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Psychological
and
Physiological
Trauma
Research
Seize Your Journeys
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Traumatic stress is found in many competent, healthy, strong, good people.
No one can completely protect themselves from traumatic experiences.
Many people have long-lasting problems following exposure to trauma.
Up to 8% of persons will have PTSD at some time in their lives. People who
react to traumas are not going crazy. What is happening to them is
part of a set of common symptoms and problems that are connected with being
in a traumatic situation, and thus, is a normal reaction to abnormal events
and experiences. Having symptoms after a traumatic event is
NOT a sign of personal weakness. Given exposure to a trauma that is
bad enough, probably all people would develop PTSD.
By understanding trauma
symptoms better, a person can become less fearful of them and better able to
manage them. By recognizing the effects of trauma and knowing more about
symptoms, a person will be better able to decide about getting treatment.
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FUNCTIONAL NEUROANATOMY
In order to best understand this atlas it is important to have a
sense of the functional neuroanatomy of the brain. Over the next
several pages there is a brief summary of the 5 major brain
systems that relate to behavior, along with the general location
seen on SPECT of these areas.
The Deep Limbic System
side active view
underside surface view
underside active view
Functions
-
sets
the emotional tone of the mind
-
filters external events through internal states
(emotional coloring)
-
tags
events as internally important
-
stores highly charged emotional memories
-
modulates motivation
-
controls appetite and sleep cycles
-
promotes bonding
-
directly processes the sense of smell
-
modulates libido
Problems
-
moodiness, irritability, clinical depression
-
increased negative thinking
-
perceive events in a negative way
-
decreased motivation
-
flood of negative emotions
-
appetite and sleep problems
-
decreased or increased sexual responsiveness
-
social isolation
The Basal Ganglia System
left side active view
underside active view
Functions
-
integrates feeling and movement
-
shifts and smoothes fine motor behavior
-
suppression of unwanted motor behaviors
-
sets
the body's idle or anxiety level
-
enhances motivation
-
pleasure/ecstasy
Problems
-
anxiety, nervousness
-
panic attacks
-
physical sensations of anxiety
-
tendency to predict the worst
-
conflict avoidance
-
Gilles de la Tourette's Syndrome/tics
-
muscle tension, soreness
-
tremors
-
fine
motor problems
-
headaches
-
low
or excessive motivation
The Prefrontal Cortex
dorsal lateral prefrontal cortex
outside view
inferior orbital prefrontal cortex
outside view
side surface view
dorsal lateral prefrontal area
inferior orbital prefrontal area
inside view
underside surface view
inferior orbital prefrontal area
top-down surface view
dorsal lateral prefrontal area
Functions
-
attention span
-
perseverance
-
judgment
-
impulse control
-
organization
-
self-monitoring and supervision
-
problem solving
-
critical thinking
-
forward thinking
-
learning from experience
-
ability to feel and express emotions
-
influences the limbic system
-
empathy
Problems
-
short attention span
-
distractibility
-
lack
of perseverance
-
impulse control problems
-
hyperactivity
-
chronic lateness, poor time management
-
disorganization
-
procrastination
-
unavailability of emotions
-
misperceptions
-
poor
judgement
-
trouble learning from experience
-
short term memory problems
-
social and test anxiety
The Cingulate Gyrus
inside side view
side active view
active top-down view
active front-on view
-
allows shifting of attention
-
cognitive flexibility
-
adaptability
-
helps the mind move from idea to idea
-
gives the ability to see options
-
helps you go with the flow
-
cooperation
Problems
-
worrying
-
holds onto hurts from the past
-
stuck on thoughts (obsessions)
-
stuck on behaviors (compulsions)
-
oppositional behavior, argumentative
-
uncooperative, tendency to say no
-
addictive behaviors (alcohol or drug abuse,
eating disorders, chronic pain)
-
cognitive inflexibility
-
obsessive compulsive disorder
-
OCD
spectrum disorders
-
eating disorders, road rage
The Temporal Lobes
side view
side surface view
underside surface view
active side view
Functions
Dominant Side (usually the left)
Problems
Dominant Temporal Lobe
-
aggression, internally or externally driven
-
dark
or violent thoughts
-
sensitivity to slights, mild paranoia
-
word
finding problems
-
auditory processing problems
-
reading difficulties
-
emotional instability
Non-dominant Side (usually the right)
-
difficulty recognizing facial expression
-
difficulty decoding vocal intonation
-
implicated in social skill struggles
Either/Both Temporal Lobe Problems
-
memory problems, amnesia
-
headaches or abdominal pain without a clear
explanation
-
anxiety or fear for no particular reason
-
abnormal sensory perceptions, visual or auditory
distortions
-
feelings of déjà vu or jamais vu
-
periods of spaciness or confusion
-
religious or moral preoccupation
-
hypergraphia, excessive writing
-
seizures
Secure Attachments as a
Defense Against Trauma
“All
people mature and thrive in a social context that has profound
effects on how they cope with life’s stresses. Particularly early
in life, the social context plays a critical role in fuffering an
individual against stressful situations, and in building the
psychological and biological capacities to deal with further
stresses. The primary function of parents can be thought of as
helping children modulate their arousal by attuned and well-timed
provision of playing, feeding, comforting, touching, looking,
cleaning, and resting—in short, by teaching them skills that will
gradually help them modulate their own arousal. Secure attachment
bonds serve as primary defenses against trauma-induced
psychopathology in both children and adults (Finkelhor & Browne,
1984). In children who have been exposed to severe stressors, the
quality of the parental bond is probably the single most important
determinant of long-term damage (McFarlane, 1988).” van der
Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds. 1996.
Traumatic stress: The effects of
overwhelming experience on mind, body, and society. New
York and London: Guilford Press. .p. 185
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Sleep Disorders
“The sleep disorders are organized into four major sections according to presumed etiology. Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible. Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors. Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions).
Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention. Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation.
Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system.
Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications).
That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance.
Five distinct sleep stages can be measured by polysomnography: rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4). Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults. Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep. Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time. REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep.
These sleep stages have a characteristic temporal organization across the night. NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation. REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes. REM sleep periods increase in duration toward the morning. Human sleep also varies characteristically across the life span. After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range. This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep. Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual.
Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity. Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea. Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep. Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night. However, daytime polysomnographic studies also are used to quantify daytime sleepiness. The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day. Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness. The converse of the MSLT is also used: In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day. Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness.
Standard terminology for polysomnographic measures is used throughout the test in this section. Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep. “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness. Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity). Sleep architecture refers to the amount and distribution of specific sleep stages. Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency).
The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders: (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association.
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Substance Dependence
“Features
The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine. The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence). Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence. Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period.
Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance. The degree to which tolerance develops varies greatly across substances. Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects. For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates. Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser. Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine. Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking. Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals). Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances. In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely). Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances. For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination.
Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance. After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening. Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes. Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics. Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis. No significant withdrawal is seen even after repeated use of hallucinogens. Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals). Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence. However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems). Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal. Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use. The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal.
The following items describe the pattern of compulsive substance use that is characteristic of Dependence. The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3). The individual may express a persistent desire to cut down or regulate substance use. Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4). The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5). In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance. Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6). The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends. Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7). The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.
Specifiers
Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate. Specifiers are provided to note their presence or absence:
With Physiological Dependence. This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).
Without Physiological Dependence. This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2). In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”
Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.
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PTSD, DID, and EMDR
Posttraumatic Stress Disorder
"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1). The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2). The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).
Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness. For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury. Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts. Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease. The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.
The traumatic event can be reexperienced in various ways. Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3). These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal. Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).
Stimuli associated with the trauma are persistently avoided. The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2). This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3). Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event. The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6). The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).
The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma. these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5). Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."
Dissociative Identity Disorder (DID)
"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B). There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C). The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.). In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.
Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness. Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name. Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed. The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive). Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect. Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict. Occasionally, one or more powerful identities allocate time to the others. Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.
Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent. The amnesia is frequently asymmetrical. The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories. An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions). Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought). There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood. Transitions among identities are often triggered by psychosocial stress. The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual. Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts. The number of identities reported ranges from 2 to more than 100. Half of reported cases include the individuals with 10 or fewer identities."
Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
EMDR
Eye Movement Desensitization and Reprocessing
"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an
information processing therapy and uses an eight phase approach.
During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of
dual attention. This sequence of dual attention and personal association is repeated many times in the session.
Eight Phases of Treatment
The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.
During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.
In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough
eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.
The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.
After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures."
www.emdr.com
__________________
Major Depressive Disorder
“Diagnostic Features
The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C). Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder. In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).
The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent. It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes. For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months. During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).
The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance. If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features. If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.
If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder. However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted. Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369
“Course
Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s. Epidemiological data suggest that the age at onset is decreasing for those born more recently. The course of Major Depressive Disorder, Recurrent, is variable. Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older. Some evidence suggests that the periods of remission generally last longer early in the course of the disorder. The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode. At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode. Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance of having a fourth. About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).
Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases). For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery. The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value. A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode. Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.
Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder. The severity of the initial Major Depressive Episode appears to predict persistence. Chronic general medical conditions are also a risk factor for more persistent episodes.
Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce. Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes. Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.
It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder. Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder. A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and statistical manual of mental disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association.
________________
Major Depressive Disorder
“Diagnostic
Features
The essential feature
of Major Depressive Disorder is a clinical course that is
characterized by one or more Major Depressive Episodes without a
history of Manic, Mixed, or Hypomanic Episodes (Criteria A and
C). Episodes of Substance-Induced Mood Disorder (due to the
direct physiological effects of a drug of abuse, a medication,
or toxin exposure) or of Mood Disorder Due to a General Medical
Condition do not count toward a diagnosis of Major Depressive
Disorder. In addition, the episodes must not be better
accounted for by Schizoaffective Disorder and are not
superimposed on Schizophrenia, Schizophreniform Disorder,
Delusional Disorder, or Psychotic Disorder Not Otherwise
Specified (Criterion B).
The
fourth digit in the diagnostic code for Major Depressive
Disorder indicates whether it is a Single Episode (used only for
first episodes) or Recurrent. It is sometimes difficult to
distinguish between a single episode with waxing and waning
symptoms and two separate episodes. For purposes of this
manual, an episode is considered to have ended when the full
criteria for eh Major Depressive Episode have not been met for
at least 2 consecutive months. During this 2-month period,
there is either complete resolution of symptoms or the presence
of depressive symptoms that no longer meet the full criteria for
a Major Depressive Episode (In Partial Remission).
The fifth
digit in the diagnostic code for Major Depressive Disorder
indicates the current state of the disturbance. If the criteria
for a Major Depressive Disorder are met, the severity of the
episode is notes as Mild, Moderate, Severe Without Psychotic
Features, or Severe With Psychotic Features. If the criteria
for a Major Depressive Episode are not currently met, the fifth
digit is used to indicate whether the disorder is In Partial
Remission or In Full Remission.
If Manic,
Mixed, or Hypomanic Episodes develop in the course of Major
Depressive Disorder, the diagnosis is changed to a Bipolar
Disorder. However, if manic or hypomanic symptoms occur as a
direct effect of antidepressant treatment, use of other
medications, substance use, or toxin exposure, the diagnosis of
Major Depressive Disorder remains appropriate and an addition
diagnosis of Substance-induced Mood Disorder, With Manic
features (or With Mixed Features), should be noted. Similarly,
if manic or hypomanic symptoms occur as a direct effect of a
general medical condition, the diagnosis of Major Depressive
Disorder remains appropriate and an additional diagnosis of Mood
Disorder Due to a General Medical Condition, With Manic Features
(or With Mixed Features), should be noted.” p. 369
“Course
Major Depressive Disorder may begin at any
age, with an average age at onset in the mid-20s.
Epidemiological data suggest that the age at onset is decreasing
for those born more recently. The course of Major Depressive
Disorder, Recurrent, is variable. Some people have isolated
episodes that are separated by many years without any depressive
symptoms, whereas others have clusters of episodes, and still
others have increasingly frequent episodes as they grow older.
Some evidence suggests that the periods of remission generally
last longer early in the course of the disorder. The number of
prior episodes predicts the likelihood of developing a
subsequent Major Depressive Episode. At least 60% of
individuals with Major Depresssive Disorder, Single Episode, can
be expected to have a second episode. Individuals who have had
tow episodes have a 70% chance of having a third, and
individuals who have had three episodes have a 90% chance of
having a fourth. About 5%-10% of individuals with Major
Depressive Disorder, single Episode, subsequently develop a
Manic Episode (i.e., develop Bipolar I Disorder).
Major
Depressive Episodes may end completely (in about two-thirds of
cases), or only partially or not at all (in about one-third of
cases). For individuals who have only partial remission, there
is a greater likelihood of developing additional episodes and of
continuing the pattern of partial interepisode recovery. The
longitudinal course specifiers With Full Interepisode Recovery
and Without Full Interepisode Recovery may therefore have
prognostic value. A number of individuals have pre-existing
Dysthymic Disorder prior to the onset of Major Depressive
Disorder, single Episode. Some evidence suggests that these
individuals are more likely to have additional Major Depressive
Episodes, have poorer interepisode recovery, and may require
additional acute-phase treatment and a longer period of
continuing treatment to attain and maintain a more thorough and
longer-lasting euthymic state.
Follow-up
naturalistic studies suggested that 1 year after the diagnosis
of a major Depressive Episode, 40% of individuals still have
symptoms that are sufficiently severe to meet criteria for a
full Major Depressive Episode, roughly 20% continue to have some
symptoms that no longer meet full criteria for a Major
Depressive Episode (i.e., major Depressive Disorder, In Partial
Remission), and 40% have no Mood Disorder. The severity of the
initial Major Depressive Episode appears to predict
persistence. Chronic general medical conditions are also a risk
factor for more persistent episodes.
Episodes
of Major Depressive Disorder often follow a severe psychosocial
stressor, such as the death of a loved one or divorce. Studies
suggest that psychosocial events 9stressors) may play a more
significant role in the precipitation of the first or second
episodes of Major Depressive Disorder and may play less of a
role in the onset of subsequent episodes. Chronic general
medical conditions and Substance Dependence (particularly
Alcohol or Cocaine Dependence) may contribute to the onset or
exacerbation of Major Depressive Disorder.
It is
difficult to predict whether the first episode of a Major
Depressive Disorder in a young person will ultimately evolve
into a Bipolar Disorder. Some data suggest that the acute onset
of severe depression, especially with psychotic features and
psychomotor retardation, in a young person without prepubertal
psychopathology is more likely to predict a bipolar disorder. A
family history of Bipolar Disorder may also be suggestive of
subsequent development of Bipolar Disorder.” p. 372-373
Diagnostic and
statistical manual of mental disorders. 2000. 4th
ed. Washington, D.C.: American Psychiatric Association.
________________
DID-PTSD-EMDR
Dissociative Identity Disorder (DID)
"The essential feature of Dissociative identity
Disorder is the presence of two or more distinct identities or
personality states (Criterion A) that recurrently take control
of behavior (Criterion B). There is an inability to recall
important personal information, the extent of which is too great
to be explained by ordinary forgetfulness (Criterion C). The
disturbance is not due tot eh direct physiological effects of a
substance or a general medical condition (Condition D.). In
children, the symptoms cannot be attributed to imaginary
playmates or other fantasy play.
Dissociative Identity Disorder reflects a failure
to integrate various aspects of identity, memory, and
consciousness. Each personality state may be experienced as if
it has a distinct personal history, self-image, and identity,
including a separate name. Usually there is a primary identity
that carries the individual's given name and is passive,
dependent, guilty, and depressed. The alternate identities
frequently have different names and characteristics that
contrast with the primary identity (e.g., are hostile,
controlling, and self-destructive). Particular identities may
emerge in specific circumstances and may differ in reported age
and gender, vocabulary, general knowledge, or predominant
affect. Alternate identities are experienced as taking control
in sequence, ore at the expense of the other, and may deny
knowledge of one another, be critical of one another, or appear
to be in open conflict. Occasionally, one or more powerful
identities allocate time to the others. Aggressive or hostile
identities may at times interrupt activities or place the others
in uncomfortable situations.
Individuals with this disorder experience
frequent gaps in memory for personal history, both remote and
recent. The amnesia is frequently asymmetrical. The more
passive identities tend to have more constricted memories,
whereas the more hostile, controlling, or "protector" identities
have more complete memories. An identity that is not in control
may nonetheless gain access to consciousness by producing
auditory or visual hallucinations (e.g., a voice giving
instructions). Evidence of amnesia may be uncovered by reports
from others who have witnessed behavior that is disavowed by the
individual or by the individual's own discoveries (e.g., finding
items of clothing at home that the individual cannot remember
having bought). There may be loss of memory not only for
recurrent periods of time, but also an overall loss of
biographical memory for some extended period of childhood,
adolescence, or even adulthood. Transitions among identities
are often triggered by psychosocial stress. The time required
to switch from one identity to another is usually a matter of
seconds, but, less frequently, may b gradual. Behavior that may
be frequently associated with identity switches include rapid
blinking, facial changes, changes in voice or demeanor, or
disruption in the individual's train of thoughts. The number of
identities reported ranges from 2 to more than 100. Half of
reported cases include the individuals with 10 or fewer
identities."
Diagnostic and Statistical Manual of Mental
Disorders.
2000. 4th ed. Washington, D.C.: American Psychiatric
Association.
PTSD, DID, and EMDR
Posttraumatic Stress Disorder
"The essential feature of Posttraumatic Stress
Disorder us the development of characteristic symptoms following
exposure to an extreme traumatic stressor involving direct
personal experience of an event that involves actual or
threatened death or serious injury, or other threat to one's
physical integrity; or witnessing an event that involves death,
injury, or a threat to the physical integrity of another person;
or learning about unexpected or violent death, serious harm, or
threat of death or injury experienced by a family member or
other close associate (Criteria A1). The person's response to
the event must involve intense fear, helplessness, or horror (or
in children, the response must involve disorganized or agitated
behavior) (Criterion A2). The characteristic symptoms resulting
from the exposure to the extreme trauma include persistent
reexperiencing of the traumatic event (Criterion E), and the
disturbance must cause clinically significant distress or
impairment in social, occupational, or other important areas of
functioning (Criterion F).
Traumatic events that are experienced directly
include, but are not limited to, military combat, violent
personal assault (sexual assault, physical attack, robbery,
mugging), being kidnapped, being taken hostage, terrorist
attack, torture, incarceration as a prisoner of war or in a
concentration camp, natural or manmade disasters, severe
automobile accidents, or being diagnosed with a life-threatening
illness. For children, sexually traumatic events may include
developmentally inappropriate sexual experiences without
threatened or actual violence or injury. Witnessed events
include, but are not limited to, observing the serious injury or
unnatural death of another person due to violent assault,
accident, war, or disaster or unexpectedly witnessing a dead
body or body parts. Events experienced by others that are
learned about include, but are not limited to, violent personal
assault, serious accident, or serious injury experienced y a
family member or a close friend; learning about the sudden,
unexpected death of a family member or a close friend; or
learning that one's child has a life threatening disease. The
disorder may be especially sever or long lasting when the
stressor is of human design (e.g., torture, rape). the
likelihood of developing this disorder may increase as the
intensity of and physical proximity to the stressor increase.
The traumatic event can be reexperienced in
various ways. Commonly the person has recurrent and intrusive
recollections of the event (Criterion B1) or recurrent
distressing dreams during which the event can be replayed or
otherwise represented (Criterion B2). In rare instances, the
person experiences dissociative states that last from a few
seconds to several hours, or even days, during which components
of the event are relived and the person behaves as though
experiencing the event at that moment (Criterion B3). These
episodes, often referred to as "flashbacks," are typically brief
but can be associated with prolonged distress and heightened
arousal. Intense psychological distress (Criterion B4) or
physiological reactivity (Criterion B5) often occurs when the
person is exposed to triggering events that resemble or
symbolize an aspect of the traumatic event (e.g., anniversaries
of the traumatic event; cold, snowy weather or uniformed guards
for survivors of death camps in cold climates; hot, humid
weather for combat veterans of the South Pacific; entering any
elevator for an woman who was reaped in an elevator).
Stimuli associated with the trauma are
persistently avoided. The person commonly makes deliberate
efforts to avoid thoughts, feelings, or conversations about the
traumatic event (Criterion C1) and to avoid activities,
situations, or people who around recollections of it (Criterion
C2). This avoidance of reminders may include amnesia for an
important aspect of the traumatic event (Criterion C3).
Diminished responsiveness to the external work, referred to as
"psychic numbing" or "emotional anesthesia," usually begins soon
after the traumatic event. The individual may complain of
having markedly diminished interest or participation in
previously enjoyed activities (Criterion C4), of feeling
detached or estranged from other people (Criterion C5), or of
having markedly reduced ability to feel emotions (especially
those associated with intimacy, tenderness and sexuality)
(Criterion C6). The individual may have a sense of a
foreshortened future (e.g., not expecting to have a career,
marriage, children, or a normal life span) (Criterion C7).
The individual has persistent symptoms of anxiety
or increased arousal that were not present before the trauma.
these symptoms may include difficulty falling or staying asleep
that may be to recurrent nightmares during which the traumatic
event is relived (Criterion D1), hypervigilance (Criterion D4),
and exaggerated startle response (Criterion D5). Some
individuals report irritability or outburst of anger (Criterion
D2) or difficulty concentrating or completing tasks (Criterion
D3)."
EMDR
Eye Movement Desensitization and Reprocessing
"Eye Movement Desensitization and Reprocessing
(EMDR)1 integrates elements of many effective
psychotherapies in structured protocols that are designed to
maximize treatment effects. These include psychodynamic,
cognitive behavioral, interpersonal, experiential, and
body-centered therapies2. EMDR is an
information
processing therapy
and uses an eight phase approach.
During EMDR1 the client attends to
past and present experiences in brief sequential doses while
simultaneously focusing on an external stimulus. Then the client
is instructed to let new material become the focus of the next
set of
dual attention.
This sequence of dual attention and personal association is
repeated many times in the session.
Eight Phases of Treatment
The first phase is a history taking session
during which the therapist assesses the client's readiness for
EMDR and develops a treatment plan. Client and therapist
identify possible targets for EMDR processing. These include
recent distressing events, current situations that elicit
emotional disturbance, related historical incidents, and the
development of specific skills and behaviors that will be needed
by the client in future situations.
During the second phase of treatment, the
therapist ensures that the client has adequate methods of
handling emotional distress and good coping skills, and that the
client is in a relatively stable state. If further stabilization
is required, or if additional skills are needed, therapy focuses
on providing these. The client is then able to use stress
reducing techniques whenever necessary, during or between
sessions. However, one goal is not to need these techniques once
therapy is complete.
In phase three through six, a target is
identified and processed using EMDR procedures. These involve
the client identifying the most vivid visual image related to
the memory (if available), a negative belief about self, related
emotions and body sensations. The client also identifies a
preferred positive belief. The validity of the positive belief
is rated, as is the intensity of the negative emotions.
After this, the client is instructed to focus on
the image, negative thought, and body sensations while
simultaneously moving his/her eyes back and forth following the
therapist's fingers as they move across his/her field of vision
for 20-30 seconds or more, depending upon the need of the
client. Athough
eye movements
are the most commonly used external stimulus, therapists often
use auditory tones, tapping, or other types of tactile
stimulation. The kind of dual attention and the length of each
set is customized to the need of the client. The client is
instructed to just notice whatever happens. After this, the
clinician instructs the client to let his/her mind go blank and
to notice whatever thought, feeling, image, memory, or sensation
comes to mind. Depending upon the client's report the clinician
will facilitate the next focus of attention. In most cases a
client-directed association process is encouraged. This is
repeated numerous times throughout the session. If the client
becomes distressed or has difficulty with the process, the
therapist follows established procedures to help the client
resume processing. When the client reports no distress related
to the targeted memory, the clinician asks him/her to think of
the preferred positive belief that was identified at the
beginning of the session, or a better one if it has emerged, and
to focus on the incident, while simultaneously engaging in the
eye movements. After several sets, clients generally report
increased confidence in this positive belief. The therapist
checks with the client regarding body sensations. If there are
negative sensations, these are processed as above. If there are
positive sensations, they are further enhanced.
In phase seven, closure, the therapist asks the
client to keep a journal during the week to document any related
material that may arise and reminds the client of the
self-calming activities that were mastered in phase two.
The next session begins with phase eight,
re-evaluation of the previous work, and of progress since the
previous session. EMDR treatment ensures processing of all
related historical events, current incidents that elicit
distress, and future scenarios that will require different
responses. The overall goal is produce the most comprehensive
and profound treatment effects in the shortest period of time,
while simultaneously maintaining a stable client within a
balanced system.
After EMDR processing, clients generally report
that the emotional distress related to the memory has been
eliminated, or greatly decreased, and that they have gained
important cognitive insights. Importantly, these emotional and
cognitive changes usually result in spontaneous behavioral and
personal change, which are further enhanced with standard EMDR
procedures."
www.emdr.com
1Shapiro,
F. (2001).
Eye Movement Desensitization and Reprocessing: Basic Principles,
Protocols and Procedures (2nd ed.). New York: Guilford Press.
2Shapiro,
F. (2002).
EMDR as an Integrative Psychotherapy Approach: Experts of
Diverse Orientations Explore the Paradigm Prism. Washington, DC:
American Psychological Association Books.
|
|
NeuroBiology of Trauma
Exposure
Therapy and PTSD
Record: 1
|
Title: |
Trauma
and substance abuse: Causes, consequences, and treatment
of comorbid disorders. |
|
Author(s): |
Ouimette, Paige, (Ed), Washington State U, Pullman, WA,
US
Brown, Pamela J., (Ed),
Private Practice, New Bedford, MA, US |
|
Source: |
Washington, DC, US: American Psychological Association,
2003. xiii, 315 pp.
Publisher URL:
http://www.apa.org/books |
|
ISBN: |
1-55798-938-9 (hardcover) |
|
Digital
Object Identifier: |
10.1037/10460-000 |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; drug use; PTSD; substance
use disorder; comorbidity; treatment |
|
Abstract: |
(from
the publicity materials) This book explores the
underdiagnosed connection between drug use and
posttraumatic stress disorder (PTSD). Patients with
trauma-related distress such as PTSD often use alcohol
and drugs in a problematic manner classifiable as
substance use disorder (SUD). By not recognizing the
connection between symptoms, providers frequently
misdiagnose or do not fully attend to SUD-PTSD
comorbidity. This book presents research on how often
the two disorders co-occur and why. Authors describe the
self-medication model and explore how specific PTSD and
substance use symptoms are functionally related to each
other. In addition, they suggest assessment approaches
and practice guidelines to facilitate proper diagnosis
and treatment. Particularly valuable are descriptions of
several new treatment approaches that have been
developed specifically for SUD-PTSD, including
cognitive-behavioral and exposure therapy (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Comorbidity; *Drug Abuse; *Emotional Trauma;
*Posttraumatic Stress Disorder; *Treatment |
|
Classification: |
Psychological & Physical Disorders (3200) |
|
Population: |
Human
(10) |
|
Intended
Audience: |
Psychology: Professional & Research (PS) |
|
Publication Type: |
Book,
Edited Book; Print |
|
Release
Date: |
20021113 |
|
Accession
Number: |
2002-06114-000 |
|
Number of
Citations in Source: |
611 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-06114-000&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-06114-000&site=ehost-live">Trauma
and substance abuse: Causes, consequences, and treatment
of comorbid disorders.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 2
|
Title: |
Virtual
reality exposure therapy for World Trade Center
post-traumatic stress disorder: A case report. |
|
Author(s): |
Difede,
Joann, Cornell U, Weill Medical Coll, New York, NY, US,
jidefede@med.cornell.edu
Hoffman, Hunter G., U
Washington, Human Interface Technology Lab, Seattle, WA,
US |
|
Address: |
Difede,
Joann, Helmsley Medical Tower, 1320 York Ave., Ste. 610,
New York, NY, US,
jidefede@med.cornell.edu |
|
Source: |
CyberPsychology & Behavior, Vol 5(6), Dec 2002. pp.
529-535.
Journal URL:
http://www.liebertpub.com/publication.aspx?pub_id=10 |
|
Publisher: |
US:
Mary Ann Liebert Publishers
Publisher URL:
http://www.liebertpub.com/ |
|
ISSN: |
1094-9313 (Print) |
|
Digital
Object Identifier: |
10.1089/109493102321018169 |
|
Language: |
English |
|
Keywords: |
virtual
reality exposure therapy; survivor; World Trade Center
attack; September 11, 2001; terrorism; posttraumatic
stress disorder; treatment outcomes; graded exposure
therapy; depression; symptoms |
|
Abstract: |
Describes the treatment of a survivor (aged 26 yrs) of
the World Trade Center (WTC) attack of 9-11-01 who had
developed acute Post-traumatic Stress Disorder (PTSD).
After she failed to improve with traditional imaginal
exposure therapy, the authors sought to increase
emotional engagement and treatment success using virtual
reality (VR) exposure therapy. Over the course of 6 1-hr
VR exposure therapy sessions, they gradually and
systematically exposed the PTSD patient to virtual
planes flying over the WTC, jets crashing into the WTC
with animated explosions and sound effects, virtual
people jumping to their deaths from the burning
buildings, towers collapsing, and dust clouds. VR graded
exposure therapy was successful for reducing acute PTSD
symptoms. Depression and PTSD symptoms as measured by
the Beck Depression Inventory and the Clinician
Administered PTSD Scale indicated a large (83%)
reduction in depression, and large (90%) reduction in
PTSD symptoms after completing VR exposure therapy.
Although case reports are scientifically inconclusive by
nature, these strong preliminary results suggest that VR
exposure therapy is a promising new medium for treating
acute PTSD. (PsycINFO Database Record (c) 2005 APA, all
rights reserved) |
|
Subjects: |
*Exposure Therapy; *Posttraumatic Stress Disorder;
*Terrorism; *Treatment Outcomes; *Virtual Reality; Human
Computer Interaction; Major Depression;
Psychotherapeutic Techniques; Survivors; Symptoms |
|
Classification: |
Behavior Therapy & Behavior Modification (3312)
Engineering & Environmental
Psychology (4000) |
|
Population: |
Human
(10)
Female (40) |
|
Location: |
US |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Young Adulthood (18-29 yrs)
(320) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20030129 |
|
Accession
Number: |
2003-01209-003 |
|
Number of
Citations in Source: |
26 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-01209-003&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-01209-003&site=ehost-live">Virtual
reality exposure therapy for World Trade Center
post-traumatic stress disorder: A case report.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 3
|
Title: |
EMDR
for women who experience traumatic events. |
|
Author(s): |
Peterson, Gary, Southeast Inst for Group & Family
Therapy, Chapel Hill, NC, US |
|
Source: |
Journal
of Clinical Psychiatry, Vol 63(11), Nov 2002. pp.
1047-1048. |
|
Publisher: |
US:
Physicians Postgraduate Press
Publisher URL:
http://www.psychiatrist.com/ |
|
ISSN: |
0160-6689 (Print) |
|
Language: |
English |
|
Keywords: |
psychotherapeutic interventions; female sexual assault
victims; eye movement desensitization; psychotherapy
treatment |
|
Abstract: |
Comments on an article by E. B. Foa and G. P. Street
(see record 2001-11162-005) regarding psychotherapeutic
interventions for women with PTSD. It is noted that Foa
and Street describe other psychotherapy procedures, but
do not mention eye movement desensitization and
reprocessing (EMDR). Peterson cites that in Effective
Treatments for PTSD: Practice Guidelines from the
International Society for Traumatic Stress Studies
[ISTSS] , 2 psychotherapy treatments for PTSD are listed
as having been shown to be effective: exposure therapy
and EMDR. SIT is reported to have had 2 well-controlled
studies published on the treatment of PTSD. Both SIT
studies were with female sexual assault victims. It is
concluded that given that EMDR has been established as
effective in the ISTSS guidelines, it may be important
for the reader to know that this form of therapy may be
applied when confronting the issues addressed in this
article. A comment by Foa follows. (PsycINFO Database
Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Eye
Movement Desensitization Therapy; *Human Females;
*Posttraumatic Stress Disorder; *Rape |
|
Classification: |
Specialized Interventions (3350) |
|
Population: |
Human
(10)
Female (40) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Document
Type: |
Comment/Reply |
|
Release
Date: |
20030115 |
|
Accession
Number: |
2002-11193-020 |
|
Number of
Citations in Source: |
5 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-11193-020&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-11193-020&site=ehost-live">EMDR
for women who experience traumatic events.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 4
|
Title: |
Diagnosen akutt stresslidelse og forebygging av
posttraumatisk stresslidelse. |
|
Translated Title: |
Acute
stress disorder and prevention of posttraumatic stress
disorder. |
|
Author(s): |
Eid,
Jarle, U Bergen, Sjokrigsskolen, Bergen, Norway,
jeid@sksk.mil.no
Johnsen, Bjorn Helge, U
Bergen, Sjokrigsskolen, Bergen, Norway |
|
Source: |
Tidsskrift for Norsk Psykologforening, Vol 39(11), Nov
2002. pp. 987-995. |
|
Publisher: |
Norway:
Norsk Psykologforening
Publisher URL:
http://www.psykol.no/ |
|
ISSN: |
0332-6470 (Print) |
|
Language: |
Norwegian |
|
Keywords: |
acute
stress disorder; diagnostic criteria; assessment
instruments; posttraumatic stress disorder; trauma
victims; prevention; early intervention; early exposure;
emotional processing |
|
Abstract: |
The
diagnosis of acute stress disorder (ASD) was introduced
in DSM-IV in 1994 in order to identify trauma victims
with a high potential for later posttraumatic stress
disorder (PTSD). This article reviews current diagnostic
criteria and available assessment instruments for ASD.
Recent studies have suggested that ASD is highly
predictive of later PTSD. Theoretical models and
randomized controlled clinical trials have indicated
that early exposure and emotional processing of
traumatic memories could be an effective early
intervention following trauma. However, evidence
indicates that some survivors seem to gain less from
exposure treatment. A casuistic presentation of early
interventions after a naval shipwreck is used to discuss
benefits and limitations of early exposure as a
preventive intervention. (PsycINFO Database Record (c)
2005 APA, all rights reserved) |
|
Subjects: |
*Early
Intervention; *Exposure Therapy; *Posttraumatic Stress
Disorder; *Prevention; *Stress Reactions; Acute Stress
Disorder; Emotional Trauma; Measurement; Psychodiagnosis |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10) |
|
Methodology: |
Literature Review |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Release
Date: |
20030324 |
|
Accession
Number: |
2002-06981-001 |
|
Number of
Citations in Source: |
46 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-06981-001&site=ehost-live |
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-06981-001&site=ehost-live">Diagnosen
akutt stresslidelse og forebygging av posttraumatisk
stresslidelse.</A> |
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|
Database: |
PsycINFO |
Record: 5
|
Title: |
Skills
training in affective and interpersonal regulation
followed by exposure: A phase-based treatment for PTSD
related to childhood abuse. |
|
Author(s): |
Cloitre, Marylene, New York Presbyterian Hosp, Anxiety &
Traumatic Stress Program, New York, NY, US,
mcloitre@med.cornell.edu
Koenen, Karestan C.,
Columbia U, Dept of Public Health, New York, NY, US
Cohen, Lisa R., St.
Luke's-Roosevelt Hosp, Dept of Psychiatry, New York, NY,
US
Han, Hyemee, Weill Medical
Coll of Cornell U, Dept of Psychiatry, New York, NY, US |
|
Address: |
Cloitre, Marylene, 418 East 59th Street, Apartment 25B,
New York, NY, US,
mcloitre@med.cornell.edu |
|
Source: |
Journal
of Consulting and Clinical Psychology, Vol 70(5), Oct
2002. pp. 1067-1074.
Journal URL:
http://www.apa.org/journals/ccp.html |
|
Publisher: |
US:
American Psychological Assn
Publisher URL:
http://www.apa.org |
|
ISSN: |
0022-006X (Print) |
|
Digital
Object Identifier: |
10.1037/0022-006X.70.5.1067 |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; child sexual abuse
survivors; cognitive behavior therapy; exposure therapy;
social skills training; emotional control; treatment
outcome; therapeutic alliance; women |
|
Abstract: |
Fifty-eight women with posttraumatic stress disorder
(PTSD) related to childhood abuse were randomly assigned
to a 2-phase cognitive-behavioral treatment or a minimal
attention wait list. Phase 1 of treatment included 8
weekly sessions of skills training in affect and
interpersonal regulation; Phase 2 included 8 sessions of
modified prolonged exposure. Compared with those on wait
list, participants in active treatment showed
significant improvement in affect regulation problems,
interpersonal skills deficits, and PTSD symptoms. Gains
were maintained at 3- and 9-month follow-up. Phase 1
therapeutic alliance and negative mood regulation skills
predicted Phase 2 exposure success in reducing PTSD,
suggesting the value of establishing a strong
therapeutic relationship and emotion regulation skills
before exposure work among chronic PTSD populations.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Cognitive Therapy; *Posttraumatic Stress Disorder;
*Sexual Abuse; *Treatment Outcomes; *Victimization;
Child Abuse; Comorbidity; Emotional Control; Human
Females; Social Skills Training; Therapeutic Alliance |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10)
Female (40) |
|
Location: |
US |
|
Methodology: |
Empirical Study; Treatment Outcome/Clinical Trial |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Release
Date: |
20020911 |
|
Accession
Number: |
2002-18226-001 |
|
Number of
Citations in Source: |
45 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-18226-001&site=ehost-live |
|
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|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-18226-001&site=ehost-live">Skills
training in affective and interpersonal regulation
followed by exposure: A phase-based treatment for PTSD
related to childhood abuse.</A> |
|
|
|
|
Database: |
PsycINFO |
|
Full Text Database: |
PsycARTICLES |
Record: 6
|
Title: |
Fear
activation and habituation patterns as early process
predictors of response to prolonged exposure treatment
in PTSD. |
|
Author(s): |
van
Minnen, Agnes, U Nijmegen, Dept of Clinical Psychology &
Personality, Nijmegen, Netherlands,
minnen@psych.kun.nl
Hagenaars, Muriel, U
Nijmegen, Dept of Clinical Psychology & Personality,
Nijmegen, Netherlands |
|
Address: |
van
Minnen, Agnes, U Nijmegen, Dept of Clinical Psychology,
PO Box 9104, 6500 HE, Nijmegen, Netherlands,
minnen@psych.kun.nl |
|
Source: |
Journal
of Traumatic Stress, Vol 15(5), Oct 2002. pp. 359-367.
Journal URL:
http://www.wkap.nl/journalhome.htm/0894-9867 |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0894-9867 (Print)
1573-6598 (Electronic) |
|
Digital
Object Identifier: |
10.1023/A:1020177023209 |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; exposure treatment; fear
activation; habituation; treatment process; treatment
outcomes; prediction; improved vs nonimproved patients
vs drop-outs |
|
Abstract: |
Improved (n=21) and nonimproved (n=13) posttraumatic
stress disorder (PTSD) patients (a mixed trauma
population) were compared for fear activation and
habituation patterns during and between the 1st and 2nd
prolonged exposure sessions. Drop-outs (n=11) were also
evaluated. Nonimproved patients had significantly higher
ratings of anxiety at the start of the first exposure
session. Improved patients showed more within-session
habituation during the self-exposures at home and more
between-session habituation. Even after controlling for
initial PTSD and depression symptom severity,
habituation between the first and second exposure
sessions was significantly related to treatment outcome.
Patients who dropped out of the treatment were found not
to differ from completers on fear activation and
within-session habituation during the first exposure
session. (PsycINFO Database Record (c) 2005 APA, all
rights reserved)(journal abstract) |
|
Subjects: |
*Exposure Therapy; *Fear; *Habituation; *Posttraumatic
Stress Disorder; *Treatment Outcomes; Patients;
Prediction; Treatment Dropouts |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Male (30)
Female (40)
Outpatient (60) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20021009 |
|
Accession
Number: |
2002-04492-003 |
|
Number of
Citations in Source: |
37 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-04492-003&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-04492-003&site=ehost-live">Fear
activation and habituation patterns as early process
predictors of response to prolonged exposure treatment
in PTSD.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 7
|
Title: |
Effectiveness of exposure therapy: A case study of
posttraumatic stress disorder and mental retardation. |
|
Author(s): |
Lemmon,
Valerie A., Riverside Associates, P.C., Harrisburg, PA,
US,
vlemmon@messiah.edu
Mizes, J. Scott, West
Virginia University, Morgantown, WV, US |
|
Address: |
Lemmon,
Valerie A., Riverside Associates, P.C., 2818 Green
Street, Harrisburg, PA, US,
vlemmon@messiah.edu |
|
Source: |
Cognitive and Behavioral Practice, Vol 9(4), Fal 2002.
pp. 317-323. |
|
Publisher: |
US:
Assn for the Advancement of Behavior Therapy
Publisher URL:
http://www.aabt.org |
|
ISSN: |
1077-7229 (Print) |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; exposure therapy;
cognitive-behavioral interventions; short-term
intervention; mental retardation; sexual assault;
comorbidity; treatment |
|
Abstract: |
Posttraumatic stress disorder (PTSD) is a common
disorder following sexual assault. There is significant
empirical evidence that cognitive-behavioral
interventions are efficacious in the treatment of PTSD.
People with mental retardation (MR) often are victims of
sexual assaults, but the presence of comorbid PTSD and
MR was not found in the current literature. In addition,
there is no evidence showing that any specific
short-term intervention is effective in treating PTSD
with comorbid MR. The present article describes a case
study in which short-term exposure therapy following
numerous sexual assaults was effective in reducing the
symptoms of PTSD in a woman with comorbid MR. (PsycINFO
Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Comorbidity; *Exposure Therapy; *Mental Retardation;
*Posttraumatic Stress Disorder; *Sexual Abuse; Cognitive
Behavior Therapy; Rape; Treatment Outcomes |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Thirties (30-39 yrs) (340) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20031110 |
|
Accession
Number: |
2003-08297-010 |
|
Number of
Citations in Source: |
26 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-08297-010&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-08297-010&site=ehost-live">Effectiveness
of exposure therapy: A case study of posttraumatic
stress disorder and mental retardation.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 8
|
Title: |
Treatment of PTSD: Stress Inoculation Training with
Prolonged Exposure compared to EMDR. |
|
Author(s): |
Lee,
Christopher, Sir Charles Gairdner Hosp, QEII Medical
Ctr, Perth, Australia,
chlee@central.murdoch.edu.au
Gavriel, Helen, HMAS
Stirling, Royal Australian Navy, Australia
Drummond, Peter, Murdoch U,
School of Psychology, Perth, Australia
Richards, Jeff, U Ballarat,
Ballarat, Australia
Greenwald, Ricky, Mount
Sinai School of Medicine, New York, NY, US |
|
Address: |
Lee,
Christopher, 88 Palmerston St., Mosman Park, WAU,
Australia,
chlee@central.murdoch.edu.au |
|
Source: |
Journal
of Clinical Psychology, Vol 58(9), Sep 2002. pp.
1071-1089.
Journal URL:
http://www.interscience.wiley.com/jpages/0021-9762/ |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0021-9762 (Print)
1097-4679 (Electronic) |
|
Digital
Object Identifier: |
10.1002/jclp.10039 |
|
Language: |
English |
|
Keywords: |
stress
inoculation training with prolonged exposure; STIPE; eye
movement desensitization & reprocessing; EMDR;
posttraumatic stress disorder; PTSD; treatment outcome |
|
Abstract: |
The
effectiveness of Stress Inoculation Training with
Prolonged Exposure (SITPE) was compared to Eye Movement
Desensitization and Reprocessing (EMDR). 24 participants
(mean age 35.3 yrs) who had a diagnosis of Post
Traumatic Stress Disorder (PTSD) were randomly assigned
to one of the treatment conditions. Participants were
also their own wait-list control. Outcome measures
included self-report and observer-rated measures of
PTSD, and self-report measures of depression. On global
PTSD measures, there were no significant differences
between the treatments at the end of therapy. However on
the subscale measures of the degree of intrusion
symptoms, EMDR did significantly better than SITPE. At
follow-up EMDR was found to lead to greater gains on all
measures. (PsycINFO Database Record (c) 2005 APA, all
rights reserved) |
|
Subjects: |
*Exposure Therapy; *Eye Movement Desensitization
Therapy; *Paradoxical Techniques; *Posttraumatic Stress
Disorder; *Treatment Outcomes |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10)
Male (30)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20021016 |
|
Accession
Number: |
2002-04131-009 |
|
Number of
Citations in Source: |
36 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-04131-009&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-04131-009&site=ehost-live">Treatment
of PTSD: Stress Inoculation Training with Prolonged
Exposure compared to EMDR.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 9
|
Title: |
Innovative use of virtual reality technology in the
treatment of PTSD in the aftermath of September 11. |
|
Author(s): |
Difede,
JoAnn, Cornell U, Weill Medical Coll, Dept of
Psychiatry, New York, NY, US,
jdifede@med.cornell.edu
Hoffman, Hunter, U
Washington, Human Interface Technology Lab, Seattle, WA,
US
Jaysinghe, Nimale, Cornell
U, Weill Medical Coll, Dept of Psychiatry, New York, NY,
US |
|
Address: |
Difede,
JoAnn,
jdifede@med.cornell.edu |
|
Source: |
Psychiatric Services, Vol 53(9), Sep 2002. pp.
1083-1085.
Journal URL:
http://psychservices.psychiatryonline.org/ |
|
Publisher: |
US:
American Psychiatric Assn
Publisher URL:
http://www.appi.org |
|
ISSN: |
1075-2730 (Print) |
|
Digital
Object Identifier: |
10.1176/appi.ps.53.9.1083 |
|
Language: |
English |
|
Keywords: |
virtual
reality technology; psychotherapy; exposure therapy;
posttraumatic stress disorder; September 11 |
|
Abstract: |
Highlights developing research on and clinical
applications of virtual reality technology to
established psychotherapeutic principles and techniques
for the treatment of anxiety disorders. In particular,
the application of virtual reality technology in the
treatment of posttraumatic stress disorder related to
September 11th is addressed. Until now, psychotherapy in
general and imaginal exposure in particular have relied
on the capacities of a patient's imagination and memory.
However, virtual environments afford opportunities not
only to capitalize on a patient's capacities, but also
to augment them with visual, auditory, and even haptic
computer-generated experiences. (PsycINFO Database
Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Exposure Therapy; *Posttraumatic Stress Disorder;
*Psychotherapeutic Techniques; *Terrorism; *Virtual
Reality |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20021016 |
|
Accession
Number: |
2002-18300-004 |
|
Number of
Citations in Source: |
16 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-18300-004&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-18300-004&site=ehost-live">Innovative
use of virtual reality technology in the treatment of
PTSD in the aftermath of September 11.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 10
|
Title: |
Cognitive-behavior therapy for PTSD in rape survivors. |
|
Author(s): |
Jaycox,
Lisa H., RAND, Arlington, VA, US,
Jaycox@rand.org
Zoellner, Lori, U
Washington, WA, US
Foa, Edna B., U
Pennsylvania, PA, US |
|
Address: |
Jaycox,
Lisa H., RAND, 1200 South Hayes Street, Arlington, VA,
US,
Jaycox@rand.org |
|
Source: |
Journal
of Clinical Psychology, Vol 58(8), Aug 2002. pp.
891-906.
Journal URL:
http://www.interscience.wiley.com/jpages/0021-9762/ |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0021-9762 (Print)
1097-4679 (Electronic) |
|
Digital
Object Identifier: |
10.1002/jclp.10065 |
|
Language: |
English |
|
Keywords: |
rape
survivors; cognitive-behavioral treatment; PTSD;
cognitive restructuring; prolonged exposure |
|
Abstract: |
Notes
that in recent years, new data have appeared, further
suggesting the utility of cognitive-behavioral
interventions for posttraumatic stress disorder (PTSD)
subsequent to sexual assault. In this article, the
authors present a model of cognitive-behavioral
treatment (CBT) for PTSD in rape survivors.
Emotional-processing theory, which proposes mechanisms
that underlie the development of disturbances following
rape, is reviewed. A CBT-based therapy (Prolonged
Exposure) is presented that entails education about
common reactions to trauma, relaxation training,
imaginal reliving of the rape memory, exposure to trauma
reminders, and cognitive restructuring. Current research
regarding the use of prolonged exposure is discussed.
The case example of a young female rape survivor (aged
25 yrs) is described in detail, and her prior substance
dependence and intense shame are highlighted. The
therapy was successful in reducing the client's symptoms
of PTSD, as well as her depressive symptoms, and these
gains were maintained at a 1-yr follow-up assessment.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved) |
|
Subjects: |
*Cognitive Restructuring; *Cognitive Therapy; *Exposure
Therapy; *Posttraumatic Stress Disorder; *Rape;
Survivors |
|
Classification: |
Cognitive Therapy (3311) |
|
Population: |
Human
(10)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Young Adulthood (18-29 yrs)
(320) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020807 |
|
Accession
Number: |
2002-15423-003 |
|
Number of
Citations in Source: |
9 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-15423-003&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-15423-003&site=ehost-live">Cognitive-behavior
therapy for PTSD in rape survivors.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 11
|
Title: |
Trauma
focus group therapy for combat-related PTSD: An update. |
|
Author(s): |
Foy,
David W., Pepperdine U, Graduate School of Education &
Psychology, Encino, CA, US,
dfoy@pepperdine.edu
Ruzek, Josef I., National
Ctr for PTSD, Palo Alto, CA, US
Glynn, Shirley M., West Los
Angeles Veterans Medical Ctr, Los Angeles, CA, US
Riney, Sherry J., National
Ctr for PTSD, Palo Alto, CA, US
Gusman, Fred D., National
Ctr for PTSD, Palo Alto, CA, US |
|
Address: |
Foy,
David W., Pepperdine U, Graduate School of Education &
Psychology, 16830 Ventura Boulevard, Suite #200, Encino,
CA, US,
dfoy@pepperdine.edu |
|
Source: |
Journal
of Clinical Psychology, Vol 58(8), Aug 2002. pp.
907-918.
Journal URL:
http://www.interscience.wiley.com/jpages/0021-9762/ |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0021-9762 (Print)
1097-4679 (Electronic) |
|
Digital
Object Identifier: |
10.1002/jclp.10066 |
|
Language: |
English |
|
Keywords: |
individual cognitive-behavioral treatment; PTSD; trauma
focus group therapy; directed exposure; combat |
|
Abstract: |
Individual cognitive-behavioral therapy involving
directed exposure to memories of traumatic events has
been found to be effective in treating posttraumatic
stress disorder. In this article, the authors present
updated information on an alternative group form of
exposure therapy: manualized trauma-focus group therapy
(TFGT), designed as an efficient means of conducting
directed exposure. The cognitive-behavioral and
developmental models from which the approach was derived
are described, and an overview of session topics and a
case illustration are presented. The authors also
provide guidelines for referring individuals to TFGT,
and offer suggestions for future research. (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Cognitive Therapy; *Emotional Trauma; *Exposure
Therapy; *Group Psychotherapy; *Posttraumatic Stress
Disorder; Cognitive Restructuring; Combat Experience;
Military Veterans |
|
Classification: |
Cognitive Therapy (3311) |
|
Population: |
Human
(10)
Male (30) |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Middle Age (40-64 yrs) (360) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020807 |
|
Accession
Number: |
2002-15423-004 |
|
Number of
Citations in Source: |
12 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-15423-004&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-15423-004&site=ehost-live">Trauma
focus group therapy for combat-related PTSD: An
update.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 12
|
Title: |
A
comparison of cognitive-processing therapy with
prolonged exposure and a waiting condition for the
treatment of chronic posttraumatic stress disorder in
female rape victims. |
|
Author(s): |
Resick,
Patricia A., U Missouri, Dept of Psychology, Ctr for
Trauma Recovery, St Louis, MO, US,
resick@umsl.edu
Nishith, Pallavi, U
Missouri, Dept of Psychology, Ctr for Trauma Recovery,
St Louis, MO, US
Weaver, Terri L., U
Missouri, Dept of Psychology, Ctr for Trauma Recovery,
St Louis, MO, US
Astin, Millie C., U
Missouri, Dept of Psychology, Ctr for Trauma Recovery,
St Louis, MO, US
Feuer, Catherine A., U
Missouri, Dept of Psychology, Ctr for Trauma Recovery,
St Louis, MO, US |
|
Address: |
Resick,
Patricia A., U Missouri, Dept of Psychology, Ctr for
Trauma Recovery, Weinman Bldg, 8001 Natural Bridge Road,
St Louis, MO, US,
resick@umsl.edu |
|
Source: |
Journal
of Consulting and Clinical Psychology, Vol 70(4), Aug
2002. pp. 867-879.
Journal URL:
http://www.apa.org/journals/ccp.html |
|
Publisher: |
US:
American Psychological Assn
Publisher URL:
http://www.apa.org |
|
ISSN: |
0022-006X (Print) |
|
Digital
Object Identifier: |
10.1037/0022-006X.70.4.867 |
|
Language: |
English |
|
Keywords: |
cognitive processing therapy; prolonged exposure;
minimal attention waiting list condition; female rape
victims; posttraumatic stress disorder; PTSD; guilt;
depression |
|
Abstract: |
The
purpose of this study was to compare
cognitive-processing therapy (CPT) with prolonged
exposure and a minimal attention condition (MA) for the
treatment of posttraumatic stress disorder (PTSD) and
depression. One hundred seventy-one female rape victims
were randomized into 1 of the 3 conditions, and 121
completed treatment. Participants were assessed with the
Clinician-Administered PTSD Scale, the PTSD Symptom
Scale, the Structured Clinical Interview for DSM-IV, the
Beck Depression Inventory, and the Trauma-Related Guilt
Inventory. Independent assessments were made at
pretreatment, posttreatment, and 3 and 9 months
posttreatment. Analyses indicated that both treatments
were highly efficacious and superior to MA. The 2
therapies had similar results except that CPT produced
better scores on 2 of 4 guilt subscales. (PsycINFO
Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Cognitive Therapy; *Exposure Therapy; *Major
Depression; *Posttraumatic Stress Disorder; *Rape;
Cognitive Processes; Guilt; Victimization |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10)
Female (40) |
|
Location: |
US |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Release
Date: |
20020731 |
|
Accession
Number: |
2002-17393-001 |
|
Number of
Citations in Source: |
35 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17393-001&site=ehost-live |
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17393-001&site=ehost-live">A
comparison of cognitive-processing therapy with
prolonged exposure and a waiting condition for the
treatment of chronic posttraumatic stress disorder in
female rape victims.</A> |
|
|
|
|
Database: |
PsycINFO |
|
Full Text Database: |
PsycARTICLES |
Record: 13
|
Title: |
Pattern
of change in prolonged exposure and cognitive-processing
therapy for female rape victims with posttraumatic
stress disorder. |
|
Author(s): |
Nishith, Pallavi, U Missouri, Dept of Psychology, Ctr
for Trauma Recovery, St Louis, MO, US,
pnishith@umsl.edu
Resick, Patricia A., U
Missouri, Dept of Psychology, Ctr for Trauma Recovery,
St Louis, MO, US
Griffin, Michael G., U
Missouri, Dept of Psychology, Ctr for Trauma Recovery,
St Louis, MO, US |
|
Address: |
Nishith, Pallavi, U Missouri, Dept of Psychology, Ctr
for Trauma Recovery, Weinman Bldg, 8001 Natural Bridge
Rd, St Louis, MO, US,
pnishith@umsl.edu |
|
Source: |
Journal
of Consulting and Clinical Psychology, Vol 70(4), Aug
2002. pp. 880-886.
Journal URL:
http://www.apa.org/journals/ccp.html |
|
Publisher: |
US:
American Psychological Assn
Publisher URL:
http://www.apa.org |
|
ISSN: |
0022-006X (Print) |
|
Digital
Object Identifier: |
10.1037/0022-006X.70.4.880 |
|
Language: |
English |
|
Keywords: |
cognitive processing therapy; prolonged exposure;
minimal attention waiting list condition; female rape
victims; posttraumatic stress disorder; PTSD; guilt;
depression; therapeutic change |
|
Abstract: |
Curve
estimation techniques were used to identify the pattern
of therapeutic change in female rape victims with
posttraumatic stress disorder (PTSD). Within-session
data on the Posttraumatic Stres Disorder Symptom Scale
were obtained, in alternate therapy sessions, on 171
women. The final sample of treatment completers included
54 prolonged exposure (PE) and 54 cognitive-processing
therapy (CPT) completers. For both PE and CPT, a
quadratic function provided the best fit for the total
PTSD, reexperiencing, and arousal scores. However, a
difference in the line of best fit was observed for the
avoidance symptoms. Although a quadratic function still
provided a better fit for the PE avoidance, a linear
function was more parsimonious in explaining the CPT
avoidance variance. Implications of the findings are
discussed. (PsycINFO Database Record (c) 2005 APA, all
rights reserved)(journal abstract) |
|
Subjects: |
*Cognitive Therapy; *Exposure Therapy; *Major
Depression; *Posttraumatic Stress Disorder;
*Psychotherapeutic Processes; Cognitive Processes;
Guilt; Rape; Statistical Analysis; Victimization |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10)
Female (40) |
|
Location: |
US |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study; Treatment Outcome/Clinical Trial |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Release
Date: |
20020731 |
|
Accession
Number: |
2002-17393-002 |
|
Number of
Citations in Source: |
18 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17393-002&site=ehost-live |
|
|
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Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17393-002&site=ehost-live">Pattern
of change in prolonged exposure and cognitive-processing
therapy for female rape victims with posttraumatic
stress disorder.</A> |
|
|
|
|
Database: |
PsycINFO |
|
Full Text Database: |
PsycARTICLES |
Record: 14
|
Title: |
Does
imaginal exposure exacerbate PTSD symptoms? |
|
Author(s): |
Foa,
Edna B., U Pennsylvania, Dept of Psychiatry, Ctr for the
Treatment & Study of Anxiety, Philadelphia, PA, US,
foa@mail.med.upenn.edu
Zoellner, Lori A., U
Pennsylvania, Dept of Psychiatry, Ctr for the Treatment
& Study of Anxiety, Philadelphia, PA, US
Feeny, Norah C., U
Pennsylvania, Dept of Psychiatry, Ctr for the Treatment
& Study of Anxiety, Philadelphia, PA, US
Hembree, Elizabeth A., U
Pennsylvania, Dept of Psychiatry, Ctr for the Treatment
& Study of Anxiety, Philadelphia, PA, US
Alvarez-Conrad, Jennifer, U
Pennsylvania, Dept of Psychiatry, Ctr for the Treatment
& Study of Anxiety, Philadelphia, PA, US |
|
Address: |
Foa,
Edna B., U Pennsylvania, Ctr for the Treatment & Study
of Anxiety, 3535 Market St, Philadelphia, PA, US,
foa@mail.med.upenn.edu |
|
Source: |
Journal
of Consulting and Clinical Psychology, Vol 70(4), Aug
2002. pp. 1022-1028.
Journal URL:
http://www.apa.org/journals/ccp.html |
|
Publisher: |
US:
American Psychological Assn
Publisher URL:
http://www.apa.org |
|
ISSN: |
0022-006X (Print) |
|
Digital
Object Identifier: |
10.1037/0022-006X.70.4.1022 |
|
Language: |
English |
|
Keywords: |
symptom
exacerbation; imaginal exposure; chronic posttraumatic
stress disorder; psychotherapy; treatment outcome;
sexual & nonsexual assault victims |
|
Abstract: |
Symptom
exacerbation (i.e., treatment side effects) has often
been neglected in the psychotherapy literature. Although
prolonged exposure has gained empirical support for the
treatment of chronic posttraumatic stress disorder
(PTSD), some have expressed concern that imaginal
exposure, a component of this therapy, may cause symptom
exacerbation, leading to inferior outcome or dropout. In
the present study, symptom exacerbation was examined in
76 women with chronic PTSD. To define a "reliable"
exacerbation, we used a method of incorporating the
standard deviation and test-retest reliability of each
outcome measure. Only a minority of participants
exhibited reliable symptoms exacerbation. Individuals
who reported symptom exacerbation benefited comparably
from treatment. Further, symptom exacerbation was
unrelated to dropout. Thus, although a minority of
individuals experienced a temporary symptom
exacerbation, this exacerbation was unrelated to
outcome. (PsycINFO Database Record (c) 2005 APA, all
rights reserved)(journal abstract) |
|
Subjects: |
*Exposure Therapy; *Imagery; *Posttraumatic Stress
Disorder; *Symptoms; *Treatment Outcomes; Chronicity
(Disorders); Crime Victims; Sex Offenses; Violence |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Female (40) |
|
Location: |
US |
|
Age
Group: |
Adolescence (13-17 yrs) (200)
Adulthood (18 yrs & older)
(300)
Young Adulthood (18-29 yrs)
(320)
Thirties (30-39 yrs) (340)
Middle Age (40-64 yrs) (360) |
|
Methodology: |
Empirical Study; Treatment Outcome/Clinical Trial |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Release
Date: |
20020731 |
|
Accession
Number: |
2002-17393-016 |
|
Number of
Citations in Source: |
36 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17393-016&site=ehost-live |
|
|
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|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17393-016&site=ehost-live">Does
imaginal exposure exacerbate PTSD symptoms?</A> |
|
|
|
|
Database: |
PsycINFO |
|
Full Text Database: |
PsycARTICLES |
Record: 15
|
Title: |
Changes
in PTSD patients' narratives during prolonged exposure
therapy: A replication and extension. |
|
Author(s): |
van
Minnen, Agnes, U Nijmegen, Dept of Clinical Psychology &
Personality, Nijmegen, Netherlands,
minnen@psych.kun.nl
Wessel, Ineke, Maastricht U,
Dept of Psychology, Maastricht, Netherlands
Dijkstra, Ton, U Nijmegen,
Nijmegen Inst for Cognition & Information, Nijmegen,
Netherlands
Roelofs, Karin, U Nijmegen,
Dept of Clinical Psychology & Personality, Nijmegen,
Netherlands |
|
Address: |
van
Minnen, Agnes, U Nijmegen, Dept of Clinical Psychology &
Personality, PO Box 9104, 6500 HE, Nijmegen,
Netherlands,
minnen@psych.kun.nl |
|
Source: |
Journal
of Traumatic Stress, Vol 15(3), Jul 2002. pp. 255-258.
Journal URL:
http://www.wkap.nl/journalhome.htm/0894-9867 |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0894-9867 (Print)
1573-6598 (Electronic) |
|
Digital
Object Identifier: |
10.1023/A:1015263513654 |
|
Language: |
English |
|
Keywords: |
narrative changes; fragmentation; organization; internal
events; external events; exposure therapy; posttraumatic
stress disorder; adults |
|
Abstract: |
Replicated and extended the findings of E. B. Foa et al
(1995), who explored the process of narrative
organization during posttraumatic stress disorder (PTSD)
treatment. Narrative changes from the first to the last
exposure session were compared for improved and
nonimproved PTSD patients (mean age 38.4 yrs) on
fragmentation, organization, internal, and external
events. The 8 improved and 12 nonimproved patients did
not differ regarding changes in fragmentation or
organized thoughts. However, improved patients showed a
greater decrease in disorganized thoughts during
treatment. Furthermore, all patients, independent of
improvement, showed significant changes in the same
direction; a decrease in disorganized thoughts and
external events and an increase in internal events.
Although previous results were partly replicated, it is
concluded that narrative changes may be due to exposure
treatment itself rather than to changes in memory
representation. (PsycINFO Database Record (c) 2005 APA,
all rights reserved) |
|
Subjects: |
*Experiences (Events); *Exposure Therapy; *Narratives;
*Posttraumatic Stress Disorder; *Thought Disturbances |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Male (30)
Female (40)
Outpatient (60) |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Thirties (30-39 yrs) (340) |
|
Methodology: |
Empirical Study; Experimental Replication |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20021016 |
|
Accession
Number: |
2002-04493-011 |
|
Number of
Citations in Source: |
11 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-04493-011&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-04493-011&site=ehost-live">Changes
in PTSD patients' narratives during prolonged exposure
therapy: A replication and extension.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 16
|
Title: |
Intrusive thoughts in posttraumatic stress disorder. |
|
Author(s): |
Falsetti, Sherry A., Medical U of South Carolina,
Charleston, SC, US
Monnier, Jeannine, Medical U
of South Carolina, Charleston, SC, US
Davis, Joanne L., Medical U
of South Carolina, Charleston, SC, US
Resnick, Heidi S., Medical U
of South Carolina, Charleston, SC, US |
|
Address: |
Falsetti, Sherry A., Medical U of South Carolina, Dept
of Psychiatry & Behavioral Sciences, 165 Cannon Street,
P.O. Box 250852, Charleston, SC, US |
|
Source: |
Journal
of Cognitive Psychotherapy, Vol 16(2), Sum 2002. Special
issue: Special Issue on Intrusions in Cognitive
Behavioral Therapy. pp. 127-143.
Journal URL:
http://www.springerpub.com/ |
|
Publisher: |
US:
Springer Publishing
Publisher URL:
http://www.springerpub.com/ |
|
ISSN: |
0889-8391 (Print) |
|
Digital
Object Identifier: |
10.1891/jcop.16.2.127.63993 |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; PTSD; intrusive symptoms;
prevalence; associated features; assessment; treatment;
intrusive thoughts |
|
Abstract: |
Reviews
the literature on prevalence, associated features,
assessment, and treatment of intrusive symptoms
associated with posttraumatic stress disorder (PTSD).
Research indicates that among trauma survivors,
intrusive thoughts and imagery are quite common and
distressing. It appears that early intrusions may be
predictive of long-term distress and that avoidance and
suppression can maintain intrusions. The treatment
outcome literature for PTSD indicates that current
cognitive behavioral treatments are effective in
reducing intrusions. New data from a recent treatment
outcome study for PTSD with comorbid panic attacks,
using Multiple Channel Exposure Therapy, also suggest
that this treatment is effective in significantly
reducing intrusions. (PsycINFO Database Record (c) 2005
APA, all rights reserved) |
|
Subjects: |
*Measurement; *Posttraumatic Stress Disorder; *Symptoms;
*Thought Disturbances; *Treatment |
|
Classification: |
Neuroses & Anxiety Disorders (3215) |
|
Population: |
Human
(10) |
|
Methodology: |
Literature Review |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020731 |
|
Accession
Number: |
2002-17473-002 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17473-002&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-17473-002&site=ehost-live">Intrusive
thoughts in posttraumatic stress disorder.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 17
|
Title: |
Prolonged exposure in patients with chronic PTSD:
Predictors of treatment outcome and dropout. |
|
Author(s): |
van
Minnen, A., U Nijmegen, Dept of Clinical Psychology,
Nijmegen, Netherlands,
minnen@psych.kun.nl
Arntz, A., U Maastricht,
Dept of Medical, Clinical & Experimental Psychology,
Maastricht, Netherlands
Keijsers, G. P. J., U
Nijmegen, Dept of Clinical Psychology, Nijmegen,
Netherlands |
|
Address: |
van
Minnen, A., U Nijmegen, Dept of Clinical Psychology, PO
Box 9104, 6500, Nijmegen, Netherlands,
minnen@psych.kun.nl |
|
Source: |
Behaviour Research and Therapy, Vol 40(4), Apr 2002. pp.
439-457.
Journal URL:
http://www.elsevier.com/wps/find/journaldescription.cws_home/265/description#description |
|
Publisher: |
Netherlands: Elsevier Science
Publisher URL:
http://elsevier.com |
|
ISSN: |
0005-7967 (Print) |
|
Digital
Object Identifier: |
10.1016/S0005-7967(01)00024-9 |
|
Language: |
English |
|
Keywords: |
treatment outcome; treatment dropout; PTSD; trauma;
symptoms; imaginal exposure therapy; drug usage; alcohol
usage; demographic characteristics; psychiatric
symptoms; benzodiazepines |
|
Abstract: |
Investigated predictors of treatment outcome and dropout
in 2 samples (N=59 and 63) of posttraumatic stress
disorder (PTSD) patients with mixed traumas treated
using prolonged imaginal exposure. Possible predictors
were analysed in both samples separately, in order to
replicate in one sample findings found in the other. The
only stable finding across the two groups was that
patients who showed more PTSD-symptoms at pre-treatment,
showed more PTSD-symptoms at post-treatment and
follow-up. Indications were found that benzodiazepine
use was related to both treatment outcome and dropout,
and alcohol use to dropout. Demographic variables,
depression and general anxiety, personality, trauma
characteristics, feelings of anger, guilt, and shame and
nonspecific variables regarding therapy were not related
to either treatment outcome or dropout, disconfirming
generally held beliefs about these factors as
contra-indications for exposure therapy. It is concluded
that it is difficult to use pre-treatment variables as a
powerful and reliable tool for predicting treatment
outcome or dropout. Clinically seen, it is therefore
argued that exclusion of PTSD-patients from prolonged
exposure treatment on the basis of pre-treatment
characteristics is not justified. (PsycINFO Database
Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Exposure Therapy; *Posttraumatic Stress Disorder;
*Symptoms; *Treatment Dropouts; *Treatment Outcomes;
Alcoholism; Benzodiazepines; Client Characteristics;
Demographic Characteristics; Drug Therapy; Drug Usage;
Emotional Trauma; Psychiatric Symptoms |
|
Classification: |
Cognitive Therapy (3311) |
|
Population: |
Human
(10)
Male (30)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020501 |
|
Accession
Number: |
2002-02741-007 |
|
Number of
Citations in Source: |
63 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02741-007&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02741-007&site=ehost-live">Prolonged
exposure in patients with chronic PTSD: Predictors of
treatment outcome and dropout.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 18
|
Title: |
A
narrative exposure treatment as intervention in a
refugee camp: A case report. |
|
Author(s): |
Neuner,
Frank, U Konstanz, Konstanz, Germany,
frank.neuner@uni-konstanz.de
Schauer, Margarete, U
Konstanz, Konstanz, Germany
Roth, Walton T., Stanford U,
Stanford, CA, US
Elbert, Thomas, U Konstanz,
Konstanz, Germany |
|
Address: |
Neuner,
Frank, U Konstanz, Dept of Psychology, Fach D25,
D-78457, Konstanz, Germany, frank.neuner@uni-konstanz.de |
|
Source: |
Behavioural and Cognitive Psychotherapy, Vol 30(2), Apr
2002. pp. 205-210.
Journal URL:
http://www.cambridge.org/uk/journals/journal_catalogue.asp?mnemonic=bcp |
|
Publisher: |
US:
Cambridge Univ Press
Publisher URL:
http://www.cup.org |
|
ISSN: |
1352-4658 (Print)
1469-1833 (Electronic) |
|
Digital
Object Identifier: |
10.1017/S1352465802002072 |
|
Language: |
English |
|
Keywords: |
narrative exposure therapy; Kosovar refugee; cognitive
behavior therapy; testimony therapy; posttraumatic
stress disorder symptoms; trauma |
|
Abstract: |
The
authors applied Narrative Exposure Treatment (NET) to a
severely traumatized Kosovar refugee (aged 24 yrs)
living in a Macedonian refugee camp during the Balkan
War. NET is a pragmatic short-term approach that
integrates effective therapeutic components deriving
from Cognitive Behavior Therapy and Testimony Therapy.
Outcome was evaluated by clinical examination and the
Posttraumatic Stress Diagnostic Scale. Three sessions of
NET were enough to afford considerable relief, although
some posttraumatic stress disorder (PTSD) symptoms
remained. The authors' experience indicates that
Narrative Exposure is a promising and realistic approach
for the treatment of even severely traumatized refugees
living in camps. In addition, it can prove valid
testimonies about human fights violations without
humiliating the witness. (PsycINFO Database Record (c)
2005 APA, all rights reserved) |
|
Subjects: |
*Cognitive Therapy; *Exposure Therapy; *Narratives;
*Posttraumatic Stress Disorder; *Refugees; Emotional
Trauma; Symptoms; Treatment Outcomes |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Female (40) |
|
Location: |
Macedonia |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Young Adulthood (18-29 yrs)
(320) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer-Reviewed Status-Unknown; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020515 |
|
Correction Date: |
20050919 |
|
Accession
Number: |
2002-02953-007 |
|
Number of
Citations in Source: |
6 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02953-007&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02953-007&site=ehost-live">A
narrative exposure treatment as intervention in a
refugee camp: A case report.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 19
|
Title: |
Prolonged exposure counterconditioning (PEC) as a
treatment for chronic post-traumatic stress disorder and
major depression in an adult survivor of repeated child
sexual and physical abuse. |
|
Author(s): |
Paunovic, Nenad, Stockholm U, Stockholm, Sweden |
|
Source: |
Clinical Case Studies, Vol 1(2), Apr 2002. pp. 148-169.
Journal URL:
http://www.sagepub.com/journal.aspx?pid=274 |
|
Publisher: |
US:
Sage Publications
Publisher URL:
http://www.sagepublications.com/ |
|
ISSN: |
1534-6501 (Print) |
|
Digital
Object Identifier: |
10.1177/1534650102001002004 |
|
Language: |
English |
|
Keywords: |
chronic
post-traumatic stress disorder; major depression;
prolonged exposure counterconditioning; adult survivor;
child sexual abuse; physical abuse; conditioned
emotional responses |
|
Abstract: |
Prolonged exposure counterconditioning (PEC) was tested
as a treatment for chronic post-traumatic stress
disorder (PTSD) in an adult male survivor (aged 42
years) of repeated child sexual and physical abuse. PEC
utilizes imaginal reliving of very pleasurable life
moments in order to weaken traumatic conditioned
emotional responses (CERs). A higher-order conditioned
stimuli (CS) is used as a traumatic CER elicitor.
Prolonged imaginal reliving of pleasurable CSs is used
as a counterconditioner to the traumatic CERs. A
statistical technique for analyzing single-case subject
designs based on classical test theory was used to
evaluate the client's progress in treatment. Results
showed that PEC effectively decreased the client's PTSD
symptoms, depression, and anxiety. In addition, the
client's negative cognitions became considerably more
positive. Also, the client lost his comorbid conditions
of chronic major depressive disorder and social phobia.
Finally, other clinically observed symptoms, which are
described in the article, improved markedly. All results
were maintained at a 3-month follow-up. (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Child
Abuse; *Conditioned Emotional Responses;
*Counterconditioning; *Exposure Therapy; *Posttraumatic
Stress Disorder; Major Depression; Physical Abuse;
Sexual Abuse; Survivors |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Male (30) |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Middle Age (40-64 yrs) (360) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20030428 |
|
Accession
Number: |
2003-03416-006 |
|
Number of
Citations in Source: |
51 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-03416-006&site=ehost-live |
|
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|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-03416-006&site=ehost-live">Prolonged
exposure counterconditioning (PEC) as a treatment for
chronic post-traumatic stress disorder and major
depression in an adult survivor of repeated child sexual
and physical abuse.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 20
|
Title: |
Integrated behavioral treatment of comorbid OCD, PTSD,
and borderline personality disorder: A case report. |
|
Author(s): |
Becker,
Carolyn Black, Trinity U, San Antonio, TX, US,
carolyn.becker@trinity.edu |
|
Address: |
Becker,
Carolyn Black, Trinity U, Dept of Psychology, 715
Stadium Dr, San Antonio, TX, US,
carolyn.becker@trinity.edu |
|
Source: |
Cognitive and Behavioral Practice, Vol 9(2), Spr 2002.
pp. 100-110. |
|
Publisher: |
US:
Assn for the Advancement of Behavior Therapy
Publisher URL:
http://www.aabt.org |
|
ISSN: |
1077-7229 (Print) |
|
Language: |
English |
|
Keywords: |
borderline personality; obsessive-compulsive disorder;
posttraumatic stress disorder; exposure therapy;
response prevention; dialectical behavior therapy;
empirically supported treatments |
|
Abstract: |
According to critics of empirically supported
treatments, comorbidity represents a significant barrier
to the implementation of such interventions in standard
clinical practice. Advocates of empirically supported
treatment have noted that comorbid disorders can be
addressed concurrently. There is, however, little
guidance in the literature regarding implementation of
concurrently delivered protocols. The present case
report describes the successful treatment of a
43-year-old woman diagnosed with comorbid
obsessive-compulsive disorder (OCD), posttraumatic
stress disorder (PTSD), and borderline personality
disorder. Treatment utilized a concurrent approach that
integrated exposure and response prevention for OCD,
exposure therapy for PTSD, and components of dialectical
behavior therapy for borderline personality disorder.
Both 12-month formal and 18-month informal follow-up
assessment indicated that improvement was maintained
after termination. Results suggest that integrated
delivery of empirically supported interventions can be
utilized to successfully treat complex, comorbid cases.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Behavior Therapy; *Borderline Personality Disorder;
*Comorbidity; *Obsessive Compulsive Disorder;
*Posttraumatic Stress Disorder; Exposure Therapy |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Middle Age (40-64 yrs) (360) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Release
Date: |
20021113 |
|
Accession
Number: |
2002-06402-004 |
|
Number of
Citations in Source: |
43 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-06402-004&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-06402-004&site=ehost-live">Integrated
behavioral treatment of comorbid OCD, PTSD, and
borderline personality disorder: A case report.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 21
|
Title: |
Marked
lability in urinary cortisol levels in subgroups of
combat veterans with posttraumatic stress disorder
during an intensive exposure treatment program. |
|
Author(s): |
Mason,
John W., Yale U School of Medicine, Dept of Psychiatry,
New Haven, CT, US, jwmason@pol.net
Wang, Sheila, Yale U School
of Medicine, Dept of Psychiatry, New Haven, CT, US
Yehuda, Rachel, Mount Sinai
Medical School, Dept of Psychiatry, New York, NY, US
Lubin, Hadar, Yale U School
of Medicine, Dept of Psychiatry, New Haven, CT, US
Johnson, David, Yale U
School of Medicine, Dept of Psychiatry, New Haven, CT,
US
Bremner, J. Douglas, Yale U
School of Medicine, Dept of Psychiatry, New Haven, CT,
US
Charney, Dennis, Yale U
School of Medicine, Dept of Psychiatry, New Haven, CT,
US
Southwick, Steven, Yale U
School of Medicine, Dept of Psychiatry, New Haven, CT,
US |
|
Address: |
Mason,
John W., 32 Maple Vale Drive, Woodbridge, CT, US,
jwmason@pol.net |
|
Source: |
Psychosomatic Medicine, Vol 64(2), Mar-Apr 2002. pp.
238-246.
Journal URL:
http://www.psychosomaticmedicine.org/ |
|
Publisher: |
US:
Lippincott Williams & Wilkins
Publisher URL:
http://www.lww.com/ |
|
ISSN: |
0033-3174 (Print)
1534-7796 (Electronic) |
|
Language: |
English |
|
Keywords: |
lability; urinary cortisol levels; posttraumatic stress
disorder; combat veterans |
|
Abstract: |
Examined longitudinal data on lability of cortisol
levels in posttraumatic stress disorder (PTSD) because
previous studies have largely been based on sampling at
a single time point and have yielded varying results.
This study measured urinary cortisol levels at
admission, midcourse, and discharge during a 90-day
hospitalization period in 51 male Vietnam combat
veterans (mean age 42.7 yrs) with PTSD. Although there
were no significant differences in the mean urinary
cortisol levels between the admission, midcourse, and
discharge values, marked lability of cortisol levels in
individual patients was observed over time. In addition,
this hormonal lability defined discrete subgroups of
patients on the basis of the longitudinal pattern of
cortisol change during exposure treatment, and there
were significant psychometric differences in the level
of social functioning between these subgroups. The
findings suggest a psychogenic basis for cortisol
alterations in PTSD in relation to psychosocial stress
and indicate a central regulatory dysfunction of the
hypothalamic-pituitary-adrenal axis characterized by a
dynamic tendency to overreact in both upward and
downward directions. (PsycINFO Database Record (c) 2005
APA, all rights reserved) |
|
Subjects: |
*Hydrocortisone; *Posttraumatic Stress Disorder;
*Psychosocial Factors; *Stress; Exposure Therapy;
Hospitalization; Military Veterans |
|
Classification: |
Neuroses & Anxiety Disorders (3215)
Military Psychology (3800) |
|
Population: |
Human
(10)
Male (30)
Inpatient (50) |
|
Location: |
US |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study; Longitudinal Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020508 |
|
Accession
Number: |
2002-02670-016 |
|
Number of
Citations in Source: |
27 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02670-016&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02670-016&site=ehost-live">Marked
lability in urinary cortisol levels in subgroups of
combat veterans with posttraumatic stress disorder
during an intensive exposure treatment program.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 22
|
Title: |
Exposure therapy for posttraumatic stress disorder. |
|
Author(s): |
Rothbaum, Barbara Olasov, Emory U School of Medicine,
Trauma & Anxiety Recovery Program, Atlanta, GA, US,
brothba@emory.edu
Schwartz, Ann C., Emory U
School of Medicine, Atlanta, GA, US |
|
Address: |
Rothbaum, Barbara Olasov, The Emory Clinic, 1365 Clifton
Road, Atlanta, GA, US, brothba@emory.edu |
|
Source: |
American Journal of Psychotherapy, Vol 56(1), 2002. pp.
59-75.
Journal URL:
http://www.ajp.org |
|
Publisher: |
US:
Assn for the Advancement of Psychotherapy
Publisher URL:
http://www.ajp.org |
|
ISSN: |
0002-9564 (Print) |
|
Language: |
English |
|
Keywords: |
exposure therapy; PTSD |
|
Abstract: |
Exposure therapy is a well-established treatment for
posttraumatic stress disorder (PTSD) that requires the
patient to focus on and describe the details of a
traumatic experience. Exposure methods include
confrontation with frightening, yet realistically safe,
stimuli that continues until anxiety is reduced. A
review of the literature on exposure therapy indicates
strong support from well-controlled studies applied
across trauma populations. However, there are many
misconceptions about exposure therapy that may interfere
with its widespread use. These myths and clinical
guidelines are addressed. It is concluded that exposure
therapy is a safe and effective treatment for PTSD when
applied as directed by experienced therapists. (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Exposure Therapy; *Posttraumatic Stress Disorder |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10) |
|
Methodology: |
Literature Review |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Release
Date: |
20020515 |
|
Accession
Number: |
2002-02940-004 |
|
Number of
Citations in Source: |
35 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02940-004&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02940-004&site=ehost-live">Exposure
therapy for posttraumatic stress disorder.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 23
|
Title: |
Trastorno de estrés postraumáitico en víctimas de
maltrato doméstico: Evaluación de un programa de
intervención. |
|
Translated Title: |
Posttraumatic stress disorder in battered women:
evaluation of an intervention program. |
|
Author(s): |
Labrador, Francisco Javier, Universidad Complutense de
Madrid, Madrid, Spain
Rincón, Paulina Paz,
Universidad Complutense de Madrid, Departamento de
Psicología Clínica, Madrid, Spain, psper30@sis.ucm.es |
|
Address: |
Rincón,
Paulina Paz, Departamento de Psicologia Clinica,
Universidad Complutense de Madrid, Campus de Somosaguas
s/n, 28223, Madrid, Spain, psper30@sis.ucm.es |
|
Source: |
Análisis y Modificación de Conducta, Vol 28(122), 2002.
pp. 905-932. |
|
Publisher: |
Spain:
Editorial Promolibro
Publisher URL:
http://www.promolibro.com |
|
ISSN: |
0211-7339 (Print) |
|
Language: |
Spanish |
|
Keywords: |
treatment program; battered women; posttraumatic stress
disorder; psychoeducation; training relaxation;
cognitive therapy; exposure therapy |
|
Abstract: |
This
study was directed to develop and prove an effective,
short length, treatment programme for posttraumatic
stress disorder (PTSD) among battered women. The
treatment program was applied to nine female PTSD
patients, according to the DSM-IV criteria, grouped in 3
member groups. The treatment program included 8 sessions
(2 months), whose main components were psychoeducation,
training relaxation, cognitive therapy and exposure
therapy. The results on the posttreatment and on the
first and third month follow-up sessions, show that the
programme was effective to reduce the TEPT on the 100%
of the patients. The results also point out an
improvement in variables such as depression,
self-esteem, social inadaptation, and posttraumatic
cognitions. The implications of this study for clinical
practice and future research in PTSD are discussed.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved) |
|
Subjects: |
*Battered Females; *Posttraumatic Stress Disorder;
*Treatment; Cognitive Therapy; Exposure Therapy;
Psychoeducation; Relaxation Therapy; Stress |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300) |
|
Methodology: |
Empirical Study; Quantitative Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available: Print |
|
Document
Type: |
Original Journal Article |
|
Release
Date: |
20040503 |
|
Accession
Number: |
2003-02221-003 |
|
Number of
Citations in Source: |
32 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-02221-003&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-02221-003&site=ehost-live">Trastorno
de estrés postraumáitico en víctimas de maltrato
doméstico: Evaluación de un programa de
intervención.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 24
|
Title: |
Cognitive restructuring within reliving: A treatment for
peritraumatic emotional 'hotspots' in posttraumatic
stress disorder. |
|
Author(s): |
Grey,
Nick, Ctr for Anxiety Disorders & Trauma, London, United
Kingdom, n.grey@iop.kcl.ac.uk
Young, Kerry, Traumatic
Stress Clinic, London, United Kingdom
Holmes, Emily, Traumatic
Stress Clinic, London, United Kingdom |
|
Address: |
Grey,
Nick, Inst of Psychiatry, Ctr for Anxiety Disorders &
Trauma, 99 Denmark Hill, London, United Kingdom, SE5
8AF, n.grey@iop.kcl.ac.uk |
|
Source: |
Behavioural and Cognitive Psychotherapy, Vol 30(1), Jan
2002. pp. 37-56.
Journal URL:
http://www.cambridge.org/uk/journals/journal_catalogue.asp?mnemonic=bcp |
|
Publisher: |
US:
Cambridge Univ Press
Publisher URL:
http://www.cup.org |
|
ISSN: |
1352-4658 (Print)
1469-1833 (Electronic) |
|
Language: |
English |
|
Keywords: |
cognitive restructuring; exposure/reliving procedures;
PTSD; pertraumatic emotional hotspots |
|
Abstract: |
This
paper describes a distinct clinical approach to the
treatment of Posttraumatic Stress Disorder (PTSD). It is
theoretically guided by recent cognitive models of PTSD
and explicitly combines cognitive therapy techniques
within exposure/reliving procedures. A clinically
pertinent distinction is made between the cognitions and
emotions experienced at the time of the trauma and,
subsequently, in flashback experiences, and secondary
negative appraisals. The term peritraumatic emotional
"hotspot" is used to describe moments of peak distress
during trauma. It is argued that a focus on cognitively
restructuring these peritraumatic emotional hotspots
within reliving can significantly improve the
effectiveness of the treatment of PTSD and help explain
some treatment failures with traditional prolonged
exposure. An approach to the identification and
treatment of these hotspots is detailed for a range of
cognitions and emotions not limited to fear. (PsycINFO
Database Record (c) 2005 APA, all rights
reserved)(journal abstract) |
|
Subjects: |
*Cognitive Restructuring; *Cognitive Therapy; *Exposure
Therapy; *Posttraumatic Stress Disorder |
|
Classification: |
Cognitive Therapy (3311) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer-Reviewed Status-Unknown; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020417 |
|
Correction Date: |
20050919 |
|
Accession
Number: |
2002-02634-004 |
|
Number of
Citations in Source: |
49 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02634-004&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02634-004&site=ehost-live">Cognitive
restructuring within reliving: A treatment for
peritraumatic emotional 'hotspots' in posttraumatic
stress disorder.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 25
|
Title: |
Behavioral/cognitive approaches to post-traumatic
stress: Theory-driven, empirically based therapy. |
|
Series
Title: |
Contributions in psychology; no. 39 |
|
Author(s): |
Roemer,
Lizabeth, U Massachusetts, Dept of Psychology, Boston,
MA, US
Harrington, Nicole T.,
Mental Health & Substance Abuse Services of the
Berkshires, Family Ctr of the Berkshires, US
Riggs, David S., State U New
York at Stony Brook, Stony Brook, NY, US |
|
Source: |
Brief
treatments for the traumatized: A project of the Green
Cross Foundation. Figley, Charles R. (Ed); pp. 59-80.
Westport, CT, US: Greenwood
Press/Greenwood Publishing Group, Inc, 2002. xxiv, 337
pp.
Publisher URL:
http://www.greenwood.com |
|
ISBN: |
0-313-32137-X (hardcover) |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; PTSD; assessment;
monitoring; psychoeducation; exposure-based therapy;
cognitive therapy; skills training intervention; relapse
prevention |
|
Abstract: |
(from
the chapter) Provides an overview of the authors'
behavioral/cognitive approach to the treatment of
trauma-related psychological difficulties. This chapter
is meant to be read with the chapter in this volume
about behavioral/cognitive theories (see record
2003-04267-002), which provides the conceptual basis for
the therapeutic approach outlined here. This chapter is
divided into a section on the initial phase of
treatment, including assessment, monitoring,
psychoeducation, and establishing a therapeutic
relationships, followed by separate sections for
exposure-based, cognitive, and skills-training
interventions as well as relapse prevention. These
treatments have been designated as active ingredients in
the treatment of posttraumatic stress disorder (PTSD)
and studies have supported their efficacy. (PsycINFO
Database Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Behavior Therapy; *Cognitive Therapy; *Emotional
Trauma; *Posttraumatic Stress Disorder; *Relapse
Prevention; Exposure Therapy; Psychoeducation;
Psychological Assessment |
|
Classification: |
Psychotherapy & Psychotherapeutic Counseling (3310) |
|
Population: |
Human
(10) |
|
Intended
Audience: |
Psychology: Professional & Research (PS) |
|
Publication Type: |
Book,
Edited Book; Print |
|
Document
Type: |
Original Chapter |
|
Release
Date: |
20030217 |
|
Accession
Number: |
2003-04267-004 |
|
Number of
Citations in Source: |
44 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-04267-004&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-04267-004&site=ehost-live">Behavioral/cognitive
approaches to post-traumatic stress: Theory-driven,
empirically based therapy.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 26
|
Title: |
Posttraumatic stress disorder. |
|
Author(s): |
Scotti,
Joseph R., West Virginia U, Dept of Psychology,
Morgantown, WV, US
Morris, Tracy L., West
Virginia U, Dept of Psychology, Morgantown, WV, US
Ruggiero, Kenneth J., West
Virginia U, Dept of Psychology, Morgantown, WV, US
Wolfgang, Julie, West
Virginia U, Dept of Psychology, Morgantown, WV, US |
|
Source: |
Clinical behavior therapy: Adults and children. Hersen,
Michel; pp. 361-382.
Hoboken, NJ, US: John Wiley
& Sons, Inc, 2002. xiv, 513 pp. |
|
ISBN: |
0-471-39258-8 (hardcover) |
|
Language: |
English |
|
Keywords: |
PTSD;
motor vehicle accidents; behavior therapy; treatment
planning; client treatment matching; treatment outcomes;
child psychotherapy; contingency management; exposure
therapy |
|
Abstract: |
(from
the create) Two children were passengers in a car
accident in which the children were in extreme distress
when their mothers injuries appeared serious and the
threesome had to wait an inordinate amount of time until
help arrived. This chapter describes the use of a
complex therapy for posttraumatic stress disorder (PTSD)
in these children, aged 3 and 9 yrs. A treatment choice
was made for the use of behavior therapy (BT), involving
anxiety management, exposure-based procedures, and
contingency management procedures. A general description
of the disorder and a specific case history and accident
description are provided. Results of a clinical
assessment and a medical consultation are then followed
by a case conceptualization and finally the rationale
for treatment choice and planning. A detailed course of
treatment is then related, including therapist-client
factors, course of termination, follow-up, and a
commentary on managed care considerations. The overall
effectiveness of BT in this case is then discussed.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved) |
|
Subjects: |
*Behavior Therapy; *Posttraumatic Stress Disorder;
*Treatment Outcomes; *Treatment Planning; *Client
Treatment Matching; Child Psychotherapy; Contingency
Management; Exposure Therapy; Motor Traffic Accidents |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Population: |
Human
(10)
Male (30)
Female (40) |
|
Age
Group: |
Childhood (birth-12 yrs) (100)
Preschool Age (2-5 yrs)
(160)
School Age (6-12 yrs) (180) |
|
Intended
Audience: |
Psychology: Professional & Research (PS) |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Book,
Edited Book; Print |
|
Document
Type: |
Original Chapter |
|
Release
Date: |
20020605 |
|
Accession
Number: |
2002-02834-019 |
|
Number of
Citations in Source: |
34 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02834-019&site=ehost-live |
|
|
|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-02834-019&site=ehost-live">Posttraumatic
stress disorder.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 27
|
Title: |
Cortisol and imaginal exposure in posstraumatic stress
disorder: A case report. |
|
Author(s): |
Otte,
Christian, University Hosp Hamburg-Eppendorf, Dept of
Psychiatry & Psychotherapy, Hamburg, Germany,
otte@uke.uni-hamburg.de
Arlt, Josef, University Hosp
Hamburg-Eppendorf, Dept of Psychiatry & Psychotherapy,
Hamburg, Germany
Wiedemann, Klaus, University
Hosp Hamburg-Eppendorf, Dept of Psychiatry &
Psychotherapy, Hamburg, Germany
Kellner, Michael, University
Hosp Hamburg-Eppendorf, Dept of Psychiatry &
Psychotherapy, Hamburg, Germany |
|
Address: |
Otte,
Christian, Dept of Psychiatry & Psychotherapy, U of
Hamburg, Martinistrasse 52, 20246, Hamburg, Germany,
otte@uke.uni-hamburg.de |
|
Source: |
German
Journal of Psychiatry, Vol 5(3), 2002. pp. 75-77.
Journal URL:
http://www.gjpsy.uni-goettingen.de/ |
|
Publisher: |
Germany: German Journal of Psychiatry
Publisher URL:
http://www.uni-goettingen.de |
|
ISSN: |
1455-1033 (Electronic) |
|
Language: |
English |
|
Keywords: |
imaginal exposure; PTSD; posstraumatic stress disorder;
glucocorticoid secretion; cortisol; distress; memory |
|
Abstract: |
Imaginal exposure is closely associated with hippocampal
processing of traumatic memory. The hippocampus is a
target for glucocorticoids which influence memory
retrieval and stress response. Glucocorticoid secretion
in response to imaginal exposure has not been
investigated. We measured subjective distress and
salivary cortisol during the 1st and the 20th exposure
session in a female patient (aged 45 yrs) with PTSD.
Despite considerable arousal and anxiety, cortisol did
not increase during the first exposure. During the 20th
exposure there was a marked reduction of distress,
although cortisol values did not differ from exposure 1.
The response of glucocorticoids to imaginal exposure and
mechanisms of the lacking cortisol response need further
research. (PsycINFO Database Record (c) 2005 APA, all
rights reserved) |
|
Subjects: |
*Exposure Therapy; *Hydrocortisone; *Imagination;
*Memory; *Posttraumatic Stress Disorder; Distress;
Glucocorticoids |
|
Classification: |
Neuroses & Anxiety Disorders (3215) |
|
Population: |
Human
(10)
Female (40) |
|
Age
Group: |
Adulthood (18 yrs & older) (300)
Middle Age (40-64 yrs) (360) |
|
Tests &
Measures: |
Posttraumatic Stress Diagnostic Scale |
|
Methodology: |
Clinical Case Study; Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Electronic
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20030616 |
|
Accession
Number: |
2003-05075-003 |
|
Number of
Citations in Source: |
19 |
|
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Persistent link to this record:
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http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-05075-003&site=ehost-live |
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-05075-003&site=ehost-live">Cortisol
and imaginal exposure in posstraumatic stress disorder:
A case report.</A> |
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Database: |
PsycINFO |
Record: 28
|
Title: |
Managing obstacles to the utilization of exposure
therapy With PTSD patients. |
|
Author(s): |
Zayfert, Claudia, Dept of Psychiatry, Dartmouth Medical
School, Lebanon, NH, US, claudia.zayfert@dartmouth.edu
Becker, Carolyn B., Trinity
U, San Antonio, TX, US, cbecker@trinity.edu
Gillock, Karen L., Dartmouth
Medical School, Lebanon, NH, US,
Karen.l.gillock@dartmouth.edu |
|
Address: |
Zayfert, Claudia, Dept of Psychiatry, Dartmouth Medical
School, One Medical Center Dr., Lebanon, NH, US,
claudia.zayfert@dartmouth.edu |
|
Source: |
Innovations in clinical practice: A source book (Vol.
20). VandeCreek, Leon (Ed); Jackson, Thomas L. (Ed); pp.
201-222.
Sarasota, FL, US:
Professional Resource Press/Professional Resource
Exchange, Inc, 2002. x, 501 pp. |
|
ISBN: |
1-56887-073-6 (looseleaf)
1-56887-074-4 (hardcover) |
|
Language: |
English |
|
Keywords: |
exposure therapy; posttraumatic stress disorder;
theoretical explanations |
|
Abstract: |
(from
the chapter) This chapter relies heavily on the authors'
experiences implementing exposure therapy (ET) in the
anxiety disorders clinic of a rural tertiary care
medical center. The authors explore factors pertinent to
the utilization of ET in a clinical context. They begin
with an overview of ET for posttraumatic stress disorder
(PTSD), and assert that, despite the limitations of
existing data and problems in the implementation of ET,
the goal of increasing its clinical use is justifiable.
Next, they offer a framework for conceptualizing
difficulties in ET implementation that incorporates
recent theoretical explanations of ET process and draws
upon empirical work on motivation and process in
behavior therapy. Within this framework, the remainder
of the chapter elaborates on specific methods to
facilitate implementation and completion of ET.
(PsycINFO Database Record (c) 2005 APA, all rights
reserved) |
|
Subjects: |
*Exposure Therapy; *Posttraumatic Stress Disorder |
|
Classification: |
Behavior Therapy & Behavior Modification (3312) |
|
Intended
Audience: |
Psychology: Professional & Research (PS) |
|
Publication Type: |
Book,
Edited Book; Print |
|
Document
Type: |
Original Chapter |
|
Release
Date: |
20031103 |
|
Accession
Number: |
2003-88018-013 |
|
Number of
Citations in Source: |
39 |
|
|
|
|
Persistent link to this record:
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http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-88018-013&site=ehost-live |
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Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2003-88018-013&site=ehost-live">Managing
obstacles to the utilization of exposure therapy With
PTSD patients.</A> |
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|
|
|
Database: |
PsycINFO |
Record: 29
|
Title: |
Is EMDR
an exposure therapy? A review of trauma protocols. |
|
Author(s): |
Rogers,
Susan, VA Medical Ctr, Coatsville, PA, US,
rogers.susan@coatsville.va.gov
Silver, Steven M. |
|
Address: |
Rogers,
Susan, DVA Medical Ctr, PTSD Program 116P, Coatsville,
PA, US, rogers.susan@coatsville.va.gov |
|
Source: |
Journal
of Clinical Psychology, Vol 58(1), Jan 2002. pp. 43-59.
Journal URL:
http://www.interscience.wiley.com/jpages/0021-9762/ |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0021-9762 (Print)
1097-4679 (Electronic) |
|
Digital
Object Identifier: |
10.1002/jclp.1128 |
|
Language: |
English |
|
Keywords: |
Eye
Movement Desensitization and Reprocessing; trauma
protocols; exposure therapy |
|
Abstract: |
Presents the well established theoretical base and
clinical practice of exposure therapy for trauma.
Necessary requirements for positive treatment results
and contraindicated procedures are reviewed. Eye
Movement Desensitization and Reprocessing (EMDR) is
contrasted with these requirements and procedures. By
the definitions and clinical practice of exposure
therapy, the classification of EMDR poses some problems.
As seen from the exposure therapy paradigm, its lack of
physiological habituation and use of spontaneous
association should result in negligible or negative
effects rather than the well researched positive
outcomes. Possible reasons for the effectiveness of EMDR
are discussed, ranging from the fundamental nature of
trauma reactions to the nonexposure mechanisms utilized
in information processing models. (PsycINFO Database
Record (c) 2005 APA, all rights reserved) |
|
Subjects: |
*Exposure Therapy; *Eye Movement Desensitization Therapy |
|
Classification: |
Specialized Interventions (3350) |
|
Population: |
Human
(10) |
|
Methodology: |
Literature Review |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020130 |
|
Accession
Number: |
2002-00072-003 |
|
Number of
Citations in Source: |
78 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-00072-003&site=ehost-live |
|
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|
|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-00072-003&site=ehost-live">Is
EMDR an exposure therapy? A review of trauma
protocols.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 30
|
Title: |
Comparison for two treatments for traumatic stress: A
community-based study of EMDR and prolonged exposure. |
|
Author(s): |
Ironson, Gail, U Miami, Cable Gables, FL, US,
gironson@aol.com
Freud, B.
Strauss, J. L.
Williams, J. |
|
Address: |
Ironson, Gail, U Miami, Behavioral Medicine Program,
P.O. Box 248185, Coral Gables, FL, gironson@aol.com |
|
Source: |
Journal
of Clinical Psychology, Vol 58(1), Jan 2002. pp.
113-128.
Journal URL:
http://www.interscience.wiley.com/jpages/0021-9762/ |
|
Publisher: |
US:
John Wiley & Sons
Publisher URL:
http://www.wiley.com/WileyCDA/ |
|
ISSN: |
0021-9762 (Print)
1097-4679 (Electronic) |
|
Digital
Object Identifier: |
10.1002/jclp.1132 |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; Eye Movement
Desensitization and Reprocessing; prolonged exposure;
trauma |
|
Abstract: |
This
pilot study compared the efficacy of 2 treatments for
postraumatic stress disorder (PTSD): Eye Movement
Desensitization and Reprocessing (EMDR) and Prolonged
Exposure (PE). Data were analyzed for 22 patients (aged
16-62 yrs) from a university based clinic serving the
outside community (predominantly rape and crime victims)
who completed at least 1 active session of treatment
after 3 preparatory sessions. Results showed both
approaches produced a significant reduction in PTSD and
depression symptoms, which were maintained at 3-month
follow-up. Successful treatment was faster with EMDR as
a larger number of people (7 of 10) had a 70% reduction
in PTSD symptoms after 3 active sessions compared to 2
of 12 with PE. EMDR appeared to be better tolerated as
the dropout rate was significantly lower in those
randomized to EMDR versus PE (0 of 10 vs 3 of 10).
However all patients who remained in treatment with PE
had a reduction in PTSD scores. Finally, Subjective
Units of Distress (SUDS) ratings decreased significantly
during the initial session of EMDR, but changed little
during PE. Postsession SUDS were significantly lower for
EMDR than for PE. Suggestions for future research are
discussed. (PsycINFO Database Record (c) 2005 APA, all
rights reserved) |
|
Subjects: |
*Emotional Trauma; *Exposure Therapy; *Eye Movement
Desensitization Therapy; *Posttraumatic Stress Disorder |
|
Classification: |
Neuroses & Anxiety Disorders (3215)
Specialized Interventions
(3350) |
|
Population: |
Human
(10)
Male (30)
Female (40) |
|
Age
Group: |
Adolescence (13-17 yrs) (200)
Adulthood (18 yrs & older)
(300)
Young Adulthood (18-29 yrs)
(320)
Thirties (30-39 yrs) (340)
Middle Age (40-64 yrs) (360) |
|
Methodology: |
Empirical Study |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020130 |
|
Accession
Number: |
2002-00072-007 |
|
Number of
Citations in Source: |
44 |
|
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|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-00072-007&site=ehost-live |
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|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-00072-007&site=ehost-live">Comparison
for two treatments for traumatic stress: A
community-based study of EMDR and prolonged
exposure.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 31
|
Title: |
Post-traumatic stress disorder. |
|
Author(s): |
Yehuda,
Rachel, Mount Sinai School of Medicine, Dept of
Psychiatry, NY, US, rachel.yehuda@med.va.gov |
|
Address: |
Yehuda,
Rachel, Bronx Veterans Affairs Medical Ctr, 130
Kingsbridge Road, Bronx, NY, US,
rachel.yehuda@med.va.gov |
|
Source: |
New
England Journal of Medicine, Vol 346(2), Jan 2002. pp.
108-114.
Journal URL:
http://content.nejm.org/ |
|
Publisher: |
US:
Massachusetts Medical Society
Publisher URL:
http://content.nejm.org/ |
|
ISSN: |
0028-4793 (Print)
1533-4406 (Electronic) |
|
Digital
Object Identifier: |
10.1056/NEJMra012941 |
|
Language: |
English |
|
Keywords: |
posttraumatic stress disorder; traumatic event;
treatment; distress; memories; event reminders; emotions
& reactions |
|
Abstract: |
Although most people will gradually recover from the
psychological effects of a traumatic event,
posttraumatic stress disorder (PTSD) will develop in a
substantial proportion. PTSD appears to represent a
failure to recover from a nearly universal set of
emotions and reactions and is typically manifested as
distressing memories or nightmares related to the
traumatic event, attempts to avoid reminders of the
trauma, and a heightened state of physiological arousal.
The treatment of PTSD involves educating the patient
about the nature of the disorder, providing a safe and
supportive environment for discussing traumatic events
and their impact, and relieving the distress associated
with memories and reminders of the event. A variety of
approaches, such as exposure therapy, cognitive therapy,
and pharmacotherapy, have been found to be effective in
the treatment of PTSD. (PsycINFO Database Record (c)
2005 APA, all rights reserved) |
|
Subjects: |
*Emotional Adjustment; *Emotional Trauma; *Experiences
(Events); *Posttraumatic Stress Disorder; *Treatment;
Distress; Memory |
|
Classification: |
Neuroses & Anxiety Disorders (3215) |
|
Population: |
Human
(10) |
|
Publication Type: |
Journal, Peer Reviewed Journal; Print
Format(s) Available:
Electronic; Print |
|
Release
Date: |
20020206 |
|
Accession
Number: |
2002-00226-001 |
|
Number of
Citations in Source: |
55 |
|
|
|
|
Persistent link to this record:
|
http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-00226-001&site=ehost-live |
|
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|
Cut and Paste: |
<A
href="http://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2002-00226-001&site=ehost-live">Post-traumatic
stress disorder.</A> |
|
|
|
|
Database: |
PsycINFO |
Record: 32
|
