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C-PTSD therapies

Eric C Meyer, Robyn Walser, Barbara Hermann, Heidi La Bash, Bryann B DeBeer, Sandra B Morissette, Nathan A Kimbrel, Oi-Man Kwok, Sonja V Batten, Paula P Schnurr
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur and are associated with worse outcomes together than either disorder alone. A lack of consensus regarding recommendations for treating PTSD-AUD exists, and treatment dropout is a persistent problem. Acceptance and Commitment Therapy (ACT), a transdiagnostic, mindfulness- and acceptance-based form of behavior therapy, has potential as a treatment option for PTSD-AUD. In this uncontrolled pilot study, we examined ACT for PTSD-AUD in 43 veterans; 29 (67%) completed the outpatient individual therapy protocol (i...
October 2018: Journal of Traumatic Stress
Siobhan Robinson, Christa C Christ, Margaret M Cahill, Sara J Aldrich, Elisa Taylor-Yeremeeva
Many people will experience at least one traumatic event in their lifetime, with up to 20% developing Post-Traumatic Stress Disorder (PTSD) or PTSD-like symptoms. In addition, the likelihood that females will develop PTSD after trauma is more than twice that of males. Despite its prevalence, current treatment strategies for trauma victims are limited and substantial portions of affected individuals remain resistant to treatment suggesting that additional interventions are necessary. Using an animal model of traumatic stress, the present studies tested the hypothesis that either voluntary exercise and/or administration of the adrenergic beta-receptor antagonist propranolol, would ameliorate stress-related maladaptive behaviors...
October 15, 2018: Physiology & Behavior
Jonathan G Shalom, Eva Gilboa-Schechtman, Dana Atzil-Slonim, Eran Bar-Kalifa, Ilanit Hasson-Ohayon, Patricia van Oppen, Anton J L M van Balkom, Idan M Aderka
OBJECTIVE: Sudden gains are robust predictors of outcome in psychotherapy. However, previous attempts at predicting sudden gains have yielded inconclusive findings. The aim of the present study was to examine a novel, transdiagnostic, transtherapeutic predictor of sudden gains that would replicate in different settings and populations. Specifically, we examined intraindividual variability in symptoms. METHOD: We examined data from a randomized controlled trial (RCT) of prolonged exposure therapy for posttraumatic stress disorder (PTSD) in children and adolescents (n = 63), an RCT of cognitive and behavioral therapies for obsessive-compulsive disorder (OCD) in adults (n = 91), and psychodynamic therapy delivered under routine clinical conditions in a naturalistic setting for diverse disorders (n = 106)...
November 2018: Journal of Consulting and Clinical Psychology
Richard A Bryant
PURPOSE OF REVIEW: The aim of this review is to provide a summary of the current evidence pertaining to the course of acute and chronic posttraumatic stress, the diagnosis of acute stress disorder (ASD), and treatment of acute stress disorder and prevention of posttraumatic stress disorder (PTSD). RECENT FINDINGS: Although acute stress disorder was introduced partly to predict subsequent PTSD, longitudinal studies indicate that ASD is not an accurate predictor of PTSD...
October 13, 2018: Current Psychiatry Reports
Joan M Cook, Richard Thompson, Vanessa Simiola, Shannon Wiltsey Stirman, Paula P Schnurr
This study examined the role of attitudes toward evidence-based psychotherapies (EBPs) in predicting use of prolonged exposure (PE) and cognitive processing therapy (CPT), two EBPs for posttraumatic stress disorder (PTSD) among PTSD treatment providers within the Department of Veterans Affairs. Providers' general attitudes toward EBPs, as well as their specific perceptions of PE and CPT, were examined as potential predictors of use. One hundred fifty-nine providers from 38 Department of Veterans Affairs' residential PTSD programs across the United States completed an online survey that included the predictors listed as well as self-reported use of PE on an individual basis and CPT on an individual and on a group basis...
September 27, 2018: Psychological Services
Denise A Hien, Kathryn Z Smith, Max Owens, Teresa López-Castro, Lesia M Ruglass, Santiago Papini
OBJECTIVE: To advance understanding of the effectiveness of evidence-based treatments for comorbid posttraumatic stress disorder (PTSD) and substance use disorder (SUD), research must provide a more nuanced picture of how substance use affects change in PTSD symptoms over the course of treatments and whether prolonged exposure techniques can be efficacious during active substance use. A data set that included patients with PTSD/subthreshold-PTSD and SUD treated with an exposure-based intervention provided an opportunity to conduct a secondary analysis to test how patients' substance use impacted PTSD change over treatment...
October 2018: Journal of Consulting and Clinical Psychology
Xi Zhu, Benjamin Suarez-Jimenez, Amit Lazarov, Liat Helpman, Santiago Papini, Ari Lowell, Ariel Durosky, Martin A Lindquist, John C Markowitz, Franklin Schneier, Tor D Wager, Yuval Neria
BACKGROUND: Recent research suggests that posttraumatic stress disorder (PTSD) is associated with altered amygdala and hippocampal resting-state functional connectivity (rsFC). However, less research has examined whether Prolonged Exposure (PE), a first line exposure-based treatment for PTSD, has the potential to alter resting state neural networks. METHODS: A total of 24 patients with PTSD and 26 matched trauma-exposed healthy controls (TEHCs) underwent resting-state functional magnetic resonance imaging (fMRI) at baseline...
October 2018: Depression and Anxiety
Kelly R Peck, Scott F Coffey, Adam P McGuire, Andrew C Voluse, Kevin M Connolly
Dysfunctional trauma-related cognitions are important in the emergence and maintenance of posttraumatic stress disorder (PTSD) and the modification of such cognitions is a proposed mechanism of trauma treatment. However, the authors are not aware of any research examining trauma-related cognitions as a treatment mechanism in a sample of individuals with comorbid PTSD and substance use disorder (SUD). Accordingly, the present study sought to address this gap in the literature and examined the relationship between trauma-related cognitions and treatment outcomes within a sample of seventy-two veterans diagnosed with PTSD and SUD...
September 15, 2018: Journal of Anxiety Disorders
Candice M Monson, Norman Shields, Michael K Suvak, Jeanine E M Lane, Philippe Shnaider, Meredith S H Landy, Anne C Wagner, Iris Sijercic, Tasoula Masina, Sonya G Wanklyn, Shannon Wiltsey Stirman
This randomized controlled hybrid implementation/effectiveness trial aimed to compare the impact of three different models of training and consultation by examining the PTSD treatment outcomes achieved by therapists who were learning a front-line recommended psychotherapy for posttraumatic stress disorder (PTSD), Cognitive Processing Therapy (CPT; Resick, Monson, & Chard, 2017). Therapists (N = 134) were randomized into one of three conditions after attending a standard CPT training workshop: No Consultation with delayed feedback on CPT fidelity, Standard Consultation involving discussion and conceptualization of cases without session audio review, and Consultation Including Audio Review, which included a review of segments of audiorecorded CPT sessions...
November 2018: Behaviour Research and Therapy
Anne L Malaktaris, Brian A Buzzella, Maya E Siegel, Ursula S Myers, Kendall C Browne, Sonya B Norman, Abigail C Angkaw
Introduction: Post-traumatic stress disorder (PTSD) has been linked to a variety of adverse mental and physical health outcomes including distressed relationships. Involving romantic partners in PTSD treatment appears to be a promising new avenue for PTSD treatment; however, additional research is necessary to clarify veteran preferences for inclusion of significant others in treatment and relationship characteristics that may influence such preferences. Accordingly, the present study was designed to evaluate Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) veterans' desire to include romantic partners in trauma-focused care (n = 74) and to explore psychological and relationship variables associated with preference for partner inclusion in PTSD treatment...
September 12, 2018: Military Medicine
Peter J Colvonen, Sean P A Drummond, Abigail C Angkaw, Sonya B Norman
OBJECTIVE: Approximately 35-61% of individuals with posttraumatic stress disorder (PTSD) report insomnia. Further, upward of 70% report clinically significant insomnia following PTSD treatment. There are converging lines of evidence suggesting that insomnia not only independently affects daytime functioning and worsens PTSD symptoms but also may compromise response to PTSD treatment, such as prolonged exposure (PE). Taken together, integrated insomnia and PTSD treatment may increase client-centered care and treatment outcomes...
September 13, 2018: Psychological Trauma: Theory, Research, Practice and Policy
E C Hurley
The effectiveness of EMDR therapy in treating veterans diagnosed with PTSD was evaluated in this study using two treatment formats: intensive daily EMDR treatment provided twice a day during a 10-day period and a second format of one session each week. The study used archived outcome data previously collected and stored at Soldier Center. Both formats provided 18-20 treatment sessions of EMDR therapy to veterans diagnosed with PTSD that included dissociative exhibitions and moral injury issues. Questions addressed included: (1) does EMDR therapy administered twice daily ameliorate veterans' PTSD symptoms; (2) does EMDR therapy administered twice daily provide equivalent outcome results as EMDR therapy administered weekly for 18-20 sessions; and (3) does the treatment outcome persist...
2018: Frontiers in Psychology
Alan L Peterson, Patricia A Resick, Jim Mintz, Stacey Young-McCaughan, Donald D McGeary, Cindy A McGeary, Dawn I Velligan, Alexandra Macdonald, Emma Mata-Galan, Stephen L Holliday, Kirsten H Dillon, John D Roache, Iman Williams Christians, John C Moring, Lindsay M Bira, Paul S Nabity, Allison K Hancock, Willie J Hale
Approximately 14% of military personnel and veterans who have deployed to the combat theater are at risk for combat-related posttraumatic stress disorder (PTSD). The treatment of combat-related PTSD in active duty service members and veterans is challenging. Combat trauma may involve multiple high levels of exposure to different types of traumatic events (e.g., human carnage after explosive blasts, life threat/injuries to self/others, etc.). Many service members and veterans are unable or unwilling to receive treatment in government facilities due to avoidance, scheduling difficulties, transportation or parking problems, concerns about career advancement, or stigma associated with seeking treatment...
October 2018: Contemporary Clinical Trials
C Rometsch-Ogioun El Sount, P Windthorst, J Denkinger, K Ziser, C Nikendei, D Kindermann, J Ringwald, V Renner, S Zipfel, F Junne
OBJECTIVE: Chronic pain in patients with posttraumatic stress disorder (PTSD) is a frequent symptom and a complicating factor in the treatment of patients. The study' purpose is to systematically review the scientific literature on patients' characteristics and the effects of specific interventions implemented for the treatment of chronic pain in traumatized refugees. METHOD: A systematic search of the current literature was conducted in PubMed and Web of Science, from 1996 to 2017...
July 30, 2018: Journal of Psychosomatic Research
Natalie E Hundt, Tracey L Smith, John C Fortney, Jeffrey A Cully, Melinda A Stanley
Many veterans do not engage in needed mental health care. To address this problem, we need to understand these patients' experiences from the very start of their care, which includes the assessment and diagnosis process and the communication of that diagnosis to the patient. The patient's reaction to this process can set the tone for the patient's relationship with the mental health system and his or her therapist, yet therapists often receive little training in how to most effectively provide a diagnosis to patients...
July 30, 2018: Psychological Services
Lisa Amaya-Jackson, Dana Hagele, John Sideris, Donna Potter, Ernestine C Briggs, Leila Keen, Robert A Murphy, Shannon Dorsey, Vanessa Patchett, George S Ake, Rebecca Socolar
BACKGROUND: A model for statewide dissemination of evidence-based treatment (EBT) for traumatized youth was piloted and taken to scale across North Carolina (NC). This article describes the implementation platform developed, piloted, and evaluated by the NC Child Treatment Program to train agency providers in Trauma-Focused Cognitive Behavioral Therapy using the National Center for Child Traumatic Stress Learning Collaborative (LC) Model on Adoption & Implementation of EBTs. This type of LC incorporates adult learning principles to enhance clinical skills development as part of training and many key implementation science strategies while working with agencies and clinicians to implement and sustain the new practice...
July 28, 2018: BMC Health Services Research
Alan L Peterson, Edna B Foa, Tabatha H Blount, Carmen P McLean, Dhiya V Shah, Stacey Young-McCaughan, Brett T Litz, Richard P Schobitz, Diane T Castillo, Timothy O Rentz, Jeffrey S Yarvis, Katherine A Dondanville, Brooke A Fina, Brittany N Hall-Clark, Lily A Brown, Bryann R DeBeer, Vanessa M Jacoby, Allison K Hancock, Douglas E Williamson, Wyatt R Evans, Samantha Synett, Casey Straud, Hunter R Hansen, Eric C Meyer, Martin A Javors, Allah-Fard M Sharrieff, Jose Lara-Ruiz, Lauren M Koch, John D Roache, Jim Mintz, Terence M Keane
Combat-related posttraumatic stress disorder (PTSD) is the most common psychological health condition in military service members and veterans who have deployed to the combat theater since September 11, 2001. One of the highest research priorities for the Department of Defense and the Department of Veterans Affairs is to develop and evaluate the most efficient and efficacious treatments possible for combat-related PTSD. However, the treatment of combat-related PTSD in military service members and veterans has been significantly more challenging than the treatment of PTSD in civilians...
September 2018: Contemporary Clinical Trials
Katherine E Miller, Rachel L Micol, Joanne L Davis, Christopher C Cranston, Kristi E Pruiksma
OBJECTIVE: This report aims to extend previous findings on predictors of treatment dropout and response within nightmare treatment. METHOD: Factors predicting treatment noninitiation, dropout, and response were examined in 70 trauma-exposed individuals treated in a randomized controlled trial of 2 conditions (exposure [EX] and nonexposure) of a therapy for trauma nightmares. RESULTS: Together, treatment noninitiation and dropout was predicted by younger age for the EX condition only and by fewer nights with nightmares at baseline for both conditions...
July 19, 2018: Psychological Trauma: Theory, Research, Practice and Policy
C Van Woudenberg, E M Voorendonk, H Bongaerts, H A Zoet, M Verhagen, C W Lee, A van Minnen, A De Jongh
Background: There is room for improvement regarding the treatment of severe post-traumatic stress disorder (PTSD). Intensifying treatment to increase patient retention is a promising development. Objective: The aim of this study was to determine the effectiveness of an intensive trauma-focused treatment programme over 8 days for individuals suffering from severe PTSD. Method: Treatment was provided for 347 PTSD patients (70% women; mean age = 38.32 years, SD  = 11.69) and consisted of daily sessions of prolonged exposure and eye movement desensitization and reprocessing (EMDR) therapy (16 sessions in total), physical activity, and psycho-education...
2018: European Journal of Psychotraumatology
Melissa L Mehalick, Amanda C Glueck
In this review, we discuss the comorbidity of traumatic brain injury (TBI) and pain among civilians and military members, the common causes of pain resulting from TBI, and offer insight about the therapeutic management of TBI symptoms and pain. Traumatic brain injury (TBI) is a debilitating health problem and one of the most common post-TBI symptoms is pain, which can contribute to psychological issues such as Post-traumatic stress disorder (PTSD) and depression. Headache pain appears to be the most common type of pain that results from TBI, yet pain can also be more widespread...
July 11, 2018: Brain Injury: [BI]
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