scholarly journals Prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: task-shifting randomised controlled trial

2018 ◽  
Vol 213 (4) ◽  
pp. 587-594 ◽  
Author(s):  
Jaco Rossouw ◽  
Elna Yadin ◽  
Debra Alexander ◽  
Soraya Seedat
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Ptsd Symptom ◽  
Post Traumatic Stress ◽  
Supportive Counselling ◽  
Post Traumatic ◽  
Ptsd Symptom Severity

BackgroundEmpirical evidence on the effectiveness of evidence-based treatments for adolescents with post-traumatic stress disorder (PTSD) in low-resource settings is needed.AimsTo evaluate the comparative effectiveness of prolonged exposure and supportive counselling in adolescents with PTSD.MethodSixty-three adolescents (13–18 years) with PTSD were randomly assigned to receive either of the interventions comprising 7–14 sessions of treatment (trial registration in the Pan African Clinical Trials Registry: PACTR201511001345372). The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale at pre-treatment, post-treatment, and at 3- and 6-month follow-up.ResultsParticipants receiving prolonged exposure experienced greater improvement on the PTSD symptom severity scale than those receiving supportive counselling (between group differences at post-intervention, mean 12.49, 95% CI 6.82–18.17, P<0.001; d = 1.22). A similar effect size was maintained at 3-month (d = 0.85) and 6-month (d = 1.02) follow-up assessments.ConclusionsAdolescents with PTSD experienced greater benefit from prolonged exposure treatment when provided by non-specialist health workers (nurses) in a community setting.Declaration of interestNone.

Long-term follow-up of a randomised controlled trial of prolonged exposure therapy and supportive counselling for post-traumatic stress disorder in adolescents: a task-shifted intervention

2020 ◽  
pp. 1-9
Author(s):  
Jaco Rossouw ◽  
Elna Yadin ◽  
Debra Alexander ◽  
Soraya Seedat
Keyword(s):  
Prolonged Exposure ◽  
Ptsd Symptom ◽  
Post Treatment ◽  
Ptsd Symptoms ◽  
Post Traumatic Stress ◽  
Prolonged Exposure Therapy ◽  
Supportive Counselling ◽  
Post Traumatic ◽  
Ptsd Symptom Severity

Abstract Background Empirical evidence on the longer-term effectiveness of evidence-based treatments for adolescents with post-traumatic stress disorder (PTSD) in low-resource settings is needed. The aim of the study was to evaluate the maintenance of treatment gains achieved in a comparative study of effectiveness of prolonged exposure therapy for adolescents (PE-A) and supportive counselling (SC) in adolescents with PTSD up to 24-months post-treatment. Method Sixty-three adolescents (13–18 years) with PTSD were randomly assigned to receive either of the interventions comprising 7–14 sessions of treatment provided by trained and supervised non-specialist health workers (NSHWs). The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale, at pretreatment, post-treatment, and at 3-, 6-, 12- and 24-months post-treatment follow-up (FU) evaluations. Results Participants in both the prolonged exposure and SC treatment groups attained a significant reduction in PTSD symptoms and maintained this reduction in PTSD symptoms at 12- and 24-month assessment. Participants receiving prolonged exposure experienced greater improvement on the PTSD symptom severity scale than those receiving SC at 12-months FU [difference in PE-A v. SC mean scores = 9.24, 95% CI (3.66–14.83), p < 0.001; g = 0.88] and at 24-months FU [difference in PE-A v. SC mean scores = 9.35, 95% CI (3.53–15.17), p = 0.002; g = 0.68]. Conclusions Adolescents with PTSD continued to experience greater benefit from prolonged exposure treatment than SC provided by NSHWs in a community setting 12 and 24 months after completion of treatment.

Firefighter With Co-Morbid Psychogenic Non-Epileptic Seizures and Post-Traumatic Stress Disorder Treated With Prolonged Exposure Therapy: Long-Term Follow-Up

2020 ◽  
pp. 153465012096318
Author(s):  
Lorna Myers ◽  
Robert Trobliger ◽  
Shanneen Goszulak
Keyword(s):  
Seizure Frequency ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Prolonged Exposure ◽  
Epileptic Seizures ◽  
Psychological Trauma ◽  
Post Traumatic Stress ◽  
Post Traumatic

Psychogenic non-epileptic seizures (PNES), are events that resemble epileptic seizures but lack electrophysiological or clinical evidence for epilepsy. Instead, they are psychogenic in origin. These episodes tend to occur with alterations in consciousness and bodily functions and are the result of mechanisms of conversion. Psychological trauma and post-traumatic stress disorder (PTSD) are prevalent among patients with PNES. This is a case report of a 32-year-old male who began treatment 1-year after developing PTSD followed some months later by PNES. His seizures were characterized by contorted movements of the head and neck, guttural sounds, and left sided movements or whole-body arching and were accompanied by frequent falls and injuries. They were usually brief but occurred daily. Psychotherapy had been discontinued because violent seizures often interrupted the sessions. He was treated with prolonged exposure (PE) at a PNES program and by the last session, had achieved an improvement in his seizure frequency (one every 4–6 days rather than daily episodes). This allowed him to begin therapy with a local therapist. Two years after completing treatment, the patient returned for a follow up visit. At that point, his seizure frequency, was one per month which shows he sustained and improved on this symptom. Former head drops, and grunting sounds disappeared, and he was no longer using a cane to ambulate. From an emotional standpoint (PTSD, suicidality, anxiety, quality of life), the patient had achieved and maintained a much healthier level of functioning (though no change on alexithymia, anger, depression, and trait anxiety).

scholarly journals Post-traumatic stress disorder in serious accidental injury: 3-year follow-up study

2008 ◽  
Vol 192 (5) ◽  
pp. 376-383 ◽  
Author(s):  
Urs Hepp ◽  
Hanspeter Moergeli ◽  
Stefan Buchi ◽  
Helke Bruchhaus-Steinert ◽  
Bernd Kraemer ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
Post Traumatic Stress ◽  
Accidental Injury ◽  
Delayed Onset ◽  
Post Traumatic

BackgroundLong-term data on post-traumatic stress disorder (PTSD) following accidents are scarce.AimsTo assess and predict PTSD in people 3 years after severe accidental injury.MethodSeverely injured patients were recruited consecutively from the intensive care unit (n=121) and assessed within 1 month of the trauma. Follow-up interviews were conducted 6 months, 12 months and 36 months later; 90 patients participated in all four interviews. Symptoms were assessed using the Clinician-Administered PTSD Scale.ResultsPost-traumatic stress disorder was diagnosed in 6% of patients 2 weeks after the accident, in 2% after 1 year and in 4% after 3 years. Robust predictors of later PTSD symptom level were intrusive symptoms shortly after the accident and biographical risk factors. There were individual changes over time between the categories PTSD, sub-threshold PTSD and no PTSD. Whereas PTSD symptom severity was low or decreased for most of the patients, some of them showed an increase or a delayed onset. Patients with persisting PTSD symptoms at 6 months and patients with delayed onset of symptoms are at risk of long-term PTSD.ConclusionsThe prevalence of PTSD was low over the whole period of 3 years.

scholarly journals The association between body mass index and recovery from post-traumatic stress disorder after the nuclear accident in Fukushima

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masato Nagai ◽  
Tetsuya Ohira ◽  
Masaharu Maeda ◽  
Seiji Yasumura ◽  
Itaru Miura ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Error Variance ◽  
Normal Weight ◽  
Post Traumatic Stress ◽  
Post Traumatic

AbstractPost-traumatic stress disorder (PTSD) and obesity share common risk factors; however, the effect of obesity on recovery from PTSD has not been assessed. We examined the association between body mass index (BMI) and recovery from PTSD after the Great East Japan Earthquake. We analyzed 4356 men and women with probable PTSD aged ≥ 16 years who were living in evacuation zones owing to the radiation accident in Fukushima, Japan. Recovery from probable PTSD was defined as Post-traumatic Stress Disorder Checklist-specific scores < 44. Using Poisson regression with robust error variance adjusted for confounders, we compared the prevalence ratios (PRs) and 95% confidence intervals (CIs) for this outcome in 2013 and 2014. Compared with point estimates for normal weight (BMI: 18.5–24.9 kg/m2), especially in 2013, those for underweight (BMI: < 18.5 kg/m2) and obesity (BMI: ≥ 30.0 kg/m2) tended to slightly increase and decrease, respectively, for recovery from probable PTSD. The multivariate-adjusted PRs (95% CIs) for underweight and obesity were 1.08 (0.88–1.33) and 0.85 (0.68–1.06), respectively, in 2013 and 1.02 (0.82–1.26) and 0.87 (0.69–1.09), respectively, in 2014. The results of the present study showed that obesity may be a useful predictor for probable PTSD recovery. Obese victims with PTSD would require more intensive support and careful follow-up for recovery.

Putative Blood Somatic Mutations in Post-Traumatic Stress Disorder-Symptomatic Soldiers: High Impact of Cytoskeletal and Inflammatory Proteins

2021 ◽  
Vol 79 (4) ◽  
pp. 1723-1734
Author(s):  
Shlomo Sragovich ◽  
Michael Gershovits ◽  
Jacqueline C.K. Lam ◽  
Victor O.K. Li ◽  
Illana Gozes
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Somatic Mutations ◽  
Stress Disorder ◽  
Ptsd Symptom ◽  
High Impact ◽  
Post Traumatic Stress ◽  
Blood Samples ◽  
Post Traumatic ◽  
The Brain

Background: We recently discovered autism/intellectual disability somatic mutations in postmortem brains, presenting higher frequency in Alzheimer’s disease subjects, compared with the controls. We further revealed high impact cytoskeletal gene mutations, coupled with potential cytoskeleton-targeted repair mechanisms. Objective: The current study was aimed at further discerning if somatic mutations in brain diseases are presented only in the most affected tissue (the brain), or if blood samples phenocopy the brain, toward potential diagnostics. Methods: Variant calling analyses on an RNA-seq database including peripheral blood samples from 85 soldiers (58 controls and 27 with symptoms of post-traumatic stress disorder, PTSD) was performed. Results: High (e.g., protein truncating) as well as moderate impact (e.g., single amino acid change) germline and putative somatic mutations in thousands of genes were found. Further crossing the mutated genes with autism, intellectual disability, cytoskeleton, inflammation, and DNA repair databases, identified the highest number of cytoskeletal-mutated genes (187 high and 442 moderate impact). Most of the mutated genes were shared and only when crossed with the inflammation database, more putative high impact mutated genes specific to the PTSD-symptom cohorts versus the controls (14 versus 13) were revealed, highlighting tumor necrosis factor specifically in the PTSD-symptom cohorts. Conclusion: With microtubules and neuro-immune interactions playing essential roles in brain neuroprotection and Alzheimer-related neurodegeneration, the current mutation discoveries contribute to mechanistic understanding of PTSD and brain protection, as well as provide future diagnostics toward personalized military deployment strategies and drug design.

scholarly journals Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach

2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Expressive Writing ◽  
Stress Disorder ◽  
Post Treatment ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Severity

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.

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