scholarly journals Investigation of a Capnometry Guided Respiratory Intervention in the Treatment of Posttraumatic Stress Disorder

2021 ◽  
Author(s):  
Michael J. Ostacher ◽  
Eileen Fischer ◽  
Ellie R. Bowen ◽  
Jihun Lyu ◽  
Denishia J. Robbins ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Respiratory Rate ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Post Treatment ◽  
Efficacy Outcome ◽  
Evidence Based Treatments ◽  
End Tidal ◽  
Respiratory Intervention

Abstract Evidence‐based treatments for posttraumatic stress disorder (PTSD), including psychotherapies and medications, have high dropout and nonresponse rates, suggesting that more acceptable and effective treatments for PTSD are needed. Capnometry Guided Respiratory Intervention (CGRI) is a digital therapeutic effective in panic disorder that measures and displays end-tidal carbon dioxide (EtCO2) and respiratory rate (RR) in real-time within a structured breathing protocol and may have benefit in PTSD by moderating breathing and EtCO2 levels. We conducted a single-arm study of a CGRI system, Freespira®, to treat symptoms of PTSD. Participants with PTSD (n = 55) were treated for four weeks with twice-daily, 17-min at-home CGRI sessions using a sensor and tablet with pre-loaded software. PTSD and associated symptoms were assessed at baseline, end-of treatment, 2-months and 6-months post-treatment. Primary efficacy outcome was 50% of participants having ≥ 6-point decrease in Clinician Administered PTSD Scale (CAPS-5) score at 2-month follow up. Tolerability, usability, safety, adherence and patient satisfaction were assessed. CGRI was well tolerated, with 88% [95% CI 74–96%] having ≥ 6-point decrease in CAPS-5 scores at 2-months post-treatment follow up. Mean CAPS-5 scores decreased from 49.5 [s.d. = 9.2] at baseline to 27.1 [s.d. = 17.8] at 2-months post-treatment follow up. Respiratory rate decreased and EtCO2 levels increased. Associated mental and physical health symptoms also improved. This CGRI intervention was safe, acceptable, and well-tolerated in improving symptoms in this study in PTSD. Further study against an appropriate comparator is warranted. Trial registration Clinicaltrials.gov NCT#03039231.

Three- to Four-Year Follow-Up to an Open Trial of Nefazodone for Combat-Related Posttraumatic Stress Disorder

2002 ◽  
Vol 14 (4) ◽  
pp. 215-221 ◽  
Author(s):  
Michael Hertzberg ◽  
Michelle Feldman ◽  
Jean Beckham ◽  
Scott Moore ◽  
Jonathan Davidson
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Open Trial

Standard EMDR Protocol for Alcohol and Substance Dependence Comorbid With Posttraumatic Stress Disorder: Four Cases With 12-Month Follow-Up

2016 ◽  
Vol 10 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Claire Kullack ◽  
Jonathan Laugharne
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Substance Use ◽  
Alcohol Dependence ◽  
Posttraumatic Stress ◽  
Substance Use Disorders ◽  
Substance Dependence ◽  
Stress Disorder ◽  
Case Series ◽  
Post Traumatic Stress

This report begins with a summary of the literature regarding the theoretical models behind the comorbid relationship between posttraumatic stress disorder and substance use disorders and the various modified addiction protocols formulated to assist in treating these disorders. This case series outlines the effect that the standard eye movement desensitization and reprocessing (EMDR) protocol had on alcohol and substance dependence for 4 patients who attended our Post Traumatic Stress Clinic in Fremantle, Western Australia, primarily for treatment for posttraumatic stress disorder. Patients were assessed for substance use disorders using the Mini International Neuropsychiatric Interview Plus prior to, immediately after, and 12 months after completing EMDR therapy. Results indicate that the standard EMDR protocol was successful in reducing alcohol and substance use. Prior to treatment, 3 patients met criteria for alcohol dependence and 1 met criteria for substance dependence. At 12-month follow-up, 3 out of 4 clients did not meet the diagnostic criteria for current alcohol dependence or current substance dependence. The implications of these findings are discussed with reference to theories of comorbid posttraumatic stress disorder and substance use disorder and the modified EMDR protocols developed for patients with substance dependence.

Posttraumatic Stress Disorder and Mild Head Trauma: Follow-up of a Case Study

1993 ◽  
Vol 76 (1) ◽  
pp. 243-246 ◽  
Author(s):  
Arthur MacNeill Horton
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Head Trauma ◽  
Behavior Therapy ◽  
Stress Disorder ◽  
Neuropsychological Test ◽  
Neuropsychological Deficits ◽  
Current Report

A current conceptual conundrum is the question of whether it is possible to have a co-occurrence of both Posttraumatic Stress Disorder and head trauma. The current report describes the results of behavior therapy and a series of neuropsychological tests for a man who suffered Posttraumatic Stress Disorder and neuropsychological deficits after an automobile accident. A series of neuropsychological test batteries documented considerable improvement. The patient was also treated for Posttraumatic Stress Disorder with behavior therapy so symptoms abated much earlier than the neuropsychological deficits.

scholarly journals Comprehensive analysis of the predictors of neurobehavioral symptom reporting in veterans

Neurology ◽  
2018 ◽  
Vol 91 (8) ◽  
pp. e732-e745 ◽  
Author(s):  
Ryan J. Andrews ◽  
Jennifer R. Fonda ◽  
Laura K. Levin ◽  
Regina E. McGlinchey ◽  
William P. Milberg
Keyword(s):  
Traumatic Brain Injury ◽  
Posttraumatic Stress Disorder ◽  
Brain Injury ◽  
Posttraumatic Stress ◽  
Cross Validation ◽  
Stress Disorder ◽  
Predictor Variables ◽  
Behavioral Measures ◽  
Behavioral Conditions

ObjectiveThis study assessed the strength of military-related concussion-, psychological-, and behavioral-related measures to predict neurobehavioral symptom (NBS) reporting in order to help clarify the extent to which persistent NBS reflect lingering effects of concussion vs other psychological/behavioral factors among veterans.MethodsBaseline analysis included 351 consecutively enrolled veterans in the Translational Research Center for Traumatic Brain Injury and Stress Disorders longitudinal cohort study. One hundred eighty-six returned for a follow-up evaluation averaging 24 months post baseline. The Neurobehavioral Symptom Inventory (NSI) was used to measure NBS reporting. Predictor variables included diagnosis of military-related mild traumatic brain injury (M-mTBI), psychological measures, including posttraumatic stress disorder, mood, anxiety, and substance abuse disorders, and behavioral measures, including self-reported current pain and sleep impairment. Hierarchical and multivariable regression analyses examined the relationships between the predictor variables and NSI scores. The k-fold cross-validation assessed generalizability and validity of the regressions.ResultsBaseline analysis revealed that psychological and behavioral conditions independently accounted for 42.5% of variance in the NSI total score compared to 1.5% for M-mTBI after controlling for psychological and behavioral conditions. Prospective analysis revealed that M-mTBI at baseline did not significantly predict NSI score at follow-up, while psychological and behavioral measures at baseline independently accounted for 24.5% of NSI variance. Posttraumatic stress disorder was the most consistent predictor. Cross-validation analyses supported generalizability of the results.ConclusionsPsychological and behavioral-related measures are strong predictors of persistent NBS reporting in veterans, while M-mTBI is negligible. NBS more likely reflect influential comorbidities as opposed to brain injury, per se.

Cognitive Therapy for Posttraumatic Stress Disorder

2001 ◽  
Vol 15 (4) ◽  
pp. 321-329 ◽  
Author(s):  
Patricia A. Resick
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Treatment Outcome ◽  
Cognitive Therapy ◽  
Posttraumatic Stress ◽  
Cognitive Processing ◽  
Stress Disorder ◽  
Exposure Therapy ◽  
Cognitive Processing Therapy ◽  
One Year

Cognitive therapy for posttraumatic stress disorder is in the early stages of development and study. This article will examine seven controlled studies that included at least a component of cognitive therapy. Two studies specifically focused on early intervention to treat PTSD and included both cognitive therapy and exposure therapy. Three studies examined cognitive processing therapy, which is predominantly cognitive therapy. Two other studies compared pure cognitive therapy with exposure therapy. Overall, cognitive therapy for PTSD appears to be highly effective compared to no-treatment, relaxation, or supportive counseling, and similar to exposure treatments. Treatment effects appear to continue through follow-up periods of up to one year. At this point, little is known about who benefits best with cognitive therapy or predictors of treatment outcome.

scholarly journals Do Acute Benefits of Interpersonal Psychotherapy for Posttraumatic Stress Disorder Endure?

2017 ◽  
Vol 63 (1) ◽  
pp. 37-43 ◽  
Author(s):  
John C. Markowitz ◽  
Tse-Hwei Choo ◽  
Yuval Neria
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Randomised Trial ◽  
Interpersonal Psychotherapy ◽  
Small Sample ◽  
Chronic Ptsd ◽  
Significant Difference

Objective: The Psychotherapies for Chronic PTSD randomised trial found that three 14-week psychotherapies acutely benefitted patients with chronic posttraumatic stress disorder (PTSD). Previous research has reported sustained follow-up benefits for prolonged exposure (PE) and relaxation therapy (RT), but few comparable data exist for interpersonal psychotherapy (IPT). We describe 3-month follow-up for acute responders to all 3 treatments. Method: Acute responders, defined a priori as ≥30% improved from baseline, were reevaluated after 3-month no-treatment follow-up by independent evaluators using the Clinician-Administered PTSD Scale (CAPS). Results: Fifty of 110 initial study entrants met acute responder status at week 14. Forty-three (86%) responders entered follow-up: 23 remitters (CAPS ≤20) and 20 responders. At week 26, 27 had achieved remission status, 10 remained responders, and 6 had relapsed. Of week 14 remitters, 8 of 9 PE, all 8 IPT, and 4 of 6 RT patients remained remitted. Relapse rates were 7% (1/9) for PE, 10% (2/20) for IPT, and 33% (3/9) for RT. At week 26, PE showed greater improvement on CAPS than RT ( P = 0.048) and a trend for superiority over IPT ( P = 0.098), with no significant difference between IPT and RT. Depressive symptoms remained low during follow-up. Conclusions: These are the first systematic data on follow-up responder status and persistence of acute treatment benefits in patients receiving individual IPT for chronic PTSD. Patients generally maintained gains across treatments, fluctuating most in RT. Study limitations include small sample size and brief follow-up interval. PTSD research should employ response and remission criteria.

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