Session 2

2019 ◽  
pp. 53-90
Author(s):  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Barbara Olasov Rothbaum ◽  
Sheila A. M. Rauch
Keyword(s):  
Trauma Survivors ◽  
Ptsd Symptoms ◽  
Patient’S Experience ◽  
Distress Scale

This session instructs the therapist on how to interactively present to the patient “common reactions to trauma,” an educational discussion that describes and validates the patient’s experience of PTSD symptoms, associated problems, and relationships among these experiences. Hope is instilled by helping the patient realize that many of his distressing symptoms are directly related to the PTSD and that much of this may improve as a function of treatment. In vivo exposures are discussed, as well as the Subjective Units of Distress Scale (SUDS) and the patient’s in vivo exposure hierarchy is constructed. A list of situations typically avoided by trauma survivors is also provided to help guide the therapist in constructing a hierarchy. After this session, patients will begin in vivo exposure practice. For most patients, the in vivo exposure practices are done between sessions as homework exercises.

Session 3: Developing the In vivo Hierarchy and Craving Management

2014 ◽  
pp. 33-44
Author(s):  
Sudie E. Back ◽  
Edna B. Foa ◽  
Therese K. Killeen ◽  
Katherine L. Mills ◽  
Maree Teesson ◽  
...  
Keyword(s):  
Treatment Program ◽  
Negative Consequences ◽  
Patient Will ◽  
Distress Scale

Chapter 5 discusses session three of the COPE treatment program, which details the development of the in vivo exposure hierarchy and craving management. The patient will construct a hierarchy of exposure exercises based on the discomfort that each exercise will cause them using a subjective units of distress scale (SUDS). Strategies for managing cravings are also presented, such as avoiding triggers, distraction, focusing on negative consequences, and challenging your thoughts.

scholarly journals Time-course of PTSD symptoms in the Australian Defence Force: a retrospective cohort study

2015 ◽  
Vol 25 (4) ◽  
pp. 393-402 ◽  
Author(s):  
M. Waller ◽  
F. J. Charlson ◽  
R. E. E. Ireland ◽  
H. A. Whiteford ◽  
A. J. Dobson
Keyword(s):  
Psychological Distress ◽  
Military Personnel ◽  
Time Course ◽  
Mental Health Problems ◽  
Stressful Events ◽  
Stressful Event ◽  
Ptsd Symptoms ◽  
C 50 ◽  
Distress Scale ◽  
The Impact

Aims.Understanding the time-course of post-traumatic stress disorder (PTSD), and the underlying events, may help to identify those most at risk, and anticipate the number of individuals likely to be diagnosed after exposure to traumatic events.Method.Data from two health surveys were combined to create a cohort of 1119 Australian military personnel who deployed to the Middle East between 2000 and 2009. Changes in PTSD Checklist Civilian Version (PCL-C) scores and the reporting of stressful events between the two self-reported surveys were assessed. Logistic regression was used to examine the association between the number of stressful events reported and PTSD symptoms, and assess whether those who reported new stressful events between the two surveys, were also more likely to report older events. We also assessed, using linear regression, whether higher scores on the Kessler Psychological Distress Scale or the Alcohol Use Disorder Identification Test were associated with subsequent increases in the PCL-C in those who had experienced a stressful event, but who initially had few PTSD symptoms.Results.Overall, the mean PCL-C scores in the two surveys were similar, and 78% of responders stayed in the same PCL-C category. Only a small percentage moved from having few symptoms of PTSD (PCL-C < 30) in Survey 1 to meeting the criteria for PTSD (PCL-C ≥ 50) at Survey 2 (1% of all responders, 16% of those with PCL-C ≥ 50 at Survey 2). Personnel who reported more stressful lifetime events were more likely to score higher on the PCL-C. Only 51% reported the same stressful event on both surveys. People who reported events occurring between the two surveys were more likely to record events from before the first survey which they had not previously mentioned (OR 1.48, 95% CI (1.17, 1.88),p< 0.001), than those who did not. In people who initially had few PTSD symptoms, a higher level of psychological distress, was significantly associated with higher PCL-C scores a few years later.Conclusions.The reporting of stressful events varied over time indicating that while the impact of some stressors endure, others may increase or decline in importance. When screening for PTSD, it is important to consider both traumatic experiences on deployment and other stressful life events, as well as other mental health problems among military personnel, even if individuals do not exhibit symptoms of PTSD on an initial assessment.

scholarly journals Effectiveness of a smartphone-based, augmented reality exposure app to reduce fear of spiders in real-life: a randomized controlled trial

2021 ◽  
Author(s):  
Anja Zimmer ◽  
Nan Wang ◽  
Merle Ibach ◽  
Bernhard Fehlmann ◽  
Nathalie Schicktanz ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Augmented Reality ◽  
Controlled Trial ◽  
Intervention Group ◽  
Real Life ◽  
Control Group ◽  
Randomized Controlled ◽  
Distress Scale

Although in vivo exposure therapy is highly effective in the treatment of specific phobias, only a minority of patients seeks therapy. Exposure to virtual objects has been shown to be better tolerated, equally efficacious, but the technology has not been made widely accessible yet. We developed an augmented reality (AR) application (app) to reduce fear of spiders and performed a randomized controlled trial comparing the effects of our app (six 30-min sessions at home over a two-week period) with no intervention. Primary outcome was subjective fear, measured by a Subjective Units of Distress Scale (SUDS) in a Behavioural Approach Test (BAT) in a real-life spider situation at six weeks follow-up. Between Oct 7, 2019, and Dec 6, 2019, 66 individuals were enrolled and randomized. The intervention led to significantly lower subjective fear in the BAT compared to the control group (intervention group, baseline: 7·12 [SD 2·03] follow-up: 5·03 [SD 2·19] vs. control group, baseline: 7·06 [SD 2·34], follow-up 6·24 [SD 2.21]; adjusted group difference -1·24, 95% CI -2·17 to -0·31; Cohen’s d=0·57, p=0·01). The repeated use of the AR app reduces subjective fear in a real-life spider situation, providing a low-threshold and low-cost treatment for fear of spiders.

scholarly journals A Network Analysis of DSM-5 posttraumatic stress disorder symptoms and correlates in U.S. military veterans

2016 ◽  
Author(s):  
Eiko I Fried
Keyword(s):  
Suicidal Ideation ◽  
Cue Reactivity ◽  
Trauma Survivors ◽  
Ptsd Symptoms ◽  
Dsm 5 ◽  
Posttraumatic Stress Disorder Symptoms ◽  
Assessment And Treatment ◽  
Recent Developments ◽  
Nationally Representative ◽  
Anxiety Depression

Object: Recent developments in psychometrics enable the application ofnetwork models to analyze psychological disorders, such as PTSD. Instead ofunderstanding symptoms as indicators of an underlying common cause, thisapproach suggests symptoms co-occur in syndromes due to causalinteractions. The current study has two goals: (1) examine the networkstructure among the 20 DSM-5 PTSD symptoms, and (2) incorporate clinicallyrelevant variables to the network to investigate whether PTSD symptomsexhibit differential relationships with suicidal ideation, depression,anxiety, physical quality of life (QoL), mental QoL, age, and sex. Method:We utilized a nationally representative U.S. military veteran’s sample; andanalyzed the data from a subsample of 221 veterans who reported clinicallysignificant DSM-5 PTSD symptoms. Networks were estimated using Gaussiangraphical models and the lasso regularization. Results: The 20-item DSM-5PTSD network revealed that symptoms were positively connected within thenetwork. The most central symptoms were negative trauma-related emotions,flashbacks, detachment, and physiological cue reactivity. Especially strongconnections emerged between nightmares and flashbacks; blame of self orothers and negative trauma-related emotions, detachment and restrictedaffect; and hypervigilance and exaggerated startle response. Incorporationof clinically relevant covariates into the network revealed paths betweenself-destructive behavior and suicidal ideation; concentration difficultiesand anxiety, depression, and mental QoL; and depression and restrictedaffect. Conclusion: These results demonstrate the utility of a networkapproach in modeling the structure of DSM-5 PTSD symptoms, and suggestdifferential associations between specific DSM-5 PTSD symptoms and clinicaloutcomes in trauma survivors. Implications of these results for informingthe assessment and treatment of this disorder, are discussed.

Reclaiming Your Life from a Traumatic Experience

2019 ◽  
Author(s):  
Barbara Olasov Rothbaum ◽  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Sheila A.M. Rauch
Keyword(s):  
Stress Disorder ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Behavioral Therapy ◽  
Traumatic Experience ◽  
Traumatic Experiences ◽  
Trauma Survivors ◽  
Ptsd Symptoms ◽  
Prolonged Exposure Therapy ◽  
Fear And Anxiety

This workbook, written for patients, is part of a brief cognitive behavioral therapy (CBT) program for individuals who are diagnosed with posttraumatic stress disorder (PTSD) or who manifest PTSD symptoms that cause distress and/or dysfunction following various types of trauma. The overall aim of the treatment is to help trauma survivors emotionally process their traumatic experiences to diminish or eliminate PTSD and other trauma-related symptoms. The term “prolonged exposure” (PE) reflects the fact that the treatment program emerged from the long tradition of exposure therapy for anxiety disorders in which patients are helped to confront safe but anxiety-evoking situations to overcome their unrealistic, excessive fear and anxiety. PE is designed to get the patient in touch with these emotions and reactions. This workbook is a companion to the Therapist’s Guide, Prolonged Exposure Therapy for PTSD.

Cultural Variations in Resilience Capacity and Posttraumatic Stress: A Tri-Cultural Comparison

2019 ◽  
Vol 54 (2-3) ◽  
pp. 273-295
Author(s):  
Ping Zheng ◽  
Matt J. Gray ◽  
Wen-Jie Duan ◽  
Samuel M. Y. Ho ◽  
Mian Xia ◽  
...  
Keyword(s):  
Hong Kong ◽  
Posttraumatic Stress ◽  
Mainland China ◽  
Psychological Trauma ◽  
Trauma Survivors ◽  
Ptsd Symptoms ◽  
Cultural Variations ◽  
Resilience Scale ◽  
The Relationship ◽  
Resilience Capacity

Resilience capacity has been associated with individuals’ flexibility and adaptability in responding to potential trauma. Culture-related appraisals influence not only interpretations of etiology of posttraumatic stress disorder (PTSD) and perception of severity of PTSD symptoms but also flexible coping strategies. However, adequate research of the mechanisms on how culture may affect the relationship between resilience and PTSD does not yet exist. The present study focused on whether and how culture (America, Hong Kong, and Mainland China) moderated the relationship between resilience capacity and severity of posttraumatic distress. Data were collected at three research sites (America, Hong Kong, and Mainland China) where 558 trauma survivors were recruited. Measures included the Life Events Checklist ( LEC-5), the PTSD Checklist for DSM-5 ( PCL-5), and the Revised Connor-Davidson Resilience Scale ( CD-RISC-R). The results of one-way analysis of variance (ANOVA) indicated that American participants were more resilient than the participants in Hong Kong and Mainland China. The results of multiple regression indicated that frequency of exposure to trauma was a weaker predictor of severity of PTSD symptoms at high versus low levels of resilience capacity. The results also indicated a weaker moderating effect of Hong Kong versus American culture on the relation between resilience capacity and PTSD. This pilot study highlighted East–West cultural differences in the baselines of resilience capacity and posttraumatic stress and may motivate clinicians and researchers to reevaluate Western diagnostic criteria to psychological trauma conceptualization and treatment for non-Western populations.

scholarly journals Relationship between change in in-vivo exposure distress and PTSD symptoms during exposure therapy for active duty soldiers

2019 ◽  
Vol 116 ◽  
pp. 133-137 ◽  
Author(s):  
Aaron M. Norr ◽  
Kyle J. Bourassa ◽  
Elizabeth S. Stevens ◽  
Matthew J. Hawrilenko ◽  
Scott T. Michael ◽  
...  
Keyword(s):  
Exposure Therapy ◽  
Active Duty ◽  
Ptsd Symptoms

scholarly journals Patterns and Predictors of Subjective Units of Distress in Anxious Youth

2010 ◽  
Vol 38 (4) ◽  
pp. 497-504 ◽  
Author(s):  
Courtney L. Benjamin ◽  
Kelly A. O'Neil ◽  
Sarah A. Crawley ◽  
Rinad S. Beidas ◽  
Meredith Coles ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Hierarchical Linear Modeling ◽  
Behavioral Treatment ◽  
Separation Anxiety ◽  
Separation Anxiety Disorder ◽  
Cognitive Behavioral Treatment ◽  
Linear Modeling ◽  
Anxious Youth ◽  
Distress Scale

Background: Subjective Units of Distress Scale (SUDS) ratings are commonly used during exposure tasks in cognitive behavioral treatment (CBT) for anxiety. Aims: The present study examined patterns and predictors of SUDS in a sample of anxiety-disordered youth. Method: Youth (N = 99) aged 7 to 14 (M = 10.4, SD = 1.8) were treated with CBT for social phobia (SP), generalized anxiety disorder (GAD), and/or separation anxiety disorder (SAD). Analyses were conducted using hierarchical linear modeling. Results: Child's peak SUDS and magnitude of change in SUDS significantly increased between sessions. Higher child self-reported pretreatment total Multidimensional Anxiety Scale for Children (MASC) score predicted greater change in SUDS within the first exposure session. Primary GAD diagnosis predicted less increase in change in SUDS between sessions. Conclusions: Results suggest that higher pretreatment total MASC scores are associated with increased first exposure within-session habituation. Additionally, youth with a principal diagnosis of GAD experienced less between-session habituation, perhaps because they may have required more imaginal than in-vivo exposures.

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