Disorders - Post Traumatic Stress Disorder
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
-
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
-
Stage: At risk (indicated or selected prevention)
-
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
-
Stage: At risk (indicated or selected prevention)
-
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
-
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
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Gutermann, J., Schwartzkopff, L., Steil, R.
To date, the long-term
effectiveness of psychological treatments in reducing post-traumatic stress disorder symptoms in children and adolescents has not been investigated
extensively. This meta-analysis quantifies the long-term effects of psychological interventions in children and adolescents with PTSD symptoms and
examines the period-dependent follow-up (FU) effects based on 47 studies. The mean FU effect sizes (ESs) for PTSD symptoms ranged from medium
(between treatment ESs for controlled studies) to large (within treatment ESs for uncontrolled studies; pooled analysis including all studies). These
effects were comparable to the post-treatment ESs, which suggests that the treatment effects remained stable. ESs did not differ depending on the
length of the FU period (6 months). In randomized controlled trials (RCTs), as well as trials conducted with treatment as usual or active control
groups, the long-term treatment effects for the reduction of PTSD symptoms were small. These results demonstrate the long-term effectiveness of
psychological interventions in the treatment of PTSD in youth. However, more studies should include a FU assessment. Further research should focus on
RCTs with long-term assessments, report comorbid symptoms and investigate the influence of potential moderators. Research is also warranted to
determine how to improve the long-term effects of treatments for PTSD in youth.
Clinical Child & Family Psychology Review, 20(4) : 422-
434
- Year: 2017
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Eye movement desensitisation and reprocessing (EMDR), Psychodynamic/Psychoanalysis, Psychoeducation, Supportive
therapy
Jensen, T. K., Holt, T., Ormhaug, S.
M.
Trauma-focused cognitive behavioral therapy (TF-CBT) is the treatment of choice for traumatized youth,
however, follow-up studies are scarce, and treatment effects for co-occurring depression show mixed findings. The aims of this study were to examine
whether treatment effects of TF-CBT are maintained at 18 month follow-up and whether degree of co-occurring depression influences treatment effects.
As rapid improvement in psychological functioning is warranted for youth, we also investigated whether the symptom trajectory was different for TF-
CBT compared to therapy as usual (TAU). The sample consisted of 156 youth (M age = 15.05, 79.50% girls) randomly assigned to TF-CBT or TAU. The youth
were assessed for posttraumatic stress symptoms (PTSS), depression, anxiety and general mental health symptoms. Mixed effects analyses followed the
symptom courses over 5 time points. Youth receiving TF-CBT maintained their symptom improvement at 18 months follow-up with scores below clinical
cut-of on all symptom measures. The most depressed youth had also a significant decline in symptoms that were maintained at follow-up. Symptom
trajectories differed as the TF-CBT group reported a more rapid symptom reduction compared to the TAU condition. In the TAU condition, participants
received 1.5 times the number of treatment sessions compared to the TF-CBT participants. After 18 months the groups were significantly different on
general mental health symptoms only. In conclusion, youth receiving TF-CBT experienced more efficient improvement in trauma related symptoms than
youth receiving TAU and these improvements were maintained after 18 months. Also youth experiencing serious co-occurring depression benefitted from
TF-CBT. (PsycINFO Database Record (c) 2017 APA, all rights reserved)
Journal of Abnormal Child Psychology, 45(8) : 1587-
1597
- Year: 2017
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Locher, C., Koechlin,
H., Zion, S. R., Werner, C., Pine, D. S., Kirsch, I., Kessler, R. C., Kossowsky, J.
IMPORTANCE: Depressive disorders (DDs), anxiety disorders (ADs), obsessive-compulsive disorder
(OCD), and posttraumatic stress disorder (PTSD) are common mental disorders in children and adolescents. OBJECTIVE: To examine the relative efficacy
and safety of selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), and placebo for the treatment of
DD, AD, OCD, and PTSD in children and adolescents. DATA SOURCES: PubMed, EMBASE, PsycINFO, Web of Science, and Cochrane Database from inception
through August 7, 2016. STUDY SELECTION: Published and unpublished randomized clinical trials of SSRIs or SNRIs in youths with DD, AD, OCD, or PTSD
were included. Trials using other antidepressants (eg, tricyclic antidepressants, monoamine oxidase inhibitors) were excluded. DATA EXTRACTION AND
SYNTHESIS: Effect sizes, calculated as standardized mean differences (Hedges g) and risk ratios (RRs) for adverse events, were assessed in a random-
effects model. MAIN OUTCOMES AND MEASURES: Primary outcomes, as defined by authors on preintervention and postintervention data, mean change data,
and adverse event data, were extracted independently by multiple observers following PRISMA guidelines. RESULTS: Thirty-six trials were eligible,
including 6778 participants (3484 [51.4%] female; mean [SD] age, 12.9 [5.1] years); 17 studies for DD, 10 for AD, 8 for OCD, and 1 for PTSD. Analysis
showed that SSRIs and SNRIs were significantly more beneficial compared with placebo, yielding a small effect size (g = 0.32; 95% CI, 0.25-0.40; P <
.001). Anxiety disorder (g = 0.56; 95% CI, 0.40-0.72; P < .001) showed significantly larger between-group effect sizes than DD (g = 0.20; 95% CI,
0.13-0.27; P < .001). This difference was driven primarily by the placebo response: patients with DD exhibited significantly larger placebo responses
(g = 1.57; 95% CI, 1.36-1.78; P < .001) compared with those with AD (g = 1.03; 95% CI, 0.84-1.21; P < .001). The SSRIs produced a relatively large
effect size for ADs (g = 0.71; 95% CI, 0.45-0.97; P < .001). Compared with participants receiving placebo, patients receiving an antidepressant
reported significantly more treatment-emergent adverse events (RR, 1.07; 95% CI, 1.01-1.12; P = .01 or RR, 1.49; 95% CI, 1.22-1.82; P < .001,
depending on the reporting method), severe adverse events (RR, 1.76; 95% CI, 1.34-2.32; P < .001), and study discontinuation due to adverse events
(RR, 1.79; 95% CI, 1.38-2.32; P < .001). CONCLUSIONS AND RELEVANCE: Compared with placebo, SSRIs and SNRIs are more beneficial than placebo in
children and adolescents; however, the benefit is small and disorder specific, yielding a larger drug-placebo difference for AD than for other
conditions. Response to placebo is large, especially in DD. Severe adverse events are significantly more common with SSRIs and SNRIs than placebo.
Copyright © 2017 American Medical Association. All rights reserved.
JAMA Psychiatry, 74(10) : 1011-
1020
- Year: 2017
- Problem: Anxiety Disorders (any), Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Serotonin-norepinephrine reuptake inhibitors
(SNRIs), Antidepressants
(any)
Morina, N., Malek, M., Nickerson, A., Bryant, R. A.
BackgroundThe majority of survivors of mass violence
live in low- and middle-income countries (LMICs).AimsTo synthesise empirical findings for psychological interventions for children and
adolescents with post-traumatic stress disorder (PTSD) and/or depression in LMICs affected by mass violence.MethodRandomised controlled trials
with children and adolescents with symptoms of PTSD and/or depression in LMICs were identified. Overall, 21 812 records were found through July 2016
in the Medline, PsycINFO and PILOTS databases; 21 met the inclusion criteria and were reviewed according to recommended
guidelines.ResultsTwenty-one studies were included. Active treatments for PTSD yielded large pre-treatment to post-treatment changes (g =
1.15) and a medium controlled effect size (g = 0.57). Effect sizes were similar at follow-up. Active treatments for depression produced small to
medium effect sizes. Finally, after adjustment for publication bias, the imputed uncontrolled and controlled effect sizes for PTSD were medium and
small respectively.ConclusionsPsychological interventions may be effective in treating paediatric PTSD in LMICs. It appears that more targeted
approaches are needed for depressive responses.
British Journal of
Psychiatry, 210(4) : 247-254
- Year: 2017
- Problem: Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Pfeiffer, E., Sachser, C., de-Haan, A., Tutus, D., Goldbeck, L.
Objective To investigate whether the change in dysfunctional posttraumatic cognitions (PTC) during Trauma-Focused
Cognitive Behavioral Therapy (TF-CBT) is a mediator of posttraumatic stress symptom (PTSS) reduction in a sample of children and adolescents. Method
A bootstrap mediation analysis was performed to investigate the indirect effect of dysfunctional PTC on treatment outcome in a recently completed RCT
study with children and adolescents (n = 123; 7-17 years old) that investigated the effectiveness of TF-CBT. Results The mediation model revealed
that changes in dysfunctional PTC mediated the relationship between the group (TF-CBT vs. waitlist) and PTSS at the end of treatment. Conclusion
Change in dysfunctional PTC is an important mechanism mediating the reduction of PTSS in TF-CBT. Monitoring dysfunctional PTC throughout treatment
might, therefore, be an important factor in optimizing treatment outcome. Copyright © 2017 Elsevier Ltd
Behaviour Research and Therapy, 97 : 178-
182
- Year: 2017
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)