Co-morbidity: Lessons learned about Post-Traumatic Stress Disorder (PTSD) from developing ptsd scales for the MMPI

1989 ◽  
Vol 45 (5) ◽  
pp. 709-717 ◽  
Author(s):  
Walter Penk ◽  
Ralph Robinowitz ◽  
John Black ◽  
Michael Dolan ◽  
William Bell ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Lessons Learned ◽  
Post Traumatic Stress ◽  
Co Morbidity ◽  
Post Traumatic

scholarly journals Prolonged exposure as early intervention in an emergency department context: lessons learned from a terminated RCT.

2019 ◽  
Author(s):  
Maria Bragesjö ◽  
Filip Arnberg ◽  
Erik Andersson
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Lessons Learned ◽  
Post Traumatic Stress ◽  
Target Sample Size ◽  
Post Traumatic ◽  
Event Based ◽  
High Degree

Abstract Objective The main purpose of the trial was to test if a brief trauma focused cognitive-behavior therapy (prolonged exposure; PE) provided within 72h after a trauma could be effective in decreasing the incidence of post-traumatic stress disorder (PTSD), replicating and extending findings from an earlier trial. After a pilot study (N=10), which indicated feasible and deliverable study procedures and interventions, we subsequently launched an RCT with a target sample size of 352 participants randomized to either three sessions PE or non-directive support. Due to an unforeseen major reorganization at the hospital, the RCT was discontinued after 32 included participants. Results In this paper, we highlight obstacles and lessons learned from our feasibility work, relevant for preventive psychological interventions for PTSD in emergency settings. One important finding was the high degree of attrition: only 78% and 34% respectively came back for the two months and six-months assessments. There were also difficulties in reaching eligible patients immediately after the event. Based on our experiences, we envisage that alternative models of implementation might overcome these obstacles, for example, with remote delivery of both assessments and treatment, combined with multiple recruitment procedures. Lessons learned from this terminated RCT are discussed in depth.

Elevated circulatory level of GABAA – antagonistic neurosteroids in patients with combat-related post-traumatic stress disorder

2000 ◽  
Vol 30 (5) ◽  
pp. 1227-1231 ◽  
Author(s):  
B. SPIVAK ◽  
R. MAAYAN ◽  
M. KOTLER ◽  
R. MESTER ◽  
I. GIL-AD ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Control Male ◽  
Chronic Ptsd ◽  
Co Morbidity ◽  
Post Traumatic ◽  
Circulatory Level

Background. Post-traumatic stress disorder (PTSD) is a multisystem neurobiological disorder with chronic alterations in various neurochemical systems. Levels of the GABAA – antagonistic neurosteroids plasma dehydroepiandrosterone (DHEA) and its sulphate derivate, dehydro-epiandrosterone sulphate (DHEAS) may be relevant to depressive and anxiety disorders, including PTSD.Methods. We assessed the circulatory levels of morning plasma DHEA and DHEAS in 21 male out-patients with untreated chronic combat-related PTSD (CR-PTSD), and 18 healthy control male subjects.Results. Compared with the control subjects, the PTSD patients showed significantly higher plasma DHEA and DHEAS levels.Conclusions. Chronic CR-PTSD may be associated with increased circulatory level of neuroactive steroids with inhibitory activity at the GABAA receptors. Neurosteroid-induced decreased GABA-ergic tone may be relevant to the symptomatology and pathophysiology of chronic PTSD, as well as to the frequent co-morbidity of PTSD with depression and anxiety disorders.

Systematic review of lessons learned from delivering tele-therapy to veterans with post-traumatic stress disorder

2017 ◽  
Vol 24 (9) ◽  
pp. 575-585 ◽  
Author(s):  
David Turgoose ◽  
Rachel Ashwick ◽  
Dominic Murphy
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Help Seeking ◽  
Stress Disorder ◽  
Potential Method ◽  
Lessons Learned ◽  
Post Traumatic Stress ◽  
Psychological Therapies ◽  
Post Traumatic ◽  
Therapy Interventions

Introduction Despite increases in the number of ex-service personnel seeking treatment for post-traumatic stress disorder (PTSD), there remain a number of barriers to help-seeking which prevents many veterans from accessing psychological therapies. Tele-therapy provides one potential method of increasing the number of veterans accessing support. This review aimed to systematically review the literature in order to summarise what lessons have been learned so far from providing trauma-focused tele-therapies to veterans with PTSD. Methods A systematic literature review was conducted from which 41 papers were reviewed. Studies were included if they involved the use of trauma-focused therapies carried out using tele-therapy technologies. Only studies using tele-therapy interventions via video or telephone with populations of ex-military personnel with PTSD were included. Results In the majority of cases tele-therapy was found to be as effective in reducing PTSD symptoms as in-person interventions. Similarly, there were few differences in most process outcomes such as dropout rates, with tele-therapy helping to increase uptake in some cases. Veterans using tele-therapy reported high levels of acceptability and satisfaction. Some challenges were reported in terms of therapeutic alliance, with some studies suggesting that veterans felt less comfortable in using tele-therapy. Several studies suggested it was harder for clinicians to read non-verbal communication in tele-therapy, but this did not affect their ability to build rapport. Technological issues were encountered, but these were not found to impede therapy processes or outcomes. Discussion Tele-therapy provides a viable alternative to in-person therapies and has the potential to increase access to therapy for veterans. Tele-therapy should continue to be evaluated and scrutinised in order to establish the most effective methods of delivery.

scholarly journals Prevention of post-traumatic stress disorder: Lessons learned from a terminated RCT of prolonged exposure

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251898
Author(s):  
Maria Bragesjö ◽  
Filip K. Arnberg ◽  
Erik Andersson
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Traumatic Event ◽  
Lessons Learned ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Post Traumatic

The main purpose of the current trial was to test if a brief trauma-focused cognitive-behaviour therapy protocol (prolonged exposure; PE) provided within 72 h after a traumatic event could be effective in decreasing the incidence of post-traumatic stress disorder (PTSD), thus replicating and extending the findings from an earlier trial. After a pilot study (N = 10), which indicated feasible and deliverable study procedures and interventions, we launched an RCT with a target sample size of 352 participants randomised to either three sessions of PE or non-directive support. Due to an unforeseen major reorganisation at the hospital, the RCT was discontinued after 32 included participants. In this paper, we highlight obstacles and lessons learned from our feasibility work that are relevant for preventive psychological interventions for PTSD in emergency settings. One important finding was the high degree of attrition, and only 75% and 34%, respectively, came back for the 2-month and 6-month assessments. There were also difficulties in reaching eligible patients immediately after the event. Based on our experiences, we envisage that alternative models of implementation might overcome these obstacles, for example, with remote delivery of both assessments and interventions via the internet or smartphones combined with multiple recruitment procedures. Lessons learned from this terminated RCT are discussed in depth.

scholarly journals Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women

2010 ◽  
Vol 41 (7) ◽  
pp. 1497-1505 ◽  
Author(s):  
C. E. Sartor ◽  
V. V. McCutcheon ◽  
N. E. Pommer ◽  
E. C. Nelson ◽  
J. D. Grant ◽  
...  
Keyword(s):  
Alcohol Dependence ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Environmental Influences ◽  
Trauma Exposure ◽  
Genetic Influences ◽  
Post Traumatic Stress ◽  
Co Morbidity ◽  
Post Traumatic

BackgroundThe few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females.MethodData were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure.ResultsAdditive genetic influences (A) accounted for 72% of the variance in PTSD; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71%. The genetic correlation between PTSD and AD was 0.54.ConclusionsThe heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited.

Post-traumatic stress disorder in the community: an epidemiological study

1991 ◽  
Vol 21 (3) ◽  
pp. 713-721 ◽  
Author(s):  
Jonathan R. T. Davidson ◽  
Dana Hughes ◽  
Dana G. Blazer ◽  
Linda K. George
Keyword(s):  
Social Support ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Chronic Ptsd ◽  
Co Morbidity ◽  
History Of ◽  
Post Traumatic ◽  
Job Instability

SYNOPSISPost-traumatic stress disorder (PTSD) was studied in the Piedmont region of North Carolina. Among 2985 subjects, the lifetime and six month prevalence figures for PTSD were 1·30 and 0·44 % respectively. In comparison to non-PTSD subjects, those with PTSD had significantly greater job instability, family history of psychiatric illness, parental poverty, child abuse, and separation or divorce of parents prior to age 10. PTSD was associated with greater psychiatric co-morbidity and attempted suicide, increased frequency of bronchial asthma, hypertension, peptic ulcer and with impaired social support. Differences were noted between chronic and acute PTSD on a number of measures, with chronic PTSD being accompanied by more frequent social phobia, reduced social support and greater avoidance symptoms.

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