Disorders - Post Traumatic Stress Disorder
Kangaslampi, S., Peltonen, K.
Refinement,
targeting, and better dissemination of trauma-focused therapies requires understanding their underlying mechanisms of change. Research on such
mechanisms among multiply traumatized children and adolescents is scarce. We examined the role of improvements in problematic qualities of traumatic
memories and maladaptive posttraumatic cognitions in PTSD symptom reduction, in a randomized, pragmatic trial of narrative exposure therapy vs.
treatment as usual with 40 participants 9-17 years old (48% female, 75% refugee background) repeatedly exposed to war or family violence related
trauma. Posttraumatic cognitions, quality of traumatic memories and PTSD symptoms were assessed by self-report before and after treatment.
Improvements in both quality of traumatic memories (rMI =.36) and posttraumatic cognitions (rMI =.46) correlated with symptom
reduction. However, improvement during treatment was only significant for quality of traumatic memories (FMI(11,333.56) = 4.77), not for
posttraumatic cognitions. We detected no difference in effects of narrative exposure therapy and treatment as usual on cognitions or memories. We
tentatively suggest problematic, overly sensory and incoherent quality of traumatic memories may be a useful target in the treatment of PTSD symptoms
among multiply traumatized children and adolescents. Changing maladaptive posttraumatic cognitions, though important, may be challenging among those
with severe, repeated trauma. Copyright © 2019, The Author(s).
Journal of
Child and Adolescent Trauma., 13 : 103 - 112
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Narrative exposure therapy (NET)
Jones, M. G., Rice, S.
M., Cotton, S. M.
Introduction As interest in Animal-Assisted Interventions (AAI) grows, there is
increasing need to differentiate informal activities from formal and professionally directed therapies, including mental health focussed Canine-
Assisted Psychotherapy (CAP). There have been no reviews focusing exclusively on CAP and the distinct developmental period of adolescence. The aims
of this study were to identify the characteristics of CAP interventions, their impacts and their acceptability, tolerability and feasibility for
adolescents with mental health disorders. Method A systematic review identified studies incorporating canines into mental health treatments for
adolescents aged 10-19 years. Studies reporting qualitative or quantitative psychological or psychosocial outcomes were included. Results Seven
studies were scrutinised. Intervention characteristics varied, including a range of formats, settings, locations, doses, and facilitators.
Information on the role of the canines in sessions was sparse. CAP had a positive impact on primary diagnoses and symptomatology, conferring
additional benefits to standard treatments for internalising disorders, post-traumatic stress disorder, and equivalent effects for anxiety, anger and
externalising disorders. CAP was associated with positive impacts on secondary factors including increased engagement and socialisation behaviours,
and reductions in disruptive behaviours within treatment sessions. Global functioning also improved. There was insufficient evidence that CAP
improved factors associated with self-esteem, subjective wellbeing, or coping. Good attendance and retention rates indicated high levels of
acceptability. Moderate to high tolerability was also indicated. Feasibility may be limited by additional training and logistical requirements.
Recommendations We recommend the development of theoretically informed, standardised (manualised) intervention protocols that may subsequently form
the basis of efficacy and effectiveness testing. Such protocols should clearly describe canine-participant-facilitator interactions via a for-malised
nomenclature; spontaneous (animal-led), adjunctive (facilitator-led), and experiential (participant-led). Conclusions There is emerging evidence to
suggest that CAP improves the efficacy of mental health treatments in self-selected adolescent populations via reductions in primary symptomatology,
and via secondary factors that improve therapeutic processes and quality, such as engagement and retention. Copyright © 2019 Jones et al. This is an
open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and
reproduction in any medium, provided the original author and source are credited.
PLoS ONE, 14 (1) (no
pagination)(e0210761) :
- Year: 2019
- 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: Complementary & Alternative
Interventions (CAM), Other complementary & alternative
interventions
Strohm, M., Siegesleitner, M., Kunze, A.
E., Ehring, T., Wittekind, C. E.
Imagery rescripting (ImRs) has been shown to be a promising intervention for
aversive emotional memories, but research on underlying mechanisms is only in its beginnings. Previous analogue studies on ImRs were mainly based on
the trauma film paradigm, but the personal relevance of film-induced memories is limited. Therefore, the present study aimed to investigate the
effects of ImRs on personally relevant autobiographical memories. Sixty-five participants who had experienced a distressing life-event were randomly
assigned to ImRs or no-intervention control (NIC). ImRs led to less intrusive memories than NIC during the 1-week follow-up period, but was not
superior in reducing overall event-related stress symptoms. When retrieving the memory after 1 week, ImRs participants reported greater reductions in
sadness and distress, and higher feelings of mastery. Findings underline the potential of the paradigm used in this study to test memory processes
involved in ImRs. Limitations and modifications of the paradigm are discussed. Copyright © 2019, Springer Science+Business Media, LLC, part of
Springer Nature.
Cognitive Therapy and Research., 43 : 1005 - 1017
- Year: 2019
- 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
Norton, C. L., Tucker, A., Farnham-Stratton,
M., Borroel, F., Pelletier, A.
Child abuse is epidemic in the United States and has dire long-term consequences. Innovative
interventions are needed to address the negative cognitive, affective and behavioral effects of child abuse. This mixed-method study examined if
adventure therapy is 1) an effective mental health intervention for child and adolescent survivors of abuse and neglect, and 2) an effective
intervention for families affected by abuse and neglect. The effectiveness of the adventure therapy intervention was measured by a reduction in child
trauma symptoms and improved family functioning, as reported via the Trauma Symptom Checklist for Children (TSCC), the Family Assessment Device
(FAD), as well as qualitative data gathered via family focus groups. Findings showed that trauma-informed adventure therapy with youth and families
affected by abuse reduces trauma symptomology in youth and improves family functioning, particularly in the areas of communication, closeness and
problem-solving skills. Copyright © 2017, Springer International Publishing.
Journal of Child and Adolescent Trauma, 12(1) : 85-
95
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Other Psychological Interventions, Physical activity, exercise, Other complementary & alternative
interventions
Vinke, Y. D., Truijens,
F., van-Polanen Petel, E., van-Emmerik, A. A. P.
OBJECTIVE: This online study
examined the effects of a single imaginal exposure-writing assignment on posttraumatic stress (PTS) and comorbid depressive symptoms. METHOD(S):
Forty-six participants with PTS were allocated to either a single imaginal exposure-writing assignment, a nontrauma writing assignment, or to a
nonwriting control condition, and were reassessed 2 and 5 weeks after baseline. Of the 49 participants, 36 were female, with an average age of 23.
Participation was conducted through Qualtrics. Effects were assessed with the Posttraumatic Diagnostic Scale (PDS) and the Beck Depression
Inventory-II (BDI-II). RESULT(S): PTS and depressive symptoms decreased over time regardless of the study condition. CONCLUSION(S): We found no
support for the efficacy of a single imaginal exposure-writing assignment in reducing PTS or comorbid depressive symptoms. Suggestions are given for
future studies that attempt to identify a minimal dose of imaginal exposure writing for PTS. Copyright © 2019 Wiley Periodicals, Inc.
Journal of clinical
psychology., :
- Year: 2019
- Problem: 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, Self-help
Turrini, G., Purgato, M., Acarturk, C., Anttila, M., Au, T., Ballette, F., Bird,
M., Carswell, K., Churchill, R., Cuijpers, P., Hall, J., Hansen, L. J., Kosters,
M., Lantta, T., Nose, M., Ostuzzi, G., Sijbrandij, M., Tedeschi,
F., Valimaki, M., Wancata, J., White, R., Van Ommeren, M., Barbui, C.
AimsIn the past few years,
there has been an unprecedented increase in the number of forcibly displaced migrants worldwide, of which a substantial proportion is refugees and
asylum seekers. Refugees and asylum seekers may experience high levels of psychological distress, and show high rates of mental health conditions. It
is therefore timely and particularly relevant to assess whether current evidence supports the provision of psychosocial interventions for this
population. We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) assessing the efficacy and acceptability of
psychosocial interventions compared with control conditions (treatment as usual/no treatment, waiting list, psychological placebo) aimed at reducing
mental health problems in distressed refugees and asylum seekers.MethodsWe used Cochrane procedures for conducting a systematic review and meta-
analysis of RCTs. We searched for published and unpublished RCTs assessing the efficacy and acceptability of psychosocial interventions in adults and
children asylum seekers and refugees with psychological distress. Post-traumatic stress disorder (PTSD), depressive and anxiety symptoms at post-
intervention were the primary outcomes. Secondary outcomes include: PTSD, depressive and anxiety symptoms at follow-up, functioning, quality of life
and dropouts due to any reason.ResultsWe included 26 studies with 1959 participants. Meta-analysis of RCTs revealed that psychosocial interventions
have a clinically significant beneficial effect on PTSD (standardised mean difference [SMD] = ?irc;'0.71; 95% confidence interval [CI] ?irc;'1.01
to ?irc;'0.41; I2 = 83%; 95% CI 78-88; 20 studies, 1370 participants; moderate quality evidence), depression (SMD = ?irc;'1.02; 95% CI
?irc;'1.52 to ?irc;'0.51; I2 = 89%; 95% CI 82-93; 12 studies, 844 participants; moderate quality evidence) and anxiety outcomes (SMD =
?irc;'1.05; 95% CI ?irc;'1.55 to ?irc;'0.56; I2 = 87%; 95% CI 79-92; 11 studies, 815 participants; moderate quality evidence). This
beneficial effect was maintained at 1 month or longer follow-up, which is extremely important for populations exposed to ongoing post-migration
stressors. For the other secondary outcomes, we identified a non-significant trend in favour of psychosocial interventions. Most evidence supported
interventions based on cognitive behavioural therapies with a trauma-focused component. Limitations of this review include the limited number of
studies collected, with a relatively low total number of participants, and the limited available data for positive outcomes like functioning and
quality of life.ConclusionsConsidering the epidemiological relevance of psychological distress and mental health conditions in refugees and asylum
seekers, and in view of the existing data on the effectiveness of psychosocial interventions, these interventions should be routinely made available
as part of the health care of distressed refugees and asylum seekers. Evidence-based guidelines and implementation packages should be developed
accordingly. Copyright © Cambridge University Press 2019 This is an Open Access article, distributed under the terms of the Creative Commons
Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium,
provided the original work is properly cited.
Epidemiology and Psychiatric Sciences., :
- Year: 2019
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Narrative exposure therapy (NET)
Matthijssen, S.J., vanBeerschoten, L.M., deJongh, A., Klugkist, I.G., vandenHout, M.A.
Background and objectives: Visual Schema Displacement Therapy (VSDT) is a novel therapy which has been described as a
treatment for stress and dysfunction caused by a traumatic event. Although its developers claim this therapy is quicker and more beneficial than
other forms of trauma therapy, its effectiveness has not been tested. Methods: We compared the efficacy of VSDT to an abbreviated EMDR protocol and a
non-active control condition (CC) in two studies. In Study 1 participants (N = 30) were asked to recall three negative emotional memories under three
conditions: VSDT, EMDR, and a CC, each lasting 8 min. Emotional disturbance and vividness of the memories were rated before and after the (within
group) conditions. The experiment was replicated using a between group study. In Study 2 participants (N = 75) were assigned to one of the three
conditions, and a follow-up after 6-8 days was added. Results: In both studies VSDT and EMDR were superior to the CC in reducing emotional
disturbance, and VSDT was superior to EMDR. VSDT and EMDR outperformed the CC in terms of reducing vividness. Limitation: Results need to be
replicated in clinical samples. Conclusions: It is unclear how VSDT yields positive effects, but irrespective of its causal mechanisms, VSDT warrants
clinical exploration. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Journal of Behavior Therapy and
Experimental Psychiatry, 63 : 48-56
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Eye movement desensitisation and reprocessing (EMDR), Other Psychological Interventions
Jaberghaderi, N., Rezaei,
M., Kolivand, M., Shokoohi, A.
Objective: This study was conducted to examine and compare the effectiveness of cognitive behavioral therapy (CBT) and eye movement
desensitization and reprocessing (EMDR) in child victims of domestic violence (child physical abuse and/or witnessing parents' conflicts). Method
(s): A total of 139 girls and boys, aged 8-12 years, were randomly assigned into CBT (n = 40), EMDR (n = 40), or control groups (n=59). All children
received up to 12 individual treatment sessions over 4-12 weeks. Blind assessment was done before and 2 weeks after the treatment and on a variety of
teacher-parent-rated and self-report measures of posttraumatic symptomatology, depression, anxiety, and behavior problems. Result(s): CBT and EMDR
were effective in ameliorating psychological sequelae of victims of domestic violence on the measured variables (p =.001). Comparison of the
treatment and control groups suggested moderate to high practical significance in treatment groups vs controls. Conclusion(s): Both CBT and EMDR can
help children to greatly recover from the outcomes of domestic violence in comparison with control group. Moreover, structured trauma treatments are
strongly recommended and can be used for children. Copyright © 2019 Tehran University of Medical Sciences. All rights reserved.
Iranian Journal of
Psychiatry, 14(1) : 67-75
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Eye movement desensitisation and reprocessing (EMDR)
Rosner, R., Rimane, E., Frick, U., Gutermann, J., Hagl, M., Renneberg, B., Schreiber, F., Vogel, A., Steil, R.
Importance: Despite the high prevalence, evidence-based treatments for abuse-related posttraumatic stress
disorder (PTSD) in adolescents have rarely been studied. Objective(s): To examine whether developmentally adapted cognitive processing therapy (D-
CPT) is more effective than a wait-list condition with treatment advice (WL/TA) among adolescents with PTSD related to childhood abuse. Design,
Setting, and Participant(s): This rater-blinded, multicenter, randomized clinical trial (stratified by center) enrolled treatment-seeking adolescents
and young adults (aged 14-21 years) with childhood abuse-related PTSD at 3 university outpatient clinics in Germany from July 2013 to June 2015, with
the last follow-up interview conducted by May 2016. Of 194 patients, 88 were eligible for randomization. Intervention(s): Participants received D-CPT
or WL/TA. Cognitive processing therapy was enhanced by a motivational and alliance-building phase, by including emotion regulation and consideration
of typical developmental tasks, and by higher session frequency in the trauma-focused core CPT phase. In WL/TA, participants received treatment
advice with respective recommendations of clinicians and were offered D-CPT after 7 months. Main Outcomes and Measures: All outcomes were assessed
before treatment (baseline), approximately 8 weeks after the start of treatment, after the end of treatment (posttreatment), and at the 3-month
follow-up. The primary outcome, PTSD symptom severity, was assessed in clinical interview (Clinician-Administered PTSD Scale for Children and
Adolescents for DSM-IV [CAPS-CA]). Secondary outcomes were self-reported PTSD severity, depression, borderline symptoms, behavior problems, and
dissociation. Result(s): The 88 participants (75 [85%] female) had a mean age of 18.1 years (95% CI, 17.6-18.6 years). In the intention-to-treat
analysis, the 44 participants receiving D-CPT (39 [89%] female) demonstrated greater improvement than the 44 WL/TA participants (36 [82%] female) in
terms of PTSD severity (mean CAPS-CA scores, 24.7 [95% CI, 16.6-32.7] vs 47.5 [95% CI, 37.9-57.1]; Hedges g = 0.90). This difference was maintained
through the follow-up (mean CAPS-CA scores, 25.9 [95% CI, 16.2-35.6] vs 47.3 [95% CI, 37.8-56.8]; Hedges g = 0.80). Treatment success was greatest
during the trauma-focused core phase. The D-CPT participants also showed greater and stable improvement in all secondary outcomes, with between-
groups effect sizes ranging from 0.65 to 1.08 at the posttreatment assessment (eg, for borderline symptoms, 14.1 [95% CI, 8.0-20.2] vs 32.0 [95% CI,
23.8-40.2]; Hedges g = 0.91). Conclusions and Relevance: Adolescents and young adults with abuse-related PTSD benefited more from D-CPT than from
WL/TA. Treatment success was stable at the follow-up and generalized to borderline symptoms and other comorbidities. Trial Registration: German
Clinical Trials Register identifier: DRKS00004787. Copyright © 2019 American Medical Association. All rights reserved.
JAMA
Psychiatry, 76(5) : 484-491
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Abdollahpour, S., Khosravi, A., Motaghi, Z., Keramat, A., Mousavi, S. A.
OBJECTIVE: Planning to promote the health of mothers in postpartum is important in all countries. This study aimed
to determine the effectiveness of two counseling method on prevention of post-traumatic stress after childbirth. METHOD(S): In this clinical trial,
193 of mothers who had experienced a traumatic birth were randomly assigned to three groups. Participants were assessed using IES_R questionnaire at
4-6 weeks and 3 months after delivery. RESULT(S): Debriefing and brief cognitive behavioral counseling (CBC) significantly improved the symptoms of
postpartum traumatic stress disorder. After 3 months, CBC had a significant effect on the symptoms. CONCLUSION(S): Screening of traumatic childbirth,
implementation of supportive care, and early counseling prior to the initiation of post-traumatic stress are recommended. TRIAL REGISTRATION NUMBER:
IRCT2015072522396N2. http://en.search.irct.ir/view/24735 .
Community Mental Health Journal., 55(7) : 1173-
1178
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT), Psychological debriefing
Rith-Najarian, L. R., Mesri, B., Park, A. L., Sun, M., Chavira, D. A., Chorpita, B. F.
Cognitive behavioral therapies (CBT)
for youth with anxiety, traumatic stress, and depression have demonstrated strong effects in individual studies and meta-analyses. Relatively more
attention has been given to posttreatment effects, though, and assessment of follow-up effects has been limited at the meta-analytic level. The
current meta-analysis aimed to (a) examine the effects of youth CBT at posttreatment, 1-month, 3-month, 6-month, 1-year, and long-term (2+ years)
follow-up as well as (b) identify research-related variables (e.g., measure respondent type) that relate to effects. Using a random effects model
across 110 child and adolescent CBT groups, within-group effect sizes were large at posttreatment (g = 1.24) and from 1-month through long-term
follow-up (g = 1.23-1.82), and effect sizes did not significantly differ by treatment target (i.e., anxiety, traumatic stress, depression). However,
availability of outcome data for effect sizes diminished across later follow-up assessments. Moreover, effect sizes were significantly associated
with outcome respondent type across assessment timing, with outcome measures from caregiver and youth respondents associated with smaller effect
sizes (B = -0.97, p < 0.001) relative to outcome measures that were evaluator-reported. Results provide initial support for the durability of
treatment effects for youth CBTs and highlight the importance of some confounding variables. Implications for improving treatment research standards
and prioritizing assessment of long-term follow-up assessment are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved)
Behavior Therapy, 50(1) : 225-
240
- Year: 2019
- Problem: Anxiety Disorders (any), Post Traumatic Stress Disorder, Depressive Disorders
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Cognitive & behavioural therapies (CBT)
Hylton, E., Ironson, G.
Background: On February 14th, 2018, a gunman open-fired a semi-automatic weapon at Marjory Stoneman Douglas Highschool in Parkland, FL,
killing seventeen students and staff members. Mass shootings have increased in the United States in recent decades and are associated with adverse
psychological outcomes. This pilot study evaluates the effectiveness of a two-week creative arts therapy camp at improving the mental health status
of adolescents exposed to the Parkland shooting. Method(s): This study used a pre-post design to evaluate a creative arts therapy intervention.
Participants (n=44) were rising high school students enrolled in a two-week summer arts therapy camp, where they had the option of participating in
visual art, drama, or music therapy. A questionnaire including the Patient Health Questionnaire 8-Item Scale, Generalized Anxiety Disorder 7-Item
Scale, and Child's Reaction to Traumatic Events Scale were administered on the first and final days of the intervention. Result(s): At baseline, a
third of participants indicated clinically significant depression (31.8%), a third indicated clinically significant anxiety (31.8%), and nearly two
thirds indicated high levels of posttraumatic stress (60.5%). There were statistically significant reductions in PTSD [mean difference=6.8, t
(33)=3.08, p=.004], depression [mean difference=1.79, t(33)=2.25, p=.031], and anxiety symptoms [mean difference=2.4 , t(33)=3.26, p=.003] between
pre- and post-intervention time points, with effect sizes between .38-.56. Drama therapy appeared to be the most effective of the three arts therapy
approaches. Within the drama group, there was a significant decrease in PTSD symptoms [mean difference=8.67, t(8)=2.80, p=.023], anxiety symptoms
[mean difference=5.33 t(9)=3.44, p=.007], and depressive symptoms [mean difference=5.03, t(9)=2.49, p=.034]. Symptom reductions within the music and
visual art groups were not statistically significant. Conclusion(s): Creative arts therapy appears to be a well-tolerated and age-appropriate
intervention to improve the mental health status of traumatized adolescents. Students have the choice to engage with the trauma to the extent that
they are ready. Of the three arts therapy types, drama therapy may be the most effective treatment to reduce anxiety, PTSD, and depressive symptoms
in adolescents exposed to gun violence.
Psychosomatic Medicine, 81 (4) : A104
- Year: 2019
- Problem: Post Traumatic Stress Disorder
- Type: Controlled clinical trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Creative expression: music, dance, drama, art