis revealed a one-dimensional structure. SkPTBS total values predicted having cPTSD diagnosis and were correlated with global symptom severity (SCL-90-R) and depressive symptoms (BDI-II). There is evidence for high clinical utility of SkPTBS. A revised version was developed. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Bullying and PTSD Symptoms

    Science.gov (United States)

    Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

    2012-01-01

    PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

  15. Internet-delivered cognitive therapy for PTSD: a development pilot series

    Directory of Open Access Journals (Sweden)

    Jennifer Wild

    2016-11-01

    Full Text Available Background: Randomised controlled trials have established that face-to-face cognitive therapy for posttraumatic stress disorder (CT-PTSD based on Ehlers and Clark's cognitive model of PTSD is highly effective and feasible with low rates of dropout. Access to evidence-based psychological treatments for PTSD is insufficient. Several studies have shown that therapist-assisted treatment delivery over the Internet is a promising way of improving access to cognitive behavioural therapy interventions. Objective: To develop an Internet version of CT-PTSD that significantly reduces therapist contact time without compromising treatment integrity or retention rates. Methods: We describe the development of an Internet version of CT-PTSD. It implements all the key procedures of face-to-face CT-PTSD, including techniques that focus on the trauma memory, such as memory updating, stimulus discrimination and revisiting the trauma site, as well as restructuring individually relevant appraisals relating to overgeneralisation of danger, guilt, shame or anger, behavioural experiments and planning activities to reclaim quality of life. A cohort of 10 patients meeting DSM-IV criteria for PTSD worked through the programme, with remote guidance from a therapist, and they were assessed at pre- and post-treatment on PTSD outcome, mood, work and social adjustment and process measures. Results: No patients dropped out. Therapists facilitated the treatment with 192 min of contact time per patient, plus 57 min for reviewing the patient's progress and messages. Internet-delivered CT-PTSD was associated with very large improvements on all outcome and process measures, with 80% of patients achieving clinically significant change and remission from PTSD. Conclusions: Internet-delivered cognitive therapy for PTSD (iCT-PTSD appears to be an acceptable and efficacious treatment. Therapist time was reduced to less than 25% of time in face-to-face CT-PTSD. Randomised controlled trials

  16. Hyperbaric Oxygen Therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury PCS and PTSD

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-10-1-0962 TITLE: Hyperbaric Oxygen therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury...Annual 3. DATES COVERED (From – To) 30Sep2014 - 29Sep2015 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-10-1-0962 Hyperbaric Oxygen therapy in...post- hyperbaric oxygen treatment. Four additional subjects have been screened in October 2015 and nine are awaiting first appointment for

  17. Cognitive therapy of trauma related guilt in patients with PTSD

    Directory of Open Access Journals (Sweden)

    Popiel, Agnieszka

    2014-06-01

    Full Text Available Various aspects of guilt are frequent problems of patients suffering from PTSD, though they have been included into the diagnostic criteria for PTSD just in the present version DSM-5. Some studies indicate limitation of effectiveness of exposure therapy in PTSD patients with predominant emotions of anger or guilt. The aim of this paper is to present cognitive conceptualization of guilt in PTSD proposed by Kubany, and a treatment protocol resulting from this conceptualization. The clinical application of the protocol is illustrated with preliminary results of systematic observation of 8 patients with moderate to severe PTSD who were treated with cognitive therapy for guilt followed by a standard prolonged exposure protocol. The cognitive therapy of guilt can be a valuable supplement for treatment of PTSD. This protocol can also be an inspiration for therapists working with patients with dysfunctional guilt as a problem in other than PTSD disorders – like depression or adjustment disorders. In discussion the place of guilt in treatment according to different (PE-Foa et al.; CPT-Resick et al.; CT-Ehlers and Clark trauma focused therapy approaches is addressed, and the need for further studies is underlined.

  18. Targeting memory processes with drugs to prevent or cure PTSD.

    Science.gov (United States)

    Cain, Christopher K; Maynard, George D; Kehne, John H

    2012-09-01

    Post-traumatic stress disorder (PTSD) is a chronic debilitating psychiatric disorder resulting from exposure to a severe traumatic stressor and an area of great unmet medical need. Advances in pharmacological treatments beyond the currently approved SSRIs are needed. Background on PTSD, as well as the neurobiology of stress responding and fear conditioning, is provided. Clinical and preclinical data for investigational agents with diverse pharmacological mechanisms are summarized. Advances in the understanding of stress biology and mechanisms of fear conditioning plasticity provide a rationale for treatment approaches that may reduce hyperarousal and dysfunctional aversive memories in PTSD. One challenge is to determine if these components are independent or reflect a common underlying neurobiological alteration. Numerous agents reviewed have potential for reducing PTSD core symptoms or targeted symptoms in chronic PTSD. Promising early data support drug approaches that seek to disrupt dysfunctional aversive memories by interfering with consolidation soon after trauma exposure, or in chronic PTSD, by blocking reconsolidation and/or enhancing extinction. Challenges remain for achieving selectivity when attempting to alter aversive memories. Targeting the underlying traumatic memory with a combination of pharmacological therapies applied with appropriate chronicity, and in combination with psychotherapy, is expected to substantially improve PTSD treatment.

  19. Cognitive-Behavioral Therapy versus Other PTSD Psychotherapies as Treatment for Women Victims of War-Related Violence: A Systematic Review

    Directory of Open Access Journals (Sweden)

    N. Inès Dossa

    2012-01-01

    All published and unpublished randomized controlled trials studying the effectiveness of CBT at reducing PTSD and/or depression severity in the population of interest were searched. Out of 738 trials identified, 33 analysed a form of CBTs effectiveness, and ten were included in the paper. The subgroup analysis shows that cognitive processing therapy (CPT, culturally adapted CPT, and narrative exposure therapy (NET contribute to the reduction of PTSD and depression severity in the population of interest. The effect size was also significant at a level of 0.01 with the exception of the effect of NET on depression score. The test of subgroup differences was also significant, suggesting CPT is more effective than NET in our population of interest. CPT as well as its culturallyadapted form and NET seem effective in helping war/conflict traumatised civilians cope with their PTSD symptoms. However, more studies are required if one wishes to recommend one of these therapies above the other.

  20. CLINICAL EXPERIENCES IN TREATING PTSD PATIENTS BY COMBINIG INDIVIDUAL AND GROUP PSYCHOTERAPY

    OpenAIRE

    Bilić, Vedran; Nemčić-Moro, Iva; Karšić, Vana; Grgić, Vesna; Stojanović-Špehar, Stanislava; Marčinko, Darko

    2010-01-01

    PTSD is a complex psychobiological disorder that couses disfunctionality in many areas. In treating PTSD different models have been applied, however, no general consensus on the method of treatment has yet been achieved. At the Clinic for Psychol.ogical Medicine we have developed the model of combined treatment for PTSD patients that involves outpatient individual psychoterapy, psychopharmacotherapy and group psyhoterapeutic techniques introduced within repeated day-hospital treatments. In th...

  1. Predictors of Treatment Response to Fluoxetine in PTSD Following a Recent History of War Zone Stress Exposure

    Science.gov (United States)

    2013-07-01

    546---50. 28. Harmon RJ, Riggs PD. Clonidine for posttraumatic stress disorder in preschool children. J Am Acad Child Adolesc Psychiatry 1996;35:1247...9. 71. Meighen KG, Hines LA, Lagges AM. Risperidone treatment of preschool children with thermal burns and acute stress disorder. J Child Adolesc...intervention for recently redeployed soldiers, as well as to develop methodologies for understanding the multiple factors that may predict outcome. The

  2. Examining potential contraindications for prolonged exposure therapy for PTSD

    Directory of Open Access Journals (Sweden)

    Agnes van Minnen

    2012-07-01

    Full Text Available Although prolonged exposure (PE has received the most empirical support of any treatment for post-traumatic stress disorder (PTSD, clinicians are often hesitant to use PE due to beliefs that it is contraindicated for many patients with PTSD. This is especially true for PTSD patients with comorbid problems. Because PTSD has high rates of comorbidity, it is important to consider whether PE is indeed contraindicated for patients with various comorbid problems. Therefore, in this study, we examine the evidence for or against the use of PE with patients with problems that often co-occur with PTSD, including dissociation, borderline personality disorder, psychosis, suicidal behavior and non-suicidal self-injury, substance use disorders, and major depression. It is concluded that PE can be safely and effectively used with patients with these comorbidities, and is often associated with a decrease in PTSD as well as the comorbid problem. In cases with severe comorbidity, however, it is recommended to treat PTSD with PE while providing integrated or concurrent treatment to monitor and address the comorbid problems.

  3. Multimodal PTSD characterization via the StartleMart game

    DEFF Research Database (Denmark)

    Holmgard, C.; Yannakakis, G. N.; Martinez, H. P.

    2015-01-01

    at the treatment of mental diagnoses such as post traumatic stress disorder (PTSD). For that purpose, we couple game design and game technology to create a game-based tool for exposure therapy and stress inoculation training that utilizes stress detection for the automatic profiling and potential personalization...... of PTSD treatments. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD by analyzing the physiological responses to those in-game stress elicitors in two separate modalities: skin...... conductance (SC) and blood volume pulse (BVP). SC is often used to monitor stress as it is connected to the activation of the sympathetic nervous system (SNS). By including BVP into the model we introduce information about para-sympathetic activation, which offers a more complete view of the psycho...

  4. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

    Directory of Open Access Journals (Sweden)

    Sadeghi-Bazargani H

    2011-07-01

    Full Text Available Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran.Methods: This prospective study examined adult patients aged 16–65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD.Results: Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01. Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned.Conclusion: PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury. Keywords: post-traumatic stress disorder, burn injury, predictors, Iran

  5. COGNITIVE-BEHAVIORAL INTERVENTION FOR PTSD IN COLOMBIAN COMBAT VETERANS

    Directory of Open Access Journals (Sweden)

    CAROLINA BOTERO GARCÍA

    2005-07-01

    Full Text Available The results of cognitive-behavioral group interventions applied from 2002 to 2004 to 42 colombian combat veteranswith Post Traumatic Stress Disorder (PTSD are presented. The goal of the study was to stablish the effectiveness ofthe group interventions based in Prolonged Exposition and Stress Inoculation treatment processes. Differencesbetween pre-in-post symptomatology scores of PTSD were measured by Foa Posttraumatic Stress Diagnostic Scale(PDS and the Beck Depression Inventory. The statistical analysis was made by t test for paired samples, with alpha of0.05. Results show significant decrease in symptomatology and severity level after the intervention both in depressionand PTSD symptoms.

  6. Psychometric properties of the IES-R in traumatized substance dependent individuals with and without PTSD.

    Science.gov (United States)

    Rash, Carla J; Coffey, Scott F; Baschnagel, Joseph S; Drobes, David J; Saladin, Michael E

    2008-08-01

    Posttraumatic stress disorder (PTSD) is common among treatment-seeking substance abusers. Despite the high prevalence of these co-occurring conditions, few PTSD screening tools have been evaluated for their utility in identifying PTSD in substance use disorder (SUD) populations. The present study evaluated the psychometric properties of the Impact of Event Scale-Revised (IES-R) in a sample of 124 substance dependent individuals. All participants had a history of a DSM-IV Criterion A traumatic event, and 71 individuals met diagnostic criteria for PTSD. Participants with comorbid PTSD reported significantly more symptoms of anxiety, depression, and PTSD compared to substance dependent individuals without PTSD. Acceptable internal consistency and convergent validity of the IES-R were established among a substance dependent sample. Examination of diagnostic effectiveness suggested a cutoff value of 22 as optimal for a substance using population, resulting in adequate classification accuracy, sensitivity, and specificity.

  7. Relationship between PTSD symptomatology and nicotine dependence severity in crime victims.

    Science.gov (United States)

    Baschnagel, Joseph S; Coffey, Scott F; Schumacher, Julie A; Drobes, David J; Saladin, Michael E

    2008-11-01

    Smoking rates are higher and cessation rates are lower among individuals with posttraumatic stress disorder (PTSD) compared to the general population, thus understanding the relationship between PTSD and nicotine dependence is important. In a sample of 213 participants with a crime-related trauma (109 with PTSD), the relationship between PTSD status, smoking status (smoker vs. non-smoker), substance abuse diagnosis (SUD), PTSD symptoms, and sex was assessed. SUD diagnosis was significantly related to smoking status, but PTSD symptomatology and sex were not. Among smokers (n=117), increased nicotine dependence severity was associated with being male and with increased level of PTSD avoidance symptoms. Correlations indicated that PTSD avoidance and hyperarousal symptom clusters and total PTSD symptom scores were significantly related to nicotine dependence severity in males, while PTSD symptomatology in general did not correlate with dependence severity for females. The results suggest that level of PTSD symptomatology, particularly avoidance symptoms, may be important targets for smoking cessation treatment among male smokers who have experienced a traumatic event.

  8. PTSD and Problems with Alcohol Use

    Science.gov (United States)

    ... Enter ZIP code here PTSD and Problems with Alcohol Use Public This section is for Veterans, General Public, Family, & Friends PTSD and Problems with Alcohol Use PTSD and alcohol use problems are often ...

  9. Anger intensification with combat-related PTSD and depression comorbidity.

    Science.gov (United States)

    Gonzalez, Oscar I; Novaco, Raymond W; Reger, Mark A; Gahm, Gregory A

    2016-01-01

    Anger is becoming more widely recognized for its involvement in the psychological adjustment problems of current war veterans. Recent research with combat veterans has found anger to be related to psychological distress, psychosocial functioning, and harm risk variables. Using behavioral health data for 2,077 treatment-seeking soldiers who had been deployed to Iraq and Afghanistan, this study examined whether anger disposition was intensified for those who met screen-threshold criteria for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Anger was assessed with a 7-item screening measure previously validated with the study population. The study tested the hypothesis that anger would be highest when "PTSD & MDD" were conjoined, compared with "PTSD only," "MDD only," and "no PTSD, no MDD." PTSD and depression were assessed with well-established screening instruments. A self-rated "wanting to harm others" variable was also incorporated. Age, gender, race, military component, military grade, and military unit social support served as covariates. Hierarchical multiple regression was used to test the hypothesis, which was confirmed. Anger was intensified in the PTSD & MDD condition, in which it was significantly higher than in the other 3 conditions. Convergent support was obtained for "wanting to harm others" as an exploratory index. Given the high prevalence and co-occurrence of PTSD and MDD among veterans, the results have research and clinical practice relevance for systematic inclusion of anger assessment postdeployment from risk-assessment and screening standpoints. (c) 2016 APA, all rights reserved).

  10. Breathing Biofeedback as an Adjunct to Exposure in Cognitive Behavioral Therapy Hastens the Reduction of PTSD Symptoms: A Pilot Study

    OpenAIRE

    Rosaura Polak, A.; Witteveen, Anke B.; Denys, Damiaan; Olff, Miranda

    2015-01-01

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of PTSD symptoms. Patients (n = 8) with chronic PTSD were randomized to regular TF-CBT or TF-CBT with complementary breathing biofeedback to exposure. PTSD symptoms were measured before, during and a...

  11. Future directions for interventions targeting PTSD in HIV-infected adults

    OpenAIRE

    Applebaum, Allison J.; Bedoya, C. Andres; Hendriksen, Ellen S.; Wilkinson, Jesse L.; Safren, Steven A.; O’Cleirigh, Conall

    2014-01-01

    Although studies consistently report high rates of comorbid Post Traumatic Stress Disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the 3 existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found 2 empirically supported cognitive-behavioral therapy (CBT)-based interventions for the treatment of ...

  12. Efficacy of structured approach therapy in reducing PTSD in returning veterans: A randomized clinical trial.

    Science.gov (United States)

    Sautter, Frederic J; Glynn, Shirley M; Cretu, Julia Becker; Senturk, Damla; Vaught, Amanda S

    2015-08-01

    The U.S. military deployed in support to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high rates of posttraumatic stress disorder (PTSD) and relationship, partner, and parenting distress. Given the pervasive effect of combat-related PTSD on returning veterans and its effect on their loved ones, the investigators have developed a couples-based treatment, structured approach therapy (SAT), to reduce PTSD while simultaneously decreasing relationship and partner distress. This study presents treatment outcome data measuring PTSD and relationship outcomes from a randomized clinical trial (RCT) comparing SAT, a manualized 12-session novel couples-based PTSD treatment, to a manualized 12-session couples-based educational intervention (PTSD Family Education [PFE]). Data were collected from 57 returning veterans meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision; DSM-IV-TR) criteria for PTSD and their cohabiting partners; data collection was scheduled for pretreatment, posttreatment, and 3-month follow-up. Findings from an intent-to-treat analysis revealed that veterans receiving SAT showed significantly greater reductions in self-rated (PTSD Checklist; p < .0006) and Clinician-Administered PTSD Scale (CAPS)-rated PTSD (p < .0001) through the 3-month follow-up compared with veterans receiving PFE; 15 of 29 (52%) veterans receiving SAT and 2 of 28 (7%) receiving PFE no longer met DSM-IV-TR criteria for PTSD. Furthermore, SAT was associated with significant improvements in veteran relationship adjustment, attachment avoidance, and state anxiety. Partners showed significant reductions in attachment anxiety. This couples-based treatment for combat-related PTSD appears to have a strong therapeutic effect on combat-related PTSD in recently returned veterans.

  13. PTSD and gene variants: new pathways and new thinking.

    Science.gov (United States)

    Skelton, Kelly; Ressler, Kerry J; Norrholm, Seth D; Jovanovic, Tanja; Bradley-Davino, Bekh

    2012-02-01

    Posttraumatic Stress Disorder (PTSD) is an anxiety disorder which can develop as a result of exposure to a traumatic event and is associated with significant functional impairment. Family and twin studies have found that risk for PTSD is associated with an underlying genetic vulnerability and that more than 30% of the variance associated with PTSD is related to a heritable component. Using a fear conditioning model to conceptualize the neurobiology of PTSD, three primary neuronal systems have been investigated - the hypothalamic-pituitary-adrenal axis, the locus coeruleus-noradrenergic system, and neurocircuitry interconnecting the limbic system and frontal cortex. The majority of the initial investigations into main effects of candidate genes hypothesized to be associated with PTSD risk have been negative, but studies examining the interaction of genetic polymorphisms with specific environments in predicting PTSD have produced several positive results which have increased our understanding of the determinants of risk and resilience in the aftermath of trauma. Promising avenues of inquiry into the role of epigenetic modification have also been proposed to explain the enduring impact of environmental exposures which occur during key, often early, developmental periods on gene expression. Studies of PTSD endophenotypes, which are heritable biomarkers associated with a circumscribed trait within the more complex psychiatric disorder, may be more directly amenable to analysis of the underlying genetics and neural pathways and have provided promising targets for elucidating the neurobiology of PTSD. Knowledge of the genetic underpinnings and neuronal pathways involved in the etiology and maintenance of PTSD will allow for improved targeting of primary prevention amongst vulnerable individuals or populations, as well as timely, targeted treatment interventions. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'. Copyright © 2011 Elsevier

  14. Predicting PTSD following bank robbery

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

    exposed to robbery (N = 371, response rate = 73 %, dropout rate = 18 %). The results of a hierarchical regression analysis showed that 51 % of the variance in PTSD severity could be explained with only peritraumatic dissociation, acute stress disorder (ASD) severity, and negative cognitions about self......Each year, numerous bank robberies take place worldwide. Even so, only few studies have investigated the psychological sequelae of bank robbery and little is known about the risk factors associated with the development of posttraumatic stress disorder (PTSD) following this potentially traumatic...... event. Knowledge about risk factors related to PTSD may allow for preventive measures to be taken against the development of PTSD and reduce the large cost associated with the disorder. We investigated multiple predictors of PTSD severity in a highly representative Danish cohort study of bank employees...

  15. Predicting PTSD following bank robbery

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

    Each year, numerous bank robberies take place worldwide. Even so, only few studies have investigated the psychological sequelae of bank robbery and little is known about the risk factors associated with the development of posttraumatic stress disorder (PTSD) following this potentially traumatic...... event. Knowledge about risk factors related to PTSD may allow for preventive measures to be taken against the development of PTSD and reduce the large cost associated with the disorder. We investigated multiple predictors of PTSD severity in a highly representative Danish cohort study of bank employees...... exposed to robbery (N = 371, response rate = 73 %, dropout rate = 18 %). The results of a hierarchical regression analysis showed that 51 % of the variance in PTSD severity could be explained with only peritraumatic dissociation, acute stress disorder (ASD) severity, and negative cognitions about self...

  16. Healing Touch with Guided Imagery for PTSD in returning active duty military: a randomized controlled trial.

    Science.gov (United States)

    Jain, Shamini; McMahon, George F; Hasen, Patricia; Kozub, Madelyn P; Porter, Valencia; King, Rauni; Guarneri, Erminia M

    2012-09-01

    Post-traumatic stress disorder (PTSD) remains a significant problem in returning military and warrants swift and effective treatment. We conducted a randomized controlled trial to determine whether a complementary medicine intervention (Healing Touch with Guided Imagery [HT+GI]) reduced PTSD symptoms as compared to treatment as usual (TAU) returning combat-exposed active duty military with significant PTSD symptoms. Active duty military (n = 123) were randomized to 6 sessions (within 3 weeks) of HT+GI vs. TAU. The primary outcome was PTSD symptoms; secondary outcomes were depression, quality of life, and hostility. Repeated measures analysis of covariance with intent-to-treat analyses revealed statistically and clinically significant reduction in PTSD symptoms (p biofield therapy approaches for mitigating PTSD in military populations is warranted.

  17. Förebyggande metoder och behandlingar för Posttraumatiskt stressyndrom (PTSD): : Systematisk litteraturstudie

    OpenAIRE

    Brinkman, Johan

    2012-01-01

    Aim: The aim of this study was to describe the impact of debriefing, brief eclectic psychotherapy, cognitive behavioral therapy and EMDR therapy for PTSD and other stress-like reactions in emergency personnel. Background: In 1980, PTSD got a name and a place in the modern psychiatric diagnosis. Interest in the treatment and prevention of PTSD has increased over the past 20 years. Responders (ambulance, police and firefighters) are professionals who often meet human pain and suffering and are ...

  18. Firearm Ownership Among Military Veterans with PTSD: A Profile of Demographic and Psychosocial Correlates

    OpenAIRE

    Heinz, Adrienne J.; Cohen, Nicole L.; Holleran, Lori; Alvarez, Jennifer A.; Bonn-Miller, Marcel O.

    2016-01-01

    Posttraumatic stress disorder (PTSD), a condition that disproportionately affects military veterans, is associated with heightened rates of aggression and suicide. Although experience with firearms is common among this population, virtually nothing is known regarding who is more likely to own a firearm and whether firearm ownership is differentially associated with psychological and behavioral risk factors among veterans with PTSD. Of 465 veterans (79% male) entering PTSD treatment, 28% owned...

  19. Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms.

    Science.gov (United States)

    Kuhn, Eric; Greene, Carolyn; Hoffman, Julia; Nguyen, Tam; Wald, Laura; Schmidt, Janet; Ramsey, Kelly M; Ruzek, Josef

    2014-01-01

    PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  20. Resilient but addicted: The impact of resilience on the relationship between smoking withdrawal and PTSD.

    Science.gov (United States)

    Asnaani, Anu; Alpert, Elizabeth; McLean, Carmen P; Foa, Edna B

    2015-06-01

    Nicotine use is common among people with posttraumatic stress disorder (PTSD). Resilience, which is reflected in one's ability to cope with stress, has been shown to be associated with lower cigarette smoking and posttraumatic stress symptoms, but relationships among these three variables have not been examined. This study investigates the relationships of resilience and nicotine withdrawal with each other and in relation to PTSD symptoms. Participants were 118 cigarette smokers with PTSD seeking treatment for PTSD and nicotine use. Data were randomly cross-sectionally sampled from three time points: week 0, week 12, and week 27 of the study. Hierarchical multiple regression analyses revealed main effects of both resilience and nicotine withdrawal symptoms on PTSD severity, controlling for the sampled time point, negative affect, and expired carbon monoxide concentration. Consistent with prior research, PTSD severity was higher among individuals who were less resilient and for those who had greater nicotine withdrawal. There was an interaction between resilience and nicotine withdrawal on self-reported PTSD severity, such that greater resilience was associated with lower PTSD severity only among participants with low nicotine withdrawal symptoms. Among individuals with high nicotine withdrawal, PTSD severity was high, regardless of resilience level. These results suggest that resilience is a protective factor for PTSD severity for those with low levels of nicotine withdrawal, but at high levels of nicotine withdrawal, the protective function of resilience is mitigated.

  1. Differences in PTSD Symptomatology Among Latinos with Childhood and Adult Trauma: The Moderating Effect of Acculturation

    Science.gov (United States)

    DiGangi, Julia A.; Goddard, Andrea J.; Miller, Steven A.; Leon, Gabriela; Jason, Leonard A.

    2016-01-01

    The development of PTSD has been shown to be dependent on a variety of factors, including ethnicity, whether the trauma was experienced as a child or adult, and acculturation. Using 104 Latinos who had completed treatment for substance abuse disorder(s), this study compared PTSD symptomatology for individuals reporting their worst traumatic event (WTE) in childhood versus adulthood. The moderating effect of acculturation was also examined. Although many studies have reported on the pernicious effects of childhood trauma, very few have provided direct comparisons of child and adult trauma in terms of PTSD symptoms. Results indicated that those reporting their WTE in childhood had greater PTSD symptomatology than those reporting in adulthood. Acculturation moderated the relationship between timing of the trauma and PTSD symptoms. Specifically, those who reported their WTE in childhood and had the lower levels of acculturation reported the higher number of PTSD symptoms. Implications and future directions are discussed. PMID:27227166

  2. Relationships between a Dissociative Subtype of PTSD and Clinical Characteristics in Patients with Substance Use Disorders.

    Science.gov (United States)

    Mergler, Michaela; Driessen, Martin; Lüdecke, Christel; Ohlmeier, Martin; Chodzinski, Claudia; Weirich, Steffen; Schläfke, Detlef; Wedekind, Dirk; Havemann-Reinecke, Ursula; Renner, Walter; Schäfer, Ingo

    2017-01-01

    The increasing support for a dissociative subtype of post-traumatic stress disorder (PTSD-D) has led to its inclusion in DSM-5. We examined relationships between PTSD-D and relevant variables in patients with substance use disorders (SUD). The sample comprised N = 459 patients with SUD. The International Diagnostic Checklist and the Posttraumatic Diagnostic Scale were used to diagnose PTSD. In addition, participants completed the Childhood Trauma Questionnaire and the Dissociative Experiences Scale. The course of SUD was assessed by means of the European Addiction Severity Index. One-fourth of participants fulfilled a diagnosis of PTSD (25.3%). Patients with PTSD-D (N = 32, 27.6% of all patients with PTSD) reported significantly more current depressive symptoms, more current suicidal thoughts, more lifetime anxiety/tension, and more suicide attempts. The PTSD-D group also showed a significantly higher need for treatment due to drug problems, higher current use of opiates/analgesics, and a higher number of lifetime drug overdoses. In a regression model, symptoms of depression in the last month and lifetime suicide attempts significantly predicted PTSD-D. These findings suggest that PTSD-D is related to additional psychopathology and to a more severe course of substance-related problems in patients with SUD, indicating that this group also has additional treatment needs.

  3. Management of trauma and PTSD

    African Journals Online (AJOL)

    Lecturer, Department of Psychiatry and Mental Health, University of Cape Town and Consultant Psychiatrist, ... PTSD.[2,3] In the primary healthcare setting .... psychiatric history were more uniform .... trials support the use of selective serotonin.

  4. Study adaptation, design, and methods of a web-based PTSD intervention for women Veterans.

    Science.gov (United States)

    Lehavot, Keren; Litz, Brett; Millard, Steven P; Hamilton, Alison B; Sadler, Anne; Simpson, Tracy

    2017-02-01

    Women Veterans are a rapidly growing population with high risk of exposure to potentially traumatizing events and PTSD diagnoses. Despite the dissemination of evidence-based treatments for PTSD in the VA, most women Veteran VA users underutilize these treatments. Web-based PTSD treatment has the potential to reach and engage women Veterans with PTSD who do not receive treatment in VA settings. Our objective is to modify and evaluate Delivery of Self Training and Education for Stressful Situations (DESTRESSS), a web-based cognitive-behavioral intervention for PTSD, to target PTSD symptoms among women Veterans. The specific aims are to: (1) obtain feedback about DESTRESS, particularly on its relevance and sensitivity to women, using semi-structured interviews with expert clinicians and women Veterans with PTSD, and make modifications based on this feedback; (2) conduct a pilot study to finalize study procedures and make further refinements to the intervention; and (3) conduct a randomized clinical trial (RCT) evaluating a revised, telephone-assisted DESTRESS compared to telephone monitoring only. We describe the results from the first two aims, and the study design and procedures for the ongoing RCT. This line of research has the potential to result in a gender-sensitive, empirically-based, online treatment option for women Veterans with PTSD.

  5. Sentiment analysis for PTSD signals

    CERN Document Server

    Kagan, Vadim; Sapounas, Demetrios

    2013-01-01

    This book describes a computational framework for real-time detection of psychological signals related to Post-Traumatic Stress Disorder (PTSD) in online text-based posts, including blogs and web forums. Further, it explores how emerging computational techniques such as sentiment mining can be used in real-time to identify posts that contain PTSD-related signals, flag those posts, and bring them to the attention of psychologists, thus providing an automated flag and referral capability.

  6. Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression.

    Science.gov (United States)

    Olff, Miranda; Polak, A Rosaura; Witteveen, Anke B; Denys, Damiaan

    2014-07-01

    'reexperiencing' and 'hyperarousal'. Depressive symptoms mediated the relation between PTSD and executive function on some executive function measures (IED total errors and OTS latency to correct), whereas PTSD did not mediate the relation between depression and executive function. PTSD patients perform worse on executive function. The impairments seem to be mostly associated with the less specific PTSD symptom cluster of 'numbing'. Depressive symptoms seem to mediate the relationship between PTSD and executive function. These findings may have clinical implications with regard to treatment indication and prognosis. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Virtual Reality Exposure Therapy for PTSD Symptoms after a Road Accident: An Uncontrolled Case Series

    Science.gov (United States)

    Beck, J. Gayle; Palyo, Sarah A.; Winer, Eliot H.; Schwagler, Brad E.; Ang, Eu Jin

    2007-01-01

    This report examined whether Virtual Reality Exposure Therapy (VRET) could be used in the treatment of posttraumatic stress disorder (PTSD) symptoms in the aftermath of a serious motor vehicle accident. Six individuals reporting either full or severe subsyndromal PTSD completed 10 sessions of VRET, which was conducted using software designed to…

  8. Using the Single Prolonged Stress Model to Examine the Pathophysiology of PTSD

    Directory of Open Access Journals (Sweden)

    Rimenez R. Souza

    2017-09-01

    Full Text Available The endurance of memories of emotionally arousing events serves the adaptive role of minimizing future exposure to danger and reinforcing rewarding behaviors. However, following a traumatic event, a subset of individuals suffers from persistent pathological symptoms such as those seen in posttraumatic stress disorder (PTSD. Despite the availability of pharmacological treatments and evidence-based cognitive behavioral therapy, a considerable number of PTSD patients do not respond to the treatment, or show partial remission and relapse of the symptoms. In controlled laboratory studies, PTSD patients show deficient ability to extinguish conditioned fear. Failure to extinguish learned fear could be responsible for the persistence of PTSD symptoms such as elevated anxiety, arousal, and avoidance. It may also explain the high non-response and dropout rates seen during treatment. Animal models are useful for understanding the pathophysiology of the disorder and the development of new treatments. This review examines studies in a rodent model of PTSD with the goal of identifying behavioral and physiological factors that predispose individuals to PTSD symptoms. Single prolonged stress (SPS is a frequently used rat model of PTSD that involves exposure to several successive stressors. SPS rats show PTSD-like symptoms, including impaired extinction of conditioned fear. Since its development by the Liberzon lab in 1997, the SPS model has been referred to by more than 200 published papers. Here we consider the findings of these studies and unresolved questions that may be investigated using the model.

  9. Using Propranolol to Block Memory Reconsolidation in Female Veterans with PTSD

    Science.gov (United States)

    2014-10-01

    increased in physical arousal (i.e., increased heart rate, muscle tension, etc.) when recalling a trauma-related memory. In this manner, a treatment that...daily life. However, there is an imbalance at the heart of combat PTSD-related research: in over three decades’ worth of research on combat stress PTSD

  10. PTSD, emotion dysregulation, and dissociative symptoms in a highly traumatized sample

    Science.gov (United States)

    Powers, Abigail; Cross, Dorthie; Fani, Negar; Bradley, Bekh

    2015-01-01

    Exposure to multiple traumas has been shown to result in many negative mental health outcomes, including posttraumatic stress disorder (PTSD). Dissociation, which involves disruptions in memory, identity, and perceptions, may be a component of PTSD, particularly among individuals who have experienced childhood trauma. Emotion regulation difficulties are also strongly associated with childhood trauma and emotion dysregulation may be a particularly important factor to consider in the development and maintenance of dissociative symptoms. The goal of the present study was to determine whether emotion dysregulation mediated the relationship between PTSD symptoms and dissociation in a sample of 154 (80% female, 97% African-American) adults recruited from a public, urban hospital. PTSD was measured using the Clinician Administered PTSD Scale, emotion dysregulation was measured using the Difficulties in Emotion Regulation Scale, and dissociation was measured using the Multiscale Dissociation Inventory. A linear regression analysis showed that both PTSD and emotion dysregulation were statistically significant predictors of dissociation even after controlling for trauma exposure. Alexithymia and an inability to use emotion regulation strategies in particular were predictive of dissociation above and beyond other predictor variables. Using bootstrapping techniques, we found that overall emotion dyregulation partially mediated the effect of PTSD symptoms on dissociative symptoms. Our results suggest that emotion dysregulation may be important in understanding the relation between PTSD and dissociative symptoms. Treatment approaches may consider a focus on training in emotional understanding and the development of adaptive regulation strategies as a way to address dissociative symptoms in PTSD patients. PMID:25573648

  11. Self-study assisted cognitive therapy for PTSD: a case study

    Directory of Open Access Journals (Sweden)

    Jennifer Wild

    2010-12-01

    Full Text Available Background: Research has demonstrated that Cognitive Therapy for PTSD (CT-PTSD, a version of trauma-focused cognitive-behavioural therapy developed by Ehlers and Clark's group (2000, is effective and feasible when offered in weekly and intensive daily formats. It is unknown whether patients with post-traumatic stress disorder (PTSD could engage in and benefit from self-study assisted cognitive therapy, which would reduce therapist contact time. Objectives: This case report aims to illustrate this possibility. Design: A patient with PTSD and comorbid major depression, who developed these problems following a road traffic accident, was treated in six sessions of cognitive therapy with six self-study modules completed in-between sessions. The patient made a complete recovery on measures of PTSD, anxiety, and depression as assessed by self-report and independent assessment. Conclusion: Self-study assisted cognitive CT-PTSD reduced the therapist contact time to half of that normally required in standard CT-PTSD. This highlights the potential feasibility and therapeutic benefits of self-study modules in the brief treatment of PTSD. Further research is required to systematically evaluate the acceptability and efficacy of brief self-study assisted CT-PTSD.

  12. Behavioral Activation and Therapeutic Exposure: An Investigation of Relative Symptom Changes in PTSD and Depression during the Course of Integrated Behavioral Activation, Situational Exposure, and Imaginal Exposure Techniques

    Science.gov (United States)

    Gros, Daniel F.; Price, Matthew; Strachan, Martha; Yuen, Erica K.; Milanak, Melissa E.; Acierno, Ron

    2012-01-01

    Effectiveness of exposure therapy for posttraumatic stress disorder (PTSD) may be adversely influenced by comorbid disorders. The present study investigated behavioral activation and therapeutic exposure (BA-TE), a new integrated treatment designed specifically for comorbid symptoms of PTSD and depression. Combat veterans with PTSD (N = 117)…

  13. Amygdala Response Predicts Trajectory of Symptom Reduction During Trauma-Focused Cognitive-Behavioral Therapy among Adolescent Girls with PTSD

    OpenAIRE

    Cisler, Josh M.; Sigel, Benjamin A.; Kramer, Teresa L.; Smitherman, Sonet; Vanderzee, Karin; Pemberton, Joy; Kilts, Clinton D.

    2015-01-01

    Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is the gold standard treatment for pediatric PTSD. Nonetheless, clinical outcomes in TF-CBT are highly variable, indicating a need to identify reliable predictors that allow forecasting treatment response. Here, we test the hypothesis that functional neuroimaging correlates of emotion processing predict PTSD symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) among adolescent girls with PTSD. Thirty-four adolescent...

  14. A Randomized, Controlled Trial of Meditation Compared to Exposure Therapy and Education Control on PTSD in Veterans

    Science.gov (United States)

    2015-10-01

    Posttraumatic stress disorder (PTSD) is a common and debilitating condition that affects up to 20% of all Veterans. PTSD is often a chronic problem for...physiological/biochemical stress markers; and 3) evaluate treatment compliance. The study will enroll 210 subjects (70 per group). The VA San Diego is...depression and suicide . Although standard treatments exist to treat PTSD, research shows that up to 50% of patients continue to have elevated symptoms. This

  15. Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

    Directory of Open Access Journals (Sweden)

    Sara A. Freedman

    2015-12-01

    Full Text Available Background: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD, but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD. Objective: This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT on the association between the two. Method: Consecutive emergency department trauma admissions with qualifying PTSD symptoms (n=501 were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms. Results: The cross-lagged effect of SRS on PTSD was statistically significant (β=−0.12, p=0.01 among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (β=−0.02, p=0.67. Both relationships were non-significant among survivors who received CBT. Discussion: SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention.

  16. PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents.

    Science.gov (United States)

    Hafstad, G S; Thoresen, S; Wentzel-Larsen, T; Maercker, A; Dyb, G

    2017-05-01

    The conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two separate waves. Young survivors of the 2011 Norway attacks (n = 325) and their parents (n = 451) were interviewed at 4-6 months (wave 1) and 15-18 months (wave 2) after the shooting. PTSD was assessed with the UCLA PTSD Reaction Index for DSM-IV adapted for DSM-5, and a subset was used as diagnostic criteria for ICD-11. In survivors, PTSD prevalence did not differ significantly at any time point, but in parents, the DSM-5 algorithm produced significantly higher prevalence rates than the ICD-11 criteria. The overlap was fair for survivors, but amongst parents a large proportion of individuals met the criteria for only one of the diagnostic systems. No systematic differences were found between ICD-11 and DSM-5 in predictive validity. The proposed ICD-11 criteria and the DSM-5 criteria performed equally well when identifying individuals in distress. Nevertheless, the overlap between those meeting the PTSD diagnosis for both ICD-11 and DSM-5 was disturbingly low, with the ICD-11 criteria identifying fewer people than the DSM-5. This represents a major challenge in identifying individuals suffering from PTSD worldwide, possibly resulting in overtreatment or unmet needs for trauma-specific treatment, depending on the area of the world in which patients are being diagnosed.

  17. The psychobiology and psychopharmacology of PTSD.

    Science.gov (United States)

    Van Der Kolk, Bessel A.

    2001-01-01

    This paper reviews the currently available knowledge about the psychobiology and psychopharmacology of post-traumatic stress disorder (PTSD). It also reviews the various studies that have elucidated changes in brain function and structure in PTSD populations, including position emission tomography (PET), single photon emission computed tomography (SPECT), and event-related potential (ERP) studies. It then reviews the literature on catecholamine and hypothalamic-pituitary-adrenal (HPA) axis abnormalities in PTSD, and finally reviews the literature available on the psychopharmacology of PTSD. It discusses how the pathophysiology of PTSD determines the nature of psychopharmacological interventions. Psychopharmacological interventions in PTSD are largely limited to good studies on the effects of the selective serotonin reuptake inhibitors (SSRIs). In order to effectively intervene in PTSD, studies of other psychopharmacological agents are necessary, specifically of agents which affect limbic activation, decreased frontal lobe functioning, altered HPA activity, and other biological features of PTSD. Copyright 2001 John Wiley & Sons, Ltd.

  18. Emotion and Cognition Interactions in PTSD: A Review of Neurocognitive and Neuroimaging Studies

    Directory of Open Access Journals (Sweden)

    Jasmeet P Hayes

    2012-10-01

    Full Text Available Posttraumatic stress disorder (PTSD is a psychiatric syndrome that develops after exposure to terrifying and life-threatening events including warfare, motor-vehicle accidents, and physical and sexual assault. The emotional experience of psychological trauma can have long-term cognitive effects. The hallmark symptoms of PTSD involve alterations to cognitive processes such as memory, attention, planning and problem solving, underscoring the detrimental impact that negative emotionality has on cognitive functioning. As such, an important challenge for PTSD researchers and treatment providers is to understand the dynamic interplay between emotion and cognition. Contemporary cognitive models of PTSD theorize that a preponderance of information processing resources are allocated towards threat detection and interpretation of innocuous stimuli as threatening, narrowing one’s attentional focus at the expense of other cognitive operations. Decades of research have shown support for these cognitive models of PTSD using a variety of tasks and methodological approaches. The primary goal of this review is to summarize the latest neurocognitive and neuroimaging research of emotion-cognition interactions in PTSD. To directly assess the influence of emotion on cognition and vice versa, the studies reviewed employed challenge tasks that included both cognitive and emotional components. The findings provide evidence for memory and attention deficits in PTSD that are often associated with changes in functional brain activity. The results are reviewed to provide future directions for research that may direct better and more effective treatments for PTSD.

  19. Proximal relationships between PTSD and drinking behavior

    OpenAIRE

    2014-01-01

    Co-morbid PTSD and alcohol use disorders are both common and debilitating. However, many of these studies rely on cross-sectional studies that obscure more complex relationships between PTSD and drinking. Event-level studies allow for examination of proximal relationships between PTSD and drinking. Among women (n=136 with past sexual victimization, n=40 no past trauma history), a two-part mixed hurdle model was used to examine daily PTSD and drinking. On days women experienced more intrusive ...

  20. Considering PTSD for DSM-5.

    Science.gov (United States)

    Friedman, Matthew J; Resick, Patricia A; Bryant, Richard A; Brewin, Chris R

    2011-09-01

    This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish "traumatic" from "non-traumatic" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD. © 2010 Wiley-Liss, Inc.

  1. Economic Analysis of Post-Traumatic Stress Disorder (PTSD) in the Global War on Terrorism (GWOT)

    Science.gov (United States)

    2008-12-01

    include treatment costs, the costs of lives lost to suicide , and costs related to lost productivity (including reduced employment and lower earnings...the costs from treatment expenditures, lost productivity, and costs associated with suicide . The increasing trends in the treatment costs of PTSD...order to capture changes across the years. The fiscal-year variables indicate the fiscal year of the PSTD diagnosis date for the PTSD population and

  2. EMDR and CBT for Cancer Patients: Comparative Study of Effects on PTSD, Anxiety, and Depression

    OpenAIRE

    Capezzani, L; Ostacoli, L; Cavallo, M; Carletto, S; Fernendez, I; Solomon, R; Pagani, M.; Cantelmi, T

    2013-01-01

    This pilot study examined the efficacy of eye movement desensitization and reprocessing (EMDR) treatment compared with cognitive behavioral therapy (CBT) in treating posttraumatic stress disorder (PTSD) in oncology patients in the follow-up phase of the disease. The secondary aim of this study was to assess whether EMDR treatment has a different impact on PTSD in the active treatment or during the followup stages of disease. Twenty-one patients in follow-up care were randomly assigned to EMDR...

  3. Determinants of altered intracellular endocrine-immune interplay in Bosnian war refugees suffering from PTSD.

    Science.gov (United States)

    Pitts, Kenneth P; Joksimovic, Ljiljana; Steudte-Schmiedgen, Susann; Rohleder, Nicolas; Wolf, Jutta M

    2016-07-01

    Posttraumatic Stress Disorder (PTSD) has been repeatedly linked to changes in glucocorticoid (GC) sensitivity. To increase our understanding of this phenomenon and its potential relevance for PTSD development and treatment, the current study investigates the interplay between two key moderators, glucocorticoid receptor (GRα) and GR co-chaperone FKBP5, and their relation to GC sensitivity. A GC sensitivity assay was performed in 52 Bosnian war refugees (19m; 40.8±8.7 years) clinically diagnosed with PTSD to divide the patient group into a high (HS) and a low (LS) GC sensitivity group. Expression of GRα and FKBP5 mRNA was quantified by real-time RT-PCR. Links between gene expression and GC sensitivity were driven by the HS group of PTSD patients, which also showed increased expression of GRα but not FKBP5 compared to the LS group. Further, expressions of FKBP5 and GRα were strongly correlated in the HS patient group, while this association was missing in the LS PTSD group. Our findings suggest that PTSD phenotypes may be characterized by differences in intracellular signaling transduction processes. The associations of expression of GRα and FKBP5 in the high-sensitive PTSD subgroup may thereby reflect physiological adaptation to preserve immune-relevant GC signaling. Further research is needed to understand the role and consequences of GRα-FKBP5 dissociation in low GC sensitivity PTSD patients.

  4. Implementing an Assessment Clinic in a Residential PTSD Program

    Directory of Open Access Journals (Sweden)

    Joan McDowell

    2014-08-01

    Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.

  5. TPM: cloud-based tele-PTSD monitor using multi-dimensional information.

    Science.gov (United States)

    Xu, Roger; Mei, Gang; Zhang, Guangfan; Gao, Pan; Pepe, Aaron; Li, Jiang

    2013-01-01

    An automated system that can remotely and non-intrusively screen individuals at high risk for Post-Traumatic Stress Disorder (PTSD) and monitor their progress during treatment would be desired by many Veterans Affairs (VAs) as well as other PTSD treatment and research organizations. In this paper, we present an automated, cloud-based Tele-PTSD Monitor (TPM) system based on the fusion of multiple sources of information. The TPM system can be hosted in a cloud environment and accessed through landline or cell phones, or on the Internet through a web portal or mobile application (app).

  6. Cognitive behavioral therapy (CBT) in a Patient with Implantable Cardioverter Defibrillator (ICD) and Posttraumatic stress disorder(PTSD).

    Science.gov (United States)

    Ansari, Sahar; Arbabi, Mohammad

    2014-07-01

    The implantable cardioverter defibrillator (ICD) has currently become the standard treatment for preventing sudden cardiac death. There are some psychological consequences in patients with ICD such as posttraumatic stress disorder (PTSD) after the shocks induced by ICD. This report aimed to present the case of a 54-year-old man with ICD who had developed PTSD; his PTSD was treated, using cognitive-behavioral psychotherapy consisting of relaxation, mindfulness and problem solving techniques. In patients with ICD who are experiencing PTSD using cognitive behavioral interventions may be helpful to reduce their psychological sufferings.

  7. Cognitive behavioral therapy (CBT in a Patient with Implantable Cardioverter Defibrillator (ICD and Posttraumatic stress disorder(PTSD.

    Directory of Open Access Journals (Sweden)

    Sahar Ansari

    2014-09-01

    Full Text Available The implantable cardioverter defibrillator (ICD has currently become the standard treatment for preventing sudden cardiac death. There are some psychological consequences in patients with ICD such as posttraumatic stress disorder (PTSD after the shocks induced by ICD. This report aimed to present the case of a 54-year-old man with ICD who had developed PTSD; his PTSD was treated, using cognitive-behavioral psychotherapy consisting of relaxation, mindfulness and problem solving techniques. In patients with ICD who are experiencing PTSD using cognitive behavioral interventions may be helpful to reduce their psychological sufferings.

  8. Grapheme-color Synesthesia and PTSD: Preliminary Results from the Veterans Health Study

    Science.gov (United States)

    Hoffman, Stuart N.; Zhang, Xiaopeng; Erlich, Porat M.; Boscarino, Joseph A.

    2013-01-01

    Objective Posttraumatic stress disorder (PTSD) is associated with altered neuropsychological function, possibly including complex visual information processing. Grapheme-color synesthesia refers to the phenomenon that a particular letter or number elicits the visual perception of a specific color. The study objective was to assess if grapheme-color synesthesia was associated with PTSD among US veterans. Method We surveyed 700 veterans who were outpatients in a multi-hospital system in Pennsylvania. All veterans had served at least one warzone deployment. PTSD and grapheme-color synesthesia were assessed using a validated research instruments. Results The mean age of veterans was 59 and 96% were men. The prevalence of current PTSD was 7% (95% C.I. = 5.1–8.8) and current partial PTSD was 11% (95% C.I. = 9.3–14.0). The prevalence of current depression was 6% (95% C.I. = 4.7–8.3). Altogether, 6% (95% C.I. = 4.8–8.5) of veterans screened positive for grapheme-color synesthesia. Bivariate analyses suggested that grapheme-color synesthesia was associated with current PTSD (odds ratio [OR] = 3.4, p = 0.004) and current partial PTSD (OR = 2.4, p = 0.013), but not current depression (OR = 1.1, p = 0.91). Multivariate logistic regression results, adjusting for age, gender, marital status, level of education, current psychotropic medication use, and concussion history, confirmed these results. Conclusion Grapheme-color synesthesia appears to be associated with PTSD among veterans who had been deployed. This finding may have implications for PTSD diagnostic screening and treatment. Research is recommended to confirm this finding and to determine if synesthesia is a risk indicator for PTSD among nonveterans. PMID:23115347

  9. Combat PTSD and implicit behavioral tendencies for positive affective stimuli: A brief report

    Directory of Open Access Journals (Sweden)

    Ashley Nicole Clausen

    2016-05-01

    Full Text Available Background: Prior cognitive research in PTSD has focused on automatic responses to negative affective stimuli, including attentional facilitation or disengagement and avoidance action tendencies. More recent research suggests PTSD may also relate to differences in reward processing, which has lead to theories of PTSD relating to approach-avoidance imbalances. The current pilot study assessed how combat-PTSD symptoms relate to automatic behavioral tendencies to both positive and negative affective stimuli. Method: Twenty male combat veterans completed the Approach-Avoidance Task (AAT, Clinician Administered PTSD Scale, Beck Depression Inventory-II, and State-Trait Anger Expression Inventory-II. During the AAT, subjects pulled (approach or pushed (avoid a joystick in response to neutral, happy, disgust, and angry faces based on border color. Bias scores were calculated for each emotion type (avoid-approach response latency differences. Main and interaction effects for psychological symptom severity and emotion type on bias score were assessed using linear mixed models. Results: There was a significant interaction between PTSD symptoms and emotion type, driven primarily by worse symptoms relating to a greater bias to avoid happy faces. Post-hoc tests revealed that veterans with worse PTSD symptoms were slower to approach as well as quicker to avoid happy faces. Neither depressive nor anger symptoms related to avoid or approach tendencies of emotional stimuli.Conclusion: PTSD severity was associated with a bias for avoiding positive affective stimuli. These results provide further evidence that PTSD may relate to aberrant processing of positively valenced, or rewarding stimuli. Implicit responses to rewarding stimuli could be an important factor in PTSD pathology and treatment. Specifically, these findings have implications for recent endeavors in using computer-based interventions to influence automatic approach-avoidance tendencies.

  10. Reduced amygdala and ventral striatal activity to happy faces in PTSD is associated with emotional numbing.

    Directory of Open Access Journals (Sweden)

    Kim L Felmingham

    Full Text Available There has been a growing recognition of the importance of reward processing in PTSD, yet little is known of the underlying neural networks. This study tested the predictions that (1 individuals with PTSD would display reduced responses to happy facial expressions in ventral striatal reward networks, and (2 that this reduction would be associated with emotional numbing symptoms. 23 treatment-seeking patients with Posttraumatic Stress Disorder were recruited from the treatment clinic at the Centre for Traumatic Stress Studies, Westmead Hospital, and 20 trauma-exposed controls were recruited from a community sample. We examined functional magnetic resonance imaging responses during the presentation of happy and neutral facial expressions in a passive viewing task. PTSD participants rated happy facial expression as less intense than trauma-exposed controls. Relative to controls, PTSD participants revealed lower activation to happy (-neutral faces in ventral striatum and and a trend for reduced activation in left amygdala. A significant negative correlation was found between emotional numbing symptoms in PTSD and right ventral striatal regions after controlling for depression, anxiety and PTSD severity. This study provides initial evidence that individuals with PTSD have lower reactivity to happy facial expressions, and that lower activation in ventral striatal-limbic reward networks may be associated with symptoms of emotional numbing.

  11. Do Treatment Improvements in PTSD Severity Affect Substance Use Outcomes? A Secondary Analysis From a Randomized Clinical Trial in NIDA's Clinical Trials Network

    National Research Council Canada - National Science Library

    Hien, Denise A; Jiang, Huiping; Campbell, Aimee N.C; Hu, Mei-Chen; Miele, Gloria M; Cohen, Lisa R; Brigham, Gregory S; Capstick, Carrie; Kulaga, Agatha; Robinson, James; Suarez-Morales, Lourdes; Nunes, Edward V

    2010-01-01

    ...) and substance use disorder among women in outpatient substance abuse treatment. MethodParticipants were 353 women randomly assigned to 12 sessions of either trauma-focused or health education group treatment...

  12. Common paths to ASD and PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

    Numerous studies have investigated the prediction of acute and long term posttraumatic symptoms following traumatic exposure. As a result several factors have been shown to be predictive of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) respectively. Furthermore, research...... suggests a strong relationship between ASD severity and subsequent PTSD severity. However, little is known in relation to whether there are common pathways to the development of ASD and PTSD. Peritraumatic responses to trauma are found to be associated with both the development of ASD and PTSD. Although...... of peritraumatic factors such as symptoms of tonic immobility, panic, and dissociation on the development of ASD (N = 458) and PTSD (n = 378) symptoms in a national study of Danish bank robbery victims. The estimated ASD rate was 11.1 % (n = 41) and the estimated PTSD rate was 6.2 % (n = 23). The results...

  13. Disseminating Evidence-Based Practices for Adults with PTSD and Severe Mental Illness in Public-Sector Mental Health Agencies

    Science.gov (United States)

    Frueh, B. Christopher; Grubaugh, Anouk L.; Cusack, Karen J.; Elhai, Jon D.

    2009-01-01

    Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mental illnesses (SMI). The treatment of psychotic symptoms usually takes precedence in the care of adults with SMI. Such oversight is problematic in that PTSD in SMI populations is common (19%-43%), contributes a significant illness burden, and hinders mental…

  14. Integrating Dialectical Behavior Therapy and Prolonged Exposure to Treat Co-Occurring Borderline Personality Disorder and PTSD: Two Case Studies

    Science.gov (United States)

    Harned, Melanie S.; Linehan, Marsha M.

    2008-01-01

    Despite the high rate of trauma and PTSD among individuals with borderline personality disorder (BPD), no studies have specifically evaluated the treatment of PTSD in a BPD population. These case studies illustrate the use of a protocol based on prolonged exposure therapy that can be integrated into standard dialectical behavior therapy to treat…

  15. PTSD in Primary Care: A Physician’s Guide to Dealing with War-Induced PTSD

    Science.gov (United States)

    2012-01-01

    with mild TBI and ASD could be effectively treated with a brief CBT protocol designed to prevent development of PTSD . Impaired family functioning...7 PTSD in Primary Care: A Physician’s Guide to Dealing with War-Induced PTSD Jeffrey S. Yarvis1 and Grace D. Landers2 1Department of Psychiatry...stress disorder ( PTSD ), as defined in DSM IV-TR, is the most common and conspicuous psychiatric problem associated with the stress experienced by

  16. Alienation appraisals distinguish adults diagnosed with DID from PTSD.

    Science.gov (United States)

    DePrince, Anne P; Huntjens, Rafaële J C; Dorahy, Martin J

    2015-11-01

    Studies are beginning to show the importance of appraisals to different types and severities of psychiatric disorders. Yet, little work in this area has assessed whether trauma-related appraisals can differentiate complex trauma-related disorders, such as posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). The current study evaluated whether any of 6 trauma-related appraisals distinguished adults diagnosed with DID from those diagnosed with PTSD. To accomplish this, we first examined the basic psychometric properties of a Dutch-translated short-form of the Trauma Appraisals Questionnaire (TAQ) in healthy control (n = 57), PTSD (n = 27) and DID (n = 12) samples. The short-form Dutch translation of the TAQ showed good internal reliability and criterion-related validity for all 6 subscales (betrayal, self-blame, fear, alienation, shame, anger). Of the 6 subscales, the alienation appraisal subscale specifically differentiated DID from PTSD, with the former group reporting more alienation. Abuse-related appraisals that emphasize disconnection from self and others may contribute to reported problems of memory and identity common in DID. The current findings suggest that addressing experiences of alienation may be particularly important in treatment for clients diagnosed with DID. (c) 2015 APA, all rights reserved).

  17. Results of psychodynamically oriented trauma-focused inpatient treatment for women with complex posttraumatic stress disorder (PTSD) and borderline personality disorder (BPD).

    Science.gov (United States)

    Sachsse, Ulrich; Vogel, Christina; Leichsenring, Falk

    2006-01-01

    In a naturalistic outcome study, the authors evaluated the results of a specific psychodynamically oriented trauma-focused inpatient treatment for women with complex posttraumatic stress disorder and concomitant borderline personality disorder, self-mutilating behavior, and depression. At admission, the frequency of self-mutilating behavior and the amount of inpatient treatment (an average of 68 days annually) of the sample was high, characterizing this patient group as "previously therapy resistant." Treatment outcome was assessed both at the end of treatment and in a 1-year follow-up. In comparison with a treatment-as-usual control group, the treatment program brought about significant and stable improvements both in trauma-specific symptoms (e.g. dissociation, intrusion, avoidance) and in general psychiatric symptoms (e.g., general symptom distress, frequency of self-mutilating behavior, number of hospitalizations). The frequency of inpatient treatments (hospitalizations) decreased dramatically (< 10 days annually; effect size: d = 2.88).

  18. Comorbidity of 9/11-related PTSD and depression in the World Trade Center Health Registry 10-11 years postdisaster.

    Science.gov (United States)

    Caramanica, Kimberly; Brackbill, Robert M; Liao, Tim; Stellman, Steven D

    2014-12-01

    Many studies report elevated prevalence of posttraumatic stress disorder (PTSD) and depression among persons exposed to the September 11, 2001 (9/11) disaster compared to those unexposed; few have evaluated long-term PTSD with comorbid depression. We examined prevalence and risk factors for probable PTSD, probable depression, and both conditions 10-11 years post-9/11 among 29,486 World Trade Center Health Registry enrollees who completed surveys at Wave 1 (2003-2004), Wave 2 (2006-2007), and Wave 3 (2011-2012). Enrollees reporting physician diagnosed pre-9/11 PTSD or depression were excluded. PTSD was defined as scoring ≥ 44 on the PTSD Checklist and depression as scoring ≥ 10 on the 8-item Patient Health Questionnaire. We examined 4 groups: comorbid PTSD and depression, PTSD only, depression only, and neither. Among enrollees, 15.2% reported symptoms indicative of PTSD at Wave 3, 14.9% of depression, and 10.1% of both. Comorbid PTSD and depression was associated with high 9/11 exposures, low social integration, health-related unemployment, and experiencing ≥ 1 traumatic life event post-9/11. Comorbid persons experienced poorer outcomes on all PTSD-related impairment measures, life satisfaction, overall health, and unmet mental health care need compared to those with only a single condition. These findings highlight the importance of ongoing screening and treatment for both conditions, particularly among those at risk for mental health comorbidity.

  19. The relationship between PTSD and chronic pain: mediating role of coping strategies and depression.

    Science.gov (United States)

    Morasco, Benjamin J; Lovejoy, Travis I; Lu, Mary; Turk, Dennis C; Lewis, Lynsey; Dobscha, Steven K

    2013-04-01

    People with chronic pain and comorbid posttraumatic stress disorder (PTSD) report more severe pain and poorer quality of life than those with chronic pain alone. This study evaluated the extent to which associations between PTSD and chronic pain interference and severity are mediated by pain-related coping strategies and depressive symptoms. Veterans with chronic pain were divided into 2 groups, those with (n=65) and those without (n=136) concurrent PTSD. All participants completed measures of pain severity, interference, emotional functioning, and coping strategies. Those with current PTSD reported significantly greater pain severity and pain interference, had more symptoms of depression, and were more likely to meet diagnostic criteria for a current alcohol or substance use disorder (all p-values self-statements. Illness-focused pain coping (i.e., guarding, resting, and asking for assistance) and depressive symptoms jointly mediated the relationship between PTSD and both pain interference (total indirect effect=0.194, p<.001) and pain severity (total indirect effect=0.153, p=.004). Illness-focused pain coping also evidenced specific mediating effects, independent of depression. In summary, specific pain coping strategies and depressive symptoms partially mediated the relationship between PTSD and both pain interference and severity. Future research should examine whether changes in types of coping strategies after targeted treatments predict improvements in pain-related function for chronic pain patients with concurrent PTSD.

  20. The shared neuroanatomy and neurobiology of comorbid chronic pain and PTSD: therapeutic implications.

    Science.gov (United States)

    Scioli-Salter, Erica R; Forman, Daniel E; Otis, John D; Gregor, Kristin; Valovski, Ivan; Rasmusson, Ann M

    2015-04-01

    Chronic pain and posttraumatic stress disorder (PTSD) are disabling conditions that affect biological, psychological, and social domains of functioning. Clinical research demonstrates that patients who are affected by chronic pain and PTSD in combination experience greater pain, affective distress, and disability than patients with either condition alone. Additional research is needed to delineate the interrelated pathophysiology of chronic pain and PTSD, with the goal of facilitating more effective therapies to treat both conditions more effectively; current treatment strategies for chronic pain associated with PTSD have limited efficacy and place a heavy burden on patients, who must visit various specialists to manage these conditions separately. This article focuses on neurobiological factors that may contribute to the coprevalence and synergistic interactions of chronic pain and PTSD. First, we outline how circuits that mediate emotional distress and physiological threat, including pain, converge. Secondly, we discuss specific neurobiological mediators and modulators of these circuits that may contribute to chronic pain and PTSD symptoms. For example, neuropeptide Y, and the neuroactive steroids allopregnanolone and pregnanolone (together termed ALLO) have antistress and antinociceptive properties. Reduced levels of neuropeptide Y and ALLO have been implicated in the pathophysiology of both chronic pain and PTSD. The potential contribution of opioid and cannabinoid system factors also will be discussed. Finally, we address potential novel methods to restore the normal function of these systems. Such novel perspectives regarding disease and disease management are vital to the pursuit of relief for the many individuals who struggle with these disabling conditions.

  1. DSM-5 Criteria and Its Implications for Diagnosing PTSD in Military Service Members and Veterans.

    Science.gov (United States)

    Guina, Jeffrey; Welton, Randon S; Broderick, Pamela J; Correll, Terry L; Peirson, Ryan P

    2016-05-01

    This review addresses how changes in the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 posttraumatic stress disorder (PTSD) criteria has the potential to affect the care and careers of those who have served in the military, where the diagnosis often determines fitness for duty and veterans' benefits. PTSD criteria changes were intended to integrate new knowledge acquired since previous DSM editions. Many believe the changes will improve diagnosis and treatment, but some worry these could have negative clinical, occupational, and legal consequences. We analyze the changes in classification, trauma definition, symptoms, symptom clusters, and subtypes and possible impacts on the military (e.g., over- and under-diagnosis, "drone" video exposure, subthreshold PTSD, and secondary PTSD). We also discuss critiques and proposals for future changes. Our objectives are to improve the screening, diagnosis, and treatment of those service members who have survived trauma and to improve policies related to the military mental healthcare and disability systems.

  2. Web-PE: Internet-Delivered Prolonged Exposure Therapy for PTSD

    Science.gov (United States)

    2015-10-01

    versus those randomized to PCT (n=60) on the following outcomes: PTSD severity and diagnostic status, depression , anger, and other frequently co...was funded by the Consortium to Alleviate PTSD (CAP) to examine the role of specific candidate biomarkers . Dr. Rauch aims to: 1) identify specific...changes in these peripheral biomarkers are directly associated with treatment changes. We intend that one human subjects research protocol reviewed by

  3. PTSD Symptoms Mediate the Effect of Attachment on Pain and Somatisation after Whiplash Injury

    OpenAIRE

    2013-01-01

    Introduction: The development of persistent pain post-whiplash injury is still an unresolved mystery despite the fact that approximately 50% of individuals reporting whiplash develop persistent pain. There is agreement that high initial pain and PTSD symptoms are indicators of a poor prognosis after whiplash injury. Recently attachment insecurity has been proposed as a vulnerability factor for both pain and PTSD. In order to guide treatment it is important to examine possible mechanisms which...

  4. Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD

    Science.gov (United States)

    2013-09-27

    Importantly, stress reactivity predicts the risk for multiple affec- tive disorders , as well as PTSD (28). Early adverse experiences are risk factors ... obsessive compulsive disorder , or being in any acute clinical state that necessitated prompt initiation of pharmacotherapy or other treatment, including...predict the risk for affective disorders , including major depression, suicide attempts, and PTSD (13–16). Moreover, the methylation state of selected

  5. Comparison of the effectiveness of trauma-focused cognitive behavioral therapy and paroxetine treatment in PTSD patients: Design of a randomized controlled trial

    National Research Council Canada - National Science Library

    Polak, A.R; Witteveen, A; Visser, R.S; Opmeer, B.C; Vulink, N; Figee, M; Denys, D; Olff, M

    2012-01-01

    ... disability [6], but also with high health care costs and economic impact due to health care utilization and negative effect on personal income [7]. Several effective treatments, however, are av...

  6. Feasibility and Efficacy of Prolonged Exposure for PTSD among Individuals with a Psychotic Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Anouk L. Grubaugh

    2017-06-01

    Full Text Available Objective: Few empirical studies have examined the feasibility of trauma-focused treatment among individuals with schizophrenia. This lack of research is important given the substantial overlap of trauma exposure and subsequent PTSD with psychotic spectrum disorders, and the potential for PTSD to complicate the course and prognosis of schizophrenia and other variants of severe mental illness.Method: As part of a larger study, 14 veterans with a psychotic spectrum disorder were enrolled to receive prolonged exposure (PE for PTSD within a single arm open trial study design. Patient reactions and responses to PE were examined using feasibility indices such as attrition, survey reactions, and treatment expectancy; pre and post-changes in PTSD severity and diagnostic status; and thematic interviews conducted post-intervention.Results: Quantitative and qualitative data indicate that implementation of PE is feasible, subjectively well-tolerated, and may result in clinically significant reductions in PTSD symptoms in patients with psychotic spectrum disorders.Conclusion: Consistent with treatment outcome data in clinical populations with a broader range of severe mental illnesses, the current results support the use of PTSD exposure-based interventions, such as PE, for individuals with psychotic spectrum disorders.

  7. Regional Center of Excellence for PTSD: Phoebe Putney Memorial Hospital

    Science.gov (United States)

    2011-09-01

    under regulatory review, with initial patient enrollment predicted for Fall 2011. 15. SUBJECT TERMS Cognitive Behavioral Therapy , Telepsychiatry...The purpose of the present study is to demonstrate that Cognitive Behavioral Therapy (CBT) delivered via telepsychiatry can be as effective for the...of Veteran Affairs, Department of Defense, 2004). Studies have shown that Cognitive Behavioral Therapy (CBT) is effective in the treatment of PTSD

  8. Real-Time fMRI Neurofeedback with War Veterans with Chronic PTSD: A Feasibility Study

    Science.gov (United States)

    Gerin, Mattia I.; Fichtenholtz, Harlan; Roy, Alicia; Walsh, Christopher J.; Krystal, John H.; Southwick, Steven; Hampson, Michelle

    2016-01-01

    Many patients with post-traumatic stress disorder (PTSD), especially war veterans, do not respond to available treatments. Here, we describe a novel neurofeedback (NF) intervention using real-time functional magnetic resonance imaging for treating and studying PTSD. The intervention involves training participants to control amygdala activity after exposure to personalized trauma scripts. Three combat veterans with chronic PTSD participated in this feasibility study. All three participants tolerated well the NF training. Moreover, two participants, despite the chronicity of their symptoms, showed clinically meaningful improvements, while one participant showed a smaller symptom reduction. Examination of changes in resting-state functional connectivity patterns revealed a normalization of brain connectivity consistent with clinical improvement. These preliminary results support feasibility of this novel intervention for PTSD and indicate that larger, well-controlled studies of efficacy are warranted. PMID:27445868

  9. A Pilot Study to Identify Barriers to Treatment in OIF/OEF Veterans with PTSD and Low Back Pain in Establishing Transdisciplinary Complementary Interventions

    Science.gov (United States)

    2009-11-01

    transdisciplinary complementary interventions PRINCIPAL INVESTIGATOR: Agnes Wallbom, M.D. CONTRACTING ORGANIZATION: Brentwood Biomedical Research...back pain in establishing transdisciplinary complementary interventions. 5b. GRANT NUMBER W81XWH-08-2-0033 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR...potentially enhance awareness of the need for a more innovative and transdisciplinary approach to the treatment of’ CLBP in Veterans with comorbid

  10. Recovery from PTSD following Hurricane Katrina.

    Science.gov (United States)

    McLaughlin, Katie A; Berglund, Patricia; Gruber, Michael J; Kessler, Ronald C; Sampson, Nancy A; Zaslavsky, Alan M

    2011-06-01

    We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina. A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview. An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD. The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina. © 2011 Wiley-Liss, Inc.

  11. A Critical Review of Negative Affect and the Application of CBT for PTSD.

    Science.gov (United States)

    Brown, Wilson J; Dewey, Daniel; Bunnell, Brian E; Boyd, Stephen J; Wilkerson, Allison K; Mitchell, Melissa A; Bruce, Steven E

    2016-06-14

    Forms of cognitive and behavioral therapies (CBTs), including prolonged exposure and cognitive processing therapy, have been empirically validated as efficacious treatments for posttraumatic stress disorder (PTSD). However, the assumption that PTSD develops from dysregulated fear circuitry possesses limitations that detract from the potential efficacy of CBT approaches. An analysis of these limitations may provide insight into improvements to the CBT approach to PTSD, beginning with an examination of negative affect as an essential component to the conceptualization of PTSD and a barrier to the implementation of CBT for PTSD. As such, the literature regarding the impact of negative affect on aspects of cognition (i.e., attention, processing, memory, and emotion regulation) necessary for the successful application of CBT was systematically reviewed. Several literature databases were explored (e.g., PsychINFO and PubMed), resulting in 25 articles that met criteria for inclusion. Results of the review indicated that high negative affect generally disrupts cognitive processes, resulting in a narrowed focus on stimuli of a negative valence, increased rumination of negative autobiographical memories, inflexible preservation of initial information, difficulty considering counterfactuals, reliance on emotional reasoning, and misinterpretation of neutral or ambiguous events as negative, among others. With the aim to improve treatment efficacy of CBT for PTSD, suggestions to incorporate negative affect into research and clinical contexts are discussed.

  12. Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of Posttraumatic Stress Disorder (PTSD) Symptoms Among Active Duty Military Members

    Science.gov (United States)

    2016-03-01

    63 Table of Contents Page  1. Introduction ... Introduction     This study seeks to evaluate the effectiveness and acceptability of stellate ganglion block (SGB)  for treatment of Posttraumatic Stress...Yes 8. Has a medical or mental health provider ever said that you were psychotic, or that you have schizophrenia or a schizoaffective disorder

  13. Pilot study of Creating Change, a new past-focused model for PTSD and substance abuse.

    Science.gov (United States)

    Najavits, Lisa M; Johnson, Kay M

    2014-01-01

    Creating Change (CC) is a new past-focused behavioral therapy model developed for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD). It was designed to address current gaps in the field, including the need for a past-focused PTSD/SUD model that has flexibility, can work with complex clients, responds to the staffing and resource limitations of SUD and other community-based treatment programs, can be conducted in group or individual format, and engages clients and clinicians. It was designed to follow the style, tone, and format of Seeking Safety, a successful present-focused PTSD/SUD model. CC can be used in conjunction with SS and/or other models if desired. We conducted a pilot outcome trial of the model with seven men and women outpatients diagnosed with current PTSD and SUD, who were predominantly minority and low-income, with chronic PTSD and SUD. Assessments were conducted pre- and post-treatment. Significant improvements were found in multiple domains including some PTSD and trauma-related symptoms (eg, dissociation, anxiety, depression, and sexual problems); broader psychopathology (eg, paranoia, psychotic symptoms, obsessive symptoms, and interpersonal sensitivity); daily life functioning; cognitions related to PTSD; coping strategies; and suicidal ideation (altogether 19 variables, far exceeding the rate expected by chance). Effect sizes were consistently large, including for both alcohol and drug problems. No adverse events were reported. Despite study methodology limitations, CC is promising. Clients can benefit from past-focused therapy that addresses PTSD and SUD in integrated fashion. © American Academy of Addiction Psychiatry.

  14. Validation of post-traumatic stress disorder (PTSD) and complex PTSD using the International Trauma Questionnaire.

    Science.gov (United States)

    Hyland, P; Shevlin, M; Brewin, C R; Cloitre, M; Downes, A J; Jumbe, S; Karatzias, T; Bisson, J I; Roberts, N P

    2017-09-01

    The 11th version of the International Classification of Diseases (ICD-11) has proposed two related trauma diagnoses: Post-traumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Using a newly developed, disorder-specific measure of PTSD and CPTSD called the International Trauma Questionnaire (ITQ) the current study will (i) assess the factorial validity of ICD-11 PTSD and CPTSD; (ii) provide the first test of the discriminant validity of these constructs; and (iii) provide the first comparison of ICD-11, and Diagnostic and Statistical Manual, Fifth Edition (DSM-5), PTSD diagnostic rates using disorder-specific measures. ICD-11 and DSM-5 PTSD-specific measures were completed by a British clinical sample of trauma-exposed patients (N = 171). The structure and validity of ICD-11 PTSD and CPTSD were assessed by means of factor analysis and assessing relationships with criterion variables. Diagnostic rates under ICD-11 were significantly lower than those under DSM-5. A two-factor second-order model reflecting the distinction between PTSD and CPTSD best represented the data from the ITQ; and the PTSD and CPTSD factors differentially predicted multiple psychological variables. The factorial and discriminant validity of ICD-11 PTSD and CPTSD was supported, and ICD-11 produces fewer diagnostic cases than DSM-5. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: a study of within-person processes

    OpenAIRE

    Asle eHoffart; Tuva eØktedalen; Tomas Formo Langkaas

    2015-01-01

    Although self-compassion is considered a promising change agent in the treatment of posttraumatic stress disorder (PTSD), no studies of this hypothesis exist. This study examined the within-person relationship of self-compassion components (self-kindness, common humanity, mindfulness, self-judgment, isolation, over-identification) and subsequent PTSD symptoms over the course of therapy. Method: PTSD patients (n = 65) were randomized to either standard prolonged exposure, which includes ima...

  16. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    de Bont, P.A.J.M.; van den Berg, D.P.G.; van der Vleugel, B.M.; de Roos, C.; de Jongh, A.; van der Gaag, M.; van Minnen, A.M.

    2016-01-01

    Background. In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method. In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  17. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: Effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    Bont, P.A.J.M. de; Berg, D.P.G. van den; Vleugel, B.M. van der; Roos, C.J.A.M. de; Jongh, A. de; Gaag, M. van der; Minnen, A. van

    2016-01-01

    Background: In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method: In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  18. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    de Bont, P.A.J.M.; van den Berg, D.P.G.; van der Vleugel, B.M.; de Roos, C.; de Jongh, A.; van der Gaag, M.; van Minnen, A.M.

    2016-01-01

    Background. In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method. In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  19. Prolonged exposure and EMDR for PTSD v. a PTSD waiting-list condition: Effects on symptoms of psychosis, depression and social functioning in patients with chronic psychotic disorders

    NARCIS (Netherlands)

    Bont, P.A.J.M. de; Berg, D.P.G. van den; Vleugel, B.M. van der; Roos, C.J.A.M. de; Jongh, A. de; Gaag, M. van der; Minnen, A. van

    2016-01-01

    Background: In patients with psychotic disorders, the effects of psychological post-traumatic stress disorder (PTSD) treatment on symptoms of psychosis, depression and social functioning are largely unknown Method: In a single-blind randomized controlled trial (RCT) 155 outpatients in treatment for

  20. PTSD

    African Journals Online (AJOL)

    Abuse. Loss. Pain. In South Africa, trauma has been described as a regular occurrence and ... as a condition of memory impairment3 that manifests only in psycho-genetically ... of both trauma and its long term sequelae. A brief overview of the ...

  1. EMDR beyond PTSD: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Alicia Valiente-Gómez

    2017-09-01

    Full Text Available Background: Eye Movement Desensitization and Reprocessing (EMDR is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD through several randomized controlled trials (RCT. Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain.Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions.Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement.Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions.

  2. Understanding resilience: New approaches for preventing and treating PTSD.

    Science.gov (United States)

    Horn, Sarah R; Charney, Dennis S; Feder, Adriana

    2016-10-01

    All individuals experience stressful life events, and up to 84% of the general population will experience at least one potentially traumatic event. In some cases, acute or chronic stressors lead to the development of posttraumatic stress disorder (PTSD) or other psychopathology; however, the majority of people are resilient to such effects. Resilience is the ability to adapt successfully in the face of stress and adversity. A wealth of research has begun to identify the genetic, epigenetic, neural, and environmental underpinnings of resilience, and has indicated that resilience is mediated by adaptive changes encompassing several environmental factors, neural circuits, numerous neurotransmitters, and molecular pathways. The first part of this review focuses on recent findings regarding the genetic, epigenetic, developmental, psychosocial, and neurochemical factors as well as neural circuits and molecular pathways that underlie the development of resilience. Emerging and exciting areas of research and novel methodological approaches, including genome-wide gene expression studies, immune, endocannabinoid, oxytocin, and glutamatergic systems, are explored to help delineate innovative mechanisms that may contribute to resilience. The second part reviews several interventions and preventative approaches designed to enhance resilience in both developmental and adult populations. Specifically, the review will delineate approaches aimed to bolster resilience in individuals with PTSD. Furthermore, we discuss novel pharmacologic approaches, including the N-methyl-d-aspartate (NMDA) receptor ketamine and neuropeptide Y (NPY), as exciting new prospects for not only the treatment of PTSD but as new targets to enhance resilience. Our growing understanding of resilience and interventions will hopefully lead to the development of new strategies for not just treating PTSD but also screening and early identification of at-risk youth and adults. Taken together, efforts aimed at

  3. Common paths to ASD and PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

    Numerous studies have investigated the prediction of acute and long term posttraumatic symptoms following traumatic exposure. As a result several factors have been shown to be predictive of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) respectively. Furthermore, research...... of peritraumatic factors such as symptoms of tonic immobility, panic, and dissociation on the development of ASD (N = 458) and PTSD (n = 378) symptoms in a national study of Danish bank robbery victims. The estimated ASD rate was 11.1 % (n = 41) and the estimated PTSD rate was 6.2 % (n = 23). The results...

  4. The effect of psychosocial supportive interventions on PTSD symptoms after Bam earthquake

    Directory of Open Access Journals (Sweden)

    Y. Fakour

    2006-08-01

    Full Text Available Background: Many studies have shown the efficacy of cognitive – behavioral therapy and psychological debriefing in treatment of post traumatic stress disorder (PTSD and a few evidences are available for using these techniques in large scale disasters. This study aimed to asses the effect of some psychological interventions in reducing PTSD symptoms after Bam earthquake in different age groups. Methods: In a before-after quasi experimental clinical trial, we compared the efficacy of one session of psychological debriefing and three sessions of group cognitive-behavioral therapy in bam earthquake PTSD symptoms in different age groups. We evaluated PTSD symptoms before and immediately and three months after interventions by CASP scaling system and analyzed data. Results: one hundred and thirty persons entered in the study and 51 persons excluded during interventions because of migration. Interventions were showed to be effective only in short term period. The means of PTSD symptoms frequency and severity of avoidance symptoms were reduced during three months period of study which were statistically significant P<0.05. Interventions showed no efficacy for recall symptoms in long term and hyper arousal symptoms in short term and long term periods. There was no statistically significant difference among age groups. Conclusion: Psychosocial supportive interventions may be effective on some of the PTSD symptoms but there is no difference in different age groups.

  5. Older Adults with PTSD: Brief State of Research and Evidence-Based Psychotherapy Case Illustration.

    Science.gov (United States)

    Cook, Joan M; McCarthy, Elissa; Thorp, Steven R

    2017-05-01

    Although lifetime exposure to potentially traumatic events among older adults is fairly high, rates of full-blown post-traumatic stress disorder (PTSD) are estimated at about 4.5%, a rate lower than that for middle-aged and young adults. Nevertheless, PTSD seems to be an under-recognized and under-treated condition in older adults. Assessment and treatment can be challenging in this population for various reasons, including potential cognitive or sensory decline and comorbid mental and physical disorders. This article provides highlights of the empirical research on PTSD in late life, including information on its effects on cognition and physical health. The bulk of this piece is spent on reviewing the theory, description of, and efficacy for an evidence-based psychotherapy, Prolonged Exposure (PE), for PTSD. A detailed successful application of PE with an older veteran with severe, chronic PTSD in the Department of Veterans Affairs Health Care System is presented. Evidence-based psychotherapy for PTSD can be safely and effectively used with older individuals. Published by Elsevier Inc.

  6. Posttraumatic stress disorders (PTSD) from different perspectives: a transdisciplinary integrative approach.

    Science.gov (United States)

    Jakovljević, Miro; Brajković, Lovorka; Jakšić, Nenad; Lončar, Mladen; Aukst-Margetić, Branka; Lasić, Davor

    2012-09-01

    Psychotraumatization continues to be a pervasive aspect of life in the 21st century all over the world so we should better understand psychological trauma and PTSD for the sake of prevention and healing. We have made an overview of available literature on PTSD to identify explanatory models, hypotheses and theories. In this paper we describe our transdisciplinary multiperspective integrative model of PTSD based on the seven perspective explanatory approach, on the fifth discipline, the art and practice of the learning organization as well as on the method of multiple working hypotheses.Trauma vulnerability, strengths, resilience and posttraumatic growth are key concepts that enable an integration of the distinct perspectives into a coherent transdisciplinary multiperspective explanatory and treatment model of PTSD. PTSD is a complex highly disabling and suffering disorder where the past is always present in people haunted by the dread frozen in memory of the traumatic events. However, PTSD also represents an oportunity for psychological and spiritual growth due to the human ability to adapt and thrive despite experiencing adversity and tough times.

  7. Efficacy of single-session abreactive ego state therapy for combat stress injury, PTSD, and ASD.

    Science.gov (United States)

    Barabasz, Arreed; Barabasz, Marianne; Christensen, Ciara; French, Brian; Watkins, John G

    2013-01-01

    Using abreactive Ego State Therapy (EST), 36 patients meeting DSM-IV-TR and PTSD checklist (PCL) criteria were exposed to either 5-6 hours of manualized treatment or placebo in a single session. EST emphasizes repeated hypnotically activated abreactive "reliving" of the trauma experience combined with therapists' ego strength. Both the placebo and EST treatment groups showed significant reductions in PTSD checklist scores immediately posttreatment (placebo: mean 17.34 points; EST: mean 53.11 points) but only the EST patients maintained significant treatment effect at 4-week and 16- to 18-week follow-ups. Abreactive EST appears to be an effective and durable treatment for PTSD inclusive of combat stress injury and acute stress disorder.

  8. Clinical experiences in treating PTSD patients by combining individual and group psychotherapy.

    Science.gov (United States)

    Bilić, Vedran; Nemcić-Moro, Iva; Karsić, Vana; Grgić, Vesna; Stojanović-Spehar, Stanislava; Marcinko, Darko

    2010-06-01

    PTSD is a complex psychobiological disorder that causes disfunctionality in many areas. In treating PTSD different models have been applied, however, no general consensus on the method of treatment has yet been achieved. At the Clinic for Psychological Medicine we have developed the model of combined treatment for PTSD patients that involves outpatient individual psychotherapy, psychopharmacotherapy and group psychotherapeutic techniques introduced within repeated day-hospital treatments. In this paper the efficiency of the above mentioned model has been explored. Three PTSD patients have been presented. We assessed changes in psychological functioning of our subjects on the basis of clinical observation and analysis of the session protocols. The model of combined and long-term treatment of PTSD in which the approach to traumatized patients has been mostly supportive, including supportive psychotherapeutic interventions and psychopharmacotherapy, has proved to be efficient in achieving integration of traumatic experiences and consolidation of the traumatised Self. Combination of individual and group approach facilitates the analysis of traumatic transference, whereas more mature defence patterns become stronger and integration of traumatic experiences improved. Consolidation of the Self leads to better socialization.

  9. Trauma management therapy with virtual-reality augmented exposure therapy for combat-related PTSD: A randomized controlled trial.

    Science.gov (United States)

    Beidel, Deborah C; Frueh, B Christopher; Neer, Sandra M; Bowers, Clint A; Trachik, Benjamin; Uhde, Thomas W; Grubaugh, Anouk

    2017-08-23

    Virtual reality exposure therapy (VRET) realistically incorporates traumatic cues into exposure therapy and holds promise in the treatment of combat-related posttraumatic stress disorder (PTSD). In a randomized controlled trial of 92 Iraq and Afghanistan veterans and active duty military personnel with combat-related PTSD, we compared the efficacy of Trauma Management Therapy (TMT; VRET plus a group treatment for anger, depression, and social isolation) to VRET plus a psychoeducation control condition. Efficacy was evaluated at mid- and post-treatment, and at 3- and 6-month follow-up. Consistent with our hypothesis, VRET resulted in significant decreases on the Clinician Administered PTSD Scale and the PTSD Checklist-Military version for both groups. Also consistent with our hypothesis, significant decreases in social isolation occurred only for those participants who received the TMT group component. There were significant decreases for depression and anger for both groups, although these occurred after VRET and before group treatment. All treatment gains were maintained six-months later. Although not part of the original hypotheses, sleep was not improved by either intervention and remained problematic. The results support the use of VRET as an efficacious treatment for combat-related PTSD, but suggest that VRET alone does not result in optimal treatment outcomes across domains associated with PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. PTSD in older bereaved people

    DEFF Research Database (Denmark)

    O'Connor, Maja

    2010-01-01

    bereaved elderly people compared to married controls and to investigate whether the loss of a spouse in old age, in contrast with earlier assumptions, could lead to PTSD. Two hundred and ninety six Danish elderly bereaved people (mean age 73 years, 113 males) were chosen from national registers and were...... subsequently assessed two months post-bereavement. They were compared with a control group of 276 married elderly people. The prevalence of PTSD and depression were measured through a self-report questionnaire. Results showed that 16% of the bereaved and 4% of the control group had a PTSD diagnosis (ES=.35......; Cohen's d=.74). It was also concluded that 37% of the bereaved and 22% of the control group had mild to severe depression (ES=.19; Cohen's d=.37). The results suggested that late life spousal bereavement, in some cases, does result in PTSD, and that the disorder is as common in elderly bereaved people...

  11. Post-Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    ... relevant brain structures, biological or genetic traits, and psychosocial factors. Some examples include: In 2009, NIH-funded ... the optimal time to begin exposure therapy after trauma exposure to prevent the development of PTSD. This ...

  12. Male combat veterans' narratives of PTSD, masculinity, and health.

    Science.gov (United States)

    Caddick, Nick; Smith, Brett; Phoenix, Cassandra

    2015-01-01

    This article uniquely examines the ways a group of male combat veterans talk about masculinity and how, following post-traumatic stress disorder (PTSD), they performed masculinities in the context of a surfing group, and what effects this had upon their health and wellbeing. Participant observations and life history interviews were conducted with a group of combat veterans who belonged to a surfing charity for veterans experiencing PTSD. Data were rigorously explored via narrative analysis. Our findings revealed the ways in which veterans enacted masculinities in accordance with the values that were cultivated during military service. These masculine performances in the surfing group had important effects both on and for the veterans' wellbeing. Significantly, the study highlights how masculine performances can be seen alternately as a danger and as a resource for health and wellbeing in relation to PTSD. The article advances knowledge on combat veterans and mental health with critical implications for the promotion of male veterans' mental health. These include the original suggestion that health-promoting masculine performances might be recognised and supported in PTSD treatment settings. Rather than automatically viewing masculinity as problematic, this article moves the field forward by highlighting how hegemonic masculinities can be reconstructed in positive ways which might improve veterans' health and wellbeing. A video abstract of this article can be found at: https://www.youtube.com/watch?v=BaYzaOP1kAY. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  13. A pilot study of a randomized controlled trial of yoga as an intervention for PTSD symptoms in women.

    Science.gov (United States)

    Mitchell, Karen S; Dick, Alexandra M; DiMartino, Dawn M; Smith, Brian N; Niles, Barbara; Koenen, Karestan C; Street, Amy

    2014-04-01

    Posttraumatic stress disorder (PTSD) is a debilitating condition that affects approximately 10% of women in the United States. Although effective psychotherapeutic treatments for PTSD exist, clients with PTSD report additional benefits of complementary and alternative approaches such as yoga. In particular, yoga may downregulate the stress response and positively impact PTSD and comorbid depression and anxiety symptoms. We conducted a pilot study of a randomized controlled trial comparing a 12-session Kripalu-based yoga intervention with an assessment control group. Participants included 38 women with current full or subthreshold PTSD symptoms. During the intervention, yoga participants showed decreases in reexperiencing and hyperarousal symptoms. The assessment control group, however, showed decreases in reexperiencing and anxiety symptoms as well, which may be a result of the positive effect of self-monitoring on PTSD and associated symptoms. Between-groups effect sizes were small to moderate (0.08-0.31). Although more research is needed, yoga may be an effective adjunctive treatment for PTSD. Participants responded positively to the intervention, suggesting that it was tolerable for this sample. Findings underscore the need for future research investigating mechanisms by which yoga may impact mental health symptoms, gender comparisons, and the long-term effects of yoga practice.

  14. Beyond symptom self-report: use of a computer "avatar" to assess post-traumatic stress disorder (PTSD) symptoms.

    Science.gov (United States)

    Myers, Catherine E; Radell, Milen L; Shind, Christine; Ebanks-Williams, Yasheca; Beck, Kevin D; Gilbertson, Mark W

    2016-11-01

    Post-traumatic stress disorder (PTSD) can occur in the wake of exposure to a traumatic event. Currently, PTSD symptoms are assessed mainly through self-report in the form of questionnaire or clinical interview. Self-report has inherent limitations, particularly in psychiatric populations who may have limited awareness of deficit, reduced attention span, or poor vocabulary and/or literacy skills. Diagnosis and evaluation of treatment efficacy would be aided by behavioral measures. A viable alternative may be virtual environments, in which the participant guides an on-screen "avatar" through a series of onscreen events meant to simulate real-world situations. Here, a sample of 82 veterans, self-assessed for PTSD symptoms was administered such a task, in which the avatar was confronted with situations that might evoke avoidant behavior, a core feature of PTSD. Results showed a strong correlation between PTSD symptom burden and task performance; in fact, the ability to predict PTSD symptom burden based on simple demographic variables (age, sex, combat exposure) was significantly improved by adding task score as a predictor variable. The results therefore suggest that virtual environments may provide a new way to assess PTSD symptoms, while avoiding at least some of the limitations associated with symptom self-report, and thus might be a useful complement to questionnaire or clinical interview, potentially facilitating both diagnosis and evaluation of treatment efficacy.

  15. Proximal relationships between PTSD and drinking behavior

    Directory of Open Access Journals (Sweden)

    Debra Kaysen

    2014-12-01

    Full Text Available Co-morbid PTSD and alcohol use disorders are both common and debilitating. However, many of these studies rely on cross-sectional studies that obscure more complex relationships between PTSD and drinking. Event-level studies allow for examination of proximal relationships between PTSD and drinking. Among women (n=136 with past sexual victimization, n=40 no past trauma history, a two-part mixed hurdle model was used to examine daily PTSD and drinking. On days women experienced more intrusive and behavioral avoidance symptoms, they were more likely to drink. For a 2 SD increase in symptoms, there was a 5% increased likelihood of drinking, and for a 2 SD increase in dysphoric symptoms or negative affect, women drank approximately half drink less. Daily-level coping self-efficacy moderated the association between distress and drinking (IRR=0.91, p<0.01. Women who reported less coping drank more as their distress increased on a certain day whereas women who reported more coping drank about the same regardless of distress. Overall, findings suggest that specific PTSD symptoms are associated with higher alcohol use and that these relationships are moderated by daily coping self-efficacy. Implications of these findings for informing models of PTSD/AUD comorbidity, as well as clinical implications will be discussed.

  16. Adaptive Disclosure: A Combat Specific PTSD Treatment

    Science.gov (United States)

    2017-03-31

    N/A Specific Objectives: Nothing to report. Key outcomes and findings: Nothing to report. Other achievements: Nothing to report. Stated goals...development: Nothing to report. Dissemination of results: Nothing to report. What do you plan to do in the next reporting period? Nothing to report (final...report). IMPACT: i. Impact on the development of the principal discipline of the project: Nothing to report. ii. Impact on other disciplines

  17. Narrative Exposure Therapy: A Proposed Model to Address Intimate Partner Violence-Related PTSD in Parenting and Pregnant Adolescents.

    Science.gov (United States)

    Volpe, Ellen M; Quinn, Camille R; Resch, Kathryn; Sommers, Marilyn S; Wieling, Elizabeth; Cerulli, Catherine

    2015-09-29

    Pregnant and parenting adolescents experience high rates of intimate partner violence (IPV) and its sequelae posttraumatic stress disorder (PTSD) and depression. Narrative exposure therapy (NET) is an innovative intervention that has demonstrated strong preliminary evidence in improving mental health. The specific aims of this article are 3-fold: (1) provide a brief background about IPV-related PTSD and depression among pregnant and parenting adolescents; (2) describe NET's theoretical principles, its therapeutic process, and provide a review of existing evidence; and (3) discuss NET as a potential treatment to address the mental health burden among adolescents experiencing IPV-related PTSD and depression.

  18. Telling the story and re-living the past: How speech analysis can reveal emotions in post-traumatic stress disorder (PTSD) patients

    NARCIS (Netherlands)

    Broek, van den Egon L.; Sluis, van der Frans; Dijkstra, Ton; Westerink, Joyce; Krans, Martijn; Ouwerkerk, Martin

    2011-01-01

    A post-traumatic stress disorder (PTSD) is a severe stress disorder and, as such, a severe handicap in daily life. To this date, its treatment is still a big endeavor for therapists. This chapter discusses an exploration towards automatic assistance in treating patients suffering from PTSD. Such ass

  19. Prolonged Exposure Therapy for a Vietnam Veteran with PTSD and Early-Stage Dementia

    Science.gov (United States)

    Duax, Jeanne M.; Waldron-Perrine, Brigid; Rauch, Sheila A. M.; Adams, Kenneth M.

    2013-01-01

    Although prolonged exposure therapy (PE) is considered an evidence-based treatment for PTSD, there has been little published about the use of this treatment for older adults with comorbid early-stage dementia. As the number of older adults in the United States continues to grow, so will their unique mental health needs. The present article…

  20. Predicting Child Ptsd: The Relationship between Acute Stress Disorder and PTSD in Injured Children

    Science.gov (United States)

    Kassam-Adams, Nancy; Winston, Flaura Koplin

    2004-01-01

    Objective: To examine the prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in injured children and to evaluate the utility of ASD as a predictor of PTSD. Method: Children hospitalized for injuries sustained in a traffic crash were enrolled in a prospective study. ASD was assessed in 243 children within 1 month…

  1. Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria.

    Science.gov (United States)

    Price, Matthew; van Stolk-Cooke, Katherine

    2015-11-01

    Exposure to traumatic events places individuals at high risk for multiple psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The high rates of comorbidity among these conditions merit evaluation in order to improve diagnosis and treatment approaches. The current study evaluated the association between PTSD, MDD, and GAD factors as presented in the DSM 5. 602 trauma-exposed individuals who experienced an event that met Criterion A for the DSM 5 PTSD diagnosis were recruited through Amazon.com, Inc.'s Mechanical Turk (MTurk) to complete an assessment of the impact of stressful events on their lives. High interrelations were detected among the 4 PTSD factors, 2 MDD factors that corresponded to somatic and affective symptoms, and the single GAD factor. The affective factor of MDD was most strongly related to the emotional numbing factor of PTSD, whereas the somatic factor of MDD was most strongly related to the hyperarousal factor of PTSD. The GAD factor was most strongly related to the hyperarousal factor of PTSD, relative to the other PTSD factors. The strength of the interrelations between factors of the three disorders is largely a function of the overlap in symptoms and calls into question the uniqueness of negative affective symptoms of PTSD, MDD and GAD. Results suggest that improved understanding of the trauma reaction requires a focus on the unique presentation of each individual and assessment of multiple disorders.

  2. Prolonged Exposure versus Eye Movement Desensitization and Reprocessing (EMDR) for PTSD rape victims.

    Science.gov (United States)

    Rothbaum, Barbara Olasov; Astin, Millie C; Marsteller, Fred

    2005-12-01

    This controlled study evaluated the relative efficacy of Prolonged Exposure (PE) and Eye Movement Desensitization and Reprocessing (EMDR) compared to a no-treatment wait-list control (WAIT) in the treatment of PTSD in adult female rape victims (n = 74). Improvement in PTSD as assessed by blind independent assessors, depression, dissociation, and state anxiety was significantly greater in both the PE and EMDR group than the WAIT group (n = 20 completers per group). PE and EMDR did not differ significantly for change from baseline to either posttreatment or 6-month follow-up measurement for any quantitative scale.

  3. PTSD symptom dimensions and their relationship to functioning in World Trade Center responders.

    Science.gov (United States)

    Ruggero, Camilo J; Kotov, Roman; Callahan, Jennifer L; Kilmer, Jared N; Luft, Benjamin J; Bromet, Evelyn J

    2013-12-30

    Post-traumatic stress disorder (PTSD) symptoms are common among responders to the 9/11 attacks on the World Trade Center and can lead to impairment, yet it is unclear which symptom dimensions are responsible for poorer functioning. Moreover, how best to classify PTSD symptoms remains a topic of controversy. The present study tested competing models of PTSD dimensions and then assessed which were most strongly associated with social/occupational impairment, depression, and alcohol abuse. World Trade Center responders (n=954) enrolled in the Long Island site of the World Trade Center Health Program between 2005 and 2006 were administered standard self-report measures. Confirmatory factor analysis confirmed the superiority of four-factor models of PTSD over the DSM-IV three-factor model. In selecting between four-factor models, evidence was mixed, but some support emerged for a broad dysphoria dimension mapping closely onto depression and contributing strongly to functional impairment. This study confirmed in a new population the need to revise PTSD symptom classification to reflect four dimensions, but raises questions about how symptoms are categorized. Results suggest that targeted treatment of symptoms may provide the most benefit, and that treatment of dysphoria-related symptoms in disaster relief workers may have the most benefit for social and occupational functioning.

  4. Access, utilization, and interest in mHealth applications among veterans receiving outpatient care for PTSD.

    Science.gov (United States)

    Erbes, Christopher R; Stinson, Rebecca; Kuhn, Eric; Polusny, Melissa; Urban, Jessica; Hoffman, Julia; Ruzek, Josef I; Stepnowsky, Carl; Thorp, Steven R

    2014-11-01

    Mobile health (mHealth) refers to the use of mobile technology (e.g., smartphones) and software (i.e., applications) to facilitate or enhance health care. Several mHealth programs act as either stand-alone aids for Veterans with post-traumatic stress disorder (PTSD) or adjuncts to conventional psychotherapy approaches. Veterans enrolled in a Veterans Affairs outpatient treatment program for PTSD (N = 188) completed anonymous questionnaires that assessed Veterans' access to mHealth-capable devices and their utilization of and interest in mHealth programs for PTSD. The majority of respondents (n = 142, 76%) reported having access to a cell phone or tablet capable of running applications, but only a small group (n = 18) reported use of existing mHealth programs for PTSD. Age significantly predicted ownership of mHealth devices, but not utilization or interest in mHealth applications among device owners. Around 56% to 76% of respondents with access indicated that they were interested in trying mHealth programs for such issues as anger management, sleep hygiene, and management of anxiety symptoms. Findings from this sample suggest that Veterans have adequate access to, and interest in, using mHealth applications to warrant continued development and evaluation of mobile applications for the treatment of PTSD and other mental health conditions.

  5. The Effects of a Short-term Cognitive Behavioral Group Intervention on Bam Earthquake Related PTSD Symptoms in Adolescents

    Directory of Open Access Journals (Sweden)

    Fatemeh Naderi

    2009-04-01

    Full Text Available "n "n "nObjective :Post traumatic stress disorder (PTSD may be the first reaction after disasters. Many studies have shown the efficacy of cognitive- behavioral therapy in treatment of post traumatic stress disorder. The main objective of this study is to evaluate the effect of group CBT in adolescent survivors of a large scale disaster (Bam earthquake. "n "nMethods: In a controlled trial, we evaluated the efficacy of a short term method of group cognitive-behavioral therapy in adolescent survivors of Bam earthquake who had PTSD symptoms and compared it with a control group. The adolescents who had severe PTSD or other psychiatric disorders that needed pharmacological interventions were excluded. We evaluated PTSD symptoms using Post traumatic Stress Scale (PSS pre and post intervention and compared them with a control group. "n "nResults: 100 adolescents were included in the study and 15 were excluded during the intervention. The mean age of the participants was 14.6±2.1 years. The mean score of total PTSD symptoms and the symptoms of avoidance was reduced after interventions, and was statistically significant. The mean change of re-experience and hyper arousal symptoms of PTSD were not significant. "n "nConclusion: Psychological debriefing and group cognitive behavioral therapy may be effective in reducing some of the PTSD symptoms.

  6. Psychotherapies for PTSD: what do they have in common?

    Directory of Open Access Journals (Sweden)

    Ulrich Schnyder

    2015-08-01

    Full Text Available Over the past three decades, research and clinical practice related to the field of traumatic stress have developed tremendously. In parallel with the steady accumulation of basic knowledge, therapeutic approaches have been developed to treat people suffering from posttraumatic stress disorder (PTSD and other trauma-related psychological problems. Today, a number of evidence-based treatments are available. They differ in various ways; however, they also have a number of commonalities. Given this situation, clinicians may wonder which treatment program to use, or more specifically, which treatment components are critical for a successful therapy. In this article, seven pioneers who have developed empirically supported psychotherapies for trauma-related disorders were asked to compose an essay of three parts: first, to provide a brief summary of the treatment they have developed; second, to identify three key interventions that are common and critical in treating PTSD; and third, to suggest important topics and future directions for research. The paper ends with a summary highlighting the identified commonalities (psychoeducation; emotion regulation and coping skills; imaginal exposure; cognitive processing, restructuring, and/or meaning making; emotions; and memory processes, pointing to future directions such as trying to better understand the underlying mechanisms of action, and developing treatments that are tailored to the needs of different patient groups.

  7. Psychotic symptoms in refugees diagnosed with PTSD: a series of case reports

    DEFF Research Database (Denmark)

    Nørredam, Marie Louise; Ekstrøm, Morten; Jensen, Mette

    2011-01-01

    BACKGROUND: In our clinical work, we treat refugees who have been exposed to trauma and who subsequently develop psychotic symptoms. However, the literature does not address the relationship between refugees with depression, post-traumatic stress disorder (PTSD) and psychotic symptoms. Therefore...... Centre Gentofte in Copenhagen during 2009. RESULTS: Our cases were all characterized by having severe symptoms of depression and PTSD. Before treatment start they had a score on the Harvard Trauma Questionnaire between 2.9 and 3.8 (cut-off: 2.5), and a score on the Hopkins Symptom Checklist-25 between 2...... into the prevalence of psychotic symptoms among refugees with depression and PTSD, including the qualitative dimensions of the symptoms in order to optimize diagnosis and treatment among this group of psychiatric patients....

  8. GUIDED IMAGERY: KONSEP KONSELING KREATIF UNTUK PENANGGANAN POST TRAUMATIC STRESS DISORDER (PTSD

    Directory of Open Access Journals (Sweden)

    author Yulianto

    2015-01-01

    Full Text Available Everyone has a different reaction in facing the extraordinary events that are triggered by the teribble events. They clash psychic cause post traumatic stress disorder or in Post Traumatic Stress Disorder (PTSD. To solve it can be done through treatment with pharmacotherapy and psychotherapy. In psychotherapy handling, one of the techniques that can be used is the technique of guided imagery as one of the PTSD treatment efforts. This technique is an effort that can be used to deal with a difficult client to communicate verbally. Communication is the basis of the counseling relationship. Implementation of counseling through guided imagery techniques are considered able to help clients resolve client’s problems. In this technique, clients are guided to be able to focus on positive thoughts and imaginations that lead to negative events experienced to be able to create a positive picture of the imagination.Keywords: Guided imagery, post traumatic stress disorder (PTSD, Creative counseling

  9. Screening for PTSD among detained adolescents: Implications of the changes in the DSM-5.

    Science.gov (United States)

    Modrowski, Crosby A; Bennett, Diana C; Chaplo, Shannon D; Kerig, Patricia K

    2017-01-01

    Screening for posttraumatic stress disorder (PTSD) is highly relevant for youth involved in the juvenile justice system given their high rates of trauma exposure and posttraumatic stress symptoms. However, to date, no studies have investigated the implications of the recent revisions to the Diagnostic and Statistical Manual for Mental Disorders (5th ed., DSM-5; American Psychiatric Association [APA], 2013) diagnostic criteria for PTSD for screening in this population. To this end, the present study compared PTSD screening rates using the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM-IV-TR; APA, 2013) versus DSM-5 criteria in a group of detained adolescents. Participants included 209 youth (60 girls) aged 13-19 (M = 15.97, SD = 1.24). Youth completed measures of lifetime trauma exposure and past-month posttraumatic stress symptoms. Over 95% of youth in the sample reported exposure to at least 1 type of traumatic event. Approximately 19.60% of the sample screened positive for PTSD according to the DSM-5 compared to 17.70% according to the DSM-IV-TR. Girls were more likely than boys to screen positive for PTSD according to the DSM-IV-TR compared to the DSM-5. The main factors accounting for the differences in screening rates across the versions of PTSD criteria involved the removal of Criterion A2 from the DSM-5, the separation of avoidance symptoms (Criterion C) into their own cluster, the addition of a cluster involving negative alterations in cognitions and mood (Criterion D), and revisions to the cluster of arousal symptoms (Criterion E). Future research should continue to investigate gender differences in PTSD symptoms in youth and consider the implications of these diagnostic changes for the accurate diagnosis and referral to treatment of adolescents who demonstrate posttraumatic stress reactions. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  10. Complex PTSD, affect dysregulation, and borderline personality disorder.

    Science.gov (United States)

    Ford, Julian D; Courtois, Christine A

    2014-01-01

    Complex PTSD (cPTSD) was formulated to include, in addition to the core PTSD symptoms, dysregulation in three psychobiological areas: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational security. The overlap of diagnostic criteria for cPTSD and borderline personality disorder (BPD) raises questions about the scientific integrity and clinical utility of the cPTSD construct/diagnosis, as well as opportunities to achieve an increasingly nuanced understanding of the role of psychological trauma in BPD. We review clinical and scientific findings regarding comorbidity, clinical phenomenology and neurobiology of BPD, PTSD, and cPTSD, and the role of traumatic victimization (in general and specific to primary caregivers), dissociation, and affect dysregulation. Findings suggest that BPD may involve heterogeneity related to psychological trauma that includes, but extends beyond, comorbidity with PTSD and potentially involves childhood victimization-related dissociation and affect dysregulation consistent with cPTSD. Although BPD and cPTSD overlap substantially, it is unwarranted to conceptualize cPTSD either as a replacement for BPD, or simply as a sub-type of BPD. We conclude with implications for clinical practice and scientific research based on a better differentiated view of cPTSD, BPD and PTSD.

  11. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

    Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and gene...... in trajectories for treatment planning will be discussed. The findings in the present study stress the importance of long-term follow-up studies in evidencebased reserch....

  12. Efficacy of specialized group psychotherapy for survivors of childhood sexual abuse in reducing symptoms of PTSD and general psychiatric distress

    DEFF Research Database (Denmark)

    Elkjær, Henriette Kiilsholm; Kristensen, Ellids; Mortensen, Erik Lykke

    2012-01-01

    Background and purpose: Several studies have found that women who have experienced childhood sexual abuse (CSA) have an increased risk of developing Post-Traumatic Stress Disorder (PTSD) related to their victimization experiences. The current study evaluated the presence of PTSD symptoms and gene...... in trajectories for treatment planning will be discussed. The findings in the present study stress the importance of long-term follow-up studies in evidencebased reserch....

  13. Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort.

    Science.gov (United States)

    Breyer, Benjamin N; Fang, Shona C; Seal, Karen H; Ranganathan, Gayatri; Marx, Brian P; Keane, Terence M; Rosen, Raymond C

    2016-06-01

    We sought to determine whether posttraumatic stress disorder (PTSD) was associated with sexual health in returned warzone-deployed veterans from the recent Iraq and Afghanistan conflicts. We studied 1,581 males and females from the Veterans After-Discharge Longitudinal Registry, a gender-balanced U.S. Department of Veterans Affairs registry of health care-seeking veterans with and without PTSD. Approximately one quarter (25.1%) of males (n = 198) and 12.7% of females (n = 101) had a sexual dysfunction diagnosis and/or prescription treatment for sexual dysfunction. Both genders were more likely to have a sexual dysfunction diagnosis and/or prescription treatment if they had PTSD compared with those without PTSD (male: 27.3% vs. 21.1%, p = .054; female: 14.9% vs. 9.4%, p = .022). Among the 1,557 subjects analyzed here, males with PTSD had similar levels of sexual activity compared to those without PTSD (71.2% vs. 75.4%, p = .22), whereas females with PTSD were less likely to be sexually active compared to females without PTSD (58.7% vs. 72.1%, p < .001). Participants with PTSD were also less likely to report sex-life satisfaction (male: 27.6% vs. 46.0%, p < .001; female: 23.0% vs. 45.7%, p < .001) compared with those without PTSD. Although PTSD was not associated with sexual dysfunction after adjusting for confounding factors, it was significantly negatively associated with sex-life satisfaction in female veterans with a prevalence ratio of .71, 95% confidence interval [.57, .90].

  14. Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.

    Science.gov (United States)

    Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J

    2017-03-01

    Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments. © 2016 The British Psychological Society.

  15. A Pilot Study of Group Mindfulness-Based Cognitive Therapy (MBCT) for Combat Veterans with Posttraumatic Stress Disorder (PTSD)

    Science.gov (United States)

    King, Anthony P.; Erickson, Thane M.; Giardino, Nicholas D.; Favorite, Todd; Rauch, Sheila A. M.; Robinson, Elizabeth; Kulkarni, Madhur; Liberzon, Israel

    2015-01-01

    Background “Mindfulness-based” interventions show promise for stress-reduction in general medical conditions, and initial evidence suggests that they are well accepted in trauma-exposed individuals. Mindfulness-based Cognitive Therapy (MBCT) shows substantial efficacy for prevention of depression relapse, but it has been less studied in anxiety disorders. This study investigated the feasibility, acceptability, and clinical outcomes of an MBCT group intervention adapted for combat PTSD. Methods Consecutive patients seeking treatment for chronic PTSD (veterans of Vietnam, Korea, WWII, Desert Storm) at a VA outpatient clinic were enrolled in eight week MBCT groups, modified for PTSD (four groups, n=20) or brief treatment-as-usual (TAU) comparison group interventions (three groups, n=16). MBCT consisted of PTSD psychoeducation, mindfulness of body, breath, and emotions, mindful movement, exercises for managing intrusive thoughts and feelings, and daily home practice though audio recording. Pre- and post-therapy psychological assessments with clinician administered PTSD scale (CAPS) were performed with all patients, and self-report measures (PTSD diagnostic scale, PDS, and Posttraumatic cognitions inventory, PTCI) were administered in the MBCT group. Results Pre- to post-treatment effects analysis demonstrated significant improvement in PTSD symptoms. Intent to treat analyses showed significant improvement in CAPS (t(19)=4.8, p<.001) in the MBCT condition but not the TAU conditions, and a significant Condition*Time interaction (F[1,26]=16.4, p<.005). MBCT completers analysis (n =15, 75%) also showed good compliance with assigned homework exercises, and significant and clinically meaningful improvement in PTSD symptom severity on post-treatment assessment in CAPS and PDS (particularly in avoidance/numbing symptoms), and reduced PTSD-relevant cognitions in PTCI (in particular, self-blame). Conclusions These data suggest group mindfulness-based cognitive therapy as an

  16. Treating PTSD in patients with psychosis: a within-group controlled feasibility study examining the efficacy and safety of evidence-based PE and EMDR protocols.

    Science.gov (United States)

    de Bont, Paul A J M; van Minnen, Agnes; de Jongh, Ad

    2013-12-01

    The present study uses a within-group controlled design to examine the efficacy and safety of two psychological approaches to posttraumatic stress disorder (PTSD) in 10 patients with a concurrent psychotic disorder. Patients were randomly assigned either to prolonged exposure (PE; N=5) or eye movement desensitization and reprocessing (EMDR; N=5). Before, during, and after treatment, a total of 20 weekly assessments of PTSD symptoms, hallucinations, and delusions were carried out. Twelve weekly assessments of adverse events took place during the treatment phase. PTSD diagnosis, level of social functioning, psychosis-prone thinking, and general psychopathology were assessed pretreatment, posttreatment, and at three-month follow-up. Throughout the treatment, adverse events were monitored at each session. An intention-to-treat analysis of the 10 patients starting treatment showed that the PTSD treatment protocols of PE and EMDR significantly reduced PTSD symptom severity; PE and EMDR were equally effective and safe. Eight of the 10 patients completed the full intervention period. Seven of the 10 patients (70%) no longer met the diagnostic criteria for PTSD at follow-up. No serious adverse events occurred, nor did patients show any worsening of hallucinations, delusions, psychosis proneness, general psychopathology, or social functioning. The results of this feasibility trial suggest that PTSD patients with comorbid psychotic disorders benefit from trauma-focused treatment approaches such as PE and EMDR.

  17. Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?

    Science.gov (United States)

    Hansen, Maj; Műllerová, Jana; Elklit, Ask; Armour, Cherie

    2016-08-01

    For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victims with PTSD. This study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared with a non-dissociative PTSD class. The results of LCA revealed a two-class solution with two highly symptomatic classes: a dissociative class and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVAs) suffering from whiplash. The results are discussed in light of their clinical implications and suggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.

  18. Feasibility of brief intensive exposure therapy for PTSD patients with childhood sexual abuse: a brief clinical report

    Directory of Open Access Journals (Sweden)

    Lotte Hendriks

    2010-12-01

    Full Text Available Despite the strong empirical support for the effectiveness of exposure-based treatments in ameliorating post-traumatic stress disorder (PTSD, improvement of treatment is wanted given relatively high dropout rates and challenges of treating patients with high comorbidity and treatment-interfering stressors. The purpose of the current paper is to introduce an intensive exposure treatment program, illustrated by four case descriptions of PTSD patients, who suffered multiple (sexual traumas in childhood, had high levels of comorbidity and psychosocial stressors, and failed to improve during “regular” trauma-focused treatment programs. The program consisted of psychoeducation, prolonged imaginal exposure, exposure in vivo, exposure by drawings combined with narrative reconstructing, and writing assignments about central trauma-related cognitions. The treatment included 5 working days with individual sessions (in total 30 h of treatment provided by a team of four therapists. The PTSD symptoms of all patients decreased substantially and the effect sizes were large (Cohen's d resp. 1.5 [pre–post], 2.4 [pre-FU1 month], and 2.3 [pre-FU3 months]. Also, none of the patients showed symptom worsening or dropped out. The evaluation of these four pilot cases suggests that it is possible to intensify exposure treatment, even for multiple traumatized PTSD patients with high comorbidity. We concluded that the first results of this new, intensive exposure program for PTSD patients with childhood sexual abuse are promising.

  19. The psychobiology of PTSD: coping with trauma.

    Science.gov (United States)

    Olff, Miranda; Langeland, Willie; Gersons, Berthold P R

    2005-11-01

    Posttraumatic stress disorder (PTSD) is one of the few psychiatric conditions where a specific psychosocial stressor is explicitly tied to etiology. Although a majority of people experience a traumatic event in their life, most of them will not develop PTSD or other mental health problems such as depressive or anxiety disorders. Emotional and neurobiological responses to psychosocial stressors show striking individual variation. In this paper cognitive appraisal and coping factors are explored as potential sources of individual differences in the neuroendocrinological stress response, and subsequently in mental health outcome. Continued study of the psychobiology of trauma and PTSD will enhance our understanding of adaptation to psychosocial stressors and support efforts to treat associated psychological and biological sequelae.

  20. Taxometric Investigation of PTSD: Data from Two Nationally Representative Samples

    Science.gov (United States)

    Broman-Fulks, Joshua J.; Ruggiero, Kenneth J.; Green, Bradley A.; Kilpatrick, Dean G.; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.

    2006-01-01

    Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build…

  1. Taxometric Investigation of PTSD: Data from Two Nationally Representative Samples

    Science.gov (United States)

    Broman-Fulks, Joshua J.; Ruggiero, Kenneth J.; Green, Bradley A.; Kilpatrick, Dean G.; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.

    2006-01-01

    Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build…

  2. A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events.

    Directory of Open Access Journals (Sweden)

    Patcho N Santiago

    Full Text Available OBJECTIVE: We conducted a systematic review of the literature to explore the longitudinal course of PTSD in DSM-5-defined trauma exposed populations to identify the course of illness and recovery for individuals and populations experiencing PTSD. METHODS: We reviewed the published literature from January 1, 1998 to December 31, 2010 for longitudinal studies of directly exposed trauma populations in order to: (1 review rates of PTSD in the first year after a traumatic event; (2 examine potential types of proposed DSM-5 direct trauma exposure (intentional and non-intentional; and (3 identify the clinical course of PTSD (early onset, later onset, chronicity, remission, and resilience. Of the 2537 identified articles, 58 articles representing 35 unique subject populations met the proposed DSM-5 criteria for experiencing a traumatic event, and assessed PTSD at two or more time points within 12 months of the traumatic event. RESULTS: The mean prevalence of PTSD across all studies decreases from 28.8% (range =3.1-87.5% at 1 month to 17.0% (range =0.6-43.8% at 12 months. However, when traumatic events are classified into intentional and non-intentional, the median prevalences trend down for the non-intentional trauma exposed populations, while the median prevalences in the intentional trauma category steadily increase from 11.8% to 23.3%. Across five studies with sufficient data, 37.1% of those exposed to intentional trauma develop PTSD. Among those with PTSD, about one third (34.8% remit after 3 months. Nearly 40% of those with PTSD (39.1% have a chronic course, and only a very small fraction (3.5% of new PTSD cases appears after three months. CONCLUSIONS: Understanding the trajectories of PTSD over time, and how it may vary by type of traumatic event (intentional vs. non-intentional will assist public health planning and treatment.

  3. Intrinsic Folding Proclivities in Cyclic β-Peptide Building Blocks: Configuration and Heteroatom Effects Analyzed by Conformer-Selective Spectroscopy and Quantum Chemistry.

    Science.gov (United States)

    Alauddin, Mohammad; Gloaguen, Eric; Brenner, Valérie; Tardivel, Benjamin; Mons, Michel; Zehnacker-Rentien, Anne; Declerck, Valérie; Aitken, David J

    2015-11-09

    This work describes the use of conformer-selective laser spectroscopy following supersonic expansion to probe the local folding proclivities of four-membered ring cyclic β-amino acid building blocks. Emphasis is placed on stereochemical effects as well as on the structural changes induced by the replacement of a carbon atom of the cycle by a nitrogen atom. The amide A IR spectra are obtained and interpreted with the help of quantum chemistry structure calculations. Results provide evidence that the building block with a trans-substituted cyclobutane ring has a predilection to form strong C8 hydrogen bonds. Nitrogen-atom substitution in the ring induces the formation of the hydrazino turn, with a related but distinct hydrogen-bonding network: the structure is best viewed as a bifurcated C8/C5 bond with the N heteroatom lone electron pair playing a significant acceptor role, which supports recent observations on the hydrazino turn structure in solution. Surprisingly, this study shows that the cis-substituted cyclobutane ring derivative also gives rise predominantly to a C8 hydrogen bond, although weaker than in the two former cases, a feature that is not often encountered for this building block.

  4. Treating PTSD in suicidal and self-injuring women with borderline personality disorder: development and preliminary evaluation of a Dialectical Behavior Therapy Prolonged Exposure Protocol.

    Science.gov (United States)

    Harned, Melanie S; Korslund, Kathryn E; Foa, Edna B; Linehan, Marsha M

    2012-06-01

    This study focused on the development and pilot testing of a protocol based on Prolonged Exposure (PE) that can be added to Dialectical Behavior Therapy (DBT) to treat PTSD in suicidal and self-injuring individuals with borderline personality disorder (BPD). Women with BPD, PTSD, and recent and/or imminent serious intentional self-injury (n = 13) received one year of DBT with the DBT PE Protocol, plus three months of follow-up assessment. The treatment was associated with significant reductions in PTSD, with the majority of patients no longer meeting criteria for PTSD at post-treatment (71.4% of DBT PE Protocol completers, 60.0% of the intent-to-treat sample). A minority of patients (27.3%) engaged in intentional self-injury during the study. Improvements were also found for suicidal ideation, dissociation, trauma-related guilt cognitions, shame, anxiety, depression, and social adjustment. There was no evidence that the DBT PE Protocol led to exacerbations of intentional self-injury urges or behaviors, PTSD, treatment dropout, or crisis service use. Overall, the results indicate that this integrated BPD and PTSD treatment is feasible to implement within one year of treatment, highly acceptable to patients and therapists, safe to administer, and shows promise as an effective intervention for PTSD in this complex and high-risk patient population. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. [Costs of Mental Health Care in Patients with Posttraumatic Stress Disorder Related to Sexual Abuse One Year Before and After Inpatient DBT-PTSD].

    Science.gov (United States)

    Priebe, Kathlen; Roth, Mascha; Krüger, Antje; Glöckner-Fink, Kristina; Dyer, Anne; Steil, Regina; Salize, Hans-Joachim; Kleindienst, Nikolaus; Bohus, Martin

    2017-03-01

    Objective In Germany, patients with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (CSA) often receive inpatient treatment. However, data on utilization and costs of mental health care as well as on the impact of trauma-focused treatment are missing. Methods Within the context of a randomized controlled trial mental health service utilization was assessed in female patients with PTSD related to CSA. Data on psychiatric-psychotherapeutic inpatient and outpatient treatment and psychotropic medication was obtained for the year before and after inpatient DBT-PTSD. Results The mean total costs of utilization of psychiatric-psychotherapeutic care and use of psychotropics were € 18.100 per patient in the year before and € 7.233 in the year after DBT-PTSD. The significant cost decrease was due to large reductions in inpatient treatment days (on average 57 days before and 14 days after DBT-PTSD), while outpatient treatment and psychotropic medication remained unchanged. Conclusion PTSD related to CSA is associated with high utilization and costs of mental health care. The results suggest that DBT-PTSD might contribute to reducing the mental health care costs. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms: a pilot study.

    Science.gov (United States)

    Rosaura Polak, A; Witteveen, Anke B; Denys, Damiaan; Olff, Miranda

    2015-03-01

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of PTSD symptoms. Patients (n = 8) with chronic PTSD were randomized to regular TF-CBT or TF-CBT with complementary breathing biofeedback to exposure. PTSD symptoms were measured before, during and after TF-CBT with the Impact of Event Scale-Revised. The results show that breathing biofeedback is feasible and can easily be complemented to TF-CBT. Although PTSD symptoms significantly decreased from pre to post treatment in both conditions, there was a clear trend towards a significantly faster (p = .051) symptom reduction in biofeedback compared to regular TF-CBT. The most important limitation was the small sample size. The hastened clinical improvement in the biofeedback condition supports the idea that breathing biofeedback may be an effective complementary component to exposure in PTSD patients. The mechanism of action of breathing biofeedback may relate to competing working memory resources decreasing vividness and emotionality, similar to eye movement desensitization and reprocessing. Future research is needed to examine this.

  7. Multi-modal memory restructuring for patients suffering from combat-related PTSD: A pilot study

    NARCIS (Netherlands)

    Steen, M. van den; Brinkman, W.P.; Vermetten, E.; Neerincx, M.

    2010-01-01

    The paper discusses the design and evaluation of a multimedia software application, which can be used in the treatment of combat-related posttraumatic stress disorder (PTSD). The application allows patients and therapist to visualize the patients' past experience using maps, personal photos, stories

  8. Involving Parents in Indicated Early Intervention for Childhood PTSD Following Accidental Injury

    Science.gov (United States)

    Cobham, Vanessa E.; March, Sonja; De Young, Alexandra; Leeson, Fiona; Nixon, Reginald; McDermott, Brett; Kenardy, Justin

    2012-01-01

    Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome…

  9. The Theoretical and Empirical Basis for Meditation as an Intervention for PTSD

    Science.gov (United States)

    Lang, Ariel J.; Strauss, Jennifer L.; Bomyea, Jessica; Bormann, Jill E.; Hickman, Steven D.; Good, Raquel C.; Essex, Michael

    2012-01-01

    In spite of the existence of good empirically supported treatments for posttraumatic stress disorder (PTSD), consumers and providers continue to ask for more options for managing this common and often chronic condition. Meditation-based approaches are being widely implemented, but there is minimal research rigorously assessing their effectiveness.…

  10. Identifying Persons at Risk for PTSD After Trauma with TSQ in The Netherlands

    NARCIS (Netherlands)

    Dekkers, A.M.M.; Olff, M.; Näring, G.W.B.

    2010-01-01

    In The Netherlands about 80% of the population experience a traumatic event while about 14% develop post traumatic stress disorder (PTSD). Considering this high prevalence the prevention or early treatment of posttraumatic stress is important from a health as well as cost-benefit perspective. The ai

  11. Psychological distress and burden among female partners of combat veterans with PTSD.

    Science.gov (United States)

    Manguno-Mire, Gina; Sautter, Frederic; Lyons, Judith; Myers, Leann; Perry, Dana; Sherman, Michelle; Glynn, Shirley; Sullivan, Greer

    2007-02-01

    Psychological distress among cohabitating female partners of combat veterans with posttraumatic stress disorder (PTSD) was examined in a cross-sectional study using a modified version of the Health Belief Model. A convenience sample of 89 cohabitating female partners of male veterans in outpatient PTSD treatment was interviewed by telephone using a structured interview. Partners endorsed high levels of psychological distress with elevations on clinical scales at or exceeding the 90th percentile. Severe levels of overall psychological distress, depression, and suicidal ideation were prevalent among partners. Multivariate analyses revealed that perceived threat, recent mental health treatment, and level of involvement with veterans predicted global partner psychological distress. Partner burden was predicted by partner self-efficacy, perceived threat, barriers to mental health treatment, and partner treatment engagement. These findings are compelling since they demonstrate that partners of veterans with combat-related PTSD experience significant levels of emotional distress that warrant clinical attention. Psychological distress and partner burden were each associated with a unique combination of predictors, suggesting that although these constructs are related, they have distinct correlates and potentially different implications within the family environment. Future research should examine these constructs separately using causal modeling analyses to identify modifiable targets for interventions to reduce psychological distress among partners of individuals with PTSD.

  12. Ecological study of sleep disruption in PTSD: a pilot study.

    Science.gov (United States)

    Germain, Anne; Hall, Martica; Katherine Shear, M; Nofzinger, Eric A; Buysse, Daniel J

    2006-07-01

    Laboratory-based sleep studies have yielded inconsistent results regarding the presence and nature of objective sleep anomalies in posttraumatic stress disorder (PTSD). This pilot study aimed at assessing sleep in adult crime victims with PTSD by using in-home polysomnography. Compared to healthy archival subjects, PTSD subjects showed longer sleep latency, reduced total sleep time, and increased duration of nocturnal awakening. Quantitative electroencephalography (EEG) measures of delta and beta activity also differed in PTSD and healthy subjects. These preliminary findings suggest that ambulatory methods can capture objective signs of sleep disruption, and corroborate subjective complaints of disrupted sleep in PTSD.

  13. Differential predictors of DSM-5 PTSD and ICD-11 complex PTSD among African American women.

    Science.gov (United States)

    Powers, Abigail; Fani, Negar; Carter, Sierra; Cross, Dorthie; Cloitre, Marylene; Bradley, Bekh

    2017-01-01

    Background: Complex posttraumatic stress disorder (CPTSD) is proposed for inclusion in the ICD-11 as a diagnosis distinct from posttraumatic stress disorder (PTSD), reflecting deficits in affective, self-concept, and relational domains. There remains significant controversy over whether CPTSD provides useful diagnostic information beyond PTSD and other comorbid conditions, such as depression or substance use disorders. Objective: The present study examined differences in psychiatric presentation for three groups: traumatized controls, DSM-5 PTSD subjects, and ICD-11 CPTSD subjects. Method: The sample included 190 African American women recruited from an urban public hospital where rates of trauma exposure are high. PTSD was measured using Clinician Administered PTSD Scale for DSM-5 and CPTSD was measured using clinician administered ICD-Trauma Interview. Psychiatric diagnoses and emotion dysregulation were also assessed. In a subset of women (n = 60), emotion recognition was measured using the Penn Emotion Recognition Task. Results: There were significant differences across groups on current and lifetime major depression (p PTSD and depression symptoms and, as expected, more severe emotion dysregulation and dissociation, compared to DSM-5 PTSD and traumatized control groups. Individuals with CPTSD also had higher levels of emotion recognition to faces on a computer-based behavioural assessment, which may be related to heightened vigilance toward emotional cues from others. CPTSD women had better facial emotion recognition on a computer-based assessment, which may suggest heightened vigilance toward emotional cues. Conclusions: Our results suggest clear, clinically-relevant differences between PTSD and CPTSD, and highlight the need for further research on this topic with other traumatized populations, particularly studies that combine clinical and neurobiological data.

  14. The STRONG STAR Multidisciplinary PTSD Research Consortium

    Science.gov (United States)

    2014-11-01

    little is known about its role as a potential risk factor for PTSD (Davis and Sandman , 2012; Talge et al., 2007). Animal studies suggest that PNS programs...Baum, A., 1986. Chronic stress and posttraumatic stress disorders. J. Consult. Clin. Psychol. 54, 303—308. Davis, E.P., Sandman , C.A., 2012. Prenatal

  15. Assessing barriers to care and readiness for cognitive behavioral therapy in early acute care PTSD interventions.

    Science.gov (United States)

    Trusz, Sarah Geiss; Wagner, Amy W; Russo, Joan; Love, Jeff; Zatzick, Douglas F

    2011-01-01

    Cognitive Behavioral Therapy (CBT) interventions are efficacious in reducing posttraumatic stress disorder (PTSD) but are challenging to implement in acute care and other non-specialty mental health settings. This investigation identified barriers impacting CBT delivery through a content analysis of interventionist chart notes from an acute care PTSD prevention trial. Only 8.5% of all intervention patients were able to complete CBT. Lack of engagement, clinical and logistical barriers had the greatest impact on CBT entry. Treatment preferences and stigma only prevented entry when more primary barriers resolved. Patients with prior diagnosis of alcohol abuse or dependence were able to enter CBT after six months of sobriety. Based on the first trial, we developed a CBT readiness assessment tool. We implemented and evaluated the tool in a second early intervention trial. Lack of engagement emerged again as the primary impediment to CBT entry. Patients who were willing to enter CBT treatment but demonstrated high rates of past trauma or diagnosis of PTSD were also the least likely to engage in any PTSD treatment one month post-discharge. Findings support the need for additional investigations into engagement and alternative delivery strategies, including those which dismantle traditional office-based, multi-session CBT into stepped, deliverable components.

  16. Risk, coping and PTSD symptom trajectories in World Trade Center responders.

    Science.gov (United States)

    Feder, Adriana; Mota, Natalie; Salim, Ryan; Rodriguez, Janice; Singh, Ritika; Schaffer, Jamie; Schechter, Clyde B; Cancelmo, Leo M; Bromet, Evelyn J; Katz, Craig L; Reissman, Dori B; Ozbay, Fatih; Kotov, Roman; Crane, Michael; Harrison, Denise J; Herbert, Robin; Levin, Stephen M; Luft, Benjamin J; Moline, Jacqueline M; Stellman, Jeanne M; Udasin, Iris G; Landrigan, Philip J; Zvolensky, Michael J; Yehuda, Rachel; Southwick, Steven M; Pietrzak, Robert H

    2016-11-01

    Trajectories of disaster-related posttraumatic stress disorder (PTSD) symptoms are often heterogeneous, and associated with common and unique risk factors, yet little is known about potentially modifiable psychosocial characteristics associated with low-symptom and recovering trajectories in disaster responders. A total of 4487 rescue and recovery workers (1874 police and 2613 non-traditional responders) involved during and in the aftermath of the unprecedented World Trade Center (WTC) attacks, were assessed an average of 3, 6, 8, and 12 years post-9/11/2001. Among police responders, WTC-related PTSD symptoms were characterized by four trajectories, including no/low-symptom (76.1%), worsening (12.1%), improving (7.5%), and chronic (4.4%) trajectories. In non-traditional responders, a five-trajectory solution was optimal, with fewer responders in a no/low-symptom trajectory (55.5%), and the remainder in subtly worsening (19.3%), chronic (10.8%), improving (8.5%), and steeply worsening (5.9%) trajectories. Consistent factors associated with symptomatic PTSD trajectories across responder groups included Hispanic ethnicity, pre-9/11 psychiatric history, greater WTC exposure, greater medical illness burden, life stressors and post-9/11 traumas, and maladaptive coping (e.g., substance use, avoidance coping). Higher perceived preparedness, greater sense of purpose in life, and positive emotion-focused coping (e.g., positive reframing, acceptance) were negatively associated with symptomatic trajectories. Findings in this unique cohort indicate considerable heterogeneity in WTC-related PTSD symptom trajectories over 12 years post-9/11/2001, with lower rates of elevated PTSD symptoms in police than in non-traditional responders. They further provide a comprehensive risk prediction model of PTSD symptom trajectories, which can inform prevention, monitoring, and treatment efforts in WTC and other disaster responders.

  17. Exposure to prolonged socio-political conflict and the risk of PTSD and depression among Palestinians.

    Science.gov (United States)

    Canetti, Daphna; Galea, Sandro; Hall, Brian J; Johnson, Robert J; Palmieri, Patrick A; Hobfoll, Stevan E

    2010-01-01

    Little is known about the impact of traumatic experiences and stressful life conditions on people in low-income countries who live in conditions of ongoing political violence. In order to determine the prevalence and predictors of post-traumatic stress disorder (PTSD) and major depression (MD) among Palestinians subjected to chronic political violence and upheaval, we used a stratified multi-stage cluster random sampling strategy to interview a representative sample of 1,200 Palestinian adults living in Gaza, the West Bank, and East Jerusalem. Prevalence of PTSD/MD for men living in the West Bank, Gaza, and East Jerusalem was 25.4%/29.9%, 22.6%/27.6%, and 16.1%/16.1%, respectively. For women, the prevalence of PTSD/MD was 23.8%/29.0%, 23.9%/28.9%, and 19.7%/27.6%. Among men, PTSD was significantly positively associated with age group, two or more incidences of political violence (compared to none), greater intrapersonal resource loss, and loss of faith in government. MD was positively associated with experiencing exposure to one, or two or more, incidences of political violence (compared to none), and greater interpersonal and intrapersonal resource loss. Among women, PTSD was positively associated with greater interpersonal and intrapersonal resource loss, and MD was positively associated with death of a loved one, two or more socio-political stressors (compared to none) previous to the past year, one or more socio-political stressors (compared to none) in the past year, and greater interpersonal and intrapersonal resource loss. Interpersonal and intrapersonal resource losses were consistently associated with PTSD and MD, suggesting potential targets for intervention and prevention efforts and thus provide important keys to treatment in areas of ongoing conflict.

  18. mHealth in the Wild: Using Novel Data to Examine the Reach, Use, and Impact of PTSD Coach.

    Science.gov (United States)

    Owen, Jason E; Jaworski, Beth K; Kuhn, Eric; Makin-Byrd, Kerry N; Ramsey, Kelly M; Hoffman, Julia E

    2015-01-01

    A majority of Americans (58%) now use smartphones, making it possible for mobile mental health apps to reach large numbers of those who are living with untreated, or under-treated, mental health symptoms. Although early trials suggest positive effects for mobile health (mHealth) interventions, little is known about the potential public health impact of mobile mental health apps. The purpose of this study was to characterize reach, use, and impact of "PTSD Coach", a free, broadly disseminated mental health app for managing posttraumatic stress disorder (PTSD) symptoms. Using a mixed-methods approach, aggregate mobile analytics data from 153,834 downloads of PTSD Coach were analyzed in conjunction with 156 user reviews. Over 60% of users engaged with PTSD Coach on multiple occasions (mean=6.3 sessions). User reviews reflected gratitude for the availability of the app and being able to use the app specifically during moments of need. PTSD Coach users reported relatively high levels of trauma symptoms (mean PTSD Checklist Score=57.2, SD=15.7). For users who chose to use a symptom management tool, distress declined significantly for both first-time users (mean=1.6 points, SD=2.6 on the 10-point distress thermometer) and return-visit users (mean=2.0, SD=2.3). Analysis of app session data identified common points of attrition, with only 80% of first-time users reaching the app's home screen and 37% accessing one of the app's primary content areas. These findings suggest that PTSD Coach has achieved substantial and sustained reach in the population, is being used as intended, and has been favorably received. PTSD Coach is a unique platform for the delivery of mobile mental health education and treatment, and continuing evaluation and improvement of the app could further strengthen its public health impact.

  19. Clinical phenomenology of childhood abuse-related complex PTSD in a population of female patients: patterns of personality disturbance.

    Science.gov (United States)

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H; Hoogendoorn, Adriaan; Veltman, Dick J; van Balkom, Anton J L M; Draijer, Nel

    2012-01-01

    Complex posttraumatic stress disorder (PTSD) involves a variety of personality disturbances presumed to result from repeated interpersonal trauma such as child abuse. As Complex PTSD patients are a heterogeneous population, we searched for clinically relevant personality-based subtypes. This study used a cluster analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Axis II features within a sample of 71 female outpatients with systematically assessed child abuse-related Complex PTSD. Two main subtypes were found: adaptive and nonadaptive. The latter was further differentiated into withdrawn, alienated, suffering, and aggressive subtypes, characterized by different levels of introversion and disinhibition. Among the nonadaptive subtypes, the severity of Complex PTSD symptoms was lowest in the withdrawn (introverted only) subtype. The subtypes differed in their level of dissociation and depression but did not differ regarding PTSD symptoms, trauma history, or parental bonding characteristics. Confirming earlier findings, our study found personality-based Complex PTSD subtypes, which could implicate differential treatment needs and results.

  20. Validity of PTSD diagnoses in VA administrative data: Comparison of VA administrative PTSD diagnoses to self-reported PTSD Checklist scores

    Directory of Open Access Journals (Sweden)

    Amy A. Gravely, MA

    2011-01-01

    Full Text Available Little research has been done on the validity of posttraumatic stress disorder (PTSD diagnoses that are found in Department of Veterans Affairs (VA administrative data, even though they are often used in VA research. We compared PTSD diagnoses found in VA administrative data with PTSD Checklist (PCL scores self-reported by 4,777 newly diagnosed participants in a national postal survey study. Using PCL scores of at least 50 as the gold standard, we compared positive predictive values (PPVs for at least one versus at least two PTSD diagnoses (found within 4 months of the first in VA administrative data overall and by subgroups of interest: age, sex, and clinic where first diagnosed. The overall PPV was 75% for at least one PTSD diagnosis and 82% for at least two PTSD diagnoses. Similarly, the PPV significantly increased for all subgroup analyses when at least two PTSD diagnoses were used. The increase in PPV was greatest for those first diagnosed in primary care and for those older than 65. To select a sample of veterans with more definitive PTSD from administrative data, researchers should select those veterans with at least two PTSD diagnoses as opposed to at least one.

  1. The Unique Associations of Sexual Assault and Intimate Partner Violence With PTSD Symptom Clusters in a Traumatized Substance-Abusing Sample.

    Science.gov (United States)

    Dworkin, Emily R; Mota, Natalie P; Schumacher, Julie A; Vinci, Christine; Coffey, Scott F

    2016-10-13

    Objective: There is a high occurrence of sexual assault (SA) and intimate partner violence (IPV) among people with substance use disorders and an established association between substance use and posttraumatic stress disorder (PTSD), but no research has examined associations between combinations of these traumas and PTSD symptom profiles among people who abuse substances. Thus, this study aimed to examine how combinations of SA and IPV histories contribute to the severity of symptoms within PTSD symptom clusters above and beyond the impact of exposure to other traumas in a substance abusing population. Method: Participants were men and women (N = 219) with trauma histories seeking treatment in a substance abuse facility. Multivariate analyses of covariance examined differences on Clinician Administrated PTSD Scale cluster scores in people with experiences of SA and/or IPV in comparison to people with other types of trauma, controlling for number of PTSD criterion A events. Results: SA was associated with increased symptom severity across all 3 PTSD symptom clusters, whereas IPV was not associated with differences in cluster scores. In addition, survivors of IPV had consistent levels of avoidance symptoms regardless of whether they had also experienced SA, but people who had not experienced IPV only evidenced increased avoidance symptoms when they had experienced SA. Follow-up analyses testing gender differences indicated that these findings were largely similar for men and women. Conclusions: SA should be assessed in people in substance use treatment settings to conceptualize their unique presentations of PTSD symptoms and inform treatment planning. (PsycINFO Database Record

  2. Ashamed and Afraid: A Scoping Review of the Role of Shame in Post-Traumatic Stress Disorder (PTSD

    Directory of Open Access Journals (Sweden)

    Tanya Saraiya

    2016-11-01

    Full Text Available Background: Despite considerable progress in the treatment of post-traumatic stress disorder (PTSD, a large percentage of individuals remain symptomatic following gold-standard therapies. One route to improving care is examining affective disturbances that involve other emotions beyond fear and threat. A growing body of research has implicated shame in PTSD’s development and course, although to date no review of this specific literature exists. This scoping review investigated the link between shame and PTSD and sought to identify research gaps. Methods: A systematic database search of PubMed, PsycInfo, Embase, Cochrane, and CINAHL was conducted to find original quantitative research related to shame and PTSD. Results: Forty-seven studies met inclusion criteria. Review found substantial support for an association between shame and PTSD as well as preliminary evidence suggesting its utility as a treatment target. Several design limitations and under-investigated areas were recognized, including the need for a multimodal assessment of shame and more longitudinal and treatment-focused research. Conclusion: This review provides crucial synthesis of research to date, highlighting the prominence of shame in PTSD, and its likely relevance in successful treatment outcomes. The present review serves as a guide to future work into this critical area of study.

  3. A Randomized Controlled Trial of 7-Day Intensive and Standard Weekly Cognitive Therapy for PTSD and Emotion-Focused Supportive Therapy

    Science.gov (United States)

    Ehlers, Anke; Hackmann, Ann; Grey, Nick; Wild, Jennifer; Liness, Sheena; Albert, Idit; Deale, Alicia; Stott, Richard; Clark, David M.

    2014-01-01

    Objective Psychological treatments for posttraumatic stress disorder (PTSD) are usually delivered once or twice weekly over several months. It is unclear whether they can be successfully delivered over a shorter period of time. This clinical trial had two goals, (1) to investigate the acceptability and efficacy of a 7-day intensive version of cognitive therapy for PTSD, and (2) to investigate whether cognitive therapy has specific treatment effects by comparing intensive and standard weekly cognitive therapy with an equally credible alternative treatment. Method Patients with chronic PTSD (N=121) were randomly allocated to 7-day intensive or standard 3-month weekly cognitive therapy for PTSD, 3-month weekly emotion-focused supportive therapy, or a 14-week waitlist condition. Primary outcomes were PTSD symptoms and diagnosis as assessed by independent assessors and self-report. Secondary outcomes were disability, anxiety, depression, and quality of life. Measures were taken at initial assessment, 6 weeks and 14 weeks (post-treatment/wait). For groups receiving treatment, measures were also taken at 3 weeks, and follow-ups at 27 and 40 weeks after randomization. All analyses were intent-to-treat. Results At post-treatment/wait assessment, 73%, 77%, 43%, 7% of the intensive cognitive therapy, standard cognitive therapy, supportive therapy, and waitlist groups, respectively, had recovered from PTSD. All treatments were well tolerated and were superior to waitlist on all outcome measures, with the exception of no difference between supportive therapy and waitlist on quality of life. For primary outcomes, disability and general anxiety, intensive and standard cognitive therapy were superior to supportive therapy. Intensive cognitive therapy achieved faster symptom reduction and comparable overall outcomes to standard cognitive therapy. Conclusions Cognitive therapy for PTSD delivered intensively over little more than a week is as effective as cognitive therapy delivered

  4. The longitudinal course of PTSD among disaster workers deployed to the World Trade Center following the attacks of September 11th.

    Science.gov (United States)

    Cukor, Judith; Wyka, Katarzyna; Mello, Brittany; Olden, Megan; Jayasinghe, Nimali; Roberts, Jennifer; Giosan, Cezar; Crane, Michael; Difede, Joann

    2011-10-01

    This study examined the long-term mental health outcomes of 2,960 nonrescue disaster workers deployed to the World Trade Center site in New York City following the September 11, 2001 (9/11) terrorist attacks. Semistructured interviews and standardized self-report measures were used to assess the prevalence of posttraumatic stress disorder (PTSD) and other psychopathology 4 and 6 years after the attacks. Clinician-measured rates of PTSD and partial PTSD 4-years posttrauma were 8.4% and 8.9%, respectively, in a subsample of 727 individuals. Rates decreased to 5.8% and 7.7% for full and partial PTSD 6 years posttrauma. For the larger sample, self-report scores revealed probable PTSD and partial PTSD prevalence to be 4.8% and 3.6% at 4 years, and 2.4% and 1.8% at 6 years. Approximately 70% of workers never met criteria for PTSD. Although PTSD rates decreased significantly over time, many workers remained symptomatic, with others showing delayed-onset PTSD. The strongest predictors of ongoing PTSD 6 years following 9/11 were trauma history (odds ratio (OR) = 2.27, 95% confidence interval (CI) [1.06, 4.85]); the presence of major depressive disorder 1-2 years following the trauma (OR = 2.80, 95% CI [1.17, 6.71]); and extent of occupational exposure (OR = 1.31, 95% CI [1.13, 1.51]). The implications of the findings for both screening and treatment of disaster workers are discussed.

  5. Involvement of allopregnanolone in the anti-PTSD-like effects of AC-5216.

    Science.gov (United States)

    Zhang, Li-Ming; Qiu, Zhi-Kun; Chen, Xiao-Fei; Zhao, Nan; Chen, Hong-Xia; Xue, Rui-; Zhang, You-Zhi; Yang, Ri-Fang; Li, Yun-Feng

    2016-05-01

    Cholesterol import into mitochondria through the translocator protein (18 KDa) (TSPO) is the starting point and an important rate-limiting step in neurosteroidogenesis. For this reason TSPO has received increased attention in the pathophysiology of post-traumatic stress disorder (PTSD). In an effort to explore the role of TSPO in mediating the anti-PTSD effect, we first assessed the effects of the TSPO ligand AC-5216 in alleviating the enhanced anxiety and fear response in a time-dependent sensitization (TDS) procedure, a rat PTSD animal model. In the present study, we showed that chronic treatment with AC-5216 caused significant suppression of the enhanced anxiety and contextual fear induced in post-TDS rats; these effects were blocked by PK11195. Furthermore, AC-5216 treatment increased the levels of allopregnanolone in the serum, prefrontal cortex, and hippocampus of post-TDS rats, and these effects were antagonized by PK11195. These results demonstrate that AC-5216 has a clear anti-PTSD-like effect, which might be partially mediated by binding to TSPO and the subsequent synthesis of allopregnanolone.

  6. Building an inner sanctuary: complex PTSD in chimpanzees.

    Science.gov (United States)

    Bradshaw, G A; Capaldo, Theodora; Lindner, Lorin; Grow, Gloria

    2008-01-01

    Through the analysis of case studies of chimpanzees (Pan troglodytes troglodytes) in residence at a sanctuary, who previously sustained prolonged captivity and biomedical experimentation, we illustrate how human psychological models of diagnosis and treatment might be approached in great apes. This study reflects growing attention to ethical, scientific, and practical problems associated with psychological well-being of animals. The analysis concludes that a diagnosis of Complex PTSD in chimpanzees is consistent with descriptions of trauma-induced symptoms as described by the DSM-IV and human trauma research. We discuss how these findings relate to diagnosis and treatment of chimpanzees in captivity and the issue of their continued laboratory use. This clinical study contributes toward theory and therapeutic practices of an emergent trans-species psychology inclusive of both humans and other species. Such an ability to extend what we know about models of human trauma opens deeper understanding and insights into ourselves as well as individuals from other species.

  7. Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: a study of within-person processes

    Science.gov (United States)

    Hoffart, Asle; Øktedalen, Tuva; Langkaas, Tomas F.

    2015-01-01

    Although self-compassion is considered a promising change agent in the treatment of posttraumatic stress disorder (PTSD), no studies of this hypothesis exist. This study examined the within-person relationship of self-compassion components (self-kindness, common humanity, mindfulness, self-judgment, isolation, over-identification) and subsequent PTSD symptoms over the course of therapy. Method: PTSD patients (n = 65) were randomized to either standard prolonged exposure, which includes imaginal exposure (IE) to the traumatic memory, or modified prolonged exposure, where imagery re-scripting (IR) of the memory replaced IE as the imagery component of prolonged exposure in a 10 weeks residential program. They were assessed weekly on self-compassion and PTSD symptom measures. The centering method of detrending was used to separate the variance related to the within-person process of change over the course of treatment from between-person variance. Results: The self-compassion components self-kindness, self-judgment, isolation, and over-identification had a within-person effect on subsequent PTSD symptoms. These relationships were independent of therapy form. The within-person relationship between self-judgment and subsequent PTSD symptoms was stronger in patients with higher initial self-judgment. By contrast, there were few indications that within-person variations in PTSD symptoms predict subsequent self-compassion components. Conclusion: The results support the role of self-compassion components in maintaining PTSD and imply the recommendation to facilitate decrease of self-judgment, isolation, and over-identification and increase of self-kindness in the treatment of PTSD patients. The reduction of self-judgment appears to be most important, especially for patients with a high initial level of self-judgment. PMID:26379596

  8. Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: A study of within-person processes

    Directory of Open Access Journals (Sweden)

    Asle eHoffart

    2015-08-01

    Full Text Available AbstractAlthough self-compassion is considered a promising change agent in the treatment of PTSD, no studies of this hypothesis exist. This study examined the within-person relationship of self-compassion components (self-kindness, common humanity, mindfulness, self-judgment, isolation, over-identification and subsequent PTSD symptoms over the course of therapy. Method: PTSD patients (n = 65 were randomized to either standard prolonged exposure, which includes imaginal exposure (IE to the traumatic memory, or modified prolonged exposure, where imagery re-scripting (IR of the memory replaced IE as the imagery component of prolonged exposure in a 10 week residential program. They were assessed weekly on self-compassion and PTSD symptom measures. The centering method of detrending was used to separate the variance related to the within-person process of change over the course of treatment from between-person variance. Results: The self-compassion components self-kindness, self-judgment, isolation, and over-identification had a within-person effect on subsequent PTSD symptoms. These relationships were independent of therapy form. The within-person relationship between self-judgment and subsequent PTSD symptoms was stronger in patients with higher initial self-judgment. By contrast, there were few indications that within-person variations in PTSD symptoms predict subsequent self-compassion components. Conclusion: The results support the role of self-compassion components in maintaining PTSD and imply the recommendation to facilitate decrease of self-judgment, isolation, and over-identification and increase of self-kindness in the treatment of PTSD patients. The reduction of self-judgment appears to be most important, especially for patients with a high initial level of self-judgment.

  9. Amygdala response predicts trajectory of symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy among adolescent girls with PTSD.

    Science.gov (United States)

    Cisler, Josh M; Sigel, Benjamin A; Kramer, Teresa L; Smitherman, Sonet; Vanderzee, Karin; Pemberton, Joy; Kilts, Clinton D

    2015-12-01

    Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is the gold standard treatment for pediatric PTSD. Nonetheless, clinical outcomes in TF-CBT are highly variable, indicating a need to identify reliable predictors that allow forecasting treatment response. Here, we test the hypothesis that functional neuroimaging correlates of emotion processing predict PTSD symptom reduction during Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) among adolescent girls with PTSD. Thirty-four adolescent girls with PTSD related to physical or sexual assault were enrolled in TF-CBT, delivered in an approximately 12 session format, in an open trial. Prior to treatment, they were engaged in an implicit threat processing task during 3T fMRI, during which they viewed faces depicting fearful or neutral expressions. Among adolescent girls completing TF-CBT (n = 23), slopes of PTSD symptom trajectories during TF-CBT were significantly related to pre-treatment degree of bilateral amygdala activation while viewing fearful vs neutral images. Adolescents with less symptom reduction were characterized by greater amygdala activation to both threat and neutral images (i.e., less threat-safety discrimination), whereas adolescents with greater symptom reduction were characterized by amygdala activation only to threat images. These clinical outcome relationships with pre-treatment bilateral amygdala activation remained when controlling for possible confounding demographic or clinical variables (e.g., concurrent psychotropic medication, comorbid diagnoses). While limited by a lack of a control group, these preliminary results suggest that pre-treatment amygdala reactivity to fear stimuli, a component of neurocircuitry models of PTSD, positively predicts symptom reduction during TF-CBT among assaulted adolescent girls, providing support for an objective measure for forecasting treatment response in this vulnerable population.

  10. Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review.

    Science.gov (United States)

    Vilchinsky, Noa; Ginzburg, Karni; Fait, Keren; Foa, Edna B

    2017-07-01

    The goal of the current systematic review was to provide an overview of the findings in the field of Cardiac-Disease-Induced Posttraumatic Stress Disorder (CDI-PTSD) in order to establish CDI-PTSD as a valid diagnostic entity for a wide spectrum of cardiac diseases and related medical procedures. In accordance with PRISMA guidelines, we conducted a systematic electronic literature search. Of the 3202 citations identified, 150 studies meeting the selection criteria were reviewed. Our main findings were that the prevalence of CDI-PTSD ranged between 0% and 38% (averaging at 12%) and was highly dependent on the assessment tool used. The most consistent risk factors are of a psychological nature (e.g., pre-morbid distress). The consequences of CDI-PTSD range from psychosocial difficulties to lack of adherence and heightened mortality rates. Much inconsistency in the field was found with regard to patients who present with diagnoses other than acute coronary syndrome (e.g., cardiac arrest) and who undergo potentially traumatic medical procedures (e.g., defibrillator implantation). Yet the current review seems to strengthen the conceptualization of CDI-PTSD as a valid diagnostic entity, at least with regard to acute cardiac events. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Forskning i musikterapi - posttraumatisk stressbelastning (PTSD)

    DEFF Research Database (Denmark)

    Beck, Bolette Daniels; Mumm, Helle

    2015-01-01

    Denne artikel præsenterer videnskabelige undersøgelser af musikterapi med mennesker, der har fået diagnosen PTSD. Der er forskningsmæssig evidens for at musikterapi kan reducere symptomer på posttraumatisk stress hos børn, unge og voksne. Undersøgelser af musikterapi med voksne med posttraumatisk...... musikterapi med børn og unge med indlæringsproblemer som følge af PTSD viser reduktion af hyperaktivitet, aggression og depression samt øget lydhørhed og forbedrede sociale kompetencer....... stress viser reduktion af symptomer som flashbacks, undgåelsesadfærd, stress samt dissociation, depression og angst. Musikterapi med voksne kan endvidere skabe forbedringer i forhold til søvnkvalitet og social kontakt, samt styrke oplevelsen af mening og sammenhæng i tilværelsen. Undersøgelser af...

  12. Efficacy of Adjunct Sleep Interventions for PTSD

    Science.gov (United States)

    2007-03-01

    dorsed symptoms of restless legs syndrome , periodic leg move- ment disorder, or delayed sleep phase syndrome on most nights associated with difficulty...cycle are offered. & 2007 Elsevier Ltd. All rights reserved.O 57 59 61UN C Introduction Posttraumatic stress disorder (PTSD) is a clinical syndrome ...sleep consolidation is proportional to lesion size.43 The medial prefrontal cortex, and especially the orbitofrontal cortex (OFC), influence sleep, and

  13. Evaluation of a Yoga Intervention for PTSD

    Science.gov (United States)

    2011-10-01

    AD_________________ Award Number: W81XWH-10-1-1066 TITLE: Evaluation of a Yoga Intervention for...CONTRACT NUMBER Evaluation of a Yoga Intervention for PTSD 5b. GRANT NUMBER W81XWH-10-1-1066 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Objective: This pilot study was designed to ascertain whether yoga is a feasible and

  14. Salivary Cortisol: A Psychophysiological Marker for PTSD

    Science.gov (United States)

    2011-04-01

    focused on the effects of pain killers ( morphine ) and the development of PTSD. The results indicated that for Soldiers who received morphine ... hippocampus and prevent neurogenesis in the same regions, both of which can interfere with cognition and the future adaptation to stress (Ganzel, Morris...cortisol can damage areas of the hippocampus . The damage caused by the cortisol then causes a lack of ability to cope with stress in the future. This

  15. Epigenetic Risk Factors in PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Florian Joachim Raabe

    2013-08-01

    Full Text Available Epidemiological and clinical studies have shown that children exposed to adverse experiences are at increased risk for the development of depression, anxiety disorders and PTSD. A history of child abuse and maltreatment increases the likelihood of being subsequently exposed to traumatic events or of developing PTSD as an adult. The brain is highly plastic during early life and encodes acquired information into lasting memories that normally subserve adaptation. Translational studies in rodents showed that enduring sensitization of neuronal and neuroendocrine circuits in response to early life adversity are likely risk factors of life time vulnerability to stress. Hereby, the hypothalamic-pituitary-adrenal (HPA axis integrates cognitive, behavioural and emotional responses to early-life stress and can be epigenetically programmed during sensitive windows of development. Epigenetic mechanisms, comprising reciprocal regulation of chromatin structure and DNA methylation, are important to establish and maintain sustained, yet potentially reversible, changes in gene transcription. The relevance of these findings for the development of PTSD requires further studies in humans where experience-dependent epigenetic programming can additionally depend on genetic variation in the underlying substrates which may protect from or advance disease development. Overall, identification of early-life stress associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention and timely therapeutic interventions, thus reducing long-term social and health costs.

  16. Evidence for a unique PTSD construct represented by PTSD's D1-D3 symptoms.

    Science.gov (United States)

    Elhai, Jon D; Biehn, Tracey L; Armour, Cherie; Klopper, Jessica J; Frueh, B Christopher; Palmieri, Patrick A

    2011-04-01

    Two models of posttraumatic stress disorder (PTSD) have received the most empirical support in confirmatory factor analytic studies: King, Leskin, King, and Weathers' (1998) Emotional Numbing model of reexperiencing, avoidance, emotional numbing and hyperarousal; and Simms, Watson, and Doebbeling's (2002) Dysphoria model of reexperiencing, avoidance, dysphoria and hyperarousal. These models only differ in placement of three PTSD symptoms: sleep problems (D1), irritability (D2), and concentration problems (D3). In the present study, we recruited 252 women victims of domestic violence and tested whether there is empirical support to separate these three PTSD symptoms into a fifth factor, while retaining the Emotional Numbing and Dysphoria models' remaining four factors. Confirmatory factor analytic findings demonstrated that separating the three symptoms into a separate factor significantly enhanced model fit for the Emotional Numbing and Dysphoria models. These three symptoms may represent a unique latent construct. Implications are discussed.

  17. From Pavlov to PTSD: the extinction of conditioned fear in rodents, humans, and anxiety disorders.

    Science.gov (United States)

    VanElzakker, Michael B; Dahlgren, M Kathryn; Davis, F Caroline; Dubois, Stacey; Shin, Lisa M

    2014-09-01

    Nearly 100 years ago, Ivan Pavlov demonstrated that dogs could learn to use a neutral cue to predict a biologically relevant event: after repeated predictive pairings, Pavlov's dogs were conditioned to anticipate food at the sound of a bell, which caused them to salivate. Like sustenance, danger is biologically relevant, and neutral cues can take on great salience when they predict a threat to survival. In anxiety disorders such as posttraumatic stress disorder (PTSD), this type of conditioned fear fails to extinguish, and reminders of traumatic events can cause pathological conditioned fear responses for decades after danger has passed. In this review, we use fear conditioning and extinction studies to draw a direct line from Pavlov to PTSD and other anxiety disorders. We explain how rodent studies have informed neuroimaging studies of healthy humans and humans with PTSD. We describe several genes that have been linked to both PTSD and fear conditioning and extinction and explain how abnormalities in fear conditioning or extinction may reflect a general biomarker of anxiety disorders. Finally, we explore drug and neuromodulation treatments that may enhance therapeutic extinction in anxiety disorders.

  18. From Pavlov to PTSD: The extinction of conditioned fear in rodents, humans, and in anxiety disorders

    Science.gov (United States)

    VanElzakker, Michael B.; Dahlgren, M. Kathryn; Davis, F. Caroline; Dubois, Stacey; Shin, Lisa M.

    2014-01-01

    Nearly 100 years ago, Ivan Pavlov demonstrated that dogs could learn to use a neutral cue to predict a biologically relevant event: after repeated predictive pairings, Pavlov's dogs were conditioned to anticipate food at the sound of a bell, which caused them to salivate. Like sustenance, danger is biologically relevant, and neutral cues can take on great salience when they predict a threat to survival. In anxiety disorders such as posttraumatic stress disorder (PTSD), this type of conditioned fear fails to extinguish, and reminders of traumatic events can cause pathological conditioned fear responses for decades after danger has passed. In this review, we use fear conditioning and extinction studies to draw a direct line from Pavlov to PTSD and other anxiety disorders. We explain how rodent studies have informed neuroimaging studies of healthy humans and humans with PTSD. We describe several genes that have been linked to both PTSD and fear conditioning and extinction and explain how abnormalities in fear conditioning or extinction may reflect a general biomarker of anxiety disorders. Finally, we explore drug and neuromodulation treatments that may enhance therapeutic extinction in anxiety disorders. PMID:24321650

  19. Concordance between physiological arousal and subjective distress among Vietnam combat veterans undergoing challenge testing for PTSD.

    Science.gov (United States)

    Marx, Brian P; Bovin, Michelle J; Suvak, Michael K; Monson, Candice M; Sloan, Denise M; Fredman, Steffany J; Humphreys, Kathryn L; Kaloupek, Danny G; Keane, Terence M

    2012-08-01

    This study examined concordance between physiological arousal and subjective distress during a laboratory challenge task. Data were collected during the multisite VA Cooperative Study 334 in the early 1990s examining psychophysiological arousal among combat-exposed Vietnam veterans with (n = 775) and without (n = 369) posttraumatic stress disorder (PTSD). Study participants were presented with 6 standardized neutral scenes and 6 standardized combat scenes. Participants provided a subjective rating of distress after each slide. During the presentation, levels of heart rate (HR) and skin conductance (SC) were recorded. Using linear mixed effects modeling, both HR level and SC level exhibited significant positive associations with subjective distress ratings (pr = .33, p < .001 and pr = .19, p < .001, respectively). Individuals with PTSD demonstrated greater concordance between their distress ratings and SC level during exposure to combat slides than participants without PTSD (pr = .28, p < .001 vs. pr = .18, p < .001). Although a significant association was found between subjective distress and HR reactivity and SC reactivity, these findings were not moderated by PTSD status. The results of these analyses suggest that patients' reports of distress during exposure-based treatments might serve as approximate measures of actual physiological arousal. Copyright © 2012 International Society for Traumatic Stress Studies.

  20. Intensive Cognitive Therapy for PTSD: A Feasibility Study

    OpenAIRE

    Ehlers, Anke; Clark, David M.; Hackmann, Ann; Grey, Nick; Liness, Sheena; Wild, Jennifer; Manley, John; Waddington, Louise; McManus, Freda

    2010-01-01

    Background: Cognitive Behaviour Therapy (CBT) of anxiety disorders is usually delivered in weekly or biweekly sessions. There is evidence that intensive CBT can be effective in phobias and obsessive compulsive disorder. Studies of intensive CBT for posttraumatic stress disorder (PTSD) are lacking. Method: A feasibility study tested the acceptability and efficacy of an intensive version of Cognitive Therapy for PTSD (CT-PTSD) in 14 patients drawn from consecutive referrals. Patients received u...

  1. PTSD og kjønnsforskjeller- en litteraturstudie

    OpenAIRE

    Muneer, Saba

    2008-01-01

    BACKGROUND: PTSD is a trauma related anxiety disorder that can develop after exposure to one or more frightening events that threatened or caused severe physical harm. Reexperience trough flashbacks and/or nightmares are common. Persistent avoidance of the stimuli which is associated with trauma and increased physiological arousal are other important aspects of PTSD. Lifetime prevalence of PTSD is one percent. Men have a greater exposure to traumatic situations but women have higher rates ...

  2. Locus coeruleus neuronal activity determines proclivity to consume alcohol in a selectively-bred line of rats that readily consumes alcohol.

    Science.gov (United States)

    West, Charles H K; Boss-Williams, Katherine A; Ritchie, James C; Weiss, Jay M

    2015-11-01

    larger than evident in the test. Finally, when increased LC activity was associated with (i.e., conditioned to) i.p. alcohol, subsequent alcohol consumption by SUS rats was markedly reduced, indicating that SUS rats consume large amounts of alcohol because of rewarding physiological consequences requiring increased VTA-DA activity. The findings reported here are consistent with the view that the influence of alcohol on LC activity leading to changes in VTA-DA activity strongly affects alcohol-mediated reward, and may well be the basis of the proclivity of SUS rats to avidly consume alcohol.

  3. Sleep disturbances in veterans with chronic war-induced PTSD

    Science.gov (United States)

    Khazaie, Habibolah; Ghadami, Mohammad Rasoul; Masoudi, Maryam

    2016-01-01

    Abstract: Post-traumatic stress disorder is related to a wide range of medical problems, with a majority of neurological, psychological, cardiovascular, respiratory, gastrointestinal disorders, diabetes, as well as sleep disorders. Although the majority of studies reveal the association between PTSD and sleep disturbances, there are few studies on the assessment of sleep disruption among veterans with PTSD. In this review, we attempt to study the sleep disorders including insomnia, nightmare, sleep-related breathing disorders, sleep-related movement disorders and parasomnias among veterans with chronic war-induced PTSD. It is an important area for further research among veterans with PTSD. PMID:27093088

  4. Efficacy of abreactive ego state therapy for PTSD: trauma resolution, depression, and anxiety.

    Science.gov (United States)

    Christensen, Ciara; Barabasz, Arreed; Barabasz, Marianne

    2013-01-01

    Using manualized abreactive Ego State Therapy (EST), 30 subjects meeting DSM-IV-TR and Clinician-Administered PTSD Scale (CAPS) criteria were exposed to either 5-6 hours of treatment or the Ochberg Counting Method (placebo) in a single session. EST emphasized repeated hypnotically activated abreactive "reliving" of the trauma and ego strengthening by the cotherapists. Posttreatment 1-month and 3-month follow-ups showed EST to be an effective treatment for PTSD. Using the Davidson Trauma Scale, Beck Depression II, and Beck Anxiety Scales, EST subjects showed significant positive effects from pretreatment levels at all posttreatment measurement periods in contrast to the placebo treatment. Most of the EST subjects responded and showed further improvement over time.

  5. Prevention of chronic PTSD with early cognitive behavioral therapy. A meta-analysis using mixed-effects modeling.

    Science.gov (United States)

    Kliem, Sören; Kröger, Christoph

    2013-11-01

    Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27-0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.

  6. Web-Delivered CBT Reduces Heavy Drinking in OEF-OIF Veterans in Primary Care With Symptomatic Substance Use and PTSD.

    Science.gov (United States)

    Acosta, Michelle C; Possemato, Kyle; Maisto, Stephen A; Marsch, Lisa A; Barrie, Kimberly; Lantinga, Larry; Fong, Chunki; Xie, Haiyi; Grabinski, Michael; Rosenblum, Andrew

    2017-03-01

    Veterans from conflicts such as the wars in Iraq and Afghanistan commonly return with behavioral health problems, including posttraumatic stress disorder (PTSD) and hazardous or harmful substance use. Unfortunately, many veterans experience significant barriers to receiving evidence-based treatment, including poor treatment motivation, concerns about stigma, and lack of access to appropriate care. To address this need, the current study developed and evaluated a web-based self-management intervention based on cognitive behavioral therapy (CBT), targeting PTSD symptoms and hazardous substance use in a group of symptomatic combat veterans enrolled in VA primary care. Veterans with PTSD/subthreshold PTSD and hazardous substance use were randomized to primary care treatment as usual (TAU; n = 81) or to TAU plus a web-based CBT intervention called Thinking Forward (n = 81). Thinking Forward consisted of 24 sections (approximately 20 minutes each), accessible over 12 weeks. Participants completed baseline and 4-, 8-, 12-, 16-, and 24-week follow-up assessments. Three primary outcomes of PTSD, alcohol and other drug use, and quality of life were examined. Significant treatment effects were found for heavy drinking, but not for PTSD or quality of life. The effect of the intervention on heavy drinking was mediated by intervening increases in coping, social support, self-efficacy, and hope for the future. These results demonstrate the promise of a web-based, self-management intervention for difficult-to-engage OEF/OIF veterans with behavioral health and substance use concerns.

  7. The Anti-Inflammatory Effects of Blueberries in an Animal Model of Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Ebenezer, Philip J; Wilson, C Brad; Wilson, Leslie D; Nair, Anand R; J, Francis

    2016-01-01

    Post-traumatic stress disorder (PTSD) is a trauma and stressor-related disorder that results in a prolonged stress response. It is associated with increased oxidative stress and inflammation in the prefrontal cortex (PFC) and hippocampus (HC). The only approved therapy for PTSD is selective serotonin re-uptake inhibitors (SSRIs), but their efficacy is marginal. Recently, we demonstrated that over-production of norepinephrine (NE) as the possible reason for the lack of efficacy of SSRIs. Hence, there is a need for novel therapeutic approaches for the treatment of PTSD. In this study, we investigated the anti-inflammatory role of blueberries in modulating inflammatory markers and neurotransmitter levels in PTSD. Rats were fed either a blueberry enriched (2%) or a control diet. Rats were exposed to cats for one hour on days 1 and 11 of a 31-day schedule to simulate traumatic conditions. The rats were also subjected to psychosocial stress via daily cage cohort changes. At the end of the study, the rats were euthanized and the PFC and HC were isolated. Monoamines were measured by high-performance liquid chromatography. Reactive oxygen species (ROS), gene and protein expression levels of inflammatory cytokines were also measured. In our PTSD model, NE levels were increased and 5-HT levels were decreased when compared to control. In contrast, a blueberry enriched diet increased 5-HT without affecting NE levels. The rate limiting enzymes tyrosine hydroxylase and tryptophan hydroxylase were also studied and they confirmed our findings. The enhanced levels free radicals, gene and protein expression of inflammatory cytokines seen in the PTSD group were normalized with a blueberry enriched diet. Decreased anxiety in this group was shown by improved performance on the elevated plus-maze. These findings indicate blueberries can attenuate oxidative stress and inflammation and restore neurotransmitter imbalances in a rat model of PTSD.

  8. Increased risk of alcohol dependency in a cohort of National Guard troops with PTSD: a longitudinal study.

    Science.gov (United States)

    Kline, Anna; Weiner, Marc D; Ciccone, Donald S; Interian, Alejandro; St Hill, Lauren; Losonczy, Miklos

    2014-03-01

    Studies show high rates of co-morbid post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) but there is no consensus on the causal direction of the relationship. Some theories suggest AUD develops as a coping mechanism to manage PTSD symptoms and others that AUD is a vulnerability factor for PTSD. A third hypothesis posits independent developmental pathways stemming from a shared etiology, such as the trauma exposure itself. We examined these hypotheses using longitudinal data on 922 National Guard soldiers, representing a subsample (56%) of a larger pre- and post-deployment cross-sectional study of New Jersey National Guard soldiers deployed to Iraq. Measures included the PTSD Checklist (PCL), DSM-IV-based measures of alcohol use/misuse from the National Household Survey of Drug Use and Health and other concurrent mental health, military and demographic measures. Results showed no effect of pre-deployment alcohol status on subsequent positive screens for new onset PTSD. However, in multivariate models, baseline PTSD symptoms significantly increased the risk of screening positive for new onset alcohol dependence (AD), which rose 5% with each unit increase in PCL score (AOR = 1.05; 95% CI = 1.02-1.07). Results also supported the shared etiology hypothesis, with the risk of a positive screen for AD increasing by 9% for every unit increase in combat exposure after controlling for baseline PTSD status (AOR = 1.09; 95% CI = 1.03-1.15) and, in a subsample with PCL scores <34, by 17% for each unit increase in exposure (AOR = 1.17; 95% CI = 1.05-1.31). These findings have implications for prevention, treatment and compensation policies governing co-morbidity in military veterans.

  9. Multiple Channel Exposure Therapy: Combining Cognitive-Behavioral Therapies for the Treatment of Posttraumatic Stress Disorder with Panic Attacks

    Science.gov (United States)

    Falsetti, Sherry A.; Resnick, Heidi S.; Davis, Joanne

    2005-01-01

    A large proportion of patients who present for treatment of posttraumatic stress disorder (PTSD) experience comorbid panic attacks, yet it is unclear to what extent currently available PTSD treatment programs address this problem. Here we describe a newly developed treatment, multiple-channel exposure therapy (M-CET), for comorbid PTSD and panic…

  10. Cognitive behavioral therapy for insomnia as a preparatory treatment for exposure therapy for posttraumatic stress disorder.

    Science.gov (United States)

    Baddeley, Jenna L; Gros, Daniel F

    2013-01-01

    Insomnia is present in a majority of individuals with posttraumatic stress disorder (PTSD). However, when both disorders are present, disagreements exist about whether to provide exposure therapy for PTSD before insomnia treatment, or vice versa. The current case study describes the psychological treatment of a psychotherapy-naive veteran with comorbid insomnia and PTSD. The patient initially refused exposure therapy for PTSD; thus, cognitive-behavioral therapy for insomnia (CBTi) was a first-step treatment. Cognitive Behavior Therapy for Insomnia provided insomnia symptom relief psychoeducation and self-monitoring of PTSD symptoms prepared the patient to enter exposure therapy. After six CBTi sessions, the patient completed seven sessions of trauma-specific exposure therapy. At the conclusion of treatment and at 90-day follow up, the patient demonstrated significant reductions in insomnia and PTSD symptoms. Findings support the safe and effective use of CBTi in patients with comorbid insomnia and PTSD to improve sleep and facilitate entry into exposure therapy for PTSD.

  11. Animal model of PTSD based on clinically relevant features of trauma susceptibility and expression

    Directory of Open Access Journals (Sweden)

    David Diamond

    2012-09-01

    Full Text Available Rationale/statement of the problem : There is an insufficient understanding of the neurobiology of post-traumatic stress disorder (PTSD. Therefore, the development of an animal model of PTSD that takes into account clinical features of the disorder is of value toward enhancing our understanding of the mechanisms, and in the development of novel treatments, of emotional trauma. Methods : Adult male rats were administered chronic psychosocial stress composed of two 1-hour periods of inescapable exposure to a cat, in conjunction with daily unstable pair housing, over a 31 day period. The rats were then given a battery of tests, including measures of behavior (anxiety testing, startle response, cognition (predator-based fear memory and new memory testing, hormone levels (basal and evoked glucocorticoids, responses to pharmacological agents (dexamethasone and yohimbine and cardiovascular activity (blood pressure/heart rate. In addition, we measured epigenetic alterations (methylation of the brain-derived neurotrophic factor (BDNF gene. Results : Psychosocially stressed rats exhibited a PTSD-like phenotype. The stressed rats exhibited a strong fear-conditioned memory of the two cat exposures, an increase in behavioral signs of anxiety, an exaggerated startle response, increased blood pressure, greater sensitivity to yohimbine and a hippocampus-dependent memory impairment, relative to controls. In addition, stressed rats exhibited reduced basal glucocorticoid levels, greater sensitivity to dexamethasone and hypermethylation of the BDNF gene in the hippocampus. Conclusion : These findings demonstrate that intense psychosocial stress produced dramatic changes in physiology and behavior in rats which are comparable to those observed in people diagnosed with PTSD. This rat model, therefore, may enhance our understanding of the mechanisms underlying human trauma and in the development of more effective pharmacotherapy for people with PTSD.

  12. A Longitudinal Analysis of PTSD Symptom Course: Delayed-Onset PTSD in Somalia Peacekeepers

    Science.gov (United States)

    Gray, Matt J.; Bolton, Elisa E.; Litz, Brett T.

    2004-01-01

    Posttraumatic stress disorder (PTSD) typically follows an acute to chronic course. However, some trauma victims do not report significant symptoms until a period of time has elapsed after the event. Although originally dismissed as an artifact of retrospective methodologies, recent prospective studies document apparent instances of delayed-onset…

  13. Symptom structure of PTSD: support for a hierarchical model separating core PTSD symptoms from dysphoria

    NARCIS (Netherlands)

    Rademaker, A.R.; Minnen, A. van; Ebberink, F.; Zuiden, M. van; Geuze, E.

    2012-01-01

    Background: As of yet, no collective agreement has been reached regarding the precise factor structure of posttraumatic stress disorder (PTSD). Several alternative factor-models have been proposed in the last decades. Objective: The current study examined the fit of a hierarchical adaptation of the

  14. SLEEP AND TREATMENT OUTCOME IN POSTTRAUMATIC STRESS DISORDER: RESULTS FROM AN EFFECTIVENESS STUDY

    OpenAIRE

    2015-01-01

    BACKGROUND: Most patients with posttraumatic stress disorder (PTSD) suffer from sleep problems. Concerns have been raised about possible detrimental effects of sleep problems on the efficacy of psychological treatments for PTSD. In this study, we investigated the relation of session-to-session changes in PTSD symptoms and sleep, and tested whether sleep problems predicted poorer short- and long-term treatment outcome.METHODS: Self-reported sleep quality, sleep duration, and PTSD symptoms were...

  15. An innovative approach to treating combat veterans with PTSD at risk for suicide.

    Science.gov (United States)

    Hendin, Herbert

    2014-10-01

    Suicide rates among military personnel had a significant drop in 2013, but there is no evidence of a drop among veterans. The problem of suicide among combat veterans with posttraumatic stress disorder (PTSD) remains a source of concern. The Department of Defense and the Department of Veterans Affairs are now calling for innovative treatment approaches to the problem. A short-term psychodynamic therapy presented here may be able to fill that need by dissipating the guilt from veterans' combat-related actions that leads to suicidal behavior. The treatment showed promise of success with veterans of the war in Vietnam. Preliminary work with combat veterans of the wars in Iraq and Afghanistan indicates that it may be equally successful in treating them. Basic aspects of the psychodynamic approach could be incorporated into current therapies and should improve their ability to treat veterans with PTSD at risk for suicide.

  16. The management of post traumatic stress disorder (PTSD) in the primary care setting.

    Science.gov (United States)

    Bobo, William V; Warner, Christopher H; Warner, Carolynn M

    2007-08-01

    Recent geopolitical events, including the terrorist attacks on the United States on September 11, 2001, and ongoing military operations in Iraq, have raised awareness of the often severe psychological after-effects of these and other types of traumatic events. Post traumatic stress disorder (PTSD) represents the most severe of these sequelae. PTSD is an under-recognized and under-treated chronic anxiety disorder associated with significant psychosocial morbidity, substance abuse, and a number of other negative health outcomes. Fortunately, the biologic underpinnings of this complex disorder and new advances in treatment are being realized. Early detection by primary care providers and rapid initiation of treatment are the keys to successful management of the disorder.

  17. Aggression in US soldiers post-deployment: Associations with combat exposure and PTSD and the moderating role of trait anger.

    Science.gov (United States)

    Wilk, Joshua E; Quartana, Phillip J; Clarke-Walper, Kristina; Kok, Brian C; Riviere, Lyndon A

    2015-01-01

    Anger and aggression are among the most common issues reported by returning service members from combat deployments. However, the pathways between combat exposure and anger and aggression have not been comprehensively characterized. The present study aimed to characterize the relationship between trait anger, combat exposure, post-deployment PTSD, and aggression. U.S. Army soldiers (N = 2,420) were administered anonymous surveys assessing combat exposure, current PTSD symptoms and aggression, as well as trait anger items 3 months after returning from deployment to Afghanistan. PTSD symptom levels were related to aggression at higher levels of trait anger, but not evident among soldiers who had lower levels of trait anger. The pathway from combat exposure to PTSD, and then to aggression, was conditional upon levels of trait anger, such that the pathway was most evident at high levels of trait anger. This was the first study to our knowledge that concurrently modeled unconditional and conditional direct and indirect associations between combat exposure, PTSD, trait anger, and aggression. The findings can be helpful clinically and for developing screening protocols for combat exposed Soldiers. The results of this study suggest the importance of assessing and managing anger and aggression in soldiers returning from combat deployment. Anger is one of the most common complaints of returning soldiers and can have debilitating effects across all domains of functioning. It is imperative that future research efforts are directed toward understanding this phenomenon and developing and validating effective treatments for it.

  18. Portuguese version of the PTSD Checklist-Military Version (PCL-M)-I: Confirmatory Factor Analysis and reliability.

    Science.gov (United States)

    Carvalho, Teresa; Cunha, Marina; Pinto-Gouveia, José; Duarte, Joana

    2015-03-30

    The PTSD Checklist-Military Version (PCL-M) is a brief self-report instrument widely used to assess Post-traumatic Stress Disorder (PTSD) symptomatology in war Veterans, according to DSM-IV. This study sought out to explore the factor structure and reliability of the Portuguese version of the PCL-M. A sample of 660 Portuguese Colonial War Veterans completed the PCL-M. Several Confirmatory Factor Analyses were conducted to test different structures for PCL-M PTSD symptoms. Although the respecified first-order four-factor model based on King et al.'s model showed the best fit to the data, the respecified first and second-order models based on the DSM-IV symptom clusters also presented an acceptable fit. In addition, the PCL-M showed adequate reliability. The Portuguese version of the PCL-M is thus a valid and reliable measure to assess the severity of PTSD symptoms as described in DSM-IV. Its use with Portuguese Colonial War Veterans may ease screening of possible PTSD cases, promote more suitable treatment planning, and enable monitoring of therapeutic outcomes. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  19. Fear conditioning and early life vulnerabilities: two distinct pathways of emotional dysregulation and brain dysfunction in PTSD

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2010-12-01

    Full Text Available The newly proposed criteria for posttraumatic stress disorder (PTSD in the Diagnostic and Statistical Manual (DSM-V include dysregulation of a variety of emotional states including fear, anger, guilt, and shame, in addition to dissociation and numbing. Consistent with these revisions, we postulate two models of emotion dysregulation in PTSD in which fear is not the prevailing emotion but is only one of several components implicated in a dysregulated emotional system that also mediates problems regulating anger, guilt, shame, dissociation, and numbing.We discuss whether there is a relationship between fear and other emotion regulation systems that may help further our understanding of PTSD and its underlying neurocircuitry. Two pathways describing the relationship between fear and other emotion regulation systems in PTSD are proposed. The first pathway describes emotion dysregulation as an outcome of fear conditioning through stress sensitization and kindling. The second pathway views emotion dysregulation as a distal vulnerability factor and hypothesizes a further exacerbation of fear and other emotion regulatory problems, including the development of PTSD after exposure to one or several traumatic event(s later in life. Future research and treatment implications are discussed.

  20. Different regional gray matter loss in recent onset PTSD and non PTSD after a single prolonged trauma exposure.

    Directory of Open Access Journals (Sweden)

    Yunchun Chen

    Full Text Available OBJECTIVE: Gray matter loss in the limbic structures was found in recent onset post traumatic stress disorder (PTSD patients. In the present study, we measured regional gray matter volume in trauma survivors to verify the hypothesis that stress may cause different regional gray matter loss in trauma survivors with and without recent onset PTSD. METHOD: High resolution T1-weighted magnetic resonance imaging (MRI were obtained from coal mine flood disaster survivors with (n = 10 and without (n = 10 recent onset PTSD and 20 no trauma exposed normal controls. The voxel-based morphometry (VBM method was used to measure the regional gray matter volume in three groups, the correlations of PTSD symptom severities with the gray matter volume in trauma survivors were also analyzed by multiple regression. RESULTS: Compared with normal controls, recent onset PTSD patients had smaller gray matter volume in left dorsal anterior cingulate cortex (ACC, and non PTSD subjects had smaller gray matter volume in the right pulvinar and left pallidum. The gray matter volume of the trauma survivors correlated negatively with CAPS scores in the right frontal lobe, left anterior and middle cingulate cortex, bilateral cuneus cortex, right middle occipital lobe, while in the recent onset PTSD, the gray matter volume correlated negatively with CAPS scores in bilateral superior medial frontal lobe and right ACC. CONCLUSION: The present study identified gray matter loss in different regions in recent onset PTSD and non PTSD after a single prolonged trauma exposure. The gray matter volume of left dorsal ACC associated with the development of PTSD, while the gray matter volume of right pulvinar and left pallidum associated with the response to the severe stress. The atrophy of the frontal and limbic cortices predicts the symptom severities of the PTSD.

  1. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias; Spindler, Helle

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinatio...

  2. Childhood Maltreatment, PTSD, and Suicidal Behavior among African American Females.

    Science.gov (United States)

    Thompson, Martie P.; Kaslow, Nadine J.; Lane, Danielle Bradshaw; Kingree, J. B.

    2000-01-01

    Investigates how childhood maltreatment and current post-traumatic stress disorder (PTSD) predict nonfatal suicide attempts among 335 African American women. PTSD in combination with any of the maltreatments of childhood increased the risk of suicide attempts. Suggests that interventions designed to reduce suicidal behavior should focus on women…

  3. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias; Spindler, Helle

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinatio...

  4. Pathways to PTSD, part I: Children with burns.

    Science.gov (United States)

    Saxe, Glenn N; Stoddard, Frederick; Hall, Erin; Chawla, Neharika; Lopez, Carlos; Sheridan, Robert; King, Daniel; King, Lynda; Yehuda, Rachel

    2005-07-01

    The goal of this study was to develop a model of risk factors for posttraumatic stress disorder (PTSD) in a group of acutely burned children. Seventy-two children between the ages of 7 and 17 who were admitted to the hospital for an acute burn were eligible for study. Members of families who consented completed the Child PTSD Reaction Index, the Multidimensional Anxiety Scale for Children, and other self-report measures of psychopathology and environmental stress both during the hospitalization and 3 months following the burn. A path analytic strategy was used to build a model of risk factors for PTSD. Two pathways to PTSD were discerned: 1) from the size of the burn and level of pain following the burn to the child's level of acute separation anxiety, and then to PTSD, and 2) from the size of the burn to the child's level of acute dissociation following the burn, and then to PTSD. Together these pathways accounted for almost 60% of the variance in PTSD symptoms and constituted a model with excellent fit indices. These findings support a model of complex etiology for childhood PTSD in which two independent pathways may be mediated by different biobehavioral systems.

  5. Psychophysiological assessment of PTSD: a potential research domain criteria construct.

    Science.gov (United States)

    Bauer, Margaret R; Ruef, Anna M; Pineles, Suzanne L; Japuntich, Sandra J; Macklin, Michael L; Lasko, Natasha B; Orr, Scott P

    2013-09-01

    Most research on posttraumatic stress disorder (PTSD) relies on clinician-administered interview and self-report measures to establish the presence/absence and severity of the disorder. Accurate diagnosis of PTSD is made challenging by the presence of symptoms shared with other psychopathologies and the subjective nature of patients' descriptions of their symptoms. A physiological assessment capable of reliably "diagnosing" PTSD could provide adjunctive information that might mitigate these diagnostic limitations. In the present study, we examined the construct validity of a potential psychophysiological measure of PTSD, that is, psychophysiological reactivity to script-driven imagery (SDI-PR), as measured against the current diagnostic "gold-standard" for PTSD, the Clinician-Administered PTSD Scale (CAPS). Convergent and predictive validity and stability were examined. Thirty-six individuals completed an SDI-PR procedure, the CAPS, and self-report measures of mental and physical health at their initial visit and approximately 6 months later. SDI-PR and the CAPS demonstrated excellent stability across measurement occasions. SDI-PR showed moderately strong convergent validity with the CAPS. After adjusting for self-reported depression, predictive validity for the CAPS, with regard to health sequelae, was reduced, whereas it remained mostly unchanged for SDI-PR. Findings support SDI-PR as a valid and stable measure of PTSD that captures a pathophysiologic process in individuals with PTSD. Results are discussed with regard to the research domain criteria framework.

  6. Alternative models of DSM-5 PTSD: Examining diagnostic implications.

    Science.gov (United States)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask; Yong Chen, Yoke; Raudzah Ghazali, Siti; Shevlin, Mark

    2017-09-09

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed models. This study aimed to generate PTSD prevalence estimates derived from the 7 alternative factor models and assess whether pre-established risk factors associated with PTSD (e.g., transportation accidents and sexual victimisation) produce consistent risk estimates. Seven alternative models were estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n = 481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit with statistical superiority for the Externalising Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models, with substantial variation emerging for sexual victimisation. These findings have important implications for research and practice and highlight that more research attention is needed to examine the diagnostic implications emerging from the alternative models of PTSD. Copyright © 2017. Published by Elsevier B.V.

  7. Mechanisms of efficacy of CBT for Cambodian refugees with PTSD: improvement in emotion regulation and orthostatic blood pressure response.

    Science.gov (United States)

    Hinton, Devon E; Hofmann, Stefan G; Pollack, Mark H; Otto, Michael W

    2009-01-01

    Based on the results of a randomized controlled trial, we examined a model of the mechanisms of efficacy of culturally adapted cognitive-behavior therapy (CBT) for Cambodian refugees with pharmacology-resistant posttraumatic stress disorder (PTSD) and comordid orthostatic panic attacks (PAs). Twelve patients were in the initial treatment condition, 12 in the delayed treatment condition. The patients randomized to CBT had much greater improvement than patients in the waitlist condition on all psychometric measures and on one physiological measure-the systolic blood pressure response to orthostasis (d = 1.31)-as evaluated by repeated-measures MANOVA and planned contrasts. After receiving CBT, the Delayed Treatment Group improved on all measures, including the systolic blood pressure response to orthostasis. The CBT treatment's reduction of PTSD severity was significantly mediated by improvement in orthostatic panic and emotion regulation ability. The current study supports our model of the generation of PTSD in the Cambodian population, and suggests a key role of decreased vagal tone in the generation of orthostatic panic and PTSD in this population. It also suggests that vagal tone is involved in emotion regulation, and that both vagal tone and emotion regulation improve across treatment.

  8. Neural Markers and Rehabilitation of Executive Functioning in Veterans with TBI and PTSD

    Science.gov (United States)

    2015-10-01

    retention of motor function.  Timeline. This paper was published in the Journal of Head Trauma Rehabilitation last year, it is attached to this...the neurobiology and neuropsychology associated with an evidence-based cognitive rehabilitation intervention will allow us to identify Veterans with...both TBI and PTSD who are predisposed to positive treatment outcomes. To our knowledge, this will be the first attempt to integrate neurobiological

  9. Alternative models of DSM-5 PTSD: Examining diagnostic implications

    DEFF Research Database (Denmark)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask

    2017-01-01

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed...... estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n=481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit...... with statistical superiority for the Externalizing Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models...

  10. PTSD in railroad drivers under the Federal employers' liability act.

    Science.gov (United States)

    Weiss, Kenneth J; Farrell, J Michael

    2006-01-01

    Railroad and subway drivers can experience psychological trauma when trains strike or nearly miss other trains, motor vehicles, or persons or become instruments of death. Derailments, collisions, and suicides on the tracks can induce feelings of helplessness, horror, guilt, and anxiety in the drivers. Although some drivers experience acute stress disorder (ASD) or post-traumatic stress disorder (PTSD), their conditions are not always acknowledged within the occupational setting. The world literature suggests that PTSD has been an increasing focus of concern, giving rise to detailed intervention protocols. In the United States, the Federal Employers' Liability Act (FELA) governs the adjudication of work-related injuries among railroad employees. In practice, it is difficult for railroad drivers with PTSD to receive benefits if there was no "direct impact" linked to the employer's negligence. In this article, the authors review the literature on PTSD among railroad drivers, discuss relevant case law, and explain how the FELA militates against some employees with PTSD.

  11. Sleep diaries of Vietnam War veterans with chronic PTSD: the relationships among insomnia symptoms, psychosocial stress, and nightmares.

    Science.gov (United States)

    Gehrman, Philip R; Harb, Gerlinde C; Cook, Joan M; Barilla, Holly; Ross, Richard J

    2015-01-01

    Impaired sleep and nightmares are known symptoms of posttraumatic stress disorder (PTSD) in the veteran population. In order to assess prospectively the sleep disturbances in this population, sleep diaries are an effective way to obtain information over an extended period of time. In this investigation, a sample of veterans (N = 105) completed daily sleep diaries for a 6-week period. Greater PTSD severity and nightmare-related distress were correlated with more awakenings, shorter duration of sleep, longer sleep latency, and greater frequency of nightmares. Perceived frequency of daytime stressors was associated with an increased number of nightmares, nightmare-related distress, and longer sleep latency. The use of sleep diaries in future investigations may allow targeted treatments for veteran populations with PTSD and sleep disturbances.

  12. PTSD, Depression, and Substance Use in Relation to Suicidality Risk among Traumatized Minority Lesbian, Gay, and Bisexual Youth.

    Science.gov (United States)

    Smith, Brian C; Armelie, Aaron P; Boarts, Jessica M; Brazil, Miquel; Delahanty, Douglas L

    2016-01-01

    Youths who are lesbian, gay, or bisexual (LGB) are more likely than heterosexuals to commit suicide. Substance use, PTSD, and depression are independent risk factors for suicidality; however, the extent to which these factors interact to predict suicidality is unclear. The current study examined the association between substance use, PTSD symptoms (PTSS), depressive symptoms, and suicidality in a sample of 68 traumatized minority LGB youths. Participants were recruited from an LGBT community center and completed a packet of questionnaires. Substance use and depressive symptoms were positively associated with prior suicide attempts. A significant three-way interaction revealed that substance use interacted with both PTSS and depressive symptoms to increase the odds of attempted suicide. Results underscore the importance of integrating substance use components into PTSD/depression treatment to reduce suicide risk in LGB youth.

  13. Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

    Science.gov (United States)

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

    2010-01-01

    Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

  14. Stabilizing Group Treatment for Complex Posttraumatic Stress Disorder Related to Childhood Abuse Based on Psycho-Education and Cognitive Behavioral Therapy: A Pilot Study

    Science.gov (United States)

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H.; van Balkom, Anton J. L. M.; van Dyck, Richard; Veltman, Dick J.; Draijer, Nel

    2010-01-01

    Objective: This study tests a Stabilizing Group Treatment protocol, designed for the management of the long-term sequelae of child abuse, that is, Complex Posttraumatic Stress Disorder (Complex PTSD). Evidence-based treatment for this subgroup of PTSD patients is largely lacking. This stabilizing treatment aims at improving Complex PTSD using…

  15. Lifetime history of traumatic events in a young adult Mexican American sample: Relation to substance dependence, affective disorder, acculturation stress, and PTSD.

    Science.gov (United States)

    Ehlers, Cindy L; Kim, Corinne; Gilder, David A; Stouffer, Gina M; Caetano, Raul; Yehuda, Rachel

    2016-12-01

    Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18-30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure.

  16. A Follow-up Study of a Multisite, Randomized, Controlled Trial for Children with Sexual Abuse-Related PTSD Symptoms

    Science.gov (United States)

    Deblinger, Esther; Mannarino, Anthony P.; Cohen, Judith A.; Steer, Robert A.

    2006-01-01

    Objective: To ascertain whether the differential responses that previously have been found between trauma-focused, cognitive-behavioral therapy (TF-CBT), and child-centered therapy (CCT) for treating posttraumatic stress disorder (PTSD) and related problems in children who had been sexually abused would persist following treatment and to examine…

  17. Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms : a pilot study

    NARCIS (Netherlands)

    Rosaura Polak, A; Witteveen, Anke B; Denys, D.; Olff, Miranda

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of

  18. Effect of Song Writing versus Recreational Music on Posttraumatic Stress Disorder (PTSD) Symptoms and Abuse Attribution in Abused Children.

    Science.gov (United States)

    Coulter, Susan J.

    2000-01-01

    Attempts to develop a song-writing technique to reduce posttraumatic stress disorder (PTSD) symptoms in abused children from 9 to 17 years old, all patients of an inpatient psychiatric child/adolescent unit who had been physically and/or sexually abused. Finds no significant change in overall scores due to treatment condition. (SR)

  19. Breathing biofeedback as an adjunct to exposure in cognitive behavioral therapy hastens the reduction of PTSD symptoms : a pilot study

    NARCIS (Netherlands)

    Rosaura Polak, A; Witteveen, Anke B; Denys, D.; Olff, Miranda

    2015-01-01

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of

  20. A Follow-up Study of a Multisite, Randomized, Controlled Trial for Children with Sexual Abuse-Related PTSD Symptoms

    Science.gov (United States)

    Deblinger, Esther; Mannarino, Anthony P.; Cohen, Judith A.; Steer, Robert A.

    2006-01-01

    Objective: To ascertain whether the differential responses that previously have been found between trauma-focused, cognitive-behavioral therapy (TF-CBT), and child-centered therapy (CCT) for treating posttraumatic stress disorder (PTSD) and related problems in children who had been sexually abused would persist following treatment and to examine…

  1. Latent profiles of DSM-5 PTSD symptoms and the "Big Five" personality traits.

    Science.gov (United States)

    Contractor, Ateka A; Armour, Cherie; Shea, M Tracie; Mota, Natalie; Pietrzak, Robert H

    2016-01-01

    Typologies of DSM-5 PTSD symptoms and personality traits were evaluated in regard to coping styles and treatment preferences using data from 1266 trauma-exposed military veterans of which the majority were male (n=1097; weighted 89.6%). Latent profile analyses indicated a best-fitting 5-class solution; PTSD asymptomatic and emotionally stable (C1); predominant re-experiencing and avoidance symptoms and less emotionally stable (C2); subsyndromal PTSD (C3); predominant negative alterations in mood/cognitions and combined internalizing-externalizing traits (C4); and high PTSD severity and combined internalizing-externalizing traits (C5). Compared to C5, C1 members were less likely to use self-distraction, denial, and substance use and more likely to use active coping; C2 and C4 members were less likely to use denial and more likely to use behavioral disengagement; C3 members were less likely to use denial and instrumental coping and more likely to use active coping; most classes were less likely to seek mental health treatment. Compared to C1, C2 members were more likely to use self-distraction, substance use, behavioral disengagement and less likely to use active coping; C3 members were more likely to use self-distraction, and substance use, and less likely to use positive reframing, and acceptance; and C4 members were more likely to use denial, substance use, emotional support, and behavioral disengagement, and less likely to use active coping, positive reframing, and acceptance; all classes were more likely to seek mental health treatment. Emotional stability was most distinguishing of the typologies. Other implications are discussed.

  2. Oxytocin improves compassion toward women among patients with PTSD.

    Science.gov (United States)

    Palgi, Sharon; Klein, Ehud; Shamay-Tsoory, Simone G

    2016-02-01

    Although impairments in social skills, including empathic abilities, are common in post-traumatic stress disorder (PTSD), the ability to feel compassion-a pro-social behavior that is based on empathy and drives us to help others-has never been assessed among these patients. The first aim of this study was to examine whether patients with PTSD suffer from deficits in compassion and to examine the association between the clusters of PTSD symptoms and these deficits. Furthermore, given that intranasal oxytocin (OT) has been suggested to possibly modulate social behaviors, the second aim of this study was to investigate whether intranasal OT may enhance compassion in these patients. Using a randomized, double-blind, placebo-controlled crossover design, we administered 24 IU of OT and placebo at a one-week interval to 32 patients with PTSD and to 30 matched healthy control participants. The results indicate that patients with PTSD exhibit deficits in compassion and that the numbing cluster emerged as the key predictor of those deficits. Moreover, the results indicate that a single intranasal dose of OT enhances compassion toward women (but not towards men), both in patients with PTSD and in controls. These results offer support for recent suggestions that intranasal OT may potentially be an effective pharmacological intervention for patients with PTSD.

  3. Interventions to improve work outcomes in work-related PTSD: a systematic review

    Directory of Open Access Journals (Sweden)

    Bonato Sarah

    2011-10-01

    Full Text Available Abstract Background Posttraumatic stress disorder acquired at work can be debilitating both for workers and their employers. The disorder can result in increased sick leave, reduced productivity, and even unemployment. Furthermore, workers are especially unlikely to return to their previous place of employment after a traumatic incident at work because of the traumatic memories and symptoms of avoidance that typically accompany the disorder. Therefore, intervening in work-related PTSD becomes especially important in order to get workers back to the workplace. Methods A systematic literature search was conducted using Medline, PsycINFO, Embase, and Web of Science. The articles were independently screened based on inclusion and exclusion criteria, followed by a quality assessment of all included articles. Results The systematic search identified seven articles for inclusion in the review. These consisted of six research articles and one systematic review. The review focused specifically on interventions using real exposure techniques for anxiety disorders in the workplace. In the research articles addressed in the current review, study populations included police officers, public transportation workers, and employees injured at work. The studies examined the effectiveness of EMDR, cognitive-behavioural techniques, and an integrative therapy approach called brief eclectic psychotherapy. Interestingly, 2 of the 6 research articles addressed add-on treatments for workplace PTSD, which were designed to treat workers with PTSD who failed to respond to traditional evidence-based psychotherapy. Conclusions Results of the current review suggest that work-related interventions show promise as effective strategies for promoting return to work in employees who acquired PTSD in the workplace. Further research is needed in this area to determine how different occupational groups with specific types of traumatic exposure might respond differently to work

  4. Life Sciences—Life Writing: PTSD as a Transdisciplinary Entity between Biomedical Explanation and Lived Experience

    Directory of Open Access Journals (Sweden)

    Norbert W. Paul

    2015-12-01

    notions of narrativity from the humanities grants access to therapeutically meaningful, enriched notions of PTSD. We focus on TCM because trauma therapy has long since become an intrinsic part of this complementary medical concept which are more widely accessible and accepted than other complementary medical practices, such as Ayurveda or homeopathy. Looking at the individual that suffers from a traumatic life event and also acknowledging the contemporary concepts of resilience, transdisciplinary concepts become particularly relevant for the medical treatment of and social reintegration of patients such as war veterans. We emphasize the necessity of a new dialogue between the life sciences and the humanities by introducing the concepts of corporeality, capability and temporality as boundary objects crucial for both the biomedical explanation, the narrative understanding and the lived experience of trauma.

  5. Research on PTSD prevalence in OEF/OIF Veterans: expanding investigation of demographic variables

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    Lynnette A. Averill

    2015-05-01

    Full Text Available Background: A series of recent articles has reported on well-designed studies examining base rates of posttraumatic stress disorder (PTSD screenings within the Operation Enduring Freedom (Afghanistan conflict/Operation Iraqi Freedom (Iraq conflict (OEF/OIF military population. Although these studies have a number of strengths, this line of research points out several key areas in need of further examination. Objective: Many OEF/OIF Veterans do not use available Veterans Affairs (VA services, especially mental health care. This highlights the need to understand the differences between those who use and do not use the VA, especially as research with pre-OEF/OIF Veterans suggests that these two groups differ in significant ways. The high rates of PTSD-related concerns in non-VA users also points to a need to understand whether—and where—Veterans are seeking care outside the VA and the accessibility of evidence-based, trauma-focused treatments in the community and private sectors. Careful examination of relationship status is also paramount as little research has examined relationship status or other relationship context issues. Social support, especially from a spouse, can buffer the development of PTSD; however, relationship discord has the potential to greatly exacerbate PTSD symptomatology. Furthermore, given the additional risk factors for sexual minority Veterans to be exposed to trauma, the 2011 repeal of the US Military “Don't Ask, Don't Tell” policy, and the emergence of the VA as likely the largest health care provider for sexual minority Veterans, it will be critically important to study the trauma and mental health experiences of this group. Conclusions: Studies that examine prevalence rates of PTSD in the returning cohort contribute significantly to our understanding of the US OEF/OIF military population. Further study of PTSD in relation to demographic variables such as VA and non-VA use, relationship status, and sexual

  6. Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD

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    Rachel eYehuda

    2013-09-01

    Full Text Available Epigenetic alterations offer promise as prognostic or diagnostic markers, but it is not known whether these measures associate with, or predict, clinical state. These questions were addressed in a pilot study with combat veterans with PTSD to determine whether cytosine methylation in promoter regions of the glucocorticoid related NR3C1 and FKBP51 genes would predict or associate with treatment outcome. Veterans with PTSD received prolonged exposure (PE psychotherapy, yielding responders (n=8, defined by no longer meeting diagnostic criteria for PTSD, and non-responders (n=8. Blood samples were obtained at pre-treatment, after 12 weeks of psychotherapy (post-treatment, and after a 3 month follow-up. Methylation was examined in DNA extracted from lymphocytes. Measures reflecting glucocorticoid receptor (GR activity were also obtained from lymphocytes (i.e., plasma and 24h-urinary cortisol, plasma ACTH, lysozyme IC50-DEX, and plasma neuropetide-Y. Methylation of the GR gene (NR3C1 exon 1F promoter assessed at pre-treatment predicted treatment outcome, but was not significantly altered in responders or non-responders at post-treatment or follow-up. In contrast, methylation of the FKBP5 gene (FKBP51 exon 1 promoter region did not predict treatment response, but decreased in association with recovery. In a subset, a corresponding group difference in FKBP5 gene expression was observed, with responders showing higher gene expression at post-treatment than non-responders. Endocrine markers also changed in association with symptom change. These preliminary observations require replication and validation. However, the results support research indicating that some glucocorticoid related genes are subject to environmental regulation throughout life. Moreover, psychotherapy constitutes a form of ‘environmental regulation’ that may alter epigenetic state. Finally, the results further suggest that different genes may be associated with prognosis and symptom

  7. Posttraumatic Stress Disorder in Children and Adolescents: A Review of Psychopharmacological Treatment

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    Huemer, J.; Erhart, F.; Steiner, H.

    2010-01-01

    PTSD in children and adolescents differs from the adult disease. Therapeutic approaches involve both psychotherapy and psychopharmacotherapy. Objectives: The current paper aims at reviewing studies on psychopharmacological treatment of childhood and adolescent PTSD. Additionally, developmental frameworks for PTSD diagnosis and research along with…

  8. Mental health and PTSD in female North Korean refugees.

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    Shin, Gisoo; Lee, Suk Jeong

    2015-01-01

    This study was conducted to identify mental health status, post-traumatic stress disorder (PTSD), and psychophysiological change in female North Korean refugees. Data were collected using questionnaires and symptom checklists that measured PTSD and the psychosomatic state of the subjects. As many as 97 subjects, who had settled in and around Seoul, South Korea, were selected by snowball sampling. Mental health and PTSD levels of the participants were above a moderate level. We conclude that health care professionals need to provide female North Korean defectors with services to improve mental health and make the sociocultural transition successfully.

  9. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review

    OpenAIRE

    Kar N

    2011-01-01

    Nilamadhab KarDepartment of Psychiatry, Wolverhampton City Primary Care Trust, Wolverhampton, UKBackground: Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods us...

  10. Gender differences in relationships among PTSD severity, drinking motives, and alcohol use in a comorbid alcohol dependence and PTSD sample.

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    Lehavot, Keren; Stappenbeck, Cynthia A; Luterek, Jane A; Kaysen, Debra; Simpson, Tracy L

    2014-03-01

    Alcohol dependence (AD) and posttraumatic stress disorder (PTSD) are highly prevalent and comorbid conditions associated with a significant level of impairment. Little systematic study has focused on gender differences specific to individuals with both AD and PTSD. The current study examined gender-specific associations between PTSD symptom severity, drinking to cope (i.e., reduce negative affect), drinking for enhancement (i.e., increase positive affect), and average alcohol use in a clinical sample of men (n = 46) and women (n = 46) with comorbid AD and PTSD. Results indicated that PTSD symptoms were highly associated with drinking-to-cope motives for both men and women, but with greater drinking for enhancement motives for men only. Enhancement motives were positively associated with average alcohol quantity for both men and women, but coping motives were significantly associated with average alcohol quantity for women only. These findings suggest that for individuals with comorbid AD and PTSD, interventions that focus on reducing PTSD symptoms are likely to lower coping motives for both genders, and targeting coping motives is likely to result in decreased drinking for women but not for men, whereas targeting enhancement motives is likely to lead to reduced drinking for both genders.

  11. Testing the validity of the proposed ICD-11 PTSD and complex PTSD criteria using a sample from Northern Uganda

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    Siobhan Murphy

    2016-09-01

    Full Text Available Background: The International Classification of Diseases (ICD-11 is currently under development with proposed changes recommended for the posttraumatic stress disorder (PTSD diagnosis and the inclusion of a separate complex PTSD (CPTSD disorder. Empirical studies support the distinction between PTSD and CPTSD; however, less research has focused on non-western populations. Objective: The aim of this study was to investigate whether distinct PTSD and CPTSD symptom classes emerged and to identify potential risk factors and the severity of impairment associated with resultant classes. Methods: A latent class analysis (LCA and related analyses were conducted on 314 young adults from Northern Uganda. Fifty-one percent were female and participants were aged between 18 and 25 years. Forty percent of the participants were former child soldiers (n=124 while the remaining participants were civilians (n=190. Results: The LCA revealed three classes: a CPTSD class (40.2%, a PTSD class (43.8%, and a low symptom class (16%. Child soldier status was a significant predictor of both CPTSD and PTSD classes (OR=5.96 and 2.82, respectively. Classes differed significantly on measures of anxiety/depression, conduct problems, somatic complaints, and war experiences. Conclusions: To conclude, this study provides preliminary support for the proposed distinction between PTSD and CPTSD in a young adult sample from Northern Uganda. However, future studies are needed using larger samples to test alternative models before firm conclusions can be made.

  12. Spontaneous Remission From PTSD Depends on the Number of Traumatic Event Types Experienced

    OpenAIRE

    Kolassa, Iris; Ertl, Verena; Eckart, Cindy; Kolassa, Stephan; Onyut, Lamaro Patience; Elbert, Thomas

    2010-01-01

    As exposure to different types of traumatic stressors increases, the prevalence of PTSD increases. However, little is known about the effects of cumulative exposure to traumatic stress on the maintenance and remission from PTSD. In 2006/2007, we investigated 444 refugees from the 1994 Rwandan genocide, assessing exposure to traumatic events, current and lifetime PTSD, and PTSD symptom severity. Higher trauma exposure was associated with higher prevalence of current and lifetime PTSD, with low...

  13. Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

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    Nele Gielen

    2014-02-01

    Full Text Available Background: Healthcare providers working in addiction facilities do not often implement integrated treatment of comorbid substance use disorder (SUD and posttraumatic stress disorder (PTSD while there is empirical evidence to do so. Objective: This study aims to get insight into the views of clinicians with regard to the diagnosis and treatment of PTSD in SUD patients. Method: A qualitative research method was chosen. Fourteen treatment staff members of different wards of an addiction care facility were interviewed by an independent interviewer. Results: Despite acknowledging adverse consequences of trauma exposure on SUD, severe underdiagnosis of PTSD was mentioned and treatment of PTSD during SUD treatment was not supported. Obstacles related to the underestimation of PTSD among SUD patients and to the perceptions of SUD clinicians concerning the treatment of comorbid SUD/PTSD were reported. Conclusions: It is concluded that SUD facilities should train their clinicians to enable them to provide for integrated treatment of SUD/PTSD.

  14. An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

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    Matthias Knefel

    2013-12-01

    Full Text Available Background : The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11 that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD, also define a new diagnosis termed “complex posttraumatic stress disorder” (CPTSD. Objective : We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision] PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. Methods : To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C and the Brief Symptom Inventory (BSI scales, to a sample of adult survivors (N=229 of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA. Results : More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8% than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD. The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively. Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. Conclusion : CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects.

  15. [Historical perspective of PTSD and future revision in DSM-5].

    Science.gov (United States)

    Kim, Yoshiharu

    2012-01-01

    One of prototypes of PTSD is a fright neurosis conceptualized by Kraepelin and is on the line of traditional psychogenic reaction category defined by Sommers in so far as the re-experience symptoms reflects the content of a traumatic experience. Other key components of PTSD, such as avoidance of traumatic memory and hyperarousal, overlap respectively with dissociative disorders and the somatoform autonomic dysfunction (ICD-10), which may consist, together with comorbid mood and anxiety disorders of PTSD, a spectrum of posttraumatic mental disorders. The DSM-5 draft of PTSD restricts the category in terms of the event and re-experience criterion, put an emphasis upon dissociation and enlarges numbing symptom in that it is re-categorized as a cognitive and affective alterations to be separated from avoidance symptom. This change partly reflects insight into the nature of the disorder brought by CBT-based clinical experience.

  16. Epigenomic mechanisms of early adversity and HPA dysfunction: Considerations for PTSD research

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    Patrick O McGowan

    2013-09-01

    Full Text Available Childhood adversity can have life-long consequences for the response to stressful events later in life. Abuse or severe neglect are well known risk factors for post-traumatic stress disorder (PTSD, at least in part via changes in neural systems mediating the endocrine response to stress. Determining the biological signatures of risk for stress-related mental disorders such as PTSD is important for identifying homogenous subgroups and improving treatment options. This review will focus on epigenetic regulation in early life by adversity and parental care – prime mediators of offspring neurodevelopment - in order to address several questions: (1 what have studies of humans and analogous animal models taught us about molecular mechanisms underlying changes in stress-sensitive physiological systems in response to early life trauma? (2 What are the considerations for studies relating early adversity and PTSD risk, going forward? I will summarize studies in animals and humans that address the epigenetic response to early adversity in the brain and in peripheral tissues. In so doing, I will describe work on the Glucocorticoid Receptor (GR and other well-characterized genes within the stress response pathway and then turn to genomic studies to illustrate the use of increasingly powerful high-throughput approaches to the study of epigenomic mechanisms.

  17. Feature: Post Traumatic Stres Disorder PTSD: A Growing Epidemic / Neuroscience and PTSD Treatments

    Science.gov (United States)

    ... how D-cycloserine, an antibiotic, affects how Iraq war veterans experience fear. "We know how fear is turned on and off, where in the brain it occurs, and what drugs facilitate or inhibit it," she says. "D-cycloserine ...

  18. A VA medical center's PTSD residential recovery program.

    Science.gov (United States)

    Devaney, Donald E

    2010-01-01

    With the influx of military veterans with Post Traumatic Stress Disorder (PTSD) increasingly affecting all healthcare facilities, including acute care and long term, learning from the experience of VA hospitals in treating those with PTSD may prove valuable. In this article, Tripler/VA Provost Marshal Donald E. Delaney describes a program that has been in operation since 1994. He may be contacted for further in formation at (808) 433-4465 or Donald.devaney@amedd.army .mil

  19. Serotonin and Cortisol as Suicidogenic Factors in Patients with PTSD

    OpenAIRE

    Grah, Majda; Mihanović, Mate; Svrdlin, Pero; Vuk Pisk, Sandra; Restek-Petrović, Branka

    2010-01-01

    Post-traumatic Stress Disorder (PTSD) frequently occurs in commorbidity with different mental disorders, including suicidal behaviour. Group of biological factors, including serotonergic system, HPA axis and some genetic factors, are being studied as potential markers, able to differentiate suicidal and non-suicidal behaviour across the group of PTSD patients. This study is examining statistical relation between platelet serotonine concentration and serum cortisole concentration, within the g...

  20. Menstrual cycle effects on psychological symptoms in women with PTSD.

    Science.gov (United States)

    Nillni, Yael I; Pineles, Suzanne L; Patton, Samantha C; Rouse, Matthew H; Sawyer, Alice T; Rasmusson, Ann M

    2015-02-01

    The menstrual cycle has been implicated as a sex-specific biological process influencing psychological symptoms across a variety of disorders. Limited research exists regarding the role of the menstrual cycle in psychological symptoms among women with posttraumatic stress disorder (PTSD). The current study examined the severity of a broad range of psychological symptoms in both the early follicular (Days 2-6) and midluteal (6-10 days postlutenizing hormone surge) phases of the menstrual cycle in a sample of trauma-exposed women with and without PTSD (N = 49). In the sample overall, total psychological symptoms (d = 0.63), as well as depression (d = 0.81) and phobic anxiety (d = 0.81) symptoms, specifically, were increased in the early follicular compared to midluteal phase. The impact of menstrual cycle phase on phobic anxiety was modified by a significant PTSD × Menstrual Phase interaction (d = 0.63). Women with PTSD reported more severe phobic anxiety during the early follicular versus midluteal phase, whereas phobic anxiety did not differ across the menstrual cycle in women without PTSD. Thus, the menstrual cycle appears to impact fear-related symptoms in women with PTSD. The clinical implications of the findings and future research directions are discussed.