Determining Psychoneuroimmunologic Markers of Yoga as an Intervention for Persons Diagnosed With PTSD: A Systematic Review

2017 ◽  
Vol 20 (3) ◽  
pp. 343-351 ◽  
Author(s):  
Ursula Ann Kelly ◽  
Dian Dowling Evans ◽  
Helen Baker ◽  
Jessica Noggle Taylor

There is a growing body of research on yoga as a therapeutic intervention for psychological symptoms of post-traumatic stress disorder (PTSD) accompanied by speculations on underlying physiologic mechanisms. The purpose of this systematic review is to identify, qualitatively evaluate, and synthesize studies of yoga as an intervention for PTSD that measured physiologic outcomes in order to gain insights into potential mechanisms. The focus is on studies evaluating yoga as a therapeutic intervention for PTSD rather than for trauma exposure, PTSD prevention, or subclinical PTSD. Multiple databases were searched for publications from the past two decades using terms derived from the question, “In people with PTSD, what is the effect of yoga on objective outcomes?” Eligibility criteria included yoga-only modalities tested as an intervention for formally diagnosed PTSD with at least one physiologic outcome. Results of this review confirmed that, though much of the published literature proposes physiological mechanisms underlying yoga’s effects on PTSD, very few studies ( n = 3) have actually evaluated physiological evidence. Additionally, several studies had methodological limitations. In light of the limited data supporting yoga’s beneficial effects on autonomic nervous system dysregulation, we present a theoretical model of the psychoneuroimmunologic processes associated with PTSD and the effects yoga may have on these processes to guide future research. Gaps in the literature remain for mechanisms related to activation of the hypothalamic–pituitary–adrenal axis and inflammation. Additional rigorous mechanistic studies are needed to guide development of effective yoga interventions for PTSD to augment existing evidence-based PTSD treatments.

2020 ◽  
Author(s):  
Zhuoni Xiao ◽  
Mina Murat Baldwin ◽  
Franziska Meinck ◽  
Ingrid Obsuth ◽  
Aja Louise Murray

Abstract Background: Research suggests that childhood psychological maltreatment (i.e., emotional abuse and emotional neglect) is associated with mental and physical health problems that persist into adulthood, for example anxiety, depression, post-traumatic stress disorder (PTSD), suicidal ideation, and aggression; however, a systematic review and meta-analysis of the existing literature would help clarify the magnitude and moderators of these associations, and the extent to which they may be affected by publication bias, as well as the methodological strengths and weakness of studies in this area.Method: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline will be employed to structure the review. Several searches will be carried out via databases including Web of Science, Medline, PubMed, PsycINFO, Applied Social Science Index and Abstract, ERIC and EMBASE. Empirical peer reviewed research articles that fit pre-specified eligibility criteria will be included in the review. This review will include literature written in either English or Chinese. Two independent reviewers will screen and assess studies for inclusion in the review as well as extract the data, with consensus reached through discussion in cases of discrepancy. A third reviewer will be consulted to resolve any discrepancies that cannot be resolved through discussion between the original reviewers. The relevant Newcastle-Ottawa scales will be used for assessing the quality of studies. If a sufficient number of comparable studies are retrieved, a meta-analysis will be conducted using a random effects model. Discussion: This systematic review will provide an understanding of the long-term effects of childhood psychological maltreatment on adult mental health, which adds to previous reviews focusing primarily on the effects of physical and sexual abuse. The results of the review will help inform clinical practice in approaches to treating those with a history of psychological maltreatment in childhood. The gaps and weaknesses in the evidence identified will also inform recommendations for future research.


2020 ◽  
Author(s):  
Meg Blackie ◽  
Kathleen De Boer ◽  
Elizabeth Seabrook ◽  
Glen William Bates ◽  
Maja Nedeljkovic

The 11th edition of the International Classification of Disease has included Complex Post-Traumatic Stress Disorder (cPTSD) as a clinical diagnosis separate to Post-Traumatic Stress Disorder (PTSD). Research has shown that cPTSD differs significantly from PTSD on core symptoms relating to the individual’s sense of self; which has driven research investigating treatment approaches to address these specific features of cPTSD. Evidence for effective treatments for cPTSD delivered within in-person settings has been synthesised, however, authors have noted significant access barriers to such specialised treatments. Digital-based intervention (DBI) approaches may overcome such access barriers and have shown effectiveness in treating non-complex PTSD across several systematic reviews and meta-analyses. The current protocol however, proposes a methodology for conducting the first systematic review of research investigating the use of DBIs for treating cPTSD, as there has not yet been a comprehensive synthesis of this research. The review seeks to understand (1) the treatment approaches employed in DBIs for addressing symptoms of cPTSD, (2) the symptoms of cPTSD that are targeted by DBIs, (3) the evidence for the acceptability and effectiveness of DBIs in treating symptoms of cPTSD, and (4) measures taken to ensure the safe and confidential delivery of DBIs for cPTSD. A systematic search of Scopus, PsychINFO, and EBSCOhost is proposed, using search terms targeting ‘cPTSD’ and ‘DBIs’. Literature will be screened against eligibility criteria by two independent reviewers and included studies will be assessed for quality using the Quality Assessment Tool for Quantitative Studies. Data will be extracted by the same two reviewers, then analysed and synthesised in narrative form by a single reviewer. The findings from the systematic review will provide an understanding of the state of current evidence and inform directions for direct future research aiming to develop effective DBIs for cPTSD.


2020 ◽  
Author(s):  
Kurt D Shulver ◽  
Nicholas A Badcock

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.


2021 ◽  
Vol 14 ◽  
Author(s):  
Joel Owen ◽  
Louise Crouch-Read ◽  
Matthew Smith ◽  
Paul Fisher

Abstract For more than a decade, Improving Access to Psychological Therapies (IAPT) has been training a new workforce of psychological therapists. Despite evidence of stress and burnout both in trainee mental health professionals, and qualified IAPT clinicians, little is known about these topics in IAPT trainees. Consequently, this systematic review sought to establish the current state of the literature regarding stress and burnout in IAPT trainees. Electronic databases were searched to identify all published and available unpublished work relating to the topic. On the basis of pre-established eligibility criteria, eight studies (including six unpublished doctoral theses) were identified and assessed for quality. This review identifies that research into the experience of IAPT trainees is under-developed. Existing evidence tentatively suggests that IAPT trainees may experience levels of stress and burnout that are higher than their qualified peers and among the higher end of healthcare professionals more generally. The experience of fulfilling dual roles as mental health professionals and university students concurrently appears to be a significant source of stress for IAPT trainees. More research regarding the levels and sources of stress and burnout in IAPT trainees is urgently needed to confirm and extend these findings. Recommendations for future research in the area are given. Key learning aims (1) To establish the current state of the literature regarding stress and burnout in IAPT trainees. (2) To raise practitioner, service and education-provider awareness regarding the levels and perceived sources of stress and burnout in IAPT trainees. (3) To make recommendations regarding future research on the topic.


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.


2004 ◽  
Vol 21 (3) ◽  
pp. 100-103 ◽  
Author(s):  
Paul Mooney ◽  
Janette Oakley ◽  
Michael Ferriter ◽  
Raymond Travers

AbstractObjective: Post-traumatic stress disorder (PTSD) is one of the most prevalent psychological disorders. Methods to alleviate its symptoms range from ‘talking therapies’ to pharmaceutical interventions. Our objective was to carry out a systematic review of the effectiveness of sertraline, an SSRI, as a treatment for PTSD.Method: Databases were searched to identify relevant research on sertraline as a treatment for PTSD.Results: Five randomised control trials were identified, along with seven open trials and case series studies.Conclusions: The review and meta-analysis supported the use of sertraline for PTSD though further research on sub-group differences (eg. gender) is required.


2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.


2018 ◽  
Vol 92 (1) ◽  
pp. 131-147 ◽  
Author(s):  
Natalie Barazzone ◽  
Ines Santos ◽  
John McGowan ◽  
Eloise Donaghay-Spire

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