Disorders - Post Traumatic Stress Disorder
Peters, W., Rice, S., Alvarez-Jimenez, M., Hetrick, S. E., Halpin, E., Kamitsis, I., Santesteban-Echarri, O., Bendall, S.
Aim: Interpersonal trauma
exposures are associated with anxiety, depression, and substance use in youth populations (aged 12-25 years). This meta-analysis reports on the
efficacy of psychological interventions on these symptom domains in addition to post-traumatic stress. Method(s): Following PRISMA guidelines, a
search of electronic databases was performed for randomized controlled trials (RCTs) assessing interventions for young people following interpersonal
trauma exposure. Risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analysed using random-effects meta-analyses. Result(s): Of
the 4832 records screened, 78 studies were reviewed, and 10 RCTs, involving 679 participants (mean age 15.6 years), were analysed. There was a large
pooled effect size for post-traumatic stress (7 studies, g = 1.43, 95% CI [0.37, 2.15], p =.002) and substance use (2 studies, g = 0.70, 95% CI [-
0.11, 1.22], p <.001) and small effect sizes for anxiety (4 studies, g = 0.30, 95% CI [0.10, 0.49], p =.003), and trend-level effect for depression
(10 studies, g = 0.27, 95% CI [0.00, 0.54], p =.052). Heterogeneity was significant for post-traumatic stress and moderate for depression.
Conclusion(s): High-quality RCTs of psychological interventions for anxiety, depression, substance use, and post-traumatic stress symptoms in young
people exposed to interpersonal trauma are scarce. While available studies show either statistically significant or trend-level efficacy for
psychological interventions in reducing these symptoms, wide confidence intervals, heterogeneity and small sample size mean that results need to be
interpreted with caution. Copyright © 2022 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.
, :
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders, Substance Use Disorders (any)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Mizzi, A. L., McKinnon, M. C., Becker, S.
Introduction: Physical activity has beneficial effects on mood in both
healthy and clinical populations. Emerging literature suggests that physical activity may benefit psychological symptoms, such as depressive mood, in
those with post-traumatic stress disorder (PTSD). It is estimated that 76% of Canadians have experienced a traumatic event during their lifetime (Van
Ameringen et al., 2008). Thus, there is a large proportion of the population that does not meet criteria for PTSD but may still suffer from trauma-
related symptoms such as depression and require support for their mental health. The current pilot study aimed to evaluate the impact of an aerobic
exercise intervention on mood symptoms in trauma-exposed young adults. Method(s): Twenty-five low active young adults with subclinical trauma
symptoms but no current or past diagnosis of PTSD were recruited. Participants were randomly assigned to participate in an 8-week exercise
intervention group or a waitlist control group. Mood symptoms were assessed before and after the intervention. In addition, measures of aerobic
fitness, trauma symptoms, emotion regulation, and trait mindfulness were assessed at both time points. Result(s): The exercise intervention was
effective at inducing the expected improvements in aerobic fitness. Overall, the exercise group had a significantly greater decrease in mood symptoms
across the intervention compared to the waitlist control group. Conclusion(s): The current pilot study is the first to evaluate the impact of aerobic
exercise on mood in trauma-exposed young adults. An 8-week intervention significantly reduced mood symptoms in exercisers relative to waitlist
controls. Our results are consistent with previous research indicating that physical activity reduced depressive symptoms in those with PTSD
(Rosenbaum et al., 2015b). Importantly, we extend these findings to individuals with subclinical or undiagnosed PTSD symptoms, where exercise may be
an effective intervention to improve mood and manage or prevent further decline in mental health in those at risk of developing PTSD. Copyright ©
2022 Mizzi, McKinnon and Becker.
, 16 (no pagination) :
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Physical activity, exercise
McWey, L. M.
Trauma exposure is a pervasive issue worldwide. People exposed to
traumatic events may develop PTSD, depression, anxiety, and other mental health symptoms. Family and intimate partner relationship problems also are
frequently associated with trauma exposure. The purpose of this study was to conduct a systematic research synthesis of the empirical evidence on
systemic interventions for traumatic event exposure from 2010 to 2019. A search of peer-reviewed research resulted in 31 articles that met inclusion
criteria and were included in this review. Systemic interventions were grouped by modality (e.g., parent-child, couple, group). The collective
evidence was strongest for systemic youth-caregiver interventions, group, and couple treatment categories for traumatic event exposure. Youth-
centered interventions that included various combinations of family member participation can be considered probably efficacious. Overall, results
indicated that systemic interventions for traumatic event exposure were successful in reducing posttraumatic stress symptoms including PTSD,
depression, and anxiety, and improving relational outcomes.
Journal of Marital & Family Therapy, 48(1) : 204-230
- 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), Other Psychological Interventions
Huang, T., Li, H., Tan, S., Xie, S., Cheng,
Q., Xiang, Y., Zhou, X.,
Background: Posttraumatic stress disorder (PTSD) is common among children and adolescents who have experienced traumatic
events. Exposure therapy (ET) has been shown to be effective in treating PTSD in adults. However, its efficacy remains uncertain in children and
adolescents. Aims: To evaluate the efficacy and acceptability of ET in children and adolescents with PTSD. Method: We searched PubMed, EMBASE,
Cochrane, Web of Science, PsycINFO, CINAHL, ProQuest, LILACS, and international trial registries for randomized controlled trials (RCTs) assessed ET
in children and adolescents (aged
BMC Psychiatry, 22 : ArtID
259
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Exposure therapy, Exposure
and response prevention, Narrative exposure therapy (NET)
Hoogsteder, L. M., Ten-Thije, L., Schippers, E. E., Stams, G. J. J. M.
This multi-level meta-analysis tested if evidence-based trauma treatment was effective in
reducing trauma symptoms and externalizing behavior problems in adolescents. Based on eight independent samples and 75 effect sizes, results
indicated that Trauma Focused-Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization Reprocessing (EMDR) had a large and significant
overall effect (d=0.909) on reducing trauma symptoms and externalizing behavior problems. Trauma treatment significantly decreased trauma symptoms
(large effect) and externalizing behavior problems (medium effect). Age and type of control group moderated treatment effects. Treatment was more
effective in older adolescents. Trauma treatment for adolescents with externalizing behavior problems had a larger effect compared to no treatment,
but not compared to treatment as usual. It seems important to provide a broad treatment offer for adolescents with severe externalizing behavior
problems, in which, besides trauma treatment, attention is paid to reducing relevant individual risk factors for behavior problems.
International journal of offender therapy and comparative criminology, 66(6-7) : 735-
757
- Year: 2022
- 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), Eye movement desensitisation and reprocessing (EMDR), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Grainger, L., Thompson, Z., Morina,
N., Hoppen, T., Meiser-Stedman, R.
Previous research suggests that the effect of therapist factors on patient
outcomes is significant. Yet, to date, no reviews have explored the potential effects of therapist characteristics on treatment outcomes for children
and youth with posttraumatic stress disorder (PTSD). This systematic review and meta-analysis aimed to summarize the professional characteristics of
trial therapists delivering trauma-focused cognitive behavioral interventions (TF-CBT) for child PTSD in clinical trials and understand the
association between treatment efficacy and therapist factors. Systematic searches for randomized controlled trials (RCTs) published through November
3, 2020, were conducted; 40 RCTs were included in the full review. PTSD treatment outcome data were extracted from each publication along with any
available data regarding trial therapists. Subgroup analyses were conducted to compare the outcomes of interventions conducted by different types of
therapists. All therapist groups yielded significant effects for TF-CBT relative to active and passive control conditions, with the largest effect
size, Hedges' g = -1.11, for RCTs that used clinical psychologists and psychiatrists. A significant moderating effect was found when comparing the
treatment outcomes of clinical psychologists and psychiatrists versus other professionals, p = .044; however, this effect was no longer apparent when
only studies with an active control arm were included. Further moderator analyses demonstrated no significant differences regarding therapists'
educational and professional backgrounds and PTSD treatment outcomes. The current RCT evidence for TF-CBT for children and youth with PTSD does not
suggest that therapist educational or professional background influences treatment efficacy. Limitations and implications for future research are
discussed. Copyright © 2022 The Authors. Journal of Traumatic Stress published by Wiley Periodicals LLC on behalf of International Society for
Traumatic Stress Studies.
Journal of traumatic
stress., 27 :
- Year: 2022
- 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), Trauma-focused cognitive behavioural therapy (TF-
CBT)
Getanda, E. M., Vostanis, P.
Background: There is limited evidence on the cultural appropriateness of first-stage psychosocial
interventions for youth with mental health problems who experience conflict and disadvantage in low- and middle-income countries (LMIC). Aim(s): To
evaluate the feasibility of such an intervention (Writing for Recovery-WfR) among youth with emerging emotional problems following internal
displacement in Kenya. Method(s): Fifty-four youth aged 14-17 years were randomly allocated to a six-session intervention or a waiting list control
group. They completed measures of stressful life events; post-traumatic stress, depressive and anxiety symptoms; quality of life; and free text on
their experience of the intervention. Result(s): Young participants reported high levels of trauma exposure and emotional problems. The intervention
was perceived as flexible and culturally acceptable, with reported short-term impact. This was found to have promising post-intervention effect in
reducing post-traumatic stress, but not depressive or anxiety symptoms; and in enhancing quality of life scores. Conclusion(s): Similar psychosocial
interventions that can be delivered by paraprofessionals are important for resource-constrained LMIC settings, but need to be integrated within a
comprehensive scaled service model. Copyright © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Journal of
Mental Health, 31(6) : 774-782
- Year: 2022
- 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), Psychoeducation, Other Psychological Interventions
Espil, F. M., Balters, S., Li, R., McCurdy, B. H., Kletter, H., Piccirilli, A., Cohen, J. A., Weems, C. F., Reiss, A. L., Carrion, V. G.
Background: Identifying neural activation patterns that predict youths' treatment response may aid in the development of imaging-based
assessment of emotion dysregulation following trauma and foster tailored intervention. Changes in cortical hemodynamic activity measured with
functional near-infrared spectroscopy (fNIRS) may provide a time and cost-effective option for such work. We examined youths' PTSD symptom change
following treatment and tested if previously identified activation patterns would predict treatment response. Method(s): Youth (N = 73, mean age =
12.97, SD = 3.09 years) were randomly assigned to trauma-focused cognitive behavioral therapy (TF-CBT), cue-centered therapy (CCT), or treatment as
usual (TAU). Parents and youth reported on youth's PTSD symptoms at pre-intervention, post-intervention, and follow-up. Neuroimaging data (N = 31)
assessed at pre-intervention were obtained while youth engaged in an emotion expression task. Treatment response slopes were calculated for youth's
PTSD symptoms. Result(s): Overall, PTSD symptoms decreased from pre-intervention through follow-up across conditions, with some evidence of relative
benefit of TF-CBT and CCT over TAU but significant individual variation in treatment response. Cortical activation patterns were correlated with PTSD
symptom improvement slopes (r = 0.53). In particular, cortical responses to fearful and neutral facial stimuli in six fNIRS channels in the bilateral
dlPFC were important predictors of PTSD symptom improvement. Conclusion(s): The use of fNIRS provides a method of monitoring and assessing cortical
activation patterns in a relatively inexpensive and portable manner. Associations between functional activation and youths' PTSD symptoms
improvement may be a promising avenue for understanding emotion dysregulation in clinical populations. Copyright © 2022
Journal of Psychiatric Research, 156 : 25-35
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Trauma-focused cognitive behavioural therapy (TF-
CBT)
Edwards, E. J., Zec, D., Campbell, M., Hoorelbeke, K., Koster, E. H. W., Derakshan, N., Wynne, J.
Cognitive control training has gained traction as an intervention for reducing anxiety and depression vulnerability in
adults. There are, however, a limited number of studies investigating such training interventions for reducing symptomology of anxiety and depression
in children and adolescents. Thus, we aimed to provide a robust review and qualitative synthesis of the available research in young people. Twelve
articles met the inclusion criteria, and all were randomised control trials. Evidence of the efficacy of cognitive control training for relief of
symptoms are reported separately for anxiety, depression, and other related psychological factors, and on the basis of type of cognitive control
training paradigm. A lack of standardisation in relation to type of intervention, duration and context, outcome measures and population was observed.
Results are discussed in terms of these variations and recommendations for future research are provided.
, 300 : 158-
171
- Year: 2022
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive remediation
therapy, Other Psychological Interventions
Dumarkaite, A., Truskauskaite-Kuneviciene, I., Andersson, G., Kazlauskas, E.
Objectives: Mindfulness-based interventions have
recently been shown to be a promising option for treating posttraumatic stress. The current study aimed to investigate the effects of an online
mindfulness-based intervention on ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) symptoms at a 3-month follow-up. Method(s): An
RCT design with three measurement points (pre-intervention, post-intervention, and 3-month follow-up) was used to investigate the effects of an 8-
week online mindfulness intervention. In total, 53 traumatized young adults (Mage = 23.21, SDage = 2.81; 84.9% female)
participated in the study: 17 in the intervention group and 36 in the waiting list control group. Result(s): Intervention group and waiting list
control group comparison revealed that the intervention was effective for reducing CPTSD disturbances in self-organization symptoms (d = -0.84 [-
1.44; -0.24]), specifically, negative self-concept (d = -0.66 [-1.25; -0.07]) and disturbances in relationships (d = -0.87 [-1.47; -0.27]), at 3-
month follow-up. There were no between-group effects for PTSD symptoms from pre-test to follow-up. Conclusion(s): This is one of the first RCT
studies to report follow-up effects of an online mindfulness-based intervention for ICD-11 PTSD or CPTSD symptoms. Our study yielded that the effects
of mindfulness-based internet intervention on CPTSD symptoms tend to retain over time. Trial Registration: This study was registered with
ClinicalTrials.gov (NCT number: NCT04333667; https://clinicaltrials.gov/ct2/show/NCT04333667). Registered April 3, 2020. Copyright © 2022 Dumarkaite,
Truskauskaite-Kuneviciene, Andersson and Kazlauskas.
Frontiers in Psychiatry, 13 (no pagination) :
- Year: 2022
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Mindfulness based
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Caldas, S. V., Fondren, A., Natesan Batley, P., Contractor, A. A.
Background and objectives: Avoidance, inherent to
posttraumatic stress disorder (PTSD) symptomatology, is theoretically and empirically linked to the maintenance of PTSD symptom severity. While
research indicates traumatized individuals avoid positive and trauma memories, several PTSD treatments focus exclusively on traumatic memories. We
examined the mediating role of PTSD's avoidance in the relationship between processing positive memories and PTSD cluster severity (intrusion,
mood/cognitions, arousal). Method(s): Sixty-five trauma-exposed college students (Mage = 22.52; 86.10% female) were randomly assigned to 3
conditions: narrating/processing, writing/processing, or control (same task across baseline [T0] and follow-up [T1]). Result(s): Half-longitudinal
mediation models indicated participation in the narrating vs. writing and control conditions predicted decreases in T1 intrusion severity via
reduction in T1 avoidance severity. Similarly, participation in the narrating vs. writing and control conditions predicted decreases in T1
mood/cognitions' severity via reduction in T1 avoidance severity. Participation in the narrating vs. writing condition predicted decreases in T1
arousal severity via reduction in T1 avoidance severity. Limitation(s): Data was obtained from an analogue small-size sample of university students.
In addition, sessions were only 6-8 days apart, with the processing component of each session lasting ~30 min. Conclusion(s): Processing positive
memories may relate to lower PTSD severity via a reduction in PTSD's avoidance, paralleling effects of processing trauma memories. Our findings
support future investigations of the mechanisms underlying impacts of positive memory processing in the context of PTSD treatments. Copyright © 2022
Elsevier Ltd
Journal of Behavior Therapy and Experimental Psychiatry, 76 (no
pagination) :
- Year: 2022
- 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), Narrative exposure therapy (NET)
Bryant, R. A., Malik, A., Aqel, I.
S., Ghatasheh, M., Habashneh, R., Dawson, K. S., Watts, S., Jordans, M.
J. D., Brown, F. L., van-Ommeren, M., Akhtar, A.
BACKGROUND: Millions of young adolescents in low- and
middle-income countries (LMICs) affected by humanitarian crises experience elevated rates of poor mental health. There is a need for scalable
programs that can improve the mental health of young adolescents. This study evaluated the effectiveness of a nonspecialist delivered group-based
intervention (Early Adolescent Skills for Emotions (EASE)) to improve young adolescents' mental health.\rMETHODS AND FINDINGS: In this single-blind,
parallel, controlled trial, Syrian refugees aged 10 to 14 years in Jordan were identified through screening of psychological distress as defined by
scores >=15 on the Paediatric Symptom Scale. Participants were randomised to either EASE or enhanced usual care (EUC) involving referral to local
psychosocial services (on a 1:1.6 ratio). Participants were aware of treatment allocation but assessors were blinded. Primary outcomes were scores on
the Paediatric Symptom Checklist (PSC; internalising, externalising, and attentional difficulty scales) assessed at week 0, 9 weeks, and 3 months
after treatment (primary outcome time point). It was hypothesised that EASE would result in greater reductions on internalising symptoms than EUC.
Secondary outcomes were depression, posttraumatic stress, well-being, functioning, school belongingness, and caregivers' parenting and mental
health. Between June 2019 and January 2020, 1,842 young adolescent refugees were screened for eligibility on the basis of psychological distress.
There were 520 adolescents (28.2%) who screened positive, of whom 471 (90.6%) agreed to enter the trial. Overall, 185 were assigned to EASE and 286
to EUC, and 169 and 254 were retained at 3 months for EASE and EUC, respectively. Intent-to-treat analyses indicated that at 3 months, EASE resulted
in greater reduction on the PSC-internalising scale than EUC (estimated mean difference 0.69, 95% CI 0.19 to 1.19; p = 0.007; effect size, 0.38) but
there were no differences for PSC-externalising (estimated mean difference 0.24, 95% CI -0.43 to 0.91; p = 0.49; effect size, -0.10), PSC-attentional
problem (estimated mean difference -0.01, 95% CI -0.51 to 0.54; p = 0.97; effect size, -0.01) scores, or on depression, posttraumatic stress, well-
being, functioning, or school belongingness. Relative to EUC, caregivers in EASE had less psychological distress (estimated mean difference 1.95, 95%
CI 0.71 to 3.19; p = 0.002) and inconsistent disciplinary parenting (mean difference 1.54, 95% CI 1.03 to 2.05; p < 0.001). Secondary analyses that
(a) focused on adolescents with probable internalising disorders; (b) completed the 3-month assessment; and (c) controlled for trauma exposure did
not alter the primary results. Mediation analysis indicated that for caregivers in the EASE condition, reduction in inconsistent disciplinary
parenting was associated with reduced attentional (beta = 0.11, SE 0.07; 95% CI 0.003, 0.274) and internalising (beta = 0.11, SE 0.07; 95% CI 0.003,
0.274) problems in their children. No adverse events were attributable to the intervention. A limitation was that EUC was not matched to EASE in
terms of facilitator attention or group involvement.\rCONCLUSIONS: EASE led to reduced internalising problems in young refugee adolescents and was
associated with reduced distress and less inconsistent disciplinary parenting in caregivers. This intervention has the potential as a scalable
intervention to mitigate young adolescents' emotional difficulties in LMIC.\rTRIAL REGISTRATION: Prospectively registered at Australian and New
Zealand Clinical Trials Registry: ACTRN12619000341123.
PLoS Medicine, 19(8) : e1004046
- Year: 2022
- 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), Cognitive & behavioural therapies (CBT), Other Psychological Interventions