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https://www.readbyqxmd.com/read/28878718/errors-in-the-2017-apa-clinical-practice-guideline-for-the-treatment-of-ptsd-what-the-data-actually-says
#1
REVIEW
Sarah K Dominguez, Christopher W Lee
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...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28793834/a-preliminary-examination-of-the-role-of-psychotherapist-fidelity-on-outcomes-of-cognitive-processing-therapy-during-an-rct-for-military-sexual-trauma-related-ptsd
#2
Nicholas Holder, Ryan Holliday, Rush Williams, Kacy Mullen, Alina Surís
While cognitive processing therapy (CPT) is an effective evidence-based treatment for many veterans with military-related post-traumatic stress disorder (PTSD), not all veterans experience therapeutic benefit. To account for the discrepancy in outcomes, researchers have investigated patient- and research design-related factors; however, therapist factors (e.g. fidelity) have received less attention. The present study is a preliminary examination of the effect of psychotherapists' fidelity during CPT on clinical outcomes during a randomized clinical trial (RCT) for military sexual trauma-related PTSD...
August 10, 2017: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/28767012/role-of-borderline-personality-disorder-in-the-treatment-of-military-sexual-trauma-related-posttraumatic-stress-disorder-with-cognitive-processing-therapy
#3
Nicholas Holder, Ryan Holliday, Anushka Pai, Alina Surís
Cognitive Processing Therapy (CPT) is an effective evidence-based treatment for many, but not all, veterans with posttraumatic stress disorder (PTSD). Understanding the factors that contribute to poorer response to CPT is important for providing the best care to veterans diagnosed with PTSD. Researchers investigating the effectiveness of CPT for individuals with comorbid personality symptoms have found that borderline personality disorder (BPD) characteristics do not negatively affect treatment outcome; however, participants in those studies were not diagnosed with BPD...
July 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28741736/increased-mindfulness-skills-as-predictors-of-reduced-trauma-related-guilt-in-treatment-seeking-veterans
#4
Philip Held, Gina P Owens, J Richard Monroe, Kathleen M Chard
The present study examined the predictive role of increased self-reported mindfulness skills on reduced trauma-related guilt in a sample of veterans over the course of residential treatment for posttraumatic stress disorder (PTSD; N = 128). The residential treatment consisted of seven weeks of intensive cognitive processing therapy (CPT) for PTSD, as well as additional psychoeducational groups, including seven sessions on mindfulness skills. Increased mindfulness skills describing, acting with awareness, and accepting without judgment were significantly associated with reductions in trauma-related guilt over the course of treatment...
August 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28667201/study-protocol-for-a-randomised-controlled-trial-of-cognitive-processing-therapy-for-post-traumatic-stress-disorder-among-japanese-patients-the-safety-power-intimacy-esteem-trust-spinet-study
#5
Masaya Ito, Masaru Horikoshi, Patricia A Resick, Akiko Katayanagi, Mitsuhiro Miyamae, Yuriko Takagishi, Yoshitake Takebayashi, Ayako Kanie, Naotsugu Hirabayashi, Toshiaki A Furukawa
INTRODUCTION: Cognitive processing therapy (CPT) is widely regarded as a safe and effective first-line treatment for individuals with post-traumatic stress disorder (PTSD); however, no comparative studies have been conducted to examine the treatment outcomes in an Asian population. The aim of the present trial is to investigate the efficacy of CPT (individual format) as a treatment for PTSD in a population of Japanese patients. METHODS AND ANALYSIS: A 16-week, single-centre, assessor-masked, randomised, parallel-group superiority trial has been designed to compare the efficacy of CPT in conjunction with treatment as usual (mostly pharmacotherapy and clinical monitoring) versus treatment as usual alone...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28503726/baroreflex-dysfunction-and-augmented-sympathetic-nerve-responses-during-mental-stress-in-veterans-with-post-traumatic-stress-disorder
#6
Jeanie Park, Paul J Marvar, Peizhou Liao, Melanie L Kankam, Seth D Norrholm, Ryan M Downey, S Ashley McCullough, Ngoc-Anh Le, Barbara O Rothbaum
KEY POINTS: Patients with post-traumatic stress disorder (PTSD) are at a significantly higher risk of developing hypertension and cardiovascular disease. The mechanisms underlying this increased risk are not known. Studies have suggested that PTSD patients have an overactive sympathetic nervous system (SNS) that could contribute to cardiovascular risk; however, sympathetic function has not previously been rigorously evaluated in PTSD patients. Using direct measurements of sympathetic nerve activity and pharmacological manipulation of blood pressure, we show that veterans with PTSD have augmented SNS and haemodynamic reactivity during both combat-related and non-combat related mental stress, impaired sympathetic and cardiovagal baroreflex sensitivity, and increased inflammation...
July 15, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28485687/therapeutic-response-to-cognitive-processing-therapy-in-white-and-black-female-veterans-with-military-sexual-trauma-related-ptsd
#7
Ryan P Holliday, Nicholas D Holder, Meredith L C Williamson, Alina Surís
Cognitive Processing Therapy (CPT) is an evidence-based treatment (EBT) for posttraumatic stress disorder (PTSD) which has been validated for female veterans with military-related PTSD. Existing trials have enrolled predominantly White veterans with some studies documenting higher rates of early termination from EBTs among Black females when compared to White females. Data from a previously published randomized clinical trial were used to evaluate the effectiveness of CPT for Black female veterans with military sexual trauma (MST)-related PTSD...
May 9, 2017: Cognitive Behaviour Therapy
https://www.readbyqxmd.com/read/28414493/predictors-of-differential-ptsd-treatment-outcomes-between-veteran-and-civilian-women-after-cognitive-processing-therapy
#8
Robyn L Gobin, Margaret-Anne Mackintosh, Emy Willis, Carolyn B Allard, Karen Kloezeman, Leslie A Morland
OBJECTIVE: This study used data from a recent randomized clinical trial (RCT) that found differences between women veterans and civilians in posttraumatic stress disorder (PTSD) treatment response, with civilians demonstrating greater improvement than did veterans. Despite having similar PTSD severity scores at baseline, veterans scored roughly 18 points higher than civilians did on the Clinician-Administered PTSD Scale (CAPS) at posttreatment (p < .01). This study sought to identify the clinical and treatment variables that were associated with the differential response to treatment demonstrated by the women in the RCT...
April 17, 2017: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/28287769/increased-utilization-of-prolonged-exposure-and-cognitive-processing-therapy-over-time-a-case-example-from-a-large-veterans-affairs-posttraumatic-stress-disorder-clinic
#9
Natalie E Hundt, Juliette M Harik, Karin E Thompson, Terri L Barrera, Shannon Reynolds Miles
Prior single-site and regional studies have documented difficulties in implementing prolonged exposure (PE) and cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) into practice in Veterans Affairs (VA) Medical Centers, estimating that between 6% and 13% of VA patients with PTSD receive PE or CPT (Lu, Plagge, Marsiglio, & Dobscha, 2016; Mott et al., 2014; Shiner et al., 2013). However, these studies examined data from fiscal years 2008-2012, and therefore may not reflect more recent utilization patterns...
March 13, 2017: Psychological Services
https://www.readbyqxmd.com/read/28270330/fidelity-to-the-cognitive-processing-therapy-protocol-evaluation-of-critical-elements
#10
Courtney C Farmer, Karen S Mitchell, Kelly Parker-Guilbert, Tara E Galovski
The contributions of individual therapy elements to the overall efficacy of evidence-based practices for the treatment of posttraumatic stress disorder (PTSD) are not well-understood. This study first examined the extent to which theoretically important treatment components of Cognitive Processing Therapy (CPT; i.e., skill in Socratic questioning; prioritizing assimilation; attention to practice assignments; emphasis on expression of natural affect) were successfully administered across the course of therapy for 68 PTSD-positive survivors of interpersonal trauma...
March 2017: Behavior Therapy
https://www.readbyqxmd.com/read/28264720/improving-and-sustaining-delivery-of-cpt-for-ptsd-in-mental-health-systems-a-cluster-randomized-trial
#11
Shannon Wiltsey Stirman, Erin P Finley, Norman Shields, Joan Cook, Rachel Haine-Schlagel, James F Burgess, Linda Dimeff, Kelly Koerner, Michael Suvak, Cassidy A Gutner, David Gagnon, Tasoula Masina, Matthew Beristianos, Kera Mallard, Vanessa Ramirez, Candice Monson
BACKGROUND: Large-scale implementation of evidence-based psychotherapies (EBPs) such as cognitive processing therapy (CPT) for posttraumatic stress disorder can have a tremendous impact on mental and physical health, healthcare utilization, and quality of life. While many mental health systems (MHS) have invested heavily in programs to implement EBPs, few eligible patients receive EBPs in routine care settings, and clinicians do not appear to deliver the full treatment protocol to many of their patients...
March 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/27893265/va-residential-treatment-providers-use-of-two-evidence-based-psychotherapies-for-ptsd-global-endorsement-versus-specific-components
#12
Richard Thompson, Vanessa Simiola, Paula P Schnurr, Shannon Wiltsey Stirman, Joan M Cook
Objective: Despite a growing body of knowledge about the dissemination of evidence-based psychotherapies (EBPs), their actual use in clinical settings is not well understood. The purpose of the current study was to compare self-reported component use with global use for 2 EBPs for posttraumatic stress disorder (PTSD), prolonged exposure (PE), and cognitive processing therapy (CPT). Method: Around 174 providers from 38 VA PTSD residential treatment programs were asked about both global use and component use of PE and CPT...
November 28, 2016: Psychological Trauma: Theory, Research, Practice and Policy
https://www.readbyqxmd.com/read/27893032/effect-of-group-vs-individual-cognitive-processing-therapy-in-active-duty-military-seeking-treatment-for-posttraumatic-stress-disorder-a-randomized-clinical-trial
#13
RANDOMIZED CONTROLLED TRIAL
Patricia A Resick, Jennifer Schuster Wachen, Katherine A Dondanville, Kristi E Pruiksma, Jeffrey S Yarvis, Alan L Peterson, Jim Mintz, Elisa V Borah, Antoinette Brundige, Elizabeth A Hembree, Brett T Litz, John D Roache, Stacey Young-McCaughan
Importance: Cognitive processing therapy (CPT), an evidence-based treatment for posttraumatic stress disorder (PTSD), has not been tested as an individual treatment among active-duty military. Group CPT may be an efficient way to deliver treatment. Objective: To determine the effects of CPT on PTSD and co-occurring symptoms and whether they differ when administered in an individual or a group format. Design, Setting, and Participants: In this randomized clinical trial, 268 active-duty servicemembers consented to assessment at an army medical center from March 8, 2012, to September 23, 2014, and were randomized to group or individual CPT...
January 1, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/27771824/treating-posttraumatic-stress-disorder-in-diverse-settings-recent-advances-and-challenges-for-the-future
#14
REVIEW
Louise E Dixon, Emily Ahles, Luana Marques
Racial and ethnic minorities are at high risk for developing posttraumatic stress disorder (PTSD) after experiencing a traumatic event and are less likely to receive evidence-based treatment for their symptoms. There is a growing body of literature showing that culturally appropriate interventions result in greater uptake, symptom reduction, and sustained treatment gains. This article review explores new findings in the cultural understanding of PTSD among racial and ethnic minorities. We first review recent advances in the understanding of PTSD symptomotology...
December 2016: Current Psychiatry Reports
https://www.readbyqxmd.com/read/27758724/-recognizing-signs-of-sexual-abuse
#15
T A M Teunissen, S H Lo Fong Wong, A L M Lagro-Janssen
Sexual abuse is very common. In the Netherlands 42% of women and 13% of men aged over 25 years have experienced unacceptable sexual behaviour. Most victims do not seek professional help nor do they report the abuse to the police, and most of the victims who do seek medical help do not mention the abuse. Doctors often do not recognize the signs of sexual abuse. Most victims of rape have symptoms that may develop into posttraumatic stress disorder (PTSD) if they persist for more than 4 weeks, such as sleep problems or panic attacks...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27750113/laboratory-impulsivity-and-depression-in-blast-exposed-military-personnel-with-post-concussion-syndrome
#16
James M Bjork, Thomas K Burroughs, Laura M Franke, Treven C Pickett, Sade E Johns, F Gerard Moeller, William C Walker
In military populations, traumatic brain injury (TBI) also holds potential to increase impulsivity and impair mood regulation due to blast injury effects on ventral frontal cortex - to put military personnel at risk for suicide or substance abuse. We assessed a linkage between depression and impaired behavioral inhibition in 117 blast-exposed service members (SM) and veterans with post-concussion syndrome (PCS), where PCS was defined using a Rivermead Postconcussive Symptom Questionnaire (RPQ) modified to clarify whether each symptom worsened compared to pre-blast...
December 30, 2016: Psychiatry Research
https://www.readbyqxmd.com/read/27681034/effectiveness-of-prolonged-exposure-and-cognitive-processing-therapy-for-u-s-veterans-with-a-history-of-traumatic-brain-injury
#17
Katie A Ragsdale, Sarah C Voss Horrell
This retrospective analysis of previously existing nonrandomized clinical data examined the effectiveness of completing prolonged exposure (PE) or cognitive processing therapy (CPT) in a sample of 41 U.S. veterans at a Veterans Affairs medical center. The sample included 19 veterans with diagnoses of posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) and 22 veterans with PTSD only. Diagnostic groups did not significantly differ on PTSD and depression symptom reduction, F(2, 36) = 0.05, p = ...
October 2016: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/27499808/mental-illness-stigma-and-engagement-in-an-implementation-trial-for-cognitive-processing-therapy-at-a-diverse-community-health-center-a-qualitative-investigation
#18
Sarah E Valentine, Louise Dixon, Christina P C Borba, Derri L Shtasel, Luana Marques
The present study aimed to describe associations between various types of mental health stigma and help-seeking behaviors among ethnically diverse clients with posttraumatic stress disorder (PTSD) served by an urban community health clinic. The present study draws qualitative data from a parent National Institute of Mental Health Study that aims to identify barriers and facilitators of implementing Cognitive Processing Therapy (CPT) for PTSD. A total of 24 participants from the initial phase of the trial were included in the present study...
2016: International Journal of Culture and Mental Health
https://www.readbyqxmd.com/read/27378013/cognitive-processing-therapy-for-spanish-speaking-latinos-a-formative-study-of-a-model-driven-cultural-adaptation-of-the-manual-to-enhance-implementation-in-a-usual-care-setting
#19
Sarah E Valentine, Christina P C Borba, Louise Dixon, Adin S Vaewsorn, Julia Gallegos Guajardo, Patricia A Resick, Shannon Wiltsey Stirman, Luana Marques
OBJECTIVE: As part of a larger implementation trial for cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) in a community health center, we used formative evaluation to assess relations between iterative cultural adaption (for Spanish-speaking clients) and implementation outcomes (appropriateness and acceptability) for CPT. METHOD: Qualitative data for the current study were gathered through multiple sources (providers: N = 6; clients: N = 22), including CPT therapy sessions, provider fieldnotes, weekly consultation team meetings, and researcher fieldnotes...
March 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/27348065/the-influence-of-patient-readiness-on-implementation-of-evidence-based-ptsd-treatments-in-veterans-affairs-residential-programs
#20
Joan M Cook, Vanessa Simiola, Jessica L Hamblen, Nancy Bernardy, Paula P Schnurr
OBJECTIVE: Mental health provider perceptions of patient readiness for trauma-focused evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD) have been found to impact outpatient care in the Department of Veterans Affairs (VA). METHOD: One hundred and 72 mental health directors and providers from 36 VA residential PTSD treatment programs completed qualitative interviews regarding implementation of two EBTs, Prolonged Exposure (PE), and Cognitive Processing Therapy (CPT)...
August 2017: Psychological Trauma: Theory, Research, Practice and Policy
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