Empirically Supported Psychological Treatments: Prolonged Exposure

2012 ◽  
pp. 426-438 ◽  
Author(s):  
Nisha Nayak ◽  
Mark B. Powers ◽  
Edna B. Foa
Keyword(s):  
Treatment Program ◽  
Emotional Processing ◽  
Prolonged Exposure ◽  
Empirical Studies ◽  
Large Body ◽  
Empirically Supported ◽  
Processing Theory ◽  
Core Elements ◽  
Underlying Mechanisms

A large body of evidence supports the efficacy of exposure therapy for the treatment of anxiety disorders, including posttraumatic stress disorder (PTSD). This chapter discusses Prolonged Exposure (PE) therapy, a structured treatment program that uses imaginal and in vivo exposure as the core elements of treatment. It was first applied with survivors of sexual assault but has since been widely applied to survivors of all types of traumas. The chapter provides a description of the treatment program. It also discusses emotional processing theory and proposed underlying mechanisms of the therapy, including fear activation, habituation, and modification of dysfunctional beliefs. The chapter then reviews empirical studies, which have demonstrated the efficacy of PE, and data that support the generalizability of positive outcomes across trauma types, treatment settings, and cultures. Limitations and future directions for research are discussed.

Overview

2008 ◽  
pp. 1-4
Author(s):  
Kelly R. Chrestman ◽  
Eva Gilboa-Schechtman ◽  
Edna B. Foa
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Treatment Program ◽  
Emotional Processing ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Processing Theory ◽  
Prolonged Exposure Therapy

Chapter 1 presents an overview of the treatment program, and explores what posttraumatic stress disorder (PTSD) is, what prolonged exposure therapy for adolescents (PE-A) entails, emotional processing theory, and outlines the treatment program's structure.

Introduction

2007 ◽  
pp. 1-10
Author(s):  
Barbara Olasov Rothbaum ◽  
Edna B. Foa ◽  
Elizabeth A. Hembree
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Treatment Program ◽  
Emotional Processing ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Risks And Benefits ◽  
Processing Theory

Chapter 1 introduces and defines Posttraumatic Stress Disorder (PTSD), Prolonged Exposure (PE) Therapy, and Emotional Processing Theory, along with a background to the development of the PE treatment program, its risks and benefits, alternative treatments, the role of medications, and an outline of the program and its structure.

Introduction

2019 ◽  
pp. 1-10
Author(s):  
Barbara Olasov Rothbaum ◽  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Sheila A. M. Rauch
Keyword(s):  
Emotional Processing ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Perceived Threat ◽  
Imaginal Exposure ◽  
Loved One ◽  
Processing Theory ◽  
Therapy Program ◽  
Threat To Life

Posttraumatic stress disorder (PTSD) is a fear and stress disorder that may develop after an event that is experienced or witnessed and involves actual or perceived threat to life or physical integrity to oneself or a loved one. This chapter discusses the characteristics of the disorder and explains both prolonged exposure (PE) therapy and Emotional Processing Theory. Readers will learn about the benefits and risks of the treatment as well as what is involved. The main tools of this therapy program, imaginal exposure and in vivo exposure, are presented.

Foundations of Prolonged Exposure

2019 ◽  
pp. 1-22
Author(s):  
Edna B. Foa ◽  
Elizabeth A. Hembree ◽  
Barbara Olasov Rothbaum ◽  
Sheila A. M. Rauch
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Emotional Distress ◽  
Emotional Processing ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Traumatic Events ◽  
Ptsd Symptoms ◽  
Imaginal Exposure

Foundations of prolonged exposure (PE) include (1) education about common reactions to trauma, what maintains trauma-related symptoms, and how PE reduces posttraumatic stress disorder (PTSD) symptoms; (2) repeated in vivo confrontation with situations, people, or objects that the patient is avoiding because they are trauma-related and cause emotional distress such as anxiety, shame, or guilt; and (3) repeated, prolonged imaginal exposure to the trauma memories followed by processing the details of the event, the emotions, and the thoughts that the patient experienced during the trauma. The aim of in vivo and imaginal exposure is to enhance emotional processing of traumatic events by helping the patient face the trauma memories and reminders and process the emotions and thoughts, as well as the details of the trauma that emerge during revisiting experiences.

Foundations of Prolonged Exposure

2020 ◽  
pp. 1-10
Author(s):  
Sheila A. M. Rauch ◽  
Barbara O. Rothbaum ◽  
Erin R. Smith ◽  
Edna B. Foa
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Emotional Processing ◽  
Prolonged Exposure ◽  
Mechanisms Of Change ◽  
Alternative Treatments ◽  
Processing Theory ◽  
Outpatient Program ◽  
Intensive Outpatient Program ◽  
Intensive Outpatient

This chapter presents the foundations for prolonged exposure (PE) therapy as they have been developed in emotional processing theory to immerse the provider in theory that will guide all decisions during PE, whether they are using the intensive outpatient program (PE-IOP) in this manual or another model (e.g., PE-Primary Care, or standard PE). The authors present a discussion on how PE works and on the research supporting the theorized mechanisms of change. In addition, alternative treatments are described, including medication and considerations for patients who are already on medications when they are engaged in PE-IOP. The chapter ends with a discussion of why this PE-IOP model was developed and when it may be indicated for patient care.

Prolonged Exposure Therapy for PTSD

2019 ◽  
Author(s):  
Edna Foa ◽  
Elizabeth A. Hembree ◽  
Barbara Olasov Rothbaum ◽  
Sheila Rauch
Keyword(s):  
Emotional Processing ◽  
Prolonged Exposure ◽  
Exposure Therapy ◽  
Behavioral Therapy ◽  
Traumatic Experience ◽  
Traumatic Experiences ◽  
Traumatic Memory ◽  
Ptsd Symptoms ◽  
Intensive Training ◽  
Processing Theory

This therapist guide of prolonged exposure (PE) treatment is accompanied by the patient workbook, Reclaiming Your Life from a Traumatic Experience. The treatment and manuals are designed for use by a therapist who is familiar with cognitive behavioral therapy (CBT) and who has undergone an intensive training workshop for prolonged exposure by experts in this therapy. The therapist guide instructs therapists to implement this brief CBT program that targets 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. At the same time, PE has emerged from the adaption and extension of Emotional Processing Theory (EPT) to PTSD, which emphasizes the central role of successfully processing the traumatic memory in the amelioration of PTSD symptoms. Throughout this guide, the authors highlight that emotional processing is the mechanism underlying successful reduction of PTSD symptoms.

Exposure in PE-IOP

2020 ◽  
pp. 47-88
Author(s):  
Sheila A. M. Rauch ◽  
Barbara O. Rothbaum ◽  
Erin R. Smith ◽  
Edna B. Foa
Keyword(s):  
Emotional Processing ◽  
Prolonged Exposure ◽  
Imaginal Exposure ◽  
Exposure Session ◽  
Outpatient Program ◽  
Intensive Outpatient Program ◽  
Intensive Outpatient ◽  
The Individual

This chapter presents in-depth details of how to implement the exposure component of the Prolonged Exposure-Intensive Outpatient Program (PE-IOP), including places where variation is acceptable and why. The authors present the logistics and rationale for individual sessions that include imaginal exposure and individualized trauma emotional processing. In addition, the authors present in vivo group exposure session logistics and rationale. The in vivo group includes the general psychoeducation components of PE, the in vivo exposure hierarchy creation, and the practice of in vivo exposure. The exposures may occur in a group or individually, escorted or non-escorted, as clinically indicated for the individual patient.

scholarly journals Cadmium and Its Neurotoxic Effects

2013 ◽  
Vol 2013 ◽  
pp. 1-12 ◽  
Author(s):  
Bo Wang ◽  
Yanli Du
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Prolonged Exposure ◽  
Epigenetic Modification ◽  
The Body ◽  
Functional Changes ◽  
Neurotoxic Effects ◽  
Underlying Mechanisms

Cadmium (Cd) is a heavy metal that has received considerable concern environmentally and occupationally. Cd has a long biological half-life mainly due to its low rate of excretion from the body. Thus, prolonged exposure to Cd will cause toxic effect due to its accumulation over time in a variety of tissues, including kidneys, liver, central nervous system (CNS), and peripheral neuronal systems. Cd can be uptaken from the nasal mucosa or olfactory pathways into the peripheral and central neurons; for the latter, Cd can increase the blood brain barrier (BBB) permeability. However, mechanisms underlying Cd neurotoxicity remain not completely understood. Effect of Cd neurotransmitter, oxidative damage, interaction with other metals such as cobalt and zinc, estrogen-like, effect and epigenetic modification may all be the underlying mechanisms. Here, we review thein vitroandin vivoevidence of neurotoxic effects of Cd. The available finding indicates the neurotoxic effects of Cd that was associated with both biochemical changes of the cell and functional changes of central nervous system, suggesting that neurotoxic effects may play a role in the systemic toxic effects of the exposure to Cd, particularly the long-term exposure.

Anthocyanins As Modulators of Cell Redox-Dependent Pathways in Non-Communicable Diseases

2020 ◽  
Vol 27 (12) ◽  
pp. 1955-1996 ◽  
Author(s):  
Antonio Speciale ◽  
Antonella Saija ◽  
Romina Bashllari ◽  
Maria Sofia Molonia ◽  
Claudia Muscarà ◽  
...  
Keyword(s):  
Human Health ◽  
Biological Activities ◽  
Wide Spectrum ◽  
Antioxidant Defenses ◽  
Noncommunicable Diseases ◽  
Protective Effects ◽  
Pathological Conditions ◽  
Chronic Pulmonary Diseases ◽  
Underlying Mechanisms

: Chronic Noncommunicable Diseases (NCDs), mostly represented by cardiovascular diseases, diabetes, chronic pulmonary diseases, cancers, and several chronic pathologies, are one of the main causes of morbidity and mortality, and are mainly related to the occurrence of metabolic risk factors. Anthocyanins (ACNs) possess a wide spectrum of biological activities, such as anti-inflammatory, antioxidant, cardioprotective and chemopreventive properties, which are able to promote human health. Although ACNs present an apparent low bioavailability, their metabolites may play an important role in the in vivo protective effects observed. : This article directly addresses the scientific evidences supporting that ACNs could be useful to protect human population against several NCDs not only acting as antioxidant but through their capability to modulate cell redox-dependent signaling. In particular, ACNs interact with the NF-κB and AP-1 signal transduction pathways, which respond to oxidative signals and mediate a proinflammatory effect, and the Nrf2/ARE pathway and its regulated cytoprotective proteins (GST, NQO, HO-1, etc.), involved in both cellular antioxidant defenses and elimination/inactivation of toxic compounds, so countering the alterations caused by conditions of chemical/oxidative stress. In addition, supposed crosstalks could contribute to explain the protective effects of ACNs in different pathological conditions characterized by an altered balance among these pathways. Thus, this review underlines the importance of specific nutritional molecules for human health and focuses on the molecular targets and the underlying mechanisms of ACNs against various diseases.

Phytosomal Curcumin Elicits Anti-tumor Properties Through Suppression of Angiogenesis, Cell Proliferation and Induction of Oxidative Stress in Colorectal Cancer

2019 ◽  
Vol 24 (39) ◽  
pp. 4626-4638 ◽  
Author(s):  
Reyhaneh Moradi-Marjaneh ◽  
Seyed M. Hassanian ◽  
Farzad Rahmani ◽  
Seyed H. Aghaee-Bakhtiari ◽  
Amir Avan ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Colorectal Cancer ◽  
Therapeutic Potential ◽  
Vegf Signaling ◽  
Anticancer Effects ◽  
Inhibition Of Angiogenesis ◽  
Underlying Mechanisms ◽  
Apoptotic Activity

Background: Colorectal cancer (CRC) is one of the most common causes of cancer-associated mortality in the world. Anti-tumor effect of curcumin has been shown in different cancers; however, the therapeutic potential of novel phytosomal curcumin, as well as the underlying molecular mechanism in CRC, has not yet been explored. Methods: The anti-proliferative, anti-migratory and apoptotic activity of phytosomal curcumin in CT26 cells was assessed by MTT assay, wound healing assay and Flow cytometry, respectively. Phytosomal curcumin was also tested for its in-vivo activity in a xenograft mouse model of CRC. In addition, oxidant/antioxidant activity was examined by DCFH-DA assay in vitro, measurement of malondialdehyde (MDA), Thiol and superoxidedismutase (SOD) and catalase (CAT) activity and also evaluation of expression levels of Nrf2 and GCLM by qRT-PCR in tumor tissues. In addition, the effect of phytosomal curcumin on angiogenesis was assessed by the measurement of VEGF-A and VEGFR-1 and VEGF signaling regulatory microRNAs (miRNAs) in tumor tissue. Results: Phytosomal curcumin exerts anti-proliferative, anti-migratory and apoptotic activity in-vitro. It also decreases tumor growth and augmented 5-fluorouracil (5-FU) anti-tumor effect in-vivo. In addition, our data showed that induction of oxidative stress and inhibition of angiogenesis through modulation of VEGF signaling regulatory miRNAs might be underlying mechanisms by which phytosomal curcumin exerted its antitumor effect. Conclusion: Our data confirmed this notion that phytosomal curcumin administrates anticancer effects and can be used as a complementary treatment in clinical settings.

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