Clinical Treatment of Posttraumatic Stress Disorder: Conceptual Challenges Raised by Recent Research

Objective: This paper highlights some of the recent findings in the field of posttraumatic stress disorder (PTSD) and examines their impact on conceptions of trauma-focused clinical treatment. Method: A series of research findings in the area of epidemiology, phenomenology, neurobiology and treatment are summarised. Results: The findings from these studies present critical challenges for clinicians who wish to treat trauma survivors using specialised trauma treatments. The major challenge is one of avoiding a simplistic view of PTSD as a singular response to trauma, as this perception may result in an underestimation of the complexity and disabling quality of the disorder, and lead to the formulation of treatment plans that are simplistic or incomplete. Conclusions: A more precise characterisation of the nature and range of the stress responses of trauma victims will significantly improve treatments of trauma survivors.

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Quality of life in workplace trauma victims seeking treatment for posttraumatic stress disorder

Journal of Workplace Behavioral Health ◽

10.1080/15555240.2017.1370379 ◽

2017 ◽

Vol 32 (4) ◽

pp. 249-266 ◽

Cited By ~ 1

Author(s):

Sophie Lacerte ◽

Stéphane Guay ◽

Dominic Beaulieu-Prévost ◽

Geneviève Belleville ◽

André Marchand

Keyword(s):

Quality Of Life ◽

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Workplace Trauma ◽

Trauma Victims

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Childbirth and Posttraumatic Stress Responses

European Journal of Psychological Assessment ◽

10.1027/1015-5759.22.4.259 ◽

2006 ◽

Vol 22 (4) ◽

pp. 259-267 ◽

Cited By ~ 40

Author(s):

Eelco Olde ◽

Rolf J. Kleber ◽

Onno van der Hart ◽

Victor J.M. Pop

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Responses ◽

Rating Scales ◽

Rating Scale ◽

Stress Disorder ◽

Traumatic Experience ◽

Event Scale ◽

Self Rating ◽

The Impact

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

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The role of cognitive processing therapy in improving psychosocial functioning, health, and quality of life in veterans with military sexual trauma-related posttraumatic stress disorder.

Psychological Services ◽

10.1037/ser0000058 ◽

2015 ◽

Vol 12 (4) ◽

pp. 428-434 ◽

Cited By ~ 20

Author(s):

Ryan Holliday ◽

Rush Williams ◽

Jessica Bird ◽

Kacy Mullen ◽

Alina Surís

Keyword(s):

Quality Of Life ◽

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Cognitive Processing ◽

Psychosocial Functioning ◽

Stress Disorder ◽

Cognitive Processing Therapy ◽

Military Sexual Trauma

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Efficacy and Underlying Mechanism of Acupuncture in the Treatment of Posttraumatic Stress Disorder: A Systematic Review of Animal Studies

Journal of Clinical Medicine ◽

10.3390/jcm10081575 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1575

Author(s):

Chan-Young Kwon ◽

Boram Lee ◽

Sang-Ho Kim

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Responses ◽

Methodological Quality ◽

Animal Studies ◽

Large Scale ◽

Stress Disorder ◽

Spatial Learning And Memory ◽

Expectancy Effects ◽

Therapeutic Mechanisms

Acupuncture is a nonpharmacological intervention that can be useful in the clinical management of posttraumatic stress disorder (PTSD), especially in situations with a lack of medical resources, including large-scale PTSD events such as disasters. Some clinical studies have reported the clinical effect of acupuncture in improving PTSD symptoms, but the underlying therapeutic mechanism has yet to be explored. Therefore, this review summarized the underlying therapeutic mechanisms of acupuncture in animal PTSD models. A comprehensive search was conducted in 14 electronic databases, and two independent researchers performed study selection, data extraction, and the methodological quality assessment. Twenty-four relevant studies were included in this review and summarized according to the proposed main mechanisms. In behavioral evaluation, acupuncture, including manual acupuncture and electro-acupuncture, reduced anxiety and fear responses and weakened fear conditioning, improved sleep architecture, reduced depressive symptoms, and alleviated disturbance of spatial learning and memory of PTSD animal models. The therapeutic mechanisms of acupuncture proposed in the included studies could be classified into two categories: (1) regulation of stress responses in the neuroendocrine system and (2) promotion of neuroprotection, neurogenesis, and synaptic plasticity in several brain areas. However, the methodological quality of the included animal studies was not high enough to produce robust evidence. In addition, mechanistic studies on specific aspects of acupuncture that may affect PTSD, including expectancy effects, in human PTSD subjects are also needed.

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Impaired Autobiographical Memory Flexibility in Iranian Trauma Survivors With Posttraumatic Stress Disorder

Clinical Psychological Science ◽

10.1177/2167702620953637 ◽

2021 ◽

Vol 9 (2) ◽

pp. 294-301 ◽

Cited By ~ 1

Author(s):

Maryam Piltan ◽

Ali Reza Moradi ◽

Mohammad Hassan Choobin ◽

Parviz Azadfallah ◽

Sara Eskandari ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Autobiographical Memory ◽

Posttraumatic Stress ◽

Emotional Disturbance ◽

Stress Disorder ◽

Small Sample ◽

Trauma Survivors ◽

Community Control ◽

Memory Specificity ◽

Memory Flexibility

Reduced ability to retrieve specific autobiographical memories is a well-defined feature of posttraumatic stress disorder (PTSD), and science-driven interventions have emerged to improve memory specificity and thereby symptoms. However, research in depressed samples indicates that the ability to flexibly move between retrieval of specific and general memory types (i.e., memory flexibility) may more accurately conceptualize autobiographical memory deficits in emotional disturbance. In this study, we evaluated memory specificity and memory flexibility in Iranian trauma survivors ( N = 63) with and without PTSD relative to community control participants. Trauma-exposed participants had experienced a serious road-traffic accident. Results indicated that individuals with PTSD experienced reduced memory specificity and memory flexibility relative to trauma-exposed participants and community control participants. A small sample size limits the strength of conclusions, although good statistical power was obtained. Findings suggest that reduced memory flexibility may be a transdiagnostic marker of emotional disturbance and support further development of memory flexibility interventions for PTSD.

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Posttraumatic Stress Disorder and Autobiographical Memories in Everyday Life

Clinical Psychological Science ◽

10.1177/2167702616688878 ◽

2017 ◽

Vol 5 (2) ◽

pp. 325-340 ◽

Cited By ~ 14

Author(s):

Sabine Schönfeld ◽

Anke Ehlers

Keyword(s):

Posttraumatic Stress Disorder ◽

Autobiographical Memory ◽

Everyday Life ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Trauma Survivors ◽

Autobiographical Memories ◽

Self Reports ◽

Distinct Features ◽

Ptsd Group

Evidence from self-reports and laboratory studies suggests that recall of nontrauma autobiographical memories may be disturbed in posttraumatic stress disorder (PTSD), but investigations in everyday life are sparse. This study investigated unintentional nontrauma and trauma memories in trauma survivors with and without PTSD ( N = 52), who kept an autobiographical memory diary for a week. We investigated whether unintentional nontrauma memories show an overgeneral memory bias and further memory abnormalities in people with PTSD, and whether unintentional trauma memories show distinct features. Compared to the no-PTSD group, the PTSD group recorded fewer nontrauma memories, which were more overgeneral, more often from before the trauma or related to the trauma, were perceived as distant, and led to greater dwelling. Trauma memories were more vivid, recurrent, and present and led to greater suppression and dwelling. Within the PTSD group, the same features distinguished trauma and nontrauma memories. Results are discussed regarding theories of autobiographical memory and PTSD.

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