scholarly journals DNA methylation changes following narrative exposure therapy in a randomized controlled trial with female former child soldiers

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Samuel Carleial ◽  
Daniel Nätt ◽  
Eva Unternährer ◽  
Thomas Elbert ◽  
Katy Robjant ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Exposure Therapy ◽  
Psychological Treatment ◽  
Controlled Trial ◽  
Child Soldiers ◽  
Narrative Exposure Therapy ◽  
Parallel Group Design ◽  
Parallel Group ◽  
Former Child Soldiers ◽  
Randomised Controlled

AbstractThe aftermath of traumatization lives on in the neural and epigenetic traces creating a momentum of affliction in the psychological and social realm. Can psychotherapy reorganise these memories through changes in DNA methylation signatures? Using a randomised controlled parallel group design, we examined methylome-wide changes in saliva samples of 84 female former child soldiers from Eastern DR Congo before and six months after Narrative Exposure Therapy. Treatment predicted differentially methylated positions (DMPs) related to ALCAM, RIPOR2, AFAP1 and MOCOS. In addition, treatment associations overlapped at gene level with baseline clinical and social outcomes. Treatment related DMPs are involved in memory formation—the key agent in trauma focused treatments—and enriched for molecular pathways commonly affected by trauma related disorders. Results were partially replicated in an independent sample of 53 female former child soldiers from Northern Uganda. Our results suggest a molecular impact of psychological treatment in women with war-related childhood trauma.Trial registration: Addressing Heightened Levels of Aggression in Traumatized Offenders With Psychotherapeutic Means (ClinicalTrials.gov Identifier: NCT02992561, 14/12/2016).

scholarly journals Narrative exposure therapy for survivors of human trafficking: feasibility randomised controlled trial

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Francesca Brady ◽  
Amy Chisholm ◽  
Eileen Walsh ◽  
Livia Ottisova ◽  
Leonardo Bevilacqua ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Human Trafficking ◽  
Mental Health Problems ◽  
Exposure Therapy ◽  
Controlled Trial ◽  
Health Concern ◽  
Wait List ◽  
Post Traumatic Stress ◽  
Narrative Exposure Therapy ◽  
Randomised Controlled

Background Human trafficking is a grave human rights violation and a major public health concern. Survivors present with high rates of mental health problems including post-traumatic stress disorder (PTSD). Studies of effective treatments for PTSD in survivors of human trafficking are lacking. Narrative exposure therapy (NET) is an effective PTSD treatment for multiple, prolonged and complex trauma, but its efficacy has not been rigorously tested in survivors of human trafficking. Aims To test the feasibility and acceptability of a randomised controlled trial (RCT) offering NET as a treatment for PTSD in trafficking survivors with a history of multiple traumatic events, as well as providing preliminary evidence regarding its efficacy (trial registration: ISRCTN95136302). Method A single-blind RCT compared NET with a wait-list control in survivors of trafficking with PTSD (n = 25). In the NET arm of the study, participants attended a mean of 17 sessions. Results NET was well tolerated by participants. There were significant reductions in PTSD, depression and anxiety symptoms post-treatment in the NET group but no significant change in the wait-list group. Conclusions The results indicate that NET is a promising and acceptable treatment for trafficking survivors. Psychological therapy in an RCT design can be safely delivered to this vulnerable group, although modifications are required to ensure their holistic needs are properly addressed.

scholarly journals A National Quality Improvement Collaborative for the clinical use of outcome measurement in specialised mental healthcare: Results from a parallel group design and a nested cluster randomised controlled trial

BJPsych Open ◽  
2017 ◽  
Vol 3 (3) ◽  
pp. 106-112 ◽  
Author(s):  
Margot J. Metz ◽  
Marjolein A. Veerbeek ◽  
Gerdien C. Franx ◽  
Christina M. van der Feltz-Cornelis ◽  
Edwin de Beurs ◽  
...  
Keyword(s):  
Outcome Measurement ◽  
Controlled Trial ◽  
Mental Healthcare ◽  
Cluster Randomised Controlled Trial ◽  
Group Design ◽  
Cluster Randomised ◽  
Parallel Group Design ◽  
Parallel Group ◽  
National Quality ◽  
Randomised Controlled

BackgroundAlthough the importance and advantages of measurement-based care in mental healthcare are well established, implementation in daily practice is complex and far from optimal.AimsTo accelerate the implementation of outcome measurement in routine clinical practice, a government-sponsored National Quality Improvement Collaborative was initiated in Dutch-specialised mental healthcare.MethodTo investigate the effects of this initiative, we combined a matched-pair parallel group design (21 teams) with a cluster randomised controlled trial (RCT) (6 teams). At the beginning and end, the primary outcome ‘actual use and perceived clinical utility of outcome measurement’ was assessed.ResultsIn both designs, intervention teams demonstrated a significant higher level of implementation of outcome measurement than control teams. Overall effects were large (parallel group d=0.99; RCT d=1.25).ConclusionsThe National Collaborative successfully improved the use of outcome measurement in routine clinical practice.

scholarly journals Does fMRI neurofeedback in the context of stress influence mood and arousal? A randomised controlled trial with parallel group design

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1031
Author(s):  
Angelo Belardi ◽  
Jong-Hwan Lee ◽  
Hyun-Chul Kim ◽  
Esther Stalujanis ◽  
Eun Kyung Jung ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Stroop Task ◽  
Controlled Trial ◽  
Anterior Cingulate ◽  
Group Design ◽  
Parallel Group Design ◽  
Parallel Group ◽  
Fmri Session ◽  
Randomised Controlled ◽  
Subjective Arousal

Background: Stress-related mental and physical health issues burden modern societies. New treatment opportunities could help to lessen long-term detrimental consequences of stress. Objective: To investigate whether real-time functional magnetic resonance imaging neurofeedback (rtfMRInf), aimed at modulating brain activity associated with a stressor, affects subjective mood and arousal. Methods: In total, 30 males participated in a randomised controlled trial with parallel-group design. rtfMRInf was the intervention, sham-neurofeedback the control condition, and the Stroop task the stressor. We instructed participants to modulate their stress response to the Stroop task via feedback from their anterior cingulate cortex and their insular cortex, concomitantly applying mental strategies. We assessed mood with the Multidimensional Mood State Questionnaire (dimensions: good/bad, GB; awake/tired, AT; and calm/nervous, CN), and subjective arousal with Self-Assessment Manikins (SAM). Results: We found significantly higher subjective arousal after neurofeedback phases in the experimental condition as compared to the control condition [t(26.6) = −2.216, 95%CI [−2.188,−0.083], p = 0.035; t(27.9) = −3.252, 95%CI [−2.685,−0.609], p = 0.003], but no significant differences between the conditions regarding mood [GB: b = 0.4, 95%CI [−0.67, 1.47], p = 0.467; AT: b = 0.769, 95%CI [−0.319, 1.857], p = 0.177; CN: b = 0.5, 95%CI [−0.53, 1.53], p = 0.352]. In both conditions, there was significantly worse and more tired mood after the fMRI session as compared to before [GB:b = −0.77, 95% CI [−1.31, 0.23], p = 0.009; AT: b = −0.652, 95%CI [−1.116,−0.187], p = 0.01]. Conclusions: Findings indicate that rtfMRInf led to higher arousal, which may counteract the aim to reduce stress responses. Whether the multitasking situation has triggered this neurofeedback-related arousal – and how to circumvent it – asks for further study. Trial registration: NCT01921088, ClinicalTrials.gov, 13th August 2013.

scholarly journals Does fMRI neurofeedback in the context of stress influence mood and arousal? A randomised controlled trial with parallel group design

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 1031
Author(s):  
Angelo Belardi ◽  
Jong-Hwan Lee ◽  
Hyun-Chul Kim ◽  
Esther Stalujanis ◽  
Eun Kyung Jung ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Stroop Task ◽  
Controlled Trial ◽  
Anterior Cingulate ◽  
Group Design ◽  
Parallel Group Design ◽  
Parallel Group ◽  
Fmri Session ◽  
Randomised Controlled ◽  
Subjective Arousal

Background: Stress-related mental and physical health issues burden modern societies. New treatment opportunities could help to lessen long-term detrimental consequences of stress. Objective: To investigate whether real-time functional magnetic resonance imaging neurofeedback (rtfMRInf), aimed at modulating brain activity associated with a stressor, affects subjective mood and arousal. Methods: In total, 30 males participated in a randomised controlled trial with parallel-group design. rtfMRInf was the intervention, sham-neurofeedback the control condition, and the Stroop task the stressor. We instructed participants to modulate their stress response to the Stroop task via feedback from their anterior cingulate cortex and their insular cortex, concomitantly applying mental strategies. We assessed mood with the Multidimensional Mood State Questionnaire (dimensions: good/bad, GB; awake/tired, AT; and calm/nervous, CN), and subjective arousal with Self-Assessment Manikins (SAM). Results: We found significantly higher subjective arousal after neurofeedback phases in the experimental condition as compared to the control condition [t(26.6) = −2.216, 95%CI [−2.188,−0.083], p = 0.035; t(27.9) = −3.252, 95%CI [−2.685,−0.609], p = 0.003], but no significant differences between the conditions regarding mood [GB: b = 0.4, 95%CI [−0.67, 1.47], p = 0.467; AT: b = 0.769, 95%CI [−0.319, 1.857], p = 0.177; CN: b = 0.5, 95%CI [−0.53, 1.53], p = 0.352]. In both conditions, there was significantly worse and more tired mood after the fMRI session as compared to before [GB:b = −0.77, 95% CI [−1.31, 0.23], p = 0.009; AT: b = −0.652, 95%CI [−1.116,−0.187], p = 0.01]. Conclusions: Findings indicate that rtfMRInf led to higher arousal, which may counteract the aim to reduce stress responses. Whether the multitasking situation has triggered this neurofeedback-related arousal – and how to circumvent it – asks for further study. Trial registration: NCT01921088, ClinicalTrials.gov, 13th August 2013.

scholarly journals Narrative Exposure Therapy versus treatment as usual in a sample of trauma survivors who live under ongoing threat of violence in Rio de Janeiro, Brazil: study protocol for a randomised controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fernanda Serpeloni ◽  
Jeanine Arabella Narrog ◽  
Simone Gonçalves de Assis ◽  
Joviana Quintes Avanci ◽  
Samuel Carleial ◽  
...  
Keyword(s):  
Community Violence ◽  
Rio De Janeiro ◽  
Exposure Therapy ◽  
Traumatic Event ◽  
Controlled Trial ◽  
Global Scale ◽  
Treatment As Usual ◽  
Narrative Exposure Therapy ◽  
Clinical Endpoints ◽  
Randomised Controlled

Abstract Background One in three individuals who live in Rio de Janeiro experience a traumatic event within a period of 12 months. In the favelas particularly, trauma exposure is ongoing. Psychological sequalae include posttraumatic stress disorder (PTSD), depression and other mental disorders. Trauma-focused therapy approaches have emerged as the treatment of choice when the dangerous events are over, but symptoms have remained for an extended time period. Ideally, the victim is in a safe context during treatment. However, frequently, survivors cannot escape from situations characterised by ongoing threat and traumatic stress. The aim of this study is to research the effectiveness of Narrative Exposure Therapy in a sample of PTSD patients living under these conditions. Methods Individuals fulfilling the criteria for PTSD and who live in conditions of ongoing community violence (i.e. in the favelas) in Rio de Janeiro will be randomly assigned to one of two treatments: Narrative Exposure Therapy (NET) or treatment as usual (TAU). Clinical endpoints will be primarily PTSD and secondarily symptoms of shutdown dissociation, depression, substance involvement  and functionality. Discussion Effective treatment for PTSD patients who live in unsafe conditions could substantially reduce suffering of individuals and their families in Brazil. Based on this result, the extent to which such interventions may be useful as a first step in tackling the consequences of violence on a global scale will be discussed. Trial registration Deutsches Register Klinischer Studien (German Clinical Trials Register) DRKS00017843. Registered on September 24, 2019

scholarly journals How well do doctors understand a scientific article in English when it is not their first language? A randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043444
Author(s):  
Martine Rostadmo ◽  
Siri Lunde Strømme ◽  
Magne Nylenna ◽  
Pal Gulbrandsen ◽  
Erlend Hem ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
First Language ◽  
Review Article ◽  
Scientific Article ◽  
Potential Range ◽  
Parallel Group ◽  
The Difference ◽  
Randomised Controlled ◽  
Primary Care Medicine

IntroductionEnglish is the lingua franca of science. How well doctors understand English is therefore crucial for their understanding of scientific articles. However, only 5% of the world’s population have English as their first language.MethodsObjectives: To compare doctors’ comprehension of a scientific article when read in their first language (Norwegian) versus their second language (English). Our hypothesis was that doctors reading the article in Norwegian would comprehend the content better than those reading it in English.Design: Parallel group randomised controlled trial. We randomised doctors to read the same clinical review article in either Norwegian or English, before completing a questionnaire about the content of the article.Setting: Conference in primary care medicine in Norway, 2018.Participants: 130 native Norwegian-speaking doctors, 71 women and 59 men. One participant withdrew before responding to the questionnaire and was excluded from the analyses.Interventions: Participants were randomly assigned to read a review article in either Norwegian (n=64) or English (n=66). Reading time was limited to 7 min followed by 7 min to answer a questionnaire.Main outcome measures: Total score on questions related to the article content (potential range −9 to 20).ResultsDoctors who read the article in Norwegian had a mean total score of 10.40 (SD 3.96) compared with 9.08 (SD 3.47) among doctors who read the article in English, giving a mean difference of 1.32 (95% CI 0.03 to 2.62; p=0.046). Age was independently associated with total score, with decreased comprehension with increasing age.ConclusionThe difference in comprehension between the group who read in Norwegian and the group who read in English was statistically significant but modest, suggesting that the language gap in academia is possible to overcome.

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