Disorders - Post Traumatic Stress Disorder
Brown, L. A., Davies, C. D., Gerlach, A., Cooper, R., Stevens, S., Craske, M. G.
While several empirically supported treatments for posttraumatic stress disorder (PTSD) have been developed, these treatments are neither widely available nor universally efficacious. This pilot, proof of concept study evaluated a computerized imaginal exposure Script-Driven Imagery Training (SDI-T) for individuals with elevated trauma reactivity. The training was supplemented with two forms of linguistic processing, affect labeling (SDI-T + AL) and distraction (SDI-T + D), to determine whether linguistic inhibitory regulation augmented the effects of SDI-T. Methods: Participants (n = 64) with trauma-related distress were randomized to SDI-T, SDI-T + AL, or SDI-T + D. Physiology and self-reported trauma distress were measured at pre- and post-training. Results: The training was acceptable to participants and effective at reducing self-reported distress (d = -0.41), and physiological activation from pre- to post-training (d = -0.49, ps <.01), with some evidence that linguistic processing (SDI-T + AL and SDIT-T + D) conferred a benefit over SDI-T. The linguistic processing groups had significantly steeper reduction in physiology relative to the non-linguistic processing group (p <.05, d = 0.59). There was no benefit of SDI-T + AL over SDI-T + D. Conclusions: This pilot study provides initial support for the acceptability and efficacy of computerized imaginal exposure training for PTSD. Clinical implications and future directions are discussed. Copyright © 2018
Journal of Anxiety Disorders, 57 : 16-23
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Chen, Y. Y., Kao, M. C.
Background: Previous research has revealed mixed findings with regard to the effects of disclosure on trauma recovery. More recently, studies on psychological trauma have found associations among religion, meaning, and health. This study investigated prior disclosure as a moderator for the association between religious emotional expression and adaptive trauma processing, as measured by post-traumatic stress disorder (PTSD) symptoms. Method(s): Using Pennebaker's written emotional expression paradigm, 105 participants were assigned to either a conventional trauma-writing condition or religious trauma-writing condition. PTSD symptoms were assessed at baseline and again at one-month post writing. Result(s): A two-way interaction was found between prior disclosure and writing condition on PTSD symptoms at follow-up. For the religious trauma-writing condition only, there was a significant difference between low versus high disclosure participants in PTSD symptoms at follow-up, such that low prior disclosure participants registered fewer PTSD symptoms than high prior disclosure participants, while prior disclosure did not have such effect in the conventional trauma-writing condition. Limitation(s): This two-way interaction may be further qualified by other important psychosocial variables, such as differences in personality, coping style, social support, or use of prayer as a form of disclosure, which were not assessed in this study. Conclusion(s): Religious emotional expression may encourage adaptive trauma processing, especially for individuals with low prior disclosure. These findings encourage further investigation of the conditions under which disclosure and religion may be a beneficial factor in trauma adaptation and treatment. Copyright © 2017, © The Author(s) 2017.
International Journal of Psychiatry in Medicine, 53(3) : 189-196
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
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Stage: Universal prevention
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Treatment and intervention: Other Psychological Interventions
Dawson, K., Joscelyne, A., Meijer, C., Steel, Z., Silove, D., Bryant, R. A.
Objective: To evaluate the relative efficacies of trauma-focused cognitive behavior therapy and problem-solving therapy in treating post-traumatic stress disorder in children affected by civil conflict in Aceh, Indonesia. Method: A controlled trial of children with post-traumatic stress disorder (N = 64) randomized children to either five individual weekly sessions of trauma-focused cognitive behavior therapy or problem-solving therapy provided by lay-counselors who were provided with brief training. Children were assessed by blind independent assessors at pretreatment, posttreatment and 3-month follow-up on post-traumatic stress disorder, depression and anger, as well as caregiver ratings of the child's post-traumatic stress disorder levels. Results: Intent-to-treat analyses indicated no significant linear time x treatment condition interaction effects for post-traumatic stress disorder at follow-up (t(129.05) = -0.55, p = 0.58), indicating the two conditions did not differ. Across both conditions, there were significant reductions in post-traumatic stress disorder on self-reported (t(131.26) = -9.26, p < 0.001) and caregiver-reported (t(170.65) = 3.53, p = 0.001) measures and anger (t(127.66) = -7.14, p < 0.001). Across both conditions, there was a large effect size for self-reported post-traumatic stress disorder (cognitive behavior therapy: 3.73, 95% confidence interval = [2.75, 3.97]; problem-solving: 2.68, 95% confidence interval = [2.07, 3.29]). Conclusions: These findings suggest that trauma-focused cognitive behavior therapy and problem-solving approaches are comparably successful in reducing post-traumatic stress disorder and anger in treating mental health in children in a post-conflict setting. This pattern may reflect the benefits of non-specific therapy effects or gains associated with trauma-focused or problem-solving approaches. Copyright © 2017, © The Royal Australian and New Zealand College of Psychiatrists 2017.
Australian and New Zealand Journal of Psychiatry, 52(3) : 253-261
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Problem solving therapy (PST)
Pfeiffer, E., Sachser, C., Rohlmann, F., Goldbeck, L.
Background: As access to evidence-based treatments for young refugees with posttraumatic stress symptoms (PTSS) is limited, we developed the trauma-focused group intervention Mein Weg to be delivered by trained social workers. A recently published pilot study delivered preliminary evidence of the intervention with regard to symptom reduction and its feasibility. The aim of this study was, therefore, to determine whether the intervention, in addition to usual care (UC), is more effective in reducing PTSS (primary outcome) compared to UC alone. Methods: A parallel group randomized controlled trial was conducted in seven German child and adolescent welfare agencies. Participants were randomly assigned to either six sessions Mein Weg (n = 50; Mage = 17.00, 94% male) or UC (n = 49; Mage = 16.92, 92% male). Mixed effect models, with fixed effects of group and time as well as their interaction, were performed on the relevant outcome measures. This trial was registered in the German Clinical Trials Registry (#DRKS00010915, https://www.d rks.de/drks_web/). Results: Intention-to-treat analyses showed that Mein Weg was significantly superior to UC regarding symptom improvement of self-reported PTSS (Mein Weg: d = .61, UC: d = .15) and depression (Mein Weg: d = .63, UC: d = .06), but not regarding caregiver-reported symptoms and self-reported dysfunctional posttraumatic cognitions. Conclusions: MeinWeg is effective for young refugees according to self-reports and can be viewed as a valuable component in a stepped care approach for this vulnerable population. The findings need to be replicated with independent clinical assessments. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Child Psychology and Psychiatry, 59(11) : 1171-1179
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
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Stage: Disorder established (diagnosed disorder)
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Treatment and intervention: Other Psychological Interventions
Rosenberg, L., Rosenberg, M., Sharp, S., Thomas, C. R., Humphries, H. F., Holzer, C. E., Herndon, D. N., Meyer, W. J.
Objective: This study examined whether acute propranolol treatment prevented posttraumatic stress disorder (PTSD), anxiety, and depression in children hospitalized in the pediatric intensive care unit for large burns. We hypothesized that the prevalence of PTSD, anxiety, and depression would be significantly less in the propranolol than nonpropranolol groups. Methods: Children who had previously participated in a randomized controlled clinical trial of acute propranolol and nonpropranolol controls were invited to participate in long-term follow-up interviews. Eligible participants from 1997 to 2008 were identified from the electronic medical records, and data were collected in 2010-2011. Measures included the Missouri Assessment of Genetics Interview for Children to assess lifetime PTSD, Revised Children's Manifest Anxiety Scale to assess anxiety, and two depression inventories Children's Depression Inventory and Beck Depression Inventory-II. Results: Of 202 participants, 89 were in the propranolol group and 113 were nonpropranolol controls. Children were an average of 7 years postburn. The average total body surface area burned was 56.4 + 15.1% (range = 24%-99%). The mean dose of propranolol was 3.64 +/- 3.19 mg/kg per day (range = 0.36-12.12). The duration of propranolol inpatient treatment days varied, mean days 26.5 +/- 19.8. The prevalence of lifetime PTSD in the propranolol group was 3.5% and controls 7.2%, but this difference was not statistically significant. We controlled for administration of pain medications, anxiolytics, and antidepressants overall and no significant differences were detected in the rates of PTSD, anxiety, or depression. Conclusions: The prevalence of PTSD, anxiety, and depression was similar in children who received propranolol acutely and those who did not. This may be influenced by the standard of care that all children received timely pharmacotherapy for pain and anxiety management and psychotherapy beginning in their acute phase of treatment. © Copyright 2018, Mary Ann Liebert, Inc.
Journal of Child and Adolescent Psychopharmacology, 28(2) : 117-123
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Biological Interventions (any)
, Other biological interventions
Santiago, C. D., Raviv, T., Ros, A. M., Brewer, S. K., Distel, L. M. L., Torres, S. A., Fuller, A. K., Lewis, K. M., Coyne, C. A., Cicchetti, C., Langley, A. K.
The current study provides the first replication trial of Bounce Back, a school-based intervention for elementary students exposed to trauma, in a different school district and geographical area.
School Psychology Quarterly, 33(1) : 1-9
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions (any)
, Trauma-focused cognitive behavioural therapy (TF-CBT)
Shors, T. J., Chang, H. Y. M., Millon, E. M.
Sexual violence against women often leads to post-traumatic stress disorder (PTSD), a mental illness characterized by intrusive thoughts and memories about the traumatic event (Shors and Millon, 2016). These mental processes are obviously generated by the brain but often felt in the body. MAP Training My BrainTM is a novel clinical intervention that combines mental training of the brain with physical training of the body (Curlik and Shors, 2013; Shors et al., 2014). Each training session begins with 20-min of sitting meditation, followed by 10-min of slow-walking meditation, and ending with 30-min of aerobic exercise at 60-80% of the maximum heart rate (see maptrainmybrain.com). In previous studies, the combination of mental and physical (MAP) training together significantly reduced symptoms of depression and ruminative thoughts, while reducing anxiety (Shors et al., 2014, 2017; Alderman et al., 2016). We also documented positive changes in brain activity during cognitive control and whole-body oxygen consumption in various populations. In the present pilot study, we asked whether the combination of meditation and aerobic exercise during MAP Training would reduce trauma-related thoughts, ruminations, and memories in women and if so, whether the combination would be more effective than either activity alone. To test this hypothesis, interventions were provided to a group of women (n = 105), many of whom had a history of sexual violence (n = 32). Groups were trained with (1) MAP Training, (2) meditation alone, (3) aerobic exercise alone, or (4) not trained. Individuals in training groups completed two sessions a week for at least 6 weeks. MAP Training My BrainTM significantly reduced post-traumatic cognitions and ruminative thoughts in women with a history of sexual violence, whereas meditation alone, and exercise alone did not. MAP Training significantly enhanced a measure of self-worth, whereas meditation and exercise alone did not. Similar positive effects were observed for all participants, although meditation alone was also effective in reducing trauma-related thoughts. Overall, these data indicate the combination of meditation and exercise is synergistic. As a consequence, MAP Training is preferable and especially so for women who have experienced sexual violence in their past. Simply put, the whole is greater than the sum of its parts. Copyright © 2018 Shors, Chang and Millon.
Frontiers in Neuroscience, 12 (APR) (no pagination)(211) :
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
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Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Meditation
, Physical activity, exercise
Hourani, L., Tueller, S., Kizakevich, P., Strange, L., Lewis, G., Weimer, B., Morgan, J., Cooney, D., Nelson, J.
In a previous study, we developed and evaluated a pilot predeployment stress inoculation training (SIT) program designed to teach relaxation breathing skills to minimize negative mental health consequences of combat stress. This study extends the investigation of the effectiveness of a SIT program of relaxation breathing on perceived stress symptoms and other mental health outcomes in a longitudinal randomized controlled trial. Heart rate variability was used to test the effect of SIT in reducing autonomic arousal in response to simulated combat-related stressors. Soldiers were randomized into SIT versus control groups at baseline and followed for 1 to 2 years. SIT did not have an overall effect on perceived stress scores or posttraumatic stress disorder symptoms when controlling for covariates. Consistent with previous findings in which SIT mitigated the risk of posttraumatic stress disorder in those without baseline mental health problems, the current study showed that SIT may prevent hyperarousal symptoms, among mentally healthy military personnel who are not otherwise interested in learning stress-control techniques, but was not supported as a general predeployment mental health prevention strategy. A heart rate variability increase in response to relaxation breathing training suggests further research is warranted into mental health effects of self-regulation techniques. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
International Journal of Stress Management, 25(S1) : 124-136
- Year: 2018
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Psychoeducation, Other Psychological Interventions
Abuwalla, Z., Clark, M. D., Burke, B., Tannenbaum, V., Patel, S., Mitacek, R., Gladstone, T., Van-Voorhees, B.
Introduction This rapid review identifies and summarizes the effectiveness of preventative telemental health interventions. It investigates studies conducted between 2010 and 2016 that improve mood and anxiety with long-term follow-up. Methods A literature search of three major databases was performed by four reviewers. After citation tracing, 3604 studies were discovered, and twenty of these met the inclusion criteria. Data from the papers were abstracted, assessed for quality, and effect sizes were calculated. Results Salient information was discussed using the Behavioural Vaccine Model of mental illness prevention. This included key concepts such as efficacy, duration of benefits, sociocultural relevance, professional guidance, peer-to-peer support, adherence, delivery and safety. Conclusion This review suggests there are clear prolonged benefits to using technology in youth mental illness prevention. Although this is a rapidly growing area of investigation in countries around the globe, there is still a dearth of research with long-term follow-up. Future studies should aim to boost engagement by increasing motivational guidance in order to recruit at-risk youth of all demographics into these promising intervention programs. Copyright © 2017
Internet Interventions, 11 : 20-29
- Year: 2018
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention
, At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions (any)
, Cognitive & behavioural therapies (CBT)
, Skills training, Attention/cognitive bias modification
, Technology, interventions delivered using technology (e.g. online, SMS)
Purgato, M., Gross, A. L., Betancourt, T., Bolton, P., Bonetto, C., Gastaldon, C., Gordon, J., OCallaghan, P., Papola, D., Peltonen, K., Punamaki, R. L., Richards, J., Staples, J. K., Unterhitzenberger, J., van-Ommeren, M., de-Jong, J., Jordans, M. J. D., Tol, W. A., Barbui, C.
Background: Results from studies evaluating the effectiveness of focused psychosocial support interventions in children exposed to traumatic events in humanitarian settings in low-income and middle-income countries have been inconsistent, showing varying results by setting and subgroup (eg, age or gender). We aimed to assess the effectiveness of these interventions, and to explore which children are likely to benefit most. Methods: We did a systematic review and meta-analysis of individual participant data (IPD) from 3143 children recruited to 11 randomised controlled trials of focused psychosocial support interventions versus waiting list. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, PsycArticles, Web of Science, and the main local low-income and middle-income countries (LMICs) databases according to the list of databases relevant to LMIC developed collaboratively by Cochrane and WHO Library, up to November, 2016. We included randomised controlled trials that assessed the effectiveness of focused psychosocial support interventions in children exposed to traumatic events in LMICs, compared with waiting lists (eg, inactive controls). We excluded quasi-randomised trials, studies that did not focus on psychosocial support interventions, and studies that compared two active interventions without control conditions. We requested anonymised data from each trial for each of the prespecified variables for each child who was randomly assigned. The main outcomes considered were continuous scores in post-traumatic stress disorder (PTSD) symptoms, depressive symptoms, and anxiety symptoms assessed with rating scales administered immediately (0-4 weeks) after the intervention. We harmonised all individual items from rating scales using item response theory methods. This study is registered with PROSPERO, number CRD42013006960. Findings: We identified a beneficial effect of focused psychosocial support interventions on PTSD symptoms (standardised mean difference [SMD] -0.33, 95% CI -0.52 to -0.14) that was maintained at follow-up (-0.21, -0.42 to -0.01). We also identified benefits at the endpoint for functional impairment (-0.29, -0.43 to -0.15) and for strengths: coping (-0.22, -0.43 to -0.02), hope (-0.29, -0.48 to -0.09), and social support (-0.27, -0.52 to -0.02). In IPD meta-analyses focused on age, gender, displacement status, region, and household size we found a stronger improvement in PTSD symptoms in children aged 15-18 years (-0.43, -0.63 to -0.23), in non-displaced children (-0.40, -0.52 to -0.27), and in children living in smaller households (<6 members; -0.27, -0.42 to -0.11). Interpretation: Overall, focused psychosocial interventions are effective in reducing PTSD and functional impairment, and in increasing hope, coping, and social support. Future studies should focus on strengthening interventions for younger children, displaced children, and children living in larger households. Funding: European Commission FP7th Framework Programme for Research (Marie Curie International Outgoing Fellowship) and the National Institute on Aging. Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license
The Lancet Global Health, 6(4) : e390-e400
- Year: 2018
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Complementary & Alternative Interventions (CAM)
, Psychological Interventions (any)
Verardo, A. R., Cioccolanti, E.
Objective: The aim of this review is to examine the efficacy of EMDR treatment on children and adolescents with post traumatic stress disorder symptoms through comparison with other established trauma treatment or no treatment control groups. Method: It was conducted a literature search concerning the effects of EMDR treatment on symptomatologic pictures derived by Post-Traumatic Stress Disorder diagnosis in children and adolescents by analysing digital databases like PsycINFO, MEDLINE, Google Scholar and Cochrane Library and with a traditional research method, targeting revisions and articles. Results: Results show efficacy of EMDR especially according to the number of sessions. Fewer EMDR sessions are associated with the best outcomes. Conclusions: These findings support the use of EMDR for treating symptoms of PTSD in children, although further replication and comparison are required. Copyright © 2017 Giovanni Fioriti Editore s.r.l.
Clinical Neuropsychiatry, 14(5) : 313-320
- Year: 2017
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
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Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions (any)
, Eye movement desensitisation and reprocessing (EMDR)
Barron, I., Abdallah, G.
The current study evaluated the new "Children and Grief" program for Palestinian adolescents (n = 158), aged 10-18, referred to counselors for complicated grief. A mixed methods quasi-experimental design involved non-randomized intervention group (n = 79), waitlist (n = 79), and measures of program fidelity and cost. Traumatic loss was identified from case files. Standardized measures assessed complicated grief, posttraumatic stress, and depression at pre and post-test. Interviews of 9 adolescents and 9 presenters explored subjective experience of program delivery. Analysis involved multivariate analysis of variance (MANOVA) and quasi-qualitative analysis of interviews. A large effect size was found for reduced complicated grief. Randomized control trials, longitudinal research, and studies that explore the impact of martyrdom on coping with grief are needed. Copyright © 2017 Taylor & Francis.
Journal of Aggression, Maltreatment and Trauma, 26(4) : 372-390
- Year: 2017
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
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Stage: At risk (indicated or selected prevention)
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Treatment and intervention: Psychological Interventions (any)
, Other Psychological Interventions