Disorders - Post Traumatic Stress Disorder
Zhao, J., Chen, D. Y., Li, X. B., Xi, Y. J., Verma, S., Zhou, F.
C., Wang, C. Y.
BACKGROUND: Post-traumatic stress disorder (PTSD) is highly
prevalent in the individuals at clinical-high risk for psychosis (CHR). The aim of this study was to examine the efficacy and safety of Eye Movement
Desensitization and Reprocessing (EMDR) in individuals at CHR with comorbid PTSD or subthreshold PTSD in a randomized controlled trial.\rMETHODS:
Fifty-seven individuals at CHR with PTSD or subthreshold PTSD formed the study sample. The eligible participants were randomly assigned to a 12 weeks
EMDR treatment (N = 28) or a waiting list condition (WL, N = 29). The structured interview for psychosis risk syndrome (SIPS), the clinician
administered post-traumatic stress disorder scale (CAPS) and a battery of self-rating inventories covering depressive, anxiety and suicidal symptoms
were administered.\rRESULTS: Twenty-six participants in the EMDR group and all the participants in the WL group completed the study. The analyses of
covariance revealed greater reduction of the mean scores on CAPS (F = 23.2, Partial eta2 = 0.3, P < 0.001), SIPS positive scales (F =
17.8, Partial eta2 = 0.25, P < 0.001) and all the self-rating inventories in the EMDR group than in the WL group. Participants in the EMDR
group were more likely to achieve remission of CHR compared to those in the WL group at endpoint (60.7 % vs. 31 %, P = 0.025).\rCONCLUSIONS: EMDR
treatment not only effectively improved traumatic symptoms, but also significantly reduced the attenuated psychotic symptoms and resulted in a higher
remission rate of CHR. This study highlighted the necessity of adding a trauma-focused component to the present approach of early intervention in
psychosis.
, 256 : 1-
7
- Year: 2023
- Problem: Post Traumatic Stress Disorder, Psychosis Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR)
Zabik, N. L., Rabinak, C. A., Peters, C. A., Iadipaolo, A.
Failure to successfully extinguish fear is a hallmark of trauma-related disorders, like
posttraumatic stress disorder (PTSD). PTSD is also characterized by dysfunctional corticolimbic activation and connectivity. The endocannabinoid
system is a putative system to target for rescuing these behavioral and neural deficits. In healthy adults, acute, low-dose delta-9-
tetrahydrocannabinol (THC) facilitates fear extinction and increases cortico-limbic activation and connectivity in response to threat. The present
study determines the effect of acute, low-dose THC on fear-related brain activation and connectivity during fear extinction in trauma-exposed adults
with (PTSD = 19) and without PTSD [trauma-exposed controls (TEC) = 26] and non-trauma-exposed [healthy controls (HC) = 26]. We used a Pavlovian fear
conditioning and extinction paradigm, where we measured concurrent functional magnetic resonance imaging (fMRI) and behavioral responses (i.e., skin
conductance responding and expectancy ratings). Using a randomized, double-blind, placebo-controlled design, N = 71 subjects were randomized to
receive placebo (PBO, n = 37) or THC (n = 34) prior to fear extinction learning. During early extinction learning, individuals with PTSD given THC
had greater vmPFC activation than their TEC counterparts. During a test of the return of fear (i.e., renewal), HC and individuals with PTSD given THC
had greater vmPFC activation compared to TEC. Individuals with PTSD given THC also had greater amygdala activation compared to those given PBO. We
found no effects of trauma group or THC on behavioral fear indices during extinction learning, recall, and fear renewal. These data suggest that low
dose, oral THC can affect neural indices of fear learning and memory in adults with trauma-exposure; this may be beneficial for future therapeutic
interventions seeking to improve fear extinction learning and memory. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Neurobiology of Learning and
Memory, 201 : 1-13
- Year: 2023
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions, Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Wuthrich, V.
M., Zagic, D., Dickson, S. J., McLellan, L. F., Chen, J. T., Jones, M. P., Rapee, R. M.
This systematic review and meta-analysis aimed to
examine the effectiveness of psychological interventions for internalising disorders in youth when delivered in routine settings. Secondary aims were
to examine the effectiveness of cognitive behavioural therapy and determine moderators of treatment response. The study was pre-registered (PROSPERO
2020 CRD42020202776). Databases were systematically searched (PsycINFO, Medline, Embase, PubMed, ERIC) in December 2022 and screened according to the
PRISMA 2020 statement. Inclusion: School aged participants (4-18 years) with a primary internalising disorder; psychotherapy delivered in a routine
setting (e.g. outpatient clinic, school) by setting staff; compared psychotherapy to any control in a randomised controlled trial; reported pre-to-
post or pre-to-follow-up comparisons on the primary disorder according to child, parent or independent evaluator report; and was published in
English. Risk of bias was assessed using the ROB 2.0 Cochrane tool. Results were synthesised using random effects to pool estimates. Risk ratios were
used to analyse dichotomous data and standardised mean differences (SMD) for continuous data. Forty-five studies were included (N = 4901
participants; M = 13 years; range 8-16; SD = 2.5). Nine used waitlist control, 17 treatment as usual, 4 placebo; 15 compared psychotherapy to active
control. Psychotherapy was associated with small significant effects pre- to post-treatment compared to non-active controls for anxiety (SMD = - 0.24
to 0.50) and depression (SMD = - 0.19 to 0.34) with effects differing by informant. Psychotherapy led to small significant pre-to-post-benefits in
youth internalising disorders in routine settings. Results are limited by reporter type and follow-up.
Clinical Child &
Family Psychology Review, 14 : 14
- Year: 2023
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Thielemann, J. F. B., Kasparik, B., Konig,
J., Unterhitzenberger, J., Rosner, R.
The efficacy of trauma-focused treatments for children and adolescents is well researched. However, less is known about the long-term
and caregiver-reported effects. Searched databases were PsychInfo, MEDLINE, Cochrane Library, PTSDPubs, PubMed, Web of Science, and OpenGrey.
Treatment effects of trauma-focused cognitive behavioral therapy (TF-CBT) were computed at 12-month follow-up with posttraumatic stress symptoms
(PTSS) as primary outcome and symptoms of depression, anxiety, and grief as secondary outcomes. Concordance between participant and caregiver ratings
were investigated. TF-CBT showed large improvements across all outcomes from pre-treatment to 12-month follow-up (PTSS: g = 1.71, CI 1.27-2.15) and
favorable results compared to active treatments and treatment as usual at 12-month follow-up (PTSS: g = .35, CI .13-.56). More pronounced effects
were found in group settings. No significant differences were detected between participant and caregiver ratings with high reliability across almost
all outcomes and assessment points. TF-CBT is a reliable treatment for pediatric PTSS and secondary symptoms with stable results at 12-month follow-
up.
Child maltreatment, : 10775595231167383
- Year: 2023
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Szota,
K., Schulte, K. L., Christiansen, H.
Although
treatment guidelines recommend interventions entailing caregiver involvement for children and adolescents following traumatic experiences, evidence
on their effectiveness is inconsistent. The present systematic review and meta-analysis considered possible moderators of their effectiveness.
METHOD(S): Eligible studies were (quasi-)randomized controlled trials and efficacy trials published in English or German with participants up to the
age of 21 years presenting symptoms of mental disorders due to traumatic experiences. The effectiveness of interventions entailing any kind and
extent of caregiver involvement had to be investigated by applying evaluated instruments. PubMed, PsycINFO, ERIC, COCHRANE and PSYNDEX were searched.
RESULT(S): A total of 33 studies with 36 independent samples were retrieved. Child- and parent-reports on PTSD, depression, anxiety, ADHD,
internalizing, externalizing symptoms and behavior problems were analyzed where available. The pooled effect size is significant and robust at post-
treatment for child-reported PTSD, g=- 0.34 (95% CI=- 0.53; - 0.14), parent-reported PTSD, g=- 0.41 (95% CI=- 0.71; - 0.11), child-reported
depression, g=- 0.29 (95% CI=- 0.46; - 0.11), child-reported anxiety, g=- 0.25 (95% CI=- 0.42; - 0.08), and parent-reported internalizing symptoms,
g=- 0.27 (95% CI=- 0.47; - 0.07). Female sex and fulfilling diagnostic criteria appeared as potential moderators. The only significant effect size at
follow-up is found for child-reported PTSD symptoms 12 months post-treatment, g=- 0.37 (95% CI=- 0.67; - 0.07). CONCLUSION(S): Interventions
entailing caregiver involvement revealed greater symptom reductions than control conditions. Determinants of their effectiveness should be examined
further. Copyright © 2022. The Author(s).
Clinical child and family psychology review, 26(1) : 17-
32
- Year: 2023
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Mohajerin,
B., Lynn, S. J., Cassiello-Robbins, C.
Harmful consequences of COVID-19, such as
prolonged quarantine, lack of social contact, and especially loss of parents or friends, can negatively impact children and adolescents' mental
health in diverse ways, including engendering posttraumatic stress symptoms. Our study is the first to compare the transdiagnostic Unified Protocol
for the Treatment of Emotional Disorders in Adolescents (UP-A; Ehrenreich et al., 2009; Ehrenreich-May et al., 2017) with Trauma-Focused Cognitive
Behavioral Therapy (TF-CBT) in terms of outcomes related to PTSD symptoms (COVID-19-related vs. COVID-19 unrelated PTSD) and comorbid symptoms (i.e.,
anxiety, depression) and other measures (i.e., emotion regulation, self-injury, anger). Individuals diagnosed with PTSD were randomly assigned to the
UP-A (n = 46) or TF-CBT group (n = 47), administered the SCID-5 and a battery of measures and followed up posttreatment and then after 3, 6, and 9
months. Ninety-three adolescents with PTSD were enrolled, 45% boys and 61% COVID-19-related PTSD. We adopted an intention-to-treat approach. At the
initial post-intervention assessment, except for emotion regulation and unexpressed angry feelings, in which UP-A participants reported greater
reductions, no significant differences in other variables were secured between the UP-A and TF-CBT. However, at follow-up assessments, the UP-A
evidenced significantly better outcomes than TF-CBT. We found support for the UP-A compared with TF-CBT in treating adolescents with PTSD, regardless
of COVID-19-related PTSD status, in maintaining treatment effectiveness over time. Copyright © 2023 Association for Behavioral and Cognitive
Therapies
Behavior
Therapy., :
- Year: 2023
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Trauma-focused cognitive behavioural therapy (TF-
CBT)
Kim,
S., Lee, K.
This study developed and evaluated an online mental health program for female
college students who experienced trauma, based on Roy's Adaptation Model. A randomized controlled trial was adopted. Participants completed a survey
on trauma and post-traumatic stress symptoms. Data from experimental and control groups (n = 16) were collected over two months. The program reduced
post-traumatic stress and depression symptoms and improved functional health and adjustment. This effect was sustained in experimental group
participants for one month post-program. The findings revealed the effectiveness of Internet mental healthcare for female students and the crucial
role nurses play in it. Copyright © 2023 Elsevier Inc. All rights reserved.
, 43 : 118-
126
- Year: 2023
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Kaminer, D., Simmons, C., Seedat, S., Skavenski, S., Murray, L., Kidd, M., Cohen, J.
A.
Background: In low- and middle- income
countries (LMICs) trauma exposure among youth is high, but mental health services are critically under-resourced. In such contexts, abbreviated
trauma treatments are needed. Objective(s): To evaluate the efficacy of an abbreviated eight-session version of Trauma-Focused Cognitive Behavioural
Therapy (TF-CBT) for improving posttraumatic stress disorder (PTSD) and depression symptoms in a sample of South African adolescents. Method(s): 75
trauma-exposed adolescents (21 males, 54 females; mean age=14.92, range=11-19) with posttraumatic stress disorder (PTSD) symptoms were randomly
assigned to eight sessions of TF-CBT or to usual services. At baseline, post-treatment and three-month follow-up, participants completed the Child
PTSD Symptom Scale for DSM 5 (CPSS-5) and the Beck Depression Inventory II (BDI-II). The trial is registered on the Pan African Trial Registry
(PACTR202011506380839).6. Result(s): 95% of TF-CBT participants completed treatment while only 47% of TAU participants accessed treatment.
Intention-to-treat analyses found that the TF-CBT group had a significantly greater reduction in CPSS-5 PTSD symptom severity at post-treatment
(Cohen's d=0. 60, p<.01) and three-month follow-up (Cohen's d=0.62, p<. 01), and a greater reduction in the proportion of participants meeting the
CPSS-5 clinical cut-off for PTSD at both time points (p=.02 and p=.03, respectively). There was also a significantly greater reduction in depression
symptom severity in the TF-CBT group at post-treatment (Cohen's d=0.51, p=.03) and three-month follow-up (Cohen's d=0.41, p=.05), and a greater
reduction in the proportion of TF-CBT participants meeting the BDI clinical cut-off for depression at both time points (p=.02 and p=.03,
respectively). Conclusion(s): The findings provide preliminary evidence of the efficacy of an abbreviated eight-session version of TF-CBT for
reducing PTSD and depression symptoms in a LMIC sample of adolescents with multiple trauma exposure.
European Journal of
Psychotraumatology, 14(1) : 2181602
- Year: 2023
- 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)
Hohne, E., Boge, K., Karnouk, C., Tschorn, M., Banaschewski, T., Hoell, A., Sukale, T., Plener, P., Schneider, F., Padberg, F., Hasan, A., Rapp, M. A., Bajbouj,
M., Kamp-Becker, I.
Adolescent refugees and asylum seekers (ARAS) are highly vulnerable to mental health problems. Stepped care
models (SCM) and culturally sensitive therapies offer promising treatment approaches to effectively provide necessary medical and psychological
support. To our knowledge, we were the first to investigate whether a culturally sensitive SCM will reduce symptoms of depression and PTSD in ARAS
more effectively and efficiently than treatment as usual (TAU). We conducted a multicentric, randomized, controlled and rater-blinded trial across
Germany with ARAS between the ages of 14 to 21 years. Participants (N = 158) were stratified by their level of depressive symptom severity and then
equally randomized to either SCM or TAU. Depending on their severity level, SCM participants were allocated to tailored interventions. Symptom
changes were assessed for depression (PHQ) and PTSD (CATS) at four time points, with the primary end point at post-intervention after 12 weeks. Based
on an intention-to-treat sample, we used a linear mixed model approach for the main statistical analyses. Further evaluations included cost-utility
analyses, sensitivity analyses, follow-up-analyses, response and remission rates and subgroup analysis. We found a significant reduction of PHQ (d =
0.52) and CATS (d = 0.27) scores in both groups. However, there was no significant difference between SCM and TAU. Cost-utility analyses indicated
that SCM generated greater cost-utility when measured as quality-adjusted life years compared to TAU. Subgroup analysis revealed different effects
for the SCM interventions depending on the outcome measure. Although culturally sensitive, SCMs did not prove to be more effective in symptom change
and represent a more cost-effective treatment alternative for mentally burdened ARAS. Our research contributes to the optimization of clinical
productivity and the improvement of therapeutic care for ARAS. Disorder-specific interventions should be further investigated. Copyright © 2023, The
Author(s).
European Child and Adolescent Psychiatry., :
- Year: 2023
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Dialectical behavioural therapy
(DBT), Psychoeducation, Other Psychological Interventions, Trauma-focused cognitive behavioural therapy (TF-
CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Dworkin, E. R., Schallert, M., Lee, C. M., Kaysen, D.
OBJECTIVE: Sexual
assault is associated with high risk for posttraumatic stress disorder (PTSD), and PTSD often co-occurs with alcohol misuse. Most sexual assault
survivors do not access early preventative interventions for such conditions. App-based interventions are a promising means to extend the reach of
early interventions and thereby reduce risk of chronic PTSD and alcohol misuse.\rMETHOD: This study was a pilot randomized clinical trial of an app-
based early intervention with phone coaching (THRIVE) for survivors of past-10-week sexual assault (NCT#: NCT03703258). Intended active components of
the THRIVE app are daily cognitive restructuring, daily activity scheduling, and as-needed relationally focused exercises, supported by coaching
calls. Forty-one adult female survivors of recent sexual assault with elevated posttraumatic stress and drinking were randomized to intervention or
control (symptom-monitoring app with phone coaching). Participants in both conditions were encouraged to use their respective app for 21 days and
completed self-report symptom assessments at baseline, postintervention, and 3-month follow-up.\rRESULTS: At 3-month follow-up, the between-group
effect size favored intervention for posttraumatic stress (d = -0.70), intoxication frequency (d = -0.62), and drinking hours per week (d = -0.39).
More participants evidenced reliable change in intervention versus control for posttraumatic stress (OR = 2.67) and alcohol problems (OR = 3.05) at 3
months.\rCONCLUSIONS: The general direction of effects indicates that THRIVE, coupled with coaching, reduces risk for PTSD and alcohol outcomes
beyond coached monitoring. These findings suggest that apps like THRIVE may provide an option for early intervention for sexual assault survivors.
(PsycInfo Database Record (c) 2023 APA, all rights reserved).
Psychological Trauma:Theory, Pesearch, Practice and Policy, 03 : 03
- Year: 2023
- Problem: Post Traumatic Stress Disorder, Alcohol
Use
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Technology, interventions delivered using technology (e.g. online, SMS)
Bhatt, M. P., Guryan, J., Pollack, H. A., Castrejon, J. C., Clark, M., Delgado-Sanchez, L., Lin, P., Lubell, M., Pinto Poehls, C., Shaver, B., Sumners, M.
This study explores whether a school-based group counseling program for adolescent
girls, implemented at scale, can mitigate trauma-related mental health harms. In a randomized trial involving 3749 Chicago public high school girls,
we find that participating in the program for 4 months induces a 22% reduction in posttraumatic stress disorder symptoms and find significant
decreases in anxiety and depression. Results surpass widely accepted cost-effectiveness thresholds, with estimated cost-utility well below $150,000
per quality adjusted life year. We find suggestive evidence that effects persist and may even increase over time. Our results provide the first
efficacy trial of such a program specifically designed for girls, conducted in America's third largest city. These findings suggest the promise of
school-based programs to mitigate trauma-related harms.
Science Advances, 9(23) : eabq2077
- Year: 2023
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Ahmadi, S. J., Jobson, L., Musavi, Z., Rezwani, S. R., Amini, F. A., Earnest, A., Samim,
N., Sarwary, S. A. A., Sarwary, S. A., McAvoy, D.
Importance:
Adolescents who experience conflict in humanitarian contexts often have high levels of psychiatric distress but rarely have access to evidence-based
interventions. Objective(s): To investigate the efficacy of Memory Training for Recovery-Adolescent (METRA) intervention in improving psychiatric
symptoms among adolescent girls in Afghanistan. Design, Setting, and Participant(s): This randomized clinical trial included girls and young women
aged 11 to 19 years with heightened psychiatric distress living in Kabul, Afghanistan, and was conducted as a parallel-group trial comparing METRA
with treatment as usual (TAU), with a 3-month follow-up. Participants were randomized 2:1 to receive either METRA or TAU. The study occurred between
November 2021 and March 2022 in Kabul. An intention-to-treat approach was used. Intervention(s): Participants assigned to METRA received a 10-session
group-intervention comprised of 2 modules (module 1: memory specificity; module 2: trauma writing). The TAU group received 10 group adolescent health
sessions. Interventions were delivered over 2 weeks. Main Outcomes and Measures: Primary outcome measures were self-reported posttraumatic stress
disorder (PTSD) and depression symptoms after the intervention. Secondary outcomes were self-reported measures of anxiety, Afghan-cultural distress
symptoms, and psychiatric difficulties. Assessments occurred at baseline, after modules 1 and 2, and at 3 months after treatment. Result(s): The 125
participants had a mean (SD) age of 15.96 (1.97) years. Overall sample size for primary analyses included 80 adolescents in the METRA group and 45
adolescents in TAU. Following the intention-to-treat principle, generalized estimating equations found that the METRA group had a 17.64-point
decrease (95% CI, -20.38 to -14.91 points) in PTSD symptoms and a 6.73-point decrease (95% CI, -8.50 to -4.95 points) in depression symptoms, while
the TAU group had a 3.34-point decrease (95% CI, -6.05 to -0.62 points) in PTSD symptoms and a 0.66-point increase (95% CI, -0.70 to 2.01 points) in
depression symptoms, with the group x time interactions being significant (all P <.001). METRA participants had significantly greater reductions in
anxiety, Afghan-cultural distress symptoms, and psychiatric difficulties than TAU participants. All improvements were maintained at 3-month follow-
up. Dropout in the METRA group was 22.5% (18 participants) vs 8.9% for TAU (4 participants). Conclusions and Relevance: In this randomized clinical
trial, those in the METRA group had significantly greater improvements in psychiatric symptoms relative to those in the TAU group. METRA appeared to
be a feasible and effective intervention for adolescents in humanitarian contexts. Trial Registration: anzctr.org.au Identifier: ACTRN12621001160820.
Copyright © 2023 American Medical Association. All rights reserved.
, 6(3) : E236086
- Year: 2023
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions