Using Prolonged Exposure With an Older Male U.S. Veteran With Childhood Sexual Abuse-Related PTSD

2018 ◽  
Vol 18 (2) ◽  
pp. 115-127 ◽  
Author(s):  
Elissa McCarthy ◽  
Joan M. Cook
Keyword(s):  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Randomized Clinical Trials ◽  
Prolonged Exposure ◽  
Case Reports ◽  
Future Research ◽  
Sexual Assaults ◽  
Meaningful Improvement ◽  
Chronic Ptsd

Older adults have generally not been included in randomized clinical trials of psychotherapy for posttraumatic stress disorder (PTSD). Of the case reports and treatment outcome studies that have included those aged 55 and older, most did not include men with sexual abuse-related PTSD. This case report presents the successful application of Prolonged Exposure (PE) to a 58-year-old single, Caucasian noncombat U.S. Army veteran with severe, chronic PTSD related to several sexual assaults, including childhood sexual abuse. PE is a manualized, short-term, evidence-based psychotherapy for the treatment of PTSD which involves psychoeducation, breathing retraining, in vivo exposure, and imaginal exposure. PTSD and depressive symptoms demonstrated clinically meaningful improvement during the course of treatment. In addition, he experienced significant improvement in quality of life as well as meaning and purpose from baseline to posttreatment. Implications for clinically working with older men with untreated childhood sexual abuse-related PTSD later in life are presented. Future research directions are discussed.

scholarly journals Non-invasive imaging of the coronary arteries

2018 ◽  
Vol 40 (29) ◽  
pp. 2444-2454 ◽  
Author(s):  
Philip D Adamson ◽  
David E Newby
Keyword(s):  
Coronary Arteries ◽  
Randomized Clinical Trials ◽  
Rapid Development ◽  
Current Status ◽  
Future Research ◽  
Research Perspective ◽  
Non Invasive ◽  
Positron Emission ◽  
Prognostic Stratification

Abstract Non-invasive imaging of the coronary arteries is an enterprise in rapid development. From the research perspective, there is great demand for in vivo techniques that can reliably identify features of high-risk plaque that may offer insight into pathophysiological processes and act as surrogate indicators of response to therapeutic intervention. Meanwhile, there is clear clinical need for greater accuracy in diagnosis and prognostic stratification. Fortunately, ongoing technological improvements and emerging data from randomized clinical trials are helping make these elusive goals a reality. This review provides an update on the current status of non-invasive coronary imaging with computed tomography, magnetic resonance, and positron emission tomography with a focus on current clinical applications and future research directions.

Persisting Hallucinations following Childhood Sexual Abuse

1990 ◽  
Vol 24 (4) ◽  
pp. 561-565 ◽  
Author(s):  
Terry Heins ◽  
Allison Gray ◽  
Maxine Tennant
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Case Reports ◽  
Early Report ◽  
Psychotic Depression ◽  
Sensory Modalities

Hallucinations can persist for many years after childhood sexual abuse. If we recognise this, we will not mis-diagnose psychosis and we may treat with psychotherapy (talk). The hallucinations are distinct from hallucinations in schizophrenia though patients have frequently been given that diagnosis. They would generally be classified as pseudo-hallucinations. They are generally self-referential. They can involve all sensory modalities. Three case reports illustrate this link. Methods for interviewing and providing ongoing help are discussed. Issues in phenomenology and diagnosis are considered. Posttraumatic stress disorder is the best diagnostic fit, though psychotic depression may explain some cases. Freud's case of Frau P (1896) was an early report of this link.

scholarly journals Update on the Molecular Genetics of Timothy Syndrome

2021 ◽  
Vol 9 ◽  
Author(s):  
Rosemary Bauer ◽  
Katherine W. Timothy ◽  
Andy Golden
Keyword(s):  
Case Reports ◽  
Clinical Findings ◽  
Future Research ◽  
Timothy Syndrome ◽  
Genetic Changes ◽  
Neurodevelopmental Delay ◽  
Future Research Directions ◽  
Prolonged Qt Interval ◽  
Biophysical Changes

Timothy Syndrome (TS) (OMIM #601005) is a rare autosomal dominant syndrome caused by variants in CACNA1C, which encodes the α1C subunit of the voltage-gated calcium channel Cav1.2. TS is classically caused by only a few different genetic changes and characterized by prolonged QT interval, syndactyly, and neurodevelopmental delay; however, the number of identified TS-causing variants is growing, and the resulting symptom profiles are incredibly complex and variable. Here, we aim to review the genetic and clinical findings of all published case reports of TS to date. We discuss multiple possible mechanisms for the variability seen in clinical features across these cases, including mosaicism, genetic background, isoform complexity of CACNA1C and differential expression of transcripts, and biophysical changes in mutant CACNA1C channels. Finally, we propose future research directions such as variant validation, in vivo modeling, and natural history characterization.

Predictors of Victim–Perpetrator Relationship Stability Following a Sexual Assault: A Brief Report

2012 ◽  
Vol 27 (1) ◽  
pp. 25-32 ◽  
Author(s):  
Katie M. Edwards ◽  
Megan C. Kearns ◽  
Christine A. Gidycz ◽  
Karen S. Calhoun
Keyword(s):  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Sexual Assault ◽  
Sexual Coercion ◽  
Close Relationships ◽  
Future Research ◽  
Relationship Stability ◽  
The Relationship ◽  
Perpetrator Blame ◽  
Trauma Symptomatology

The researchers assessed the predictors of victim–perpetrator relationship stability following a sexual assault. Participants included 254 women sexually assaulted by a friend, casual dating partner, or steady dating partner. Results suggested that most victim–perpetrator relationships (75%) continued following the sexual assault. Greater trauma symptomatology, less perpetrator blame, and nondisclosure of the assault by victims predicted relationship continuation with the perpetrator. Additionally, the odds of continuing the relationship were greater following acts of sexual coercion than following acts of completed rape. Close relationships (steady dating partner) were more likely to continue following the sexual assault than less close relationships (friends and casual dating partners). Unexpectedly, the odds of relationship stability were greater for women without histories of childhood sexual abuse than women with histories of childhood sexual abuse. Implications for future research and intervention are discussed.

The Links Between Religiosity, Childhood Sexual Abuse, and Subsequent Marijuana Use

2011 ◽  
Vol 56 (6) ◽  
pp. 937-954 ◽  
Author(s):  
Doris C. Chu
Keyword(s):  
High School ◽  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Sexual Victimization ◽  
Negative Impact ◽  
Marijuana Use ◽  
Well Being ◽  
Policy Implications ◽  
Future Research ◽  
The Impact

A number of studies indicate that childhood sexual abuse (CSA) has a negative impact on later psychological well-being. It is well documented that experiences of CSA are associated with depression, self-destructiveness, and subsequent substance abuse or alcohol consumption. Compared with women who experienced no such sexual abuse in childhood, women who were victims of sexual abuse in childhood were more likely to be depressed and use drugs or consume alcohol in later life. Analyzing data of 1,569 females derived from the “Longitudinal Study of Violence Against Women,” this study examines whether the strain caused by sexual victimization leads to a higher level of subsequent marijuana use and whether religiosity moderates the negative effects of CSA. It was found that CSA was associated with an increased level of marijuana use in high school. However, more proximate sexual victimization (victimization in college) seemed to override the impact of CSA on subsequent marijuana use. Religiosity was found to moderate the effect of CSA on marijuana use in high school. Religiosity was negatively associated with marijuana use in high school as well as the second and fourth collegiate years. Policy implications and promising directions for future research are discussed.

The Role of Childhood Sexual Abuse (CSA) in Adult Cognitive Behaviour Therapy

2007 ◽  
Vol 35 (4) ◽  
pp. 447-455 ◽  
Author(s):  
Michael Linden ◽  
Ahmes Zehner
Keyword(s):  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Cognitive Behaviour Therapy ◽  
Suicide Attempts ◽  
Case Reports ◽  
Specific Treatment ◽  
Male Victims ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Therapeutic Schools

Sexual abuse in childhood is a pathogenetic factor for psychological disorders. The attention given to this phenomenon varies between therapists and therapeutic schools. The question is how often sexual abuse is recognized as a problem in cognitive behaviour therapy and how this is related to the present symptoms and therapeutic problems. 1223 case reports, written as application for reimbursement of routine cognitive behaviour therapy, were submitted to a content analysis in respect to childhood sexual abuse. Sexual abuse was mentioned in 10.3% of the cases; 59% of female and 50.0% of male victims were abused by relatives. Sexually abused patients showed significantly increased rates of inadequate care and negative life events during childhood. In comparison to controls, cases showed significantly increased rates of “eating disorders” (15 vs. 6; p<.05), “substance abuse/addiction” (16 vs. 6; p<.05), “suicide attempts” (15 vs. 3; p<.01), “strict refusal of sexual partners” (15 vs. 5; p<.05), “frequently changing partners” (21 vs. 3; p<.001), “problems in marriage/partnership” (95 vs. 77; p<.05) and “sexual problems” (51 vs. 24; p<.001). Childhood sexual abuse is a problem, frequently seen in behaviour therapy patients and therefore also warranting special attention in routine patient care. Sexual abuse is understood by cognitive behaviour therapists as an indicator for traumatizing conditions in general during childhood. It is associated with specific treatment problems and therapeutic needs in adulthood.

Older immigrant Latino gay men and childhood sexual abuse: Findings from the Palabras Fuertes project

2021 ◽  
pp. 147332502110276
Author(s):  
David Camacho ◽  
César V Rodriguez ◽  
Kiara L Moore ◽  
Ellen P Lukens
Keyword(s):  
Older Adults ◽  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Gay Men ◽  
Psychosocial Functioning ◽  
Work Experience ◽  
Future Research ◽  
Sexual Experiences ◽  
Latino Gay Men

Childhood Sexual Abuse (CSA) and maltreatment have long-term negative impacts on survivors, including older adults. Yet, limited qualitative examinations of how these experiences impact the lives of older adults exists and even fewer among older Latino gay men. We drew data from life-history narratives the first author conducted with five Spanish speaking older Latino gay men in New York City. Our analyses were guided by an Ecological Model, a Suffering lens, and our clinical social work experience with older adults, sexual minorities and people of color. All participants reported sexual experiences prior to the age of 15 and possible emotional and physical maltreatment. Yet, not all participants perceived these experiences as abuse. Our findings indicate how cultural, linguistic and contextual factors may affect disclosure and coping. Despite the fact that CSA and maltreatment occurred decades ago, these early experiences affected long-term psychosocial functioning. Our findings support a need for future research and clinical practice that considers the subjective perceptions of childhood sexual experiences and maltreatment and how these relate to psychosocial functioning in Latino gay men during older adulthood.

Responsivity to Stress in Chronic Posttraumatic Stress Disorder Due to Childhood Sexual Abuse

2004 ◽  
Vol 94 (2) ◽  
pp. 408-410 ◽  
Author(s):  
Ursula M. H. Klumpers ◽  
Leo Timmerman ◽  
Anton J. M. Loonen ◽  
Joke H. M. Tulen ◽  
Durk Fekkes ◽  
...  
Keyword(s):  
Sexual Abuse ◽  
Childhood Sexual Abuse ◽  
Stress Test ◽  
Adult Women ◽  
Stress Tests ◽  
Chronic Ptsd ◽  
Psychological Differences ◽  
Healthy Female ◽  
Stroop Color Word Test ◽  
Symptom Check List

The purpose of this study was to investigate psychological, cardiovascular, and neuroendocrine reactivity to standardized stress tests (orthostatic challenge, Stroop Color Word Test) in drug-free adult women with chronic PTSD due to repetitive childhood sexual abuse. At baseline, the 11 patients showed significantly higher mean scores on the Symptom Check List-90 and the Profile of Mood States than 13 healthy female controls, whereas baseline cardiovascular or hormonal parameters showed no differences between the groups. Also, no significant differences were found between the two groups in cardiovascular and hormonal responsivity to the stress tests. Thus, in the presence of robust psychological differences, the patients with chronic PTSD due to childhood sexual abuse did not show alterations in baseline values of neurobiological parameters, nor did they react differently to a physical and mental stress test when compared to healthy controls.

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