Disorders - Post Traumatic Stress Disorder
Yoon, C., Blount, T., Fields, K., Garrett, A.
Background: Trauma
focused-cognitive behavioral therapy (TF-CBT) has proven efficacious for treating PTSD in youth, but information about neural mechanisms is limited.
Our study measured symptom severity and neural activation before and after each phase of TF-CBT to determine whether neural changes co-occur with or
precede symptom improvement. Method(s): Youth, ages 9-17, seeking treatment for PTSD were semi-randomly assigned to TF-CBT (n=11) or Treatment as
Usual (TAU; n=6). Symptom severity (total and in each symptom cluster) and neural responses to an fMRI trauma-reminder task were measured at baseline
and after each phase of TF-CBT or the same time intervals for the TAU group. Activation to trauma reminder contrasted with neutral words was
extracted from amygdala and dorsolateral prefrontal cortex and correlated with symptom measures using SPSS. Result(s): During the first phase of
treatment (skills), the TF-CBT group showed a significant increase in DLPFC activation (p=.029) that co-occurred with significant improvement in
negative thoughts and feelings (p=.001) and hyperarousal (p=.003). These early changes were correlated with (subsequent) total symptom improvement at
end of treatment (p=.001). During the second narrative phase, total symptoms did not improve, but amygdala activation decreased more in the TF-CBT
group than comparison (p=.043) when considering treatment responders only. Improvement in symptoms of avoidance during this phase (p=.049) was not
correlated with amygdala changes. Conclusion(s): Preliminary results suggest that neural changes can occur several weeks before symptoms improve,
suggesting neural markers that can be used as predictors as well as targets of treatment. Supported By: Department of Psychiatry and Behavioral
Sciences; University of Texas Health Science Center at San Antonio Keywords: PTSD - Posttraumatic Stress Disorder, CBT, Brain Imaging, fMRI, Trauma-
Focused Psychotherapy Copyright © 2022
Biological
Psychiatry, 91(9 Supplement) : S352
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Yohannan, J., Carlson, J. S., Volker, M. A.
Due to the negative impact of trauma exposure, effective treatments are necessary to
prevent and improve negative trauma-related outcomes. Cognitive behavioral therapy (CBT) is considered an efficacious treatment for children and
adolescents exposed to traumatic events. Despite the various meta-analyses that have examined trauma treatments, there is a paucity of research on
the moderating variables that may impact treatment outcomes. This meta-analytic CBT study addressed those limitations by examining the moderating
effects of treatment components on outcomes. A search identified 94 CBT studies with 97 relevant effect sizes for children and adolescents exposed to
traumatic events. Consistent with prior meta-analytic studies, CBT was shown to be effective for trauma-exposed youth. CBT subtreatments did not
produce significantly different results from one another. Moderators shown to significantly impact CBT treatment outcomes for posttraumatic stress
symptom were trauma type, Q = 24.09, p = .004, ds = -0.22 to -1.42, and gender, Q = 10.68, p = .005, ds = -0.53 to -1.36, whereas moderators shown to
impact treatment outcomes for depression were study design, Q = 10.95, p = .004, ds = -0.26 to -0.50, and treatment setting, Q = 10.98, p = .004, ds
= -0.31 to -0.56. The implications of these findings for research and practice are discussed. Copyright © 2021 International Society for Traumatic
Stress Studies.
Journal of traumatic stress, 35(2) : 706-
717
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Exposure therapy, Exposure
and response prevention, Trauma-focused cognitive behavioural therapy (TF-
CBT)
Xian-Yu, C. Y., Deng, N. J., Zhang, J., Li, H. Y., Gao, T. Y., Zhang, C., Gong, Q. Q.
Background: Children and adolescents who experience
traumatic events may develop post-traumatic stress disorder (PTSD), which is often associated with other psychiatric disorders, including depression
and anxiety. Cognitive behavioral therapy (CBT) is widely used in psychotherapy to treat PTSD in children and adolescents. This meta-analysis
evaluated previous studies on the effectiveness of CBT in the treatment of PTSD in children and adolescents. Method(s): Randomized controlled trials
(RCTs) published before July 25, 2021, were retrieved from seven databases. All RCTs of CBT compared to control, including conventional treatment or
other treatments, in children or adolescents with PTSD. Random effect models were employed for all outcomes. Risk of bias was performed by Cochrane
Collaboration's tool. The publication bias was evaluated using the Egger's regression analysis. Result(s): Nineteen RCTs were included in the
meta-analysis. Compared with control, CBT was effective in reducing the symptoms of PTSD in children and adolescents, with a variety of scales used
to measure the overall PTSD symptoms: CAPS (SMD = -0.41, 95%CI [-0.71, -0.12]), CPSS (SMD = -0.88, 95%CI [-1.42, -0.34]) and UCLA-PTSD RI (SMD = -
1.70, 95%CI [-2.98, -0.42]). Furthermore, CBT also improved the comorbidities of depression (SMD = -0.43, 95%CI [-0.70, -0.17]) and anxiety (SMD = -
0.29, 95%CI [-0.56, -0.03]) associated with PTSD. However, CBT was not effective in reducing avoidance symptoms (SMD = 0.38, 95%CI [-0.55, 1.31]).
Conclusion(s): CBT can reduce the severity of PTSD in children and adolescents and improve the symptoms of depression and anxiety, as evident in the
treatment of PTSD victims of sexual abuse and war and in patients aged more than 7 years. Copyright © 2022
, 308 : 502-511
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Thielemann, J. F. B., Kasparik, B., Konig, J., Unterhitzenberger, J., Rosner, R.
BACKGROUND: Among minors,
posttraumatic stress symptoms (PTSS) are a common consequence of traumatic events requiring trauma-focused treatment.\rOBJECTIVE: This meta-analysis
quantified treatment effects of trauma-focused cognitive behavioral therapy (TF-CBT) with PTSS as primary outcome and symptoms of depression,
anxiety, and grief as secondary outcomes.\rPARTICIPANTS AND SETTING: Inclusion criteria for individual settings: (1) patients aged between 3 and 21,
(2) at least one traumatic event, (3) minimum 8 sessions of (4) TF-CBT according to Cohen, Mannarino and Deblinger (2006, 2017), (5) a quantitative
PTSS measure at pre- and post-treatment, (6) original research only. Inclusion criteria for group settings: had to involve (1) psychoeducation, (2)
coping strategies, (3) exposure, (4) cognitive processing/restructuring, (5) contain some reference to the manual and no minimum session number was
required.\rMETHODS: Searched databases were PsychInfo, MEDLINE, Cochrane Library, PTSDPubs, PubMed, Web of Science, and OpenGrey.\rRESULTS: 4523
participants from 28 RCTs and 33 uncontrolled studies were included. TF-CBT showed large improvements across all outcomes from pre- to post-treatment
(PTSS: g = 1.14, CI 0.97-1.30) and favorable results compared to any control condition including wait-list, treatment as usual, and active treatment
at post-treatment (PTSS: g = 0.52, CI 0.31-0.73). Effects were more pronounced for group settings. We give pooled estimates adjusted for risk of bias
and publication bias, which initially limited the quality of the analyzed data.\rCONCLUSIONS: TF-CBT is an effective treatment for pediatric PTSS as
well as for depressive, anxiety, and grief symptoms. It is superior to control conditions, supporting international guidelines recommending it as a
first-line treatment.
Child Abuse &
Neglect, 134 : 105899
- Year: 2022
- 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)
Steil, R., Weiss, J., Rimane, E., Renneberg, B., Rosner, R.
BACKGROUND: Adolescents and young adults with abuse-related post traumatic stress disorder (PTSD) have been
shown to benefit from Developmentally Adapted Cognitive Processing Therapy (D-CPT), yet long-term efficacy of D-CPT has not yet been studied.
\rOBJECTIVE: To assess the long-term efficacy of D-CPT in a sample of adolescents and young adults (age 14-21 years) with childhood abuse related
PTSD.\rPARTICIPANTS AND SETTING: Patients of a previously conducted multicenter randomized controlled trial which showed the efficacy of D-CPT
compared to a waitlist with treatment advice (WL/TA) were invited for follow-up assessments at 6 and 12 months after the end of treatment.\rMETHODS:
Primary outcome was the PTSD symptom severity, assessed with the Clinician-administered PTSD Scale for Children and Adolescents (CAPS-CA). Secondary
outcomes were self-reported PTSD severity, depression, borderline symptom severity, behavior problems, and dissociation.\rRESULTS: Of the 44
participants who received D-CPT, 28 (63 %) responded and were assessed at 6-month follow-up. At 12-month follow-up, 22 participants (50 %) responded.
The majority of participants in the WL/TA group received D-CPT after the end of the trial and were hence not available for follow-up assessment. In
the D-CPT group, treatment gains were maintained at 6- and 12-month follow-up in the CAPS-CA as well as in all secondary outcomes.\rCONCLUSIONS: The
positive effects of D-CPT were stable in adolescents and young adults with abuse-related PTSD indicating that they can benefit in the long term from
a treatment with D-CPT.
Child Abuse & Neglect, 132 : 105808
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Somers, K., Spruit, A., Stams, G. J., Vandevelde, S., Lindauer, R., Assink, M.
Children can develop post-traumatic stress disorder (PTSD) and
mental health symptoms after traumatic events. This meta-analysis evaluated the influence of moderators of cognitive behavioural trauma treatment
(CBTT) with caregiver involvement in traumatized children. A total of 28 studies were included, with 23 independent samples and 332 effect sizes,
representing the data of 1931 children (M age = 11.10 years, SD = 2.36). Results showed a significant medium overall effect (d = 0.55, t = 2.478, p =
0.014), indicating CBTT with caregiver involvement was effective in treating PTSD (d = 0.70), with somewhat smaller effect sizes for internalizing,
externalizing, social, cognitive and total problems (0.35 < d > 0.48). The positive treatment effect was robust; we found somewhat smaller effect
sizes at follow-up (d = 0.49) compared to post-test (d = 0.57) assessments. Furthermore, several sample (i.e. child's age, gender, and trauma
event), programme (i.e. the duration of treatment, number of sessions), study (i.e. control condition, type of instrument, informant, type of
sample), and publication (i.e. publication year and impact factor) characteristics moderated the treatment outcomes of the child. In sum, the results
of our meta-analysis might help to improve the effectiveness of cognitive behavioural trauma treatment for youth with PTSD, and guide the development
of innovative trauma interventions that involve caregivers. Implications for theory and practice are discussed.
European Child & Adolescent
Psychiatry, 30 : 30
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Soltan, F., Cristofalo, D., Marshall, D., Purgato, M., Taddese, H., Vanderbloemen, L., Barbui, C., Uphoff, E.
Background: An unprecedented number of people around the world are experiencing forced displacement due
to natural or man-made events. More than 50% of refugees worldwide are children or adolescents. In addition to the challenges of settling in a new
country, many have witnessed or experienced traumatic events. Therefore, refugee children and adolescents are at risk of developing mental health
problems such as post-traumatic stress disorder, and require appropriate and effective support within communities. Objective(s): To assess the
effectiveness and acceptability of community-based interventions (RCTs only) in comparison with controls (no treatment, waiting list, alternative
treatment) for preventing and treating mental health problems (major depression, anxiety, post-traumatic stress disorder, psychological distress) and
improving mental health in refugee children and adolescents in high-income countries. Search Method(s): Databases searches included the Cochrane
Common Mental Disorders Controlled Trials Register (all available years), CENTRAL/CDSR (2021, Issue 2), Ovid MEDLINE, Embase, six other databases,
and two trials registries to 21 February 2021. We checked reference lists of included study reports. Selection Criteria: Studies of any design were
eligible as long as they included child or adolescent refugees and evaluated a community-based mental health intervention in a high-income country.
At a second stage, we selected randomised controlled trials. Data Collection and Analysis: For randomised controlled trials, we extracted data
relating to the study and participant characteristics, and outcome data relating to the results of the trial. For studies using other evaluation
methods, we extracted data relating to the study and participant characteristics. W derived evidence on the efficacy and availability of
interventions from the randomised controlled trials only. Data were synthesised narratively. Main Result(s): We screened 5005 records and sought
full-text manuscripts of 62 relevant records. Three randomised controlled trials were included in this review. Key concerns in the risk of bias
assessments included a lack of clarity about the randomisation process, potential for bias is outcome measurement, and risk of bias in the selection
of results. Primary outcomes. There was no evidence of an effect of community-based interventions when compared with a waiting list for symptoms of
post-traumatic stress (mean difference (MD) -1.46, 95% confidence interval (CI) -6.78 to 3.86: 1 study; low-certainty evidence), symptoms of
depression (MD 0.26, 95% CI -2.15 to 2.67: 1 study; low-certainty evidence), and psychological distress (MD -10.5, 95% CI -47.94 to 26.94; 1 study;
very low-certainty evidence). There were no data on adverse events. Secondary outcomes. Three trials reported on short-term changes in child
behaviour, using different measures, and found no evidence of an effect of the intervention versus a waiting list (low to very low certainty). None
of the trials reported on quality of life or well-being, participation and functioning, or participant satisfaction. Authors' conclusions: There is
insufficient evidence to determine the efficacy and acceptability of community-based mental health interventions for refugee children and
adolescents. Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cochrane Database of Systematic
Reviews, 2022(5) (no pagination) :
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other service delivery and improvement
interventions
Sasaki, T., Hashimoto, K., Niitsu, T., Hosoda, Y., Oda, Y., Shiko,
Y., Ozawa, Y., Kawasaki, Y., Kanahara, N., Shiina, A., Hashimoto, T., Suzuki, T., Sugawara, T., Hanaoka, H., Iyo, M.
Background: Several lines of evidence suggest that glutamatergic
neurotransmission via the N-methyl-D-aspartate (NMDA) receptor plays a role in certain behavioral manifestations common to Post-Traumatic Stress
Disorder (PTSD). Ifenprodil tartrate is a neuroprotective agent that binds to the GluN2B subunit of the NMDA receptor. The aim of this study is to
confirm whether ifenprodil tartrate is effective in the adolescent PTSD patients. Method(s): This is a randomized, double-blind, placebo-controlled
trial. Ten adolescent (13 to 18 years old) PTSD patients were randomized into two arms: placebo (n = 4), 40 mg/day ifenprodil tartrate (n = 6) for 4
weeks. All of the patients were assessed by IES-R-J (Primary outcome measure), TSCC-J, CDRS-R, DSRS-C-J and CGI-I. Result(s): A comparison of
baseline IES-R-J total scores and 4-week end-point scores showed a mild trend of improvement (p = 0.0895) and the difference score was -9.314. A
comparison of baseline scores and 2-week intermediate-point scores showed that IES-R-J hyperarousal subscores and TSCC-J subscores (dissociation
subscores, sexual concerns subscores) improved significantly. A comparison of baseline TSCC-J sexual concerns subscores and 4-week end-point scores
improved significantly. Conclusion(s): Our study may prove to be an short-term effective alternative safe treatment for adolescent patients with
PTSD. Copyright © 2022
Psychiatry Research, 311 (no
pagination) :
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Other biological interventions
Salloum, A., Lu, Y., Chen,
H., Quast, T., Cohen, J. A., Scheeringa, M. S., Salomon, K., Storch, E. A.
Objective: Trauma-focused cognitive-behavioral
therapy (TF-CBT) is an evidence-based therapist-led treatment for children after trauma. Parents often experience barriers to treatment engagement,
including cost. Stepped care TF-CBT (SC-TF-CBT) was developed as an alternative delivery system. Step One is a parent-led therapist-assisted
treatment. Step Two provides therapist-led TF-CBT for children who did not benefit from Step One and require more intensive treatment. This study
compared SC-TF-CBT to standard TF-CBT in a community-based non-inferiority trial. Method(s): A total of 183 children (aged 4-12 years) experiencing
posttraumatic stress symptoms (PTSS) and their caregivers were randomly assigned to SC-TF-CBT or standard TF-CBT within 6 community clinics.
Assessments occurred at baseline, mid- and posttreatment, and 6 and 12 months. Primary outcomes included PTSS and impairment. Secondary outcomes
included severity, diagnostic status, remission, and response. Treatment cost, acceptability, and satisfaction were measured. Difference and non-
inferiority tests were applied. Result(s): SC-TF-CBT participants changed at rates comparable to participants in TF-CBT for primary and secondary
measures. SC-TF-CBT was non-inferior to TF-CBT for PTSS, impairment, and severity at all time points except for impairment at the 6-month assessment.
Attrition did not differ between treatment arms (132 participants were completers). Baseline treatment acceptability was lower for SC-TF-CBT parents,
although there was no difference in expected treatment improvements or treatment satisfaction at posttreatment. Based on regression estimates, total
costs were 38.4% lower for SC-TF-CBT compared to TF-CBT, whereas recurring costs were 53.7% lower. Conclusion(s): Stepped Care TF-CBT provides an
alternative way to deliver treatment for some children and parents, with reduced cost for providers and parents. Clinical trial registration
information: Stepped Care for Children after Trauma: Optimizing Treatment; https://clinicaltrials.gov; NCT02537678. Copyright © 2022 American Academy
of Child and Adolescent Psychiatry
Journal of the American Academy of Child and Adolescent
Psychiatry, 61(8) : 1010-1022.e4
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Trauma-focused cognitive behavioural therapy (TF-
CBT), Other service delivery and improvement
interventions
Roberts, N.
P., Lotzin, A., Schafer, I.
Background: The psychological treatment of comorbid post-traumatic stress disorder (PTSD) and substance use disorder (SUD)
is clinically challenging, and outcomes are often poor. Impact Statement Highlights: For PTSD, evidence was strongest for trauma-focused CBT-based
approaches, but effects were modest. There was little evidence of any added benefit on substance use, beyond that of standard addiction treatments,
for any included intervention. Dropout from treatment was high. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Abstract (Spanish)
Antecedentes: El tratamiento psicologico del trastorno de estres postraumatico (TEPT) comorbido con trastorno por uso de sustancias (TUS) es un
desafio clinico y los resultados suelen ser deficientes. Objetivo: Este articulo describe una revision sistematica y meta-analisis, los cuales
buscaron establecer la eficacia actual para un determinado numero de enfoques psicologicos para adultos y adolescentes, en comparacion con
intervenciones solo para TUS, y otros enfoques activos, siguiendo un protocolo previamente registrado. Metodo: Esta revision siguio las guias PRISMA
y de Colaboracion de Cochrane. Todos los autores realizaron extraccion de datos y evaluacion de riesgo de sesgos usando los criterios de Cochrane.
Los resultados primarios fueron severidad de TEPT y uso de sustancias post-tratamiento. La calidad de los hallazgos fue evaluada utilizando GRADE.
Luego de una busqueda exhaustiva, realizada el 13 de septiembre del 2021, se incluyeron 27 estudios. Resultados: Encontramos un nivel de abandono
relativamente alto en los estudios. En nuestras principales comparaciones no encontramos mayores beneficios en los actuales abordajes de tratamiento
focalizados en mejorar las habilidades de afrontamiento en comparacion con las intervenciones exclusivas para TUS. Encontramos beneficios modestos
para intervenciones centradas en trauma sumada a intervencion para TUS post-tratamiento de TEPT (DMP = -0.36 CI-0.64, -0.08), y a los 6-13 meses para
TEPT (DMP = -0.48 CI-0.81, -0.15) y uso de alcohol (DMP = -0.23 CI -0.44, -0.02). No hubo beneficios para las intervenciones para reestructuracion
cognitiva como grupo, pero encontramos un efecto modesto post-tratamiento para la terapia cognitivo conductual integrada (TCCI) para el TEPT (DMP =
-0.33 CI -0.62, -0.04). Hubo evidencia de algun beneficio para intervenciones enfocadas en trauma sobre las intervenciones centradas en el presente
para TEPT de un solo estudio y para la reduccion del abandono para la participacion incentivada para la intervencion centrada en el trauma de otro
estudio aislado. La mayoria de los hallazgos fueron de muy baja calidad. Conclusion: Concluimos que existe evidencia de que la terapia centrada en el
trauma y la TCCI pueden mejorar el TEPT para algunos individuos, pero muchos pacientes no se comprometen totalmente con el tratamiento y los efectos
de tratamiento promedio son modestos. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
European Journal of Psychotraumatology Vol 13(1), 2022,
ArtID 2041831, 13(1) :
- Year: 2022
- Problem: Post Traumatic Stress Disorder, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Ramaiya, M. K., McLean, C. L., Pokharel, M., Thapa, K., Schmidt, M. A., Berg, M., Simoni, J. M., Rao, D., Kohrt, B. A.
Background: Child and adolescent mental health problems are major contributors to the global burden of
disease in low- and middle-income country (LMIC) settings. To advance the evidence base for adolescent mental health interventions in LMICs, we
evaluated the feasibility and acceptability of a school-based emotion regulation prevention intervention (READY-Nepal) for adolescents who had a
recent exposure to a humanitarian disaster. Method(s): A mixed-method, non-randomized controlled trial was conducted with Nepali secondary school
students in one heavily affected post-earthquake district. Students (N = 102; aged 13 to 17 years) were enrolled in the intervention (n = 42) and
waitlist control (n = 60) conditions. Feasibility and acceptability were examined via attendance, and by qualitative interviews with a subset of
students (n = 15), teachers (n = 2), and caregivers (n = 3). Preliminary efficacy was examined on primary outcome (emotion regulation) and secondary
outcomes (anxiety symptoms, posttraumatic stress symptoms, functional impairment, resilience, coping skills), which were measured at baseline and
post-intervention (four weeks). Result(s): Delivering the intervention was feasible and acceptable, as demonstrated by low dropout (8%) and high
program attendance (6.7 of 8 sessions). Qualitative data suggested high uptake of anger regulation skills, but lower uptake of mindfulness skills.
Despite this, there were no significant differences by condition on primary or secondary outcomes at four-week follow-up. Students provided
suggestions for improvement of the program. Conclusion(s): Further research on longitudinal outcome measurement, use of alternatives to retrospective
self-report data, and rigorous development of culturally grounded models of emotion regulation is necessary to explore the utility of school-based
emotion regulation interventions in Nepal and other LMICs. Copyright © 2022 by the authors.
International Journal of Environmental Research
and Public Health, 19(21) (no pagination) :
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Dialectical behavioural therapy
(DBT), Skills training, Other Psychological Interventions
Proenca, C.
R., Markowitz, J. C., Coimbra, B. M., Cogo-Moreira, H., Maciel, M. R., Mello, A. F., Mello, M. F.
Background: Sexual assault often triggers posttraumatic stress disorder (PTSD), a potentially chronic severe mental disorder.
Most guidelines recommend selective serotonin reuptake inhibitors (SSRIs) and trauma-focused psychotherapies as treatment options. Interpersonal
Psychotherapy (IPT), adapted for PTSD (IPT-PTSD), focuses on interpersonal consequences of trauma rather than confronting the trauma itself. Studies
have found IPT-PTSD efficaciously reduced PTSD symptoms with limited attrition. No efficacy trials have compared IPT-PTSD and SSRI. We hypothesized
IPT would reduce PTSD, anxiety, and depressive symptoms more than sertraline among women with PTSD following a recent sexual assault. Objective(s):
To compare the efficacy of IPT-PTSD to SSRI sertraline in a 14-week randomized clinical trial for women with PTSD following a recent sexual assault.
Method(s): Seventy-four women with PTSD who had suffered sexual assault in the last six months were randomly assigned to 14 weeks of IPT-PTSD (n=39)
or sertraline (n=35). Instruments assessed PTSD, anxiety, and depressive symptoms. This randomized clinical trial was conducted in Sao Paulo, Brazil,
using the Clinician-Administered PTSD Scale-5 (CAPS-5) as the primary outcome measure. Result(s): Both treatments significantly reduced PTSD,
anxiety, and depressive symptoms, without between-group outcome differences. CAPS-5 mean decreased from 42.5 (SD=9.4) to 27.1 (SD=15.9) with
sertraline and from 42.6 (SD=9.1) to 29.1 (SD=15.5) with IPT-PTSD. Attrition was high in both arms (p=.40). Conclusion(s): This trial showed within-
group improvements without differences between IPT-PTSD and sertraline treatment of PTSD. Our findings suggest that non-exposure-based
psychotherapies may benefit patients with PTSD, although we did not directly compare these treatments to an exposure therapy. Brazilian Clinical
Trials Registry RBR-3z474z. Copyright © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
European Journal of Psychotraumatology, 13
(2) : 2127474
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Interpersonal therapy (IPT)