scholarly journals Uncharted Waters: Treating Trauma Symptoms in the Context of Early Psychosis

2019 ◽  
Vol 8 (9) ◽  
pp. 1456 ◽  
Author(s):  
Folk ◽  
Tully ◽  
Blacker ◽  
Liles ◽  
Bolden ◽  
...  

Psychosis is conceptualized in a neurodevelopmental vulnerability-stress framework, and childhood trauma is one environmental factor that can lead to psychotic symptoms and the development of psychotic disorders. Higher rates of trauma are associated with higher psychosis risk and greater symptom frequency and severity, resulting in increased hospitalization rates and demand on outpatient primary care and mental health services. Despite an estimated 70% of individuals in the early stages of psychosis reporting a history of experiencing traumatic events, trauma effects (post-traumatic anxiety or depressive symptoms) are often overlooked in psychosis treatment and current interventions typically do not target commonly comorbid post-traumatic stress symptoms. We presented a protocol for Trauma-Integrated Cognitive Behavioral Therapy for Psychosis (TI-CBTp), an approach to treating post-traumatic stress symptoms in the context of early psychosis care. We provided a brief summary of TI-CBTp as implemented in the context of Coordinated Specialty Care and presented preliminary data supporting the use of TI-CBTp in early psychosis care. The preliminary results suggest that individuals with comorbid psychosis and post-traumatic stress symptoms can be appropriately and safely treated using TI-CBTp within Coordinated Specialty Care.

2020 ◽  
pp. 1-8
Author(s):  
Amy Hardy ◽  
Ciaran O'Driscoll ◽  
Craig Steel ◽  
Mark van der Gaag ◽  
David van den Berg

Abstract Background Understanding the interplay between trauma-related psychological mechanisms and psychotic symptoms may improve the effectiveness of interventions for post-traumatic stress reactions in psychosis. Network theory assumes that mental health problems persist not because of a common latent variable, but from dynamic feedback loops between symptoms, thereby addressing the heterogeneous and overlapping nature of traumagenic and psychotic diagnoses. This is a proof-of-concept study examining interactions between post-traumatic stress symptoms, which were hypothesized to reflect trauma-related psychological mechanisms, and auditory hallucinations and delusions. Method Baseline data from two randomised controlled trials (N = 216) of trauma-focused therapy in people with post-traumatic stress symptoms (87.5% met diagnostic criteria for PTSD) and psychotic disorder were analysed. Reexperiencing, hyperarousal, avoidance, trauma-related beliefs, auditory hallucinations and delusional beliefs were used to estimate a Gaussian graphical model along with expected node influence and predictability (proportion of explained variance). Results Trauma-related beliefs had the largest direct influence on the network and, together with hypervigilance, were implicated in the shortest paths from flashbacks to delusions and auditory hallucinations. Conclusions These findings are in contrast to previous research suggesting a central role for re-experiencing, emotional numbing and interpersonal avoidance in psychosis. Trauma-related beliefs were the psychological mechanism most associated with psychotic symptoms, although not all relevant mechanisms were measured. This work demonstrates that investigating multiple putative mediators may clarify which processes are most relevant to trauma-related psychosis. Further research should use network modelling to investigate how the spectrum of traumatic stress reactions play a role in psychotic symptoms.


2010 ◽  
Author(s):  
S. Gascon ◽  
J. P. Pereira ◽  
M. J. Cunha ◽  
M. A. Santed ◽  
B. Martinez-Jarreta

2019 ◽  
pp. 74-80
Author(s):  
Thi Tan Nguyen ◽  
Van Minh Doan ◽  
Nhat Minh Tran ◽  
Van Hung Nguyen

Post-traumatic Stress Disorder (PTSD) is a mental disorder that develops in people who have experienced or witnessed a serious traumatic event, such as natural catastrophes, sexual assaults, war… Some studies showed that acupuncture was effective for PTSD. However, there is no published research on the treatment of PTSD using acupuncture and cognitive behavioral therapy (CBT) in Vietnam. The aim of this study was to evaluate the effectiveness of treating PTSD using acupuncture combined with CBT in Thua Thien Hue province. Method and subject: This study was an interventional study conducted in two districts of Thua Thien Hue province. Thirty patients were diagnosed with PTSD using Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Participants were assessed on PTSD symptoms using PTSD Checklist for DSM-5 (PCL–5); depression, anxiety and stress status using DASS-21; and other health states before and after treatment. Result: The effectiveness rate of treatment was 83.3% by PCL–5 and 86.7% by DASS-21. The improvement of symptoms after 5 weeks of treatment was statistically significant (p <0.05). Side effects were itch (5.0%), pain (4.3%); bleeding (1.3%); and others (0%). Conclusion: Treatment of PTSD using acupuncture and CBT has a high effectiveness rate on PCL - 5 scale and DASS21 scale. Improvement was similar when evaluated by the two scales. Acupuncture was safe and did not cause any significant side effects. Key words: Post-traumatic Stress Disorder, PTSD, acupuncture, cognitive behavior therapy, CBT, Thua Thien Hue


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
T. Dolev ◽  
S. Zubedat ◽  
Z. Brand ◽  
B. Bloch ◽  
E. Mader ◽  
...  

AbstractLack of established knowledge and treatment strategies, and change in work environment, may altogether critically affect the mental health and functioning of physicians treating COVID-19 patients. Thus, we examined whether treating COVID-19 patients affect the physicians’ mental health differently compared with physicians treating non-COVID-19 patients. In this cohort study, an association was blindly computed between physiologically measured anxiety and attention vigilance (collected from 1 May 2014 to 31 May 31 2016) and self-reports of anxiety, mental health aspects, and sleep quality (collected from 20 April to 30 June 2020, and analyzed from 1 July to 1 September 2020), of 91 physicians treating COVID-19 or non-COVID-19 patients. As a priori hypothesized, physicians treating COVID-19 patients showed a relative elevation in both physiological measures of anxiety (95% CI: 2317.69–2453.44 versus 1982.32–2068.46; P < 0.001) and attention vigilance (95% CI: 29.85–34.97 versus 22.84–26.61; P < 0.001), compared with their colleagues treating non-COVID-19 patients. At least 3 months into the pandemic, physicians treating COVID-19 patients reported high anxiety and low quality of sleep. Machine learning showed clustering to the COVID-19 and non-COVID-19 subgroups with a high correlation mainly between physiological and self-reported anxiety, and between physiologically measured anxiety and sleep duration. To conclude, the pattern of attention vigilance, heightened anxiety, and reduced sleep quality findings point the need for mental intervention aimed at those physicians susceptible to develop post-traumatic stress symptoms, owing to the consequences of fighting at the forefront of the COVID-19 pandemic.


Sign in / Sign up

Export Citation Format

Share Document