Too painful to think about: chemsex and trauma

2019 ◽  
Vol 19 (1) ◽  
pp. 42-48
Author(s):  
Stephen Morris

Purpose Whilst chemsex is a relatively new phenomenon, trauma is not. Freud borrowed the word from physical medicine, where it was used to describe tissue damage, and applied it, for the first time, as a metaphor to a psychological process by which the protective functioning of the mind can too be pierced and wounded by events. The chemsex environment hosts a myriad of potentially traumatising scenarios and experiences, though perhaps disguised as exhilaration or excitement. The paper aims to discuss these issues. Design/methodology/approach The paper is a practitioner’s experience. Findings These experiences piled on top of childhood experiences of being “less than” for being gay, can be responsible for widespread undiagnosed post-traumatic stress disorder (PTSD) among those who engage in chemsex. This paper explores this possibility and offers solutions. Originality/value Compounded trauma and PTSD symptoms amongst MSM who engage in chemsex has to date, not been researched.

1994 ◽  
Vol 164 (4) ◽  
pp. 533-541 ◽  
Author(s):  
K. Vaughan ◽  
M. Wiese ◽  
R. Gold ◽  
N. Tarrier

A novel approach is described for the treatment of post-traumatic stress disorder (PTSD). Eye-movement desensitisation (EMD) requires the patient to generate images of the trauma in the mind and define physiological and emotional arousal states. While concentrating on these states, lateral multisaccardic eye movements are induced. Ten consecutive cases are reported who presented with symptoms originating from a range of traumas. The effectiveness of EMD in reducing symptoms outlined by DSM–III–R is described. An independent rater indicated that eight of the ten cases showed considerable improvement in PTSD symptoms following EMD, which was maintained at follow-up. Particular reference is given to the ‘specificity’ of EMD in treating symptoms and the changing pattern of effect at follow-up.


Author(s):  
Susanne Fischer ◽  
Tabea Schumacher ◽  
Christine Knaevelsrud ◽  
Ulrike Ehlert ◽  
Sarah Schumacher

Abstract Background Less than half of all individuals with post-traumatic stress disorder (PTSD) remit spontaneously and a large proportion of those seeking treatment do not respond sufficiently. This suggests that there may be subgroups of individuals who are in need of augmentative or alternative treatments. One of the most frequent pathophysiological findings in PTSD is alterations in the hypothalamic–pituitary–adrenal (HPA) axis, including enhanced negative feedback sensitivity and attenuated peripheral cortisol. Given the role of the HPA axis in cognition, this pattern may contribute to PTSD symptoms and interfere with key processes of standard first-line treatments, such as trauma-focused cognitive behavioural therapy (TF-CBT). Methods This review provides a comprehensive summary of the current state of research regarding the role of HPA axis functioning in PTSD symptoms and treatment. Results Overall, there is preliminary evidence that hypocortisolaemia contributes to symptom manifestation in PTSD; that it predicts non-responses to TF-CBT; and that it is subject to change in parallel with positive treatment trajectories. Moreover, there is evidence that genetic and epigenetic alterations within the genes NR3C1 and FKBP5 are associated with this hypocortisolaemic pattern and that some of these alterations change as symptoms improve over the course of treatment. Conclusions Future research priorities include investigations into the role of the HPA axis in day-to-day symptom variation, the time scale in which biological changes in response to treatment occur, and the effects of sex. Furthermore, before conceiving augmentative or alternative treatments that target the described mechanisms, multilevel studies are warranted.


2021 ◽  
pp. 088626052110219
Author(s):  
Matthew M. Yalch ◽  
Sloane R. M. Rickman

Intimate partner violence (IPV) is a common problem for women in the United States and is associated with symptoms of post-traumatic stress disorder (PTSD) as well as hazardous use of substances like alcohol and drugs. However, not all subtypes of IPV (i.e., physical, sexual, and psychological) are equally predictive of PTSD and hazardous substance use. Although previous research suggests that psychological IPV has the strongest relative effect on PTSD symptoms and substance use, there is less research on IPV subtypes’ cumulative effects. In this study, we examined the relative and cumulative effects of physical, sexual, and psychological IPV on PTSD symptoms and hazardous substance use in a sample of women in the United States recruited via Amazon’s Mechanical Turk ( N = 793) using bootstrapped multiple regression and configural frequency analyses. Results suggest that physical IPV had the most pronounced influence (medium-large effect sizes) on substance use across women, but that the cumulative effects of all three IPV subtypes were most closely associated with diagnostic levels of both PTSD and substance use at the level of groups of women. These findings clarify and extend previous research on the differential effects of IPV subtypes and provide directions for future research and clinical intervention.


2015 ◽  
Vol 206 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Mathew Hoskins ◽  
Jennifer Pearce ◽  
Andrew Bethell ◽  
Liliya Dankova ◽  
Corrado Barbui ◽  
...  

BackgroundPharmacological treatment is widely used for post-traumatic stress disorder (PTSD) despite questions over its efficacy.AimsTo determine the efficacy of all types of pharmacotherapy, as monotherapy, in reducing symptoms of PTSD, and to assess acceptability.MethodA systematic review and meta-analysis of randomised controlled trials was undertaken; 51 studies were included.ResultsSelective serotonin reuptake inhibitors were found to be statistically superior to placebo in reduction of PTSD symptoms but the effect size was small (standardised mean difference −0.23, 95% CI −0.33 to −0.12). For individual pharmacological agents compared with placebo in two or more trials, we found small statistically significant evidence of efficacy for fluoxetine, paroxetine and venlafaxine.ConclusionsSome drugs have a small positive impact on PTSD symptoms and are acceptable. Fluoxetine, paroxetine and venlafaxine may be considered as potential treatments for the disorder. For most drugs there is inadequate evidence regarding efficacy for PTSD, pointing to the need for more research in this area.


2021 ◽  
Vol 21 (2) ◽  
pp. 143-162
Author(s):  
Anwar Khan ◽  
Faseeh Ullah ◽  
Omer Abid ◽  
Khizra Hafeez Awan

"Post-Traumatic Stress Disorder (PTSD) develops after exposure to or witnessing traumatic events. PTSD is very common among the Spinal Cord Injury (SCI) patients. PTSD can be successfully treated with the Cognitive Behavioral Therapy (CBT). However, CBT is mostly used in the western countries, so its efficacy in the eastern culture is still not fully known. Keeping this in view, the current study has determined the efficacy of CBT in the treatment of PTSD among the SCI patients in Pakistan. Using a Randomized Controlled Pilot Study design, data were collected through the Clinician-Administered PTSD Scale for DSM-5 from thirty patients admitted to the Paraplegic Center. Trauma-focused CBT(TF-CBT) protocol was applied through fourteen sessions. Data were analyzed by descriptive and multivariate statistics. Findings show that the level of PTSD symptoms gradually decreased from high at baseline (CAPS-5 Mean Scores μ= 3.6) to low during follow-up stage (CAPS-5 Mean Scores μ= 0.89). Results obtained from the present study on the efficacy of CBT are in concurrence with the research findings in other countries. This study supports the efficiency CBT intervention among Pakistani patients who had developed PTSD symptoms after suffering from SCI. Therefore, CBT can be widely used in the management of PTSD in Pakistan."


2017 ◽  
Vol 16 (1) ◽  
pp. 37-44 ◽  
Author(s):  
Megan Kelly ◽  
Shihwe Wang ◽  
Robert Rosenheck

Purpose Veterans with post-traumatic stress disorder (PTSD) have high lifetime rates of smoking and often have substantial difficulty quitting. However, relatively little research has focussed on the use of Veterans Health Administration (VHA) intensive tobacco cessation counseling services by veterans with PTSD and the characteristics of veterans with PTSD who do and do not use these services. The paper aims to discuss these issues. Design/methodology/approach The present study is an analysis of national VHA administrative data fiscal year 2012 that identified utilization rates of VHA intensive tobacco cessation counseling among veterans with diagnoses of both PTSD and tobacco use disorder (TUD) (N=144,990) and the correlates of tobacco cessation counseling use. Findings Altogether, 7,921 veterans with PTSD diagnosed with TUD used VHA tobacco cessation services (5.5 percent). Veterans with PTSD who used tobacco cessation counseling services were more likely to have been homeless, to have a comorbid drug use disorder, and had used other VHA services more frequently than their counterparts who did not access tobacco cessation counseling. The use of outpatient mental health and substance use services was the strongest correlate of tobacco cessation counseling use by veterans in this sample. Notably, veterans with PTSD, TUD and HIV were more likely to engage in tobacco cessation services. Originality/value This study demonstrates that future efforts should focus on increasing provider and veteran awareness of and accessibility to VHA intensive tobacco cessation counseling for veterans with PTSD.


2010 ◽  
Vol 28 (23) ◽  
pp. 3754-3761 ◽  
Author(s):  
Katherine N. DuHamel ◽  
Catherine E. Mosher ◽  
Gary Winkel ◽  
Larissa E. Labay ◽  
Christine Rini ◽  
...  

Purpose A significant number of survivors of hematopoietic stem-cell transplantation (HSCT) report enduring adverse effects of treatment, including illness-related post-traumatic stress disorder (PTSD) symptoms and general distress. We report results of a randomized clinical trial that tested the effects of a 10-session, telephone-administered cognitive-behavioral therapy (CBT) intervention on PTSD, depression, and distress symptoms. Methods Survivors who had undergone HSCT 1 to 3 years earlier (N = 408) were assessed for study eligibility. Those who met study eligibility criteria (n = 89) completed a baseline assessment that included a clinical interview and self-report measures of PTSD symptoms (the primary outcome) and depression and general distress (the secondary outcomes). Next, they were randomly assigned to CBT or an assessment-only condition. Survivors in the CBT group completed 10 individual telephone-based CBT sessions (T-CBT) that included strategies to reduce PTSD symptoms, depression, and general distress. Follow-up assessments occurred at 6, 9, and 12 months after the baseline assessment. Results Linear mixed-model analyses revealed that, compared with HSCT survivors in the assessment-only condition, survivors who completed T-CBT reported fewer illness-related PTSD symptoms, including less avoidance (P < .001) and fewer intrusive thoughts (P < .05) as well as less general distress and fewer depressive symptoms (P < .05) even after controlling for potential demographic and medical covariates. These results were consistent across the three follow-up assessments. Conclusion A brief, telephone-administered CBT intervention developed for HSCT survivors is an efficacious treatment for reducing illness-related PTSD symptoms and general distress.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Nisha Kader ◽  
Bushra Elhusein ◽  
Nirvana Swamy Kudlur Chandrappa ◽  
Abdulqadir J. Nashwan ◽  
Prem Chandra ◽  
...  

Abstract Background Intensive care unit (ICU) staff have faced unprecedented challenges during the coronavirus disease 2019 (COVID-19) pandemic, which could significantly affect their mental health and well-being. The present study aimed to investigate perceived stress and post-traumatic stress disorder (PTSD) symptoms reported by ICU staff working directly with COVID-19 patients. Methods The Perceived Stress Scale was used to assess perceived stress, the PTSD Diagnostic Scale for the Diagnostic and Statistical Manual of Mental Disorders (5th edition) was used to determine PTSD symptoms, and a sociodemographic questionnaire was used to record different sociodemographic variables. Results Altogether, 124 participants (57.2% of whom were men) were included in the analysis. The majority of participants perceived working in the ICU with COVID-19 patients as moderately to severely stressful. Moreover, 71.4% of doctors and 74.4% of nurses experienced moderate-to-severe perceived stress. The staff with previous ICU experience were less likely to have a probable diagnosis of PTSD than those without previous ICU experience. Conclusions Assessing perceived stress levels and PTSD among ICU staff may enhance our understanding of COVID-19-induced mental health challenges. Specific strategies to enhance ICU staff’s mental well-being during the COVID-19 pandemic should be employed and monitored regularly. Interventions aimed at alleviating sources of anxiety in a high-stress environment may reduce the likelihood of developing PTSD.


2014 ◽  
Vol 4 (1) ◽  
pp. 19-32 ◽  
Author(s):  
Kristine A. Peace ◽  
Victoria E.S. Richards

Purpose – The purpose of this paper is to address how context for malingering and the provision of incentives influence malingered symptom profiles of post-traumatic stress disorder (PTSD). Design/methodology/approach – A 2 (case context)×3 (incentive) factorial design was utilized. Participants (n=298) were given an incentive (positive, negative, or no incentive), randomly assigned to a criminal or civil context, and asked to provide a fake claim of child abuse with corresponding malingered symptoms of PTSD. Under these conditions, participants completed several questionnaires pertaining to symptoms of trauma and PTSD. Findings – Results indicated that negative incentives were primarily associated with lower symptom scores. Therefore, “having something to lose” may result in more constrained (and realistic) symptom reports relative to exaggeration evidenced with positive incentives. Originality/value – These results have implications for forensic settings where malingered claims of PTSD are common and incentives for such claims (e.g. having something to gain or lose) frequently exist. Previous studies have failed to address incentives (positive and negative) in relation to a crime (i.e. abuse) that can span both criminal and civil contexts.


2019 ◽  
Vol 19 (2) ◽  
pp. 159-168 ◽  
Author(s):  
Deborah Oyine Aluh ◽  
Roland Nnaemeka Okoro ◽  
Adamu Zimboh

Purpose The purpose of this paper is to assess the prevalence of depression and post-traumatic stress disorder (PTSD) among internally displaced persons (IDPs) in Maiduguri. Design/methodology/approach The study was a cross-sectional study that took place among the six IDP camps located in Maiduguri metropolis in Borno State. A non-randomized technique was used to sample 1,200 respondents. Face-to-face interviews with selected members of households were carried out confidentially. The study used the Patient Health Questionnaire (PHQ-9) and Impact of Event Scale-6 which were translated to Kanuri. Descriptive and inferential statistics were employed using SPSS version 21. Findings The response rate was 100 percent. In total, 96.1 percent (1,153) of the respondents were depressed, while 78 percent (936) of the respondents were symptomatic for PTSD. The prevalence rate of comorbid PTSD with depression was 68.1 percent (817). About one-third of the respondents had moderately severe depression (29.6 percent, n=355) while about one in ten of them were severely depressed (11.3 percent, n=136). The odds of being depressed was 3.308 higher in people aged 51–60 years compared to people between 18 and 20 years. Significant predictors of depression in the sampled population were screening positive for PTSD and being unemployed. Practical implications The high prevalence of depression and PTSD among the sampled population calls for structured interventions to deal with mental health problems. The study findings suggest the need for more research (preferably qualitative) on the mental health issues in this population. Originality/value This study contributes to the sparse available literature on the mental health of IDPs in Nigeria.


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