scholarly journals Predicting treatment response in psychotherapy for posttraumatic stress disorder: A pilot study

Psihologija ◽  
2021 ◽  
Vol 54 (1) ◽  
pp. 1-14
Author(s):  
Lutz Wittmann ◽  
Julia Müller ◽  
Naser Morina ◽  
Andreas Maercker ◽  
Ulrich Schnyder
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Treatment Response ◽  
Time Course ◽  
Stress Disorder ◽  
Treatment Manual ◽  
Treatment Protocols ◽  
Increased Risk ◽  
Treatment Research ◽  
Pre Treatment

Prediction of treatment response to trauma-focused psychotherapy remains a difficult task. This study evaluated treatment response to Brief Eclectic Psychotherapy for posttraumatic stress disorder (BEPP) dependent on pre-treatment variables, symptom progression, and manual adherence. We tested differences in pre-treatment variables and symptom time course between treatment responders and non-responders in 27 patients, using exact regression analyses and general linear models. Associations of therapists? adherence to the treatment manual during different therapy phases with response status were also studied using independent samples t-test. Lower education and complete inability to work were negatively related to therapy outcome. Significant differences in symptom time course between responders and non-responders were detected from session nine onwards, whereas adherence to treatment was not related to outcome during any treatment phase. Our results indicate that early identification of treatment response may meaningfully expand previous research on outcome predicton based on pre-treatment variables in trauma-focused psychotherapy. Furthermore, adaptations of treatment protocols for specific groups of patients with increased risk of poor treatment outcomes may be advisable. If replicated by more naturalistic designs, our results could contribute towards limiting the requirement of strict manual adherence to efficacy studies in posttraumatic stress disorder treatment research.

Auditory N2 Correlates of Treatment Response in Posttraumatic Stress Disorder

2021 ◽  
Author(s):  
Gail D. Tillman ◽  
Michael A. Motes ◽  
Christina M. Bass ◽  
Elizabeth Ellen Morris ◽  
Penelope Jones ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Treatment Response ◽  
Stress Disorder

scholarly journals Time course of symptoms in posttraumatic stress disorder with delayed expression: a systematic review

2021 ◽  
Author(s):  
Jens Peter Ellekilde Bonde ◽  
Johan Høy Jensen ◽  
Geert E. Smid ◽  
Esben Meulengracht Flachs ◽  
Ask Elklit ◽  
...  
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Time Course ◽  
Stress Disorder

Abstract P127: Posttraumatic Stress Disorder and Risk for Coronary Heart Disease: A Meta-analytic Review

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Donald Edmondson ◽  
Ian M Kronish ◽  
Jonathan A Shaffer ◽  
Louise Falzon ◽  
Matthew M Burg
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Forest Plot ◽  
Increased Risk ◽  
Analytic Review

Context: Recent evidence suggests that posttraumatic stress disorder (PTSD) may be associated with increased risk for coronary heart disease (CHD). Objective: To determine the association of PTSD to incident CHD using systematic review and meta-analysis. Data Sources: Articles were identified by searching Ovid MEDLINE, PsycINFO, Scopus, Cochrane Library, PILOTS database, and through manual search of reference lists. Study Selection: Prospective cohort studies that assessed PTSD in participants free of CHD and assessed subsequent CHD or cardiac-specific mortality. Data Extraction: We extracted estimates of the association of PTSD to incident CHD, as well as study characteristics. Odds ratios were converted to hazard ratios (HR), and a random-effects model was used to pool results. Data Synthesis: Five studies met our inclusion criteria (N= 401,712); 4 of these included depression as a covariate. The pooled HR for the magnitude of the relationship between PTSD and CHD was 1.53 (95% CI, 1.27-1.84) before adjustment for depression. The pooled HR estimate for the 4 depression-adjusted estimates (N= 362,388) was 1.22 (95% CI, 1.05-1.42). Conclusion: PTSD is independently associated with increased risk for incident CHD, even after adjusting for depression and other covariates. Figure 1. Forest plot of association of PTSD to incident MI or cardiac mortality Note: The area of each square is proportional to the study’s weight in the meta-analysis, and each line represents the confidence interval around the estimate. The diamond represents the aggregate estimate, and its lateral points indicate confidence intervals for this estimate.

scholarly journals Time course of panic disorder and posttraumatic stress disorder onsets

2018 ◽  
Vol 54 (5) ◽  
pp. 639-647 ◽  
Author(s):  
Erin C. Berenz ◽  
Timothy P. York ◽  
Hanaan Bing-Canar ◽  
Ananda B. Amstadter ◽  
Briana Mezuk ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Panic Disorder ◽  
Posttraumatic Stress ◽  
Time Course ◽  
Stress Disorder

scholarly journals The Impact of Posttraumatic Stress Disorder on Clinical Presentation and Psychosocial Treatment Response in Youth with Functional Abdominal Pain Disorders: An Exploratory Study

Children ◽  
2020 ◽  
Vol 7 (6) ◽  
pp. 56
Author(s):  
Sarah Nelson ◽  
Natoshia Cunningham
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Abdominal Pain ◽  
Posttraumatic Stress ◽  
Treatment Response ◽  
Psychosocial Functioning ◽  
Stress Disorder ◽  
Pain Treatment ◽  
Psychosocial Treatment ◽  
Functional Abdominal Pain ◽  
The Impact

Youth with functional abdominal pain disorders (FAPDs) may report high rates of trauma and/or posttraumatic stress disorder (PTSD), which could impact both physical and psychosocial functioning, in addition to psychosocial treatment response. The current study aimed to examine the rates of PTSD in a sample of 89 youth with FAPDs and examine the association between PTSD with physical and psychosocial functioning. The impact of PTSD on psychosocial treatment response in a subsample of youth with FAPDs was also explored. Participants were youth with FAPDs (ages 9–14) enrolled in a larger study examining the effect of a short-term pain and anxiety focused cognitive behavioral therapy (CBT) treatment (Aim to Decrease Anxiety and Pain Treatment (ADAPT)) for youth with FAPDs. Youth were administered a semi-structured diagnostic interview by a trained clinician to confirm the presence of psychological diagnoses, including PTSD. Measures of physical and psychosocial functioning were also completed. Results revealed a high rate of PTSD in youth with FAPDs with 12.4% meeting diagnostic criteria for the disorder. PTSD was associated with several indicators of increased psychosocial impairment and one indicator of physical impairment. Exploratory analyses revealed comorbid PTSD may impact response to a brief CBT intervention targeting pain and anxiety, but more rigorous controlled studies are needed.

An Intensive Treatment Program for Chronic Posttraumatic Stress Disorder: 2-Year Outcome Data

1999 ◽  
Vol 33 (6) ◽  
pp. 848-854 ◽  
Author(s):  
Leanne Humphreys ◽  
John Westerink ◽  
Leah Giarratano ◽  
Robert Brooks
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Treatment Program ◽  
Vietnam Veterans ◽  
Stress Disorder ◽  
Outcome Data ◽  
Behaviour Therapy ◽  
Post Discharge ◽  
Cognitive Behaviour ◽  
Pre Treatment

Objective: The present study evaluates the efficacy of a closed-cohort treatment program for chronic posttraumatic stress disorder (PTSD). Method: The treatment orientation was a combined approach involving cognitive behaviour therapy and pharmacotherapy. Treatment involved an inpatient phase of 4 weeks, with group and individual follow-up sessions of at least 6-month duration. The treatment population consisted largely of Australian Vietnam veterans. Standardised psychometric measures were obtained pre-treatment, on completion of the residential phase; and at 6, 12 and 24 months post discharge from the residential program. Results: The results obtained from 64 patients demonstrate significant reductions in depression, anxiety and PTSD symptoms, maintained at 2 years post discharge from the residential phase of the treatment program. Conclusions: This paper presents encouraging findings for treatment with this troubled population.

scholarly journals Early onset neurocirculatory response to static handgrip is associated with greater blood pressure variability in women with posttraumatic stress disorder

2020 ◽  
Vol 318 (1) ◽  
pp. H49-H58 ◽  
Author(s):  
Jeung-Ki Yoo ◽  
Mark B. Badrov ◽  
Rosemary S. Parker ◽  
Elizabeth H. Anderson ◽  
Jessica L. Wiblin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Posttraumatic Stress Disorder ◽  
Muscle Contraction ◽  
Posttraumatic Stress ◽  
Early Onset ◽  
Stress Disorder ◽  
Muscle Sympathetic Nerve Activity ◽  
Pressor Responses ◽  
Increased Risk

Posttraumatic stress disorder (PTSD) is a psychiatric illness that is more prevalent in women, and accumulating evidence suggests a link between PTSD and future development of cardiovascular disease. The underlying mechanisms are unclear, but augmented sympathetic reactivity to daily stressors may be involved. We measured muscle sympathetic nerve activity (MSNA), blood pressure (BP), and heart rate responses in 14 women with PTSD and 14 healthy women (controls) during static handgrip (SHG) exercise to fatigue at 40% of maximal voluntary contraction (MVC). Two minutes of postexercise circulatory arrest (PECA) was followed immediately after SHG to fatigue. MVC and the time to fatigue during SHG did not differ between groups (both P > 0.05). At the first 30 s of SHG, women with PTSD showed augmented sympathetic neural [mean ± SD, ∆MSNA burst frequency (BF): 5 ± 4 vs. 2 ± 3 bursts/30 s, P = 0.02 and ∆MSNA total activity (TA): 82 ± 58 vs. 25 ± 38 arbitrary units/30 s, P = 0.004] and pressor (∆systolic BP: 10 ± 5 vs. 4 ± 3 mmHg, P = 0.003) responses compared with controls. However, MSNA and BP responses at fatigue and during PECA were not different between groups. More interestingly, the augmented initial neural and pressor responses to SHG were associated with greater awake systolic BP variability during ambulation in women with PTSD (MSNA BF: r = 0.55, MSNA TA: r = 0.62, and SBP: r = 0.69, all P < 0.05). These results suggest that early onset exercise pressor response in women with PTSD may be attributed to enhanced mechano- rather than metaboreflexes, which might contribute to the mechanisms underlying the link between PTSD and cardiovascular risk. NEW & NOTEWORTHY The novel findings of the current study are that women with posttraumatic stress disorder (PTSD) exhibited augmented sympathetic neural and pressor responses at the first 30 s of submaximal isometric muscle contraction. More interestingly, exaggerated neurocirculatory responses at the onset of muscle contraction were associated with greater ambulatory awake systolic blood pressure fluctuations in women with PTSD. Our findings expand the knowledge on the physiological mechanisms that perhaps contribute to increased risk of cardiovascular disease in such a population.

scholarly journals Depression and Psychosocial Stress Are Associated With Subclinical Carotid Atherosclerosis Among Women Living With HIV

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Matthew E. Levy ◽  
Kathryn Anastos ◽  
Steven R. Levine ◽  
Michael Plankey ◽  
Amanda D. Castel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Posttraumatic Stress Disorder ◽  
Depressive Symptoms ◽  
Posttraumatic Stress ◽  
Psychosocial Stress ◽  
Latent Class ◽  
Stress Disorder ◽  
Plaque Formation ◽  
Psychosocial Risk ◽  
Increased Risk

Background To identify reasons for increased atherosclerotic risk among women living with HIV ( WLWH ), we evaluated the associations between psychosocial risk factors (depressive symptoms, perceived stress, and posttraumatic stress disorder symptoms) and subclinical atherosclerosis among WLWH and HIV ‐negative women. Methods and Results Carotid artery focal plaque (localized intima‐media thickness >1.5 mm) was measured using B‐mode ultrasound imaging in 2004–2005 and 2010–2012 in the Women's Interagency HIV Study. We created psychosocial risk groups using latent class analysis and defined prevalent plaque at the final measurement. We also examined repeated semiannual depression measures with respect to focal plaque formation throughout follow‐up. The associations between latent class and prevalent plaque, and between depressive symptom persistence and plaque formation, were assessed separately by HIV status using multivariable logistic regression. Among 700 women (median age 47 years), 2 latent classes were identified: high (n=163) and low (n=537) psychosocial risk, with corresponding prevalence of depression (65%/13%), high stress (96%/12%), and probable posttraumatic stress disorder (46%/2%). Among WLWH , plaque prevalence was 23% and 11% in high versus low psychosocial risk classes (adjusted odds ratio [aOR], 2.12; 95% CI, 1.11–4.05) compared with 9% and 9% among HIV ‐negative women (aOR, 1.07; 95% CI, 0.24–4.84), respectively. New plaque formation occurred among 17% and 9% of WLWH who reported high depressive symptoms at ≥45% versus <45% of visits (aOR, 1.96; 95% CI, 1.06–3.64), compared with 9% and 7% among HIV ‐negative women (aOR, 0.82; 95% CI, 0.16–4.16), respectively. Conclusions Psychosocial factors were independent atherosclerotic risk factors among WLWH . Research is needed to determine whether interventions for depression and psychosocial stress can mitigate the increased risk of atherosclerosis for WLWH .

scholarly journals Posttraumatic stress disorder symptom trajectories within the first year following emergency department admissions: pooled results from the International Consortium to predict PTSD

2020 ◽  
pp. 1-11 ◽  
Author(s):  
Sarah R. Lowe ◽  
Andrew Ratanatharathorn ◽  
Betty S. Lai ◽  
Willem van der Mei ◽  
Anna C. Barbano ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Multinomial Logistic Regression ◽  
Female Gender ◽  
Interpersonal Trauma ◽  
Demographic Characteristics ◽  
Ptsd Symptoms ◽  
Symptom Trajectories ◽  
Increased Risk

Abstract Background Research exploring the longitudinal course of posttraumatic stress disorder (PTSD) symptoms has documented four modal trajectories (low, remitting, high, and delayed), with proportions varying across studies. Heterogeneity could be due to differences in trauma types and patient demographic characteristics. Methods This analysis pooled data from six longitudinal studies of adult survivors of civilian-related injuries admitted to general hospital emergency departments (EDs) in six countries (pooled N = 3083). Each study included at least three assessments of the clinician-administered PTSD scale in the first post-trauma year. Latent class growth analysis determined the proportion of participants exhibiting various PTSD symptom trajectories within and across the datasets. Multinomial logistic regression analyses examined demographic characteristics, type of event leading to the injury, and trauma history as predictors of trajectories differentiated by their initial severity and course. Results Five trajectories were found across the datasets: Low (64.5%), Remitting (16.9%), Moderate (6.7%), High (6.5%), and Delayed (5.5%). Female gender, non-white race, prior interpersonal trauma, and assaultive injuries were associated with increased risk for initial PTSD reactions. Female gender and assaultive injuries were associated with risk for membership in the Delayed (v. Low) trajectory, and lower education, prior interpersonal trauma, and assaultive injuries with risk for membership in the High (v. Remitting) trajectory. Conclusions The results suggest that over 30% of civilian-related injury survivors admitted to EDs experience moderate-to-high levels of PTSD symptoms within the first post-trauma year, with those reporting assaultive violence at increased risk of both immediate and longer-term symptoms.

The Cycle of Trauma: Relationship Aggression in Male Vietnam Veterans With Symptoms of Posttraumatic Stress Disorder

1996 ◽  
Vol 11 (3) ◽  
pp. 213-225 ◽  
Author(s):  
Christina A. Byrne ◽  
David S. Riggs
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Vietnam Veterans ◽  
Stress Disorder ◽  
Psychological Aggression ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Female Partners ◽  
Relationship Aggression ◽  
Increased Risk

This study examined the association between symptoms of Posttraumatic Stress Disorder (PTSD) in male Vietnam veterans and their use of aggressive behavior in relationships with intimate female partners. Fifty couples participated in the study. Veterans reported on their PTSD symptoms, and veterans and partners completed measures assessing the veterans’ use of physical, verbal,’ and psychological aggression during the preceding year as well as measures of their own perceptions of problems in the relationship. Results indicated that PTSD symptomatology places veterans at increased risk for perpetrating relationship aggression against their partners. The association between veterans’ PTSD symptoms and their use of aggression in relationships was mediated by relationship problems. Clinical implications of these findings and suggestions for future research are discussed.

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