Treating Eating Disorder–Posttraumatic Stress Disorder Patients

2017 ◽  
pp. 40-59
Author(s):  
Julie G. Trim ◽  
Tara E. Galovski ◽  
Amy Wagner ◽  
Timothy D. Brewerton
Keyword(s):  
Eating Disorder ◽  
Dialectical Behavior Therapy ◽  
Stress Disorder ◽  
Treatment Plan ◽  
Post Traumatic Stress ◽  
High Risk Behaviors ◽  
Concurrent Treatment ◽  
Ptsd Treatment ◽  
Self Harm ◽  
Post Traumatic

Despite elevated prevalence rates of trauma and post-traumatic stress disorder (PTSD) in eating disorder (ED) individuals, there is a surprising lack of data on how to effectively treat this population. The most significant gaps in the literature include the “what” (which PTSD treatment to use) and “when” (sequential vs. concurrent treatment) of PTSD treatment. Clinicians are often fearful in working with this ED subgroup, particularly given that these patients often report high-risk behaviors such as suicidality and self-harm. This chapter presents a new approach to treating comorbid PTSD that seems to be very promising for ED–PTSD patients. Borrowed from dialectical behavior therapy (DBT), this approach (called DBT PE) outlines readiness criteria and a protocol for altering the treatment plan if concerning behaviors emerge during the course of PTSD treatment. ED clinicians are encouraged to use DBT PE principles and to disseminate their results.

scholarly journals Paranoia in patients attending child and adolescent mental health services

2021 ◽  
pp. 000486742098141
Author(s):  
Jessica C Bird ◽  
Emma C Fergusson ◽  
Miriam Kirkham ◽  
Christina Shearn ◽  
Ashley-Louise Teale ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Services ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Network Analyses ◽  
Self Harm ◽  
Post Traumatic ◽  
Peer Difficulties

Objective: Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for adolescent social relationships, especially in the context of mental health disorders. We set out to examine the prevalence, symptom associations, and persistence of paranoia in a cohort of young people attending child and adolescent mental health services. Method: A total of 301 patients (11–17 years old) completed measures of paranoia, affect, peer difficulties and behavioural problems. Clinicians also rated each participant’s psychiatric symptoms. Patterns of association were examined using linear regressions and network analyses. In total, 105 patients repeated the measures several months later. Results: Most of the adolescents had affective disorders ( n = 195), self-harm/suicidality ( n = 82), or neurodevelopmental conditions ( n = 125). Few had suspected psychosis ( n = 7). Rates of paranoia were approximately double compared with previous reports from the general population. In this patient sample, 35% had at least elevated paranoia, 15% had at least moderate paranoia, and 6% had high paranoia. Paranoia had moderate associations with clinician-rated peer difficulties, self-harm, and trauma, and small associations with clinician-rated social anxiety, depression, generalised anxiety, and educational problems. Network analyses showed paranoia had the strongest unique relationship with peer difficulties. Paths from peer difficulties to anxiety, self-harm, post-traumatic stress disorder symptoms, and behavioural problems were all via paranoia. Both self-harm and post-traumatic stress disorder were solely associated with paranoia in the network. Paranoia remained persistent for three-quarters and was associated with greater psychological problems over time. Conclusion: Paranoia is relatively common and persistent across a range of clinical presentations in youth. When paranoia occurs alongside emotional problems, important peer interactions may be adversely affected. Wider consideration of paranoia in adolescent patients is needed.

Epigenetic Effects of PTSD Remediation in Veterans Using Clinical Emotional Freedom Techniques: A Randomized Controlled Pilot Study

2016 ◽  
Vol 32 (1) ◽  
pp. 112-122 ◽  
Author(s):  
Dawson Church ◽  
Garret Yount ◽  
Kenneth Rachlin ◽  
Louis Fox ◽  
Jerrod Nelms
Keyword(s):  
Gene Expression ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Intervention Period ◽  
Post Traumatic Stress ◽  
Ptsd Treatment ◽  
Epigenetic Effects ◽  
Post Traumatic

Purpose: To assess the feasibility of measuring changes in gene expression associated with post-traumatic stress disorder (PTSD) treatment using emotional freedom techniques (EFT). Design: Participants were randomized into an EFT group receiving EFT and treatment as usual (TAU) throughout a 10-week intervention period and a group receiving only TAU during the intervention period and then receiving EFT. Setting: A community clinic and a research institute in California. Participants: Sixteen veterans with clinical levels of PTSD symptoms. Intervention: Ten hour-long sessions of EFT. Measures: Messenger RNA levels for a focused panel of 93 genes related to PTSD. The Symptom Assessment 45 questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Scale, SF-12v2 for physical impairments, and Rivermead Postconcussion Symptoms Questionnaire. Analysis: Pre-, posttreatment, and follow-up mean scores on questionnaires were assessed using repeated measures 1-way analysis of variance. A Student t test and post hoc analyses were performed on gene expression data. Results: Post-traumatic stress disorder symptoms declined significantly in the EFT group (−53%, P < .0001). Participants maintained their gains on follow-up. Significant differential expression of 6 genes was found ( P < .05) when comparing the expression levels before and after the intervention period in participants receiving EFT. Conclusion: Study results identify candidate gene expression correlates of successful PTSD treatment, providing guidelines for the design of further studies aimed at exploring the epigenetic effects of EFT.

scholarly journals Predictors of treatment failure among patients with gunshot wounds and post-traumatic stress disorder

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iurii Leonidovych Kuchyn ◽  
Vasyl’ Romanovych Horoshko
Keyword(s):  
Postoperative Pain ◽  
Treatment Failure ◽  
Treatment Outcomes ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Gunshot Wounds ◽  
Post Traumatic Stress ◽  
Ptsd Treatment ◽  
Post Traumatic

Abstract Background The 82.1% treatment failure of post-traumatic stress disorder (PTSD), associated with gunshot wounds, is related to high incidence of chronic pain syndrome as well as resistance to the PTSD treatment. Defining treatment failure predictors among the PTSD patients with gunshot extremity wounds and the following therapy would improve treatment outcomes. Methods A total of 218 patients completed the study. The Mississippi Scale for Combat-Related PTSD (M-PTSD) was used for assessment of the treatment outcome rate. The risk relation between treatment failure and factors was assessed by a univariate or multivariate logistic regression method, with the model accuracy measured by the AUC – Area under the ROC curve. The odds ratio (OR) was considered for the qualitative factor assessment. Results The predictors of the PTSD treatment failure among the patients with gunshot wounds to the extremities are: 1) anesthesia type: the risk of failure is higher with the general anesthesia compared to the regional (p = 0.002), OR = 0.30 (95% CI 0.13-0.69) and the regional one with sedation (p = 0.004), OR = 0.30 (95% CI 0,14-0.65); 2) severe postoperative pain: the risk of treatment failure rises with increased pain intensity assessed by the visual analogue scale (p = 0.02), OR = 3.2 (95% CI 1.2-8.3). Conclusions The analysis showed that administration of general anesthesia compared to the regional one (regardless of the sedation) and high postoperative pain intensity are associated with higher risk of the PTSD treatment failure among patients with gunshot wounds to the extremities. The preference of regional anesthesia and postoperative pain control may potentially improve the treatment outcomes. Trial registration ClinicalTrials.gov: Retrospectively registered on December 30, 2020, NCT04689022.

ID: 42: FACTORS ASSOCIATED WITH TREATMENT SEEKING IN VETERANS WITH LATE-ONSET PTSD

2016 ◽  
Vol 64 (4) ◽  
pp. 946.1-946
Author(s):  
S Ramaswamy ◽  
A Hickert ◽  
K Miller ◽  
V Kolli ◽  
D Driscoll ◽  
...  
Keyword(s):  
Risk Factors ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Late Onset ◽  
Treatment Seeking ◽  
Health Administration ◽  
Post Traumatic Stress ◽  
Ptsd Treatment ◽  
Post Traumatic

Background and SignificancePost-traumatic stress disorder (PTSD) is a chronic anxiety disorder with a lifetime prevalence of 6.8% in the general population and up to 30% among Vietnam War veterans. While presentation of PTSD is typically acute, delayed onset of PTSD (i.e., 6 months post trauma) is considered to be relatively rare. There is anecdotal evidence supporting reactivation of trauma memories and symptoms of PTSD among aging veterans who previously had no symptoms or treatment for PTSD. Clinically this type of presentation appears to be different from those presenting with symptoms earlier in life. It is unclear what might precipitate or reactivate these symptoms many years following trauma exposure. The Veterans Health Administration has a growing population of aging veterans exposed to combat during their military service. Current treatment guidelines provide limited guidance towards the management of late-onset PTSD. The prevalence of PTSD among OEF/OIF veterans is very high and as this cohort ages, we need to be better equipped to manage clinical changes seen across the lifespan. Understanding the clinical phenomenology, risk factors and potential biomarkers of this condition could pave the way for better screening methods and treatment interventions for clinicians.ObjectiveTo identify the characteristics and risk factors among late-life post-traumatic stress disorder (PTSD) treatment seekers.MethodsThe study is a retrospective chart review of patients diagnosed with PTSD after the age of 55 and a comparison group of veterans diagnosed with PTSD prior to the age of 55 in the VA Nebraska–Western Iowa Health Care System.ResultsPrimary variables for analysis included demographic factors, military history, age at treatment seeking, PTSD Checklist (PCL) scores, PTSD treatment, recent stressors/reasons for seeking treatment (e.g., recent life changes, another trauma or reminder), and comorbid medical conditions.ConclusionsA number of explanations have been proposed for the development of late-onset PTSD, including chronic inflammation and cumulative stress. We are conducting a separate study to determine whether plasma concentration of the inflammatory marker C-reactive protein (CRP) might help in predicting late-onset PTSD. Further studies are needed to evaluate the contributions of other factors (e.g., physical or cognitive decline, sleep disturbances, other traumas) to late-onset PTSD.

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