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PTSD treatment

Alexander J Steiner, Nathalie Boulos, James Mirocha, Stephanie M Wright, Katherine L Collison, Waguih W IsHak
OBJECTIVES: Posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) often have high comorbidity, consequently influencing patient-reported outcomes of depressive symptom severity, quality of life (QOL), and functioning. We hypothesized that the combined effects of concurrent PTSD and MDD would result in worse treatment outcomes, whereas individuals who achieved MDD remission would have better treatment outcomes. METHODS: We analyzed 2280 adult participants who received level 1 treatment (citalopram monotherapy) in the Sequenced Treatment Alternatives to Relieve Depression study, including 2158 participants with MDD without comorbid PTSD and 122 participants with MDD with comorbid PTSD (MDD + PTSD)...
October 18, 2016: Clinical Neuropharmacology
Liat Helpman, Marie-France Marin, Santiago Papini, Xi Zhu, Gregory M Sullivan, Franklin Schneier, Mariana Neria, Erel Shvil, Maria Josefa Malaga Aragon, John C Markowitz, Martin A Lindquist, Tor Wager, Mohammad Milad, Yuval Neria
BACKGROUND: Neurobiological models of posttraumatic stress disorder (PTSD) implicate fear processing impairments in the maintenance of the disorder. Specific deficits in extinction recall, the retention of learned extinction, have been demonstrated. While deficient extinction recall, and the associated activation pattern of prefrontal and hippocampal regions, distinguishes individuals with PTSD from controls, research has not yet examined changes following treatment. We examined the behavioral and neural correlates of extinction recall before and after cognitive behavioral treatment of PTSD...
2016: NeuroImage: Clinical
Miriam Reisman
More than a decade of war in the Middle East has pushed post-traumatic stress disorder (PTSD) to the forefront of public health concerns. The author defines the disorder and discusses risk factors, treatments, and the barriers to effective care.
October 2016: P & T: a Peer-reviewed Journal for Formulary Management
Sheri E Pegram, Antonia Abbey
There are well-established associations between sexual assault victimization and deleterious psychological and physical health outcomes. The present study contributes to the emerging health disparities literature by examining similarities and differences in relationships between the severity of the sexual assault and health in a community sample of African American and Caucasian survivors. Although the overall pattern of relationships was expected to be comparable for all survivors, some associations were hypothesized to be stronger for African American survivors as compared with Caucasian survivors based on theories of chronic stress...
October 17, 2016: Journal of Interpersonal Violence
Robert J Ursano, Jing Wang, Holly Ramsawh, Dale Russell, Natasha Benfer, Robert K Gifford, Gregory H Cohen, Sandro Galea, Carol S Fullerton
OBJECTIVES: We documented the prevalence of post-traumatic stress disorder (PTSD), depression, and binge drinking in U.S. Reserve and National Guard (Reserve Component [RC]) personnel for each service and branch by rank, gender, and deployment status. METHODS: Structured interviews were conducted with a nationally representative sample of RC personnel (n = 2,003). We used weighted descriptive statistics to examine the prevalence of PTSD, depression, and binge drinking...
October 2016: Military Medicine
Kartavya J Vyas, Susan F Fesperman, Bonnie J Nebeker, Steven K Gerard, Nicholas D Boyd, Eileen M Delaney, Jennifer A Webb-Murphy, Scott L Johnston
The present study investigates the role of psychological resilience in protecting against the development of post-traumatic stress disorder (PTSD), depression, and comorbid PTSD and depression; and estimates the percent reductions in incidence of, and associated treatment cost savings for, each condition as a function of increasing resilience. A retrospective cohort of mental health care-seeking service members (n = 2,171) completed patient-reported outcome measures approximately every 10 weeks as part of the Psychological Health Pathways program...
October 2016: Military Medicine
Adrienne J Heinz, Nicole L Cohen, Lori Holleran, Jennifer A Alvarez, Marcel O Bonn-Miller
Post-traumatic 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 a firearm (median number of firearms among owners = 3, range = 1-40)...
October 2016: Military Medicine
Jonas Schaffrath, Mario Schmitz-Buhl, Ali Kemal Gün, Euphrosyne Gouzoulis-Mayfrank
Medical and psychological care of refugees is among the most important current challenges in German health politics. Work with patients from this heterogeneous group who have often faced severe stress before, during and after their migration is currently based on a thin data foundation. Based on introductory information on current knowledge concerning psychiatric morbidity of refugees this article presents the psychiatric care of refugees at LVR Clinics Cologne - a psychiatric specialty hospital situated in North Rhine-Westphalia, Germany...
October 17, 2016: Psychotherapie, Psychosomatik, Medizinische Psychologie
Nicholas W Gilpin, Jeff L Weiner
Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly co-morbid in humans. Although we have some understanding of the structural and functional brain changes that define each of these disorders, and how those changes contribute to the behavioral symptoms that define them, little is known about the neurobiology of co-morbid PTSD and AUD, which may be due in part to a scarcity of adequate animal models for examining this research question. The goal of this review is to summarize the current state-of-the-science on co-morbid PTSD and AUD: we summarize epidemiological data documenting the prevalence of this co-morbidity, review what is known about the potential neurobiological basis for the frequent co-occurrence of PTSD and AUD, and discuss successes and failures of past and current treatment strategies...
October 17, 2016: Genes, Brain, and Behavior
Craig S Rosen, Kathryn J Azevedo, Quyen Q Tiet, Carolyn J Greene, Amanda E Wood, Patrick Calhoun, Thomas Bowe, Bruce P Capehart, Eric F Crawford, Mark A Greenbaum, Alex H S Harris, Michael Hertzberg, Steven E Lindley, Brandy N Smith, Paula P Schnurr
OBJECTIVE: This study assessed whether adding telephone care management to usual outpatient mental health care improved treatment attendance, medication compliance, and clinical outcomes of veterans with posttraumatic stress disorder (PTSD). METHODS: In a multisite randomized controlled trial, 358 veterans were assigned to either usual outpatient mental health treatment (N=165) or usual care plus twice-a-month telephone care management (TCM) and support in the first three months of treatment (N=193)...
October 17, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
Martin Sack, Stefanie Zehl, Alexander Otti, Claas Lahmann, Peter Henningsen, Johannes Kruse, Markus Stingl
BACKGROUND: Currently, there is controversy on the possible benefits of dual-attention tasks during eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD). METHODS: A total of 139 consecutive patients (including 85 females) suffering from PTSD were allocated randomly among 3 different treatment conditions: exposure with eyes moving while fixating on the therapist's moving hand (EM), exposure with eyes fixating on the therapist's nonmoving hand (EF), and exposure without explicit visual focus of attention as control condition (EC)...
October 15, 2016: Psychotherapy and Psychosomatics
Carol A Keane, Christopher A Magee, Peter J Kelly
Traumatic childhood experiences predict many adverse outcomes in adulthood including Complex-PTSD. Understanding complex trauma within socially disadvantaged populations has important implications for policy development and intervention implementation. This paper examined the nature of complex trauma experienced by disadvantaged individuals using a latent class analysis (LCA) approach. Data were collected through the large-scale Journeys Home Study (N=1682), utilising a representative sample of individuals experiencing low housing stability...
October 13, 2016: Child Abuse & Neglect
Noreen L Watson, Jaimee L Heffner, Jennifer B McClure, Jonathan B Bricker
OBJECTIVES: Although social anxiety is associated with higher prevalence of smoking and lower cessation rates, little is known about the underlying mechanisms of these relationships. Research suggests that socially anxious smokers have higher levels of smoking-specific experiential avoidance and are inclined to smoke to avoid internal smoking cues. However, it is unknown which types of internal smoking cues they avoid. Thus, this study aimed to address this gap in the literature. METHODS: Participants (N = 450) were adult smokers from a group-based trial for smoking cessation...
October 14, 2016: Journal of Dual Diagnosis
Stella M Resko, Suzanne Brown, Natasha S Mendoza, Shantel Crosby, Antonio González-Prendes
OBJECTIVE: Perception of need is a key factor that influences decisions to seek help and complete treatment for substance use and mental health problems. In the current study, we examine patterns of perceived treatment needs among women with co-occurring substance use disorders and post-traumatic stress disorder (PTSD) and explore how these patterns are associated with demographics, psychosocial variables, and treatment-related factors. METHODS: Secondary data analysis of the Women and Trauma Study from the National Institute on Drug Abuse's Clinical Trial Network was conducted...
October 14, 2016: Journal of Dual Diagnosis
Mary R Summers, Remington L Nevin
Concerns over the rising prevalence of post-traumatic stress disorder (PTSD), particularly among military service members returning from combat, and over barriers that hinder individuals from seeking out or adhering to standard therapies have contributed to interest in alternative therapies for the disorder. A novel alternative therapy for PTSD-stellate ganglion block (SGB)-may be considered lacking in formal evidence of efficacy despite having shown considerable promise. This review of the recent and historical literature related to SGB finds evidence of substantial beneficial psychiatric effects and substantiates that this fast-acting, somatic treatment may provide positive results for patients with PTSD and may reduce barriers to therapy, particularly among military populations...
October 14, 2016: Pain Practice: the Official Journal of World Institute of Pain
Patricia Pilkinton, Carlos Berry, Seth Norrholm, Al Bartolucci, Badari Birur, Lori L Davis
OBJECTIVE: Selective serotonin reuptake inhibitors (SSRIs) remain the first-line treatment for posttraumatic stress disorder (PTSD). However, adjunctive atypical antipsychotics are often used to target residual or refractory symptoms. Asenapine is a novel atypical antipsychotic that possesses a high serotonin (5-HT2A) to dopamine (D2) affinity ratio and alpha-adrenergic antagonism, which may be advantageous in treating PTSD. This pilot study aimed to identify the therapeutic potential of asenapine as an adjunctive treatment for PTSD...
August 15, 2016: Psychopharmacology Bulletin
Emily R Dworkin, Natalie P Mota, Julie A Schumacher, Christine Vinci, Scott F Coffey
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...
October 13, 2016: Psychological Trauma: Theory, Research, Practice and Policy
Sudie E Back, Jenna L McCauley, Kristina J Korte, Daniel F Gros, Virginia Leavitt, Kevin M Gray, Mark B Hamner, Stacia M DeSantis, Robert Malcolm, Kathleen T Brady, Peter W Kalivas
OBJECTIVE: The antioxidant N-acetylcysteine is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders (SUDs). This study explored the efficacy of N-acetylcysteine in the treatment of posttraumatic stress disorder (PTSD), which frequently co-occurs with SUD and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. METHODS: Veterans with PTSD and SUD per DSM-IV criteria (N = 35) were randomly assigned to receive a double-blind, 8-week course of N-acetylcysteine (2,400 mg/d) or placebo plus cognitive-behavioral therapy for SUD (between March 2013 and April 2014)...
October 11, 2016: Journal of Clinical Psychiatry
Mark Goodhew, Allison M Salmon, Christina Marel, Katherine L Mills, Marianne Jauncey
The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm...
October 12, 2016: Harm Reduction Journal
Julian D Ford, Andres R Schneeberger, Irina Komarovskaya, Kristina Muenzenmaier, Dorothy Castille, Lewis A Opler, Bruce Link
A new clinician rating measure, the Symptoms of Trauma Scale (SOTS) was administered to adult psychiatric outpatients (46 men, 47 women) with severe mental illness (SMI) who reported a history of trauma exposure and were recently discharged from inpatient psychiatric treatment. SOTS composite severity scores for DSM-IV and DSM-5 posttraumatic stress disorder (PTSD), complex PTSD (cPTSD), and total PTSD/cPTSD severity had acceptable internal consistency reliability. SOTS scores' construct and convergent validity was supported by correlations with self-report measures of childhood and adult trauma history, and PTSD, dissociation, and anger symptoms...
October 12, 2016: Journal of Trauma & Dissociation
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