Treatment for Women With Post-Traumatic Stress Disorder Related to Childhood Abuse

Background It is unclear whether people with post-traumatic stress disorder (PTSD) and symptoms of complex PTSD due to childhood abuse need a treatment approach different from approaches in the PTSD treatment guidelines. Aims To determine whether a phase-based approach is more effective than an immediate trauma-focused approach in people with childhood-trauma related PTSD (Netherlands Trial Registry no.: NTR5991). Method Adults with PTSD following childhood abuse were randomly assigned to either a phase-based treatment condition (8 sessions of Skills Training in Affect and Interpersonal Regulation (STAIR), followed by 16 sessions of eye-movement desensitisation and reprocessing (EMDR) therapy; n = 57) or an immediately trauma-focused treatment condition (16 sessions of EMDR therapy; n = 64). Participants were assessed for symptoms of PTSD and complex PTSD, and other forms of psychopathology before, during and after treatment and at 3- and 6-month follow-ups. Results Data were analysed with linear mixed models. No significant differences between the two treatments on any variable at post-treatment or follow-up were found. Post-treatment, 68.8% no longer met PTSD diagnostic criteria. Self-reported PTSD symptoms significantly decreased for both STAIR–EMDR therapy (d = 0.93) and EMDR therapy (d = 1.54) from pre- to post-treatment assessment, without significant difference between the two conditions. No differences in drop-out rates between the conditions were found (STAIR–EMDR 22.8% v. EMDR 17.2%). No study-related adverse events occurred. Conclusions This study provides compelling support for the use of EMDR therapy alone for the treatment of PTSD due to childhood abuse as opposed to needing any preparatory intervention.

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Effectiveness of pharmacological and psychological interventions for treating post-traumatic stress disorder in adults with childhood abuse: protocol for a systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-048790 ◽

2021 ◽

Vol 11 (12) ◽

pp. e048790

Author(s):

Nour Waleed Alhussaini ◽

Muhammad Riaz

Keyword(s):

Childhood Abuse ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Treatment Effectiveness ◽

Traumatic Event ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Post Traumatic Stress ◽

Post Traumatic

IntroductionPost-traumatic stress disorder (PTSD) is a debilitating mental disorder that develops after being exposed to a traumatic event. PTSD is common among adults who have experienced physical/sexual childhood abuse. Several psychological and pharmacological interventions are used for treating PTSD in this particular group, and it is important to identify what interventions, whether alone or in combination with other treatments, are more effective compared with others. Therefore, this review aims to provide synthesis of evidence on the effectiveness of different interventions used for treating PTSD following childhood abuse.Methods and analysisElectronic search will be conducted using different databases such as PubMed, EMBASE, PsycINFO to identify randomised controlled trials (RCTs) used for assessing interventions for PTSD following childhood abuse. Data on treatment effectiveness for PTSD with childhood abuse and other variables will be extracted from each paper and reported as appropriate. Extracted effect-size estimates will be combined using Bayesian network meta-analysis (NMA). Risk of bias will be assessed through the Cochrane Collaboration tool for RCTs tool. NMA assumptions (heterogeneity, transitivity, inconsistency) will be assessed and reported. Meta-regression and subgroup analyses will be performed to explore and explain possible sources of heterogeneity.Ethics and disseminationThis research is based on literature review and does not require the approval of ethical board as it does not involve dealing with humans or animals. Findings of this review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020207409.

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Bearing the unbearable: meditations on being in rhythm

Attachment New Directions in Psychotherapy and Relational Psychoanalysis ◽

10.33212/att.v12n1.2018.48 ◽

2018 ◽

Vol 12 (1) ◽

Author(s):

Karen Hopenwasser

Keyword(s):

Childhood Abuse ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Post Traumatic ◽

Unbearable Pain ◽

Journal Entries

Many individuals who have suffered persistent, severe childhood abuse have coped with the pain and terror of abuse through a dissociative adaptation. In long-term psychotherapy with these individuals, psychotherapists can experience attunement with multiple self states, often leading to confusion and fatigue. This piece describes journal entries made by the author over several years of working with patients with complex post-traumatic stress disorder. Meditative daily walks at sunrise through a treelined river park served to comfort and balance the stress of this work. These entries describe attunement as an embodied rhythmic encounter that facilitates the management of unbearable pain in a shared healing experience.

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