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1. van Etten, M. L., & Taylor, S. (1998). Comparative efficacy of treatments for posttraumatic stress disorder:  A meta-analysis. Clinical Psychology and Psychotherapy, 5(3), 126-144. doi:10.1002/(SICI)1099-0879(199809).

Language: English

Format: Journal

Abstract:
A meta-analysis was conducted on 61 treatment outcome trials for PTSD. Conditions included drug therapies (TCAs, carbamazepine, MAOIs, SSRIs, and BDZs), psychological therapies (behaviour therapy, Eye-Movement Desensitization and Reprocessing (EMDR), relaxation training, hypnotherapy, and dynamic therapy), and control conditions (pill placebo, wait-list controls, supportive psychotherapies, and non-saccade EMDR control). Psychological therapies had significantly lower drop-out rates than pharmacotherapies (14% versus 32%), with attrition being uniformly low across all psychological therapies. In terms of symptom reduction, psychological therapies were more effective than drug therapies, and both were more effective than controls. Among the drug therapies, the SSRIs and carbamazepine had the greatest effect sizes, although the latter was based upon a single trial. Among the psychological therapies, behaviour therapy and EMDR were most effective, and generally equally so. The most effective psychological therapies and drug therapies were generally equally effective. Differences across treatment conditions were generally evident across symptom domains, with little matching of symptom domain to treatment type. However, SSRIs had some advantage over psychological therapies in treating depression. Follow-up results were not available for most treatments, but available data indicates that treatment effects for behaviour therapy and EMDR are maintained at 15-week follow-up. [Author Abstract]

Keywords: Antimanic Drugs  Benzodiazepine Derivatives  Hypnotherapy  Meta Analysis  Monoamine Oxidase Inhibitors  Posttraumatic Stress Disorder  Psychoanalytic Psychotherapy  PTSD  Relaxation Therapy  Selective Serotonin Reuptake Inhibitors  Treatment Effectiveness  Tricyclic Derivatives  

Accuracy Verified: Yes


2. Kapfhammer, H.-P. (2008, December). Therapeutische möglichkeiten nach traumatischen erlebnissen [Therapeutic possibilities after traumatic experiences]. Psychiatria Danubina, 20(4), 532-545.

Language: German

Format: Journal

Abstract:
Acute Belastungsstörung (ASD) und Posttraumatische Belastungsstörung (PTSD) sind häufige, aber nicht zwingend psychologische Folgeerscheinungen nach einem Trauma. Eine wichtige Untergruppe der Patienten vor einer chronischen Verlauf der Erkrankung mit einem erhöhten psychiatrischen Komorbidität und erhebliche Beeinträchtigungen in psychosozialen Anpassung assoziiert. Der typische psychopathologische Symptome von ASD und PTSD werden am besten in einem multifaktoriellen Modell der Integration sowohl neurobiologische und psychosoziale Einflüsse beschrieben. Die komplexen Ätiopathogenese von akuten und posttraumatischen Belastungsstörung begünstigt multimodalen Ansätzen in der Behandlung. Differential psychotherapeutische und pharmakologische Strategien zur Verfügung stehen. In einer kritischen Studie über empirische Studien, können psychologische Debriefing nicht als einen positiven Ansatz betrachtet werden, als allgemeine vorbeugende Maßnahme in der unmittelbaren posttraumatischen Phase empfohlen werden. Positive Auswirkungen der kognitiv-verhaltenstherapeutischen Interventionen kann für ASD eingerichtet werden. Psychodynamische Psychotherapie, kognitive Verhaltenstherapie und EMDR zeigen viel versprechende Ergebnisse bei der Behandlung von PTSD. Wesentliche klinische Einschränkungen der Patienten innerhalb von speziellen Probenahmen Forschungseinrichtungen, jedoch nicht gestatten, eine bedingungslose Verallgemeinerung dieser Daten zu psychiatrischen Routineversorgung. In einer empirischen Analyse der SSRIs sind die meisten und am besten untersuchten Medikamente für ASD und PTSD. Im Vergleich zu trizyklischen Antidepressiva SSRIs zeigen ein breiteres Spektrum an therapeutischen Wirkungen und sind besser verträglich. Die Substanzklassen der SNRI, DAS, SARI und NaSSA sind als Medikamente der zweiten Wahl angesehen werden. Sie versprechen eine therapeutische Wirksamkeit der SSRI gleichwertig, wobei bisher nur in offenen Studien untersucht. MAO-Hemmer können eine positive therapeutische Potenzial verfügen, müssen ihr Profil der Nebenwirkungen geachtet, jedoch werden. Mood-Stabilisatoren und atypische Neuroleptika können in Anspruch genommen werden und vor allem im Add-On-Strategien. Benzodiazepine sollten nur mit Vorsicht erhöht für eine kurze Zeit in den Staaten der akuten Krise eingesetzt werden. In frühen Interventionen, die blockierende Substanzen norepinephric Hyperaktivität scheinen vielversprechende Alternativen. Stress Dosen von Hydrocortison kann als experimentelle pharmakologische Strategie betrachtet so weit sein. [PubMed]

Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are frequent, but not obligatory psychological sequelae following trauma. A major subgroup of patients face a chronic course of illness associated with an increased psychiatric comorbidity and significant impairments in psychosocial adaptation. The typical psychopathological symptoms of ASD and PTSD are best described within a multifactorial model integrating both neurobiological and psychosocial influences. The complex etiopathogenesis of acute and posttraumatic stress disorder favours multimodal approaches in the treatment. Differential psychotherapeutic and pharmacological strategies are available. In a critical survey on empirical studies, psychological debriefing cannot be considered as a positive approach to be recommended as general preventive measure during the immediate posttraumatic phase. Positive effects of cognitive-behavioral interventions can be established for ASD. Psychodynamic psychotherapy, cognitive-behavioral therapy and EMDR show promising results in the treatment of PTSD. Major clinical restrictions of patient sampling within special research facilities, however, do not allow an unconditional generalization of these data to psychiatric routine care. In an empirical analysis the SSRIs are the most and best studied medications for ASD and PTSD. In comparison to tricyclic antidepressants SSRIs demonstrate a broader spectrum of therapeutic effects and are better tolerated. The substance classes of SSNRI, DAS, SARI and NaSSA are to be considered as drugs of second choice. They promise a therapeutic efficacy equivalent to the SSRIs, being investigated so far only in open studies. MAO-inhibitors may dispose of a positive therapeutic potential, their profile of side effects must be respected, however. Mood stabilizers and atypical neuroleptics may be used first and foremost in add-on strategies. Benzodiazepines should be used only with increased caution for a short time in states of acute crisis. In early interventions, substances blocking the norepinephric hyperactivity seem to be promising alternatives. Stress doses of hydrocortisone may be considered as an experimental pharmacological strategy so far.[PUBMED]

Keywords: Acute Stress Disorder  ASD  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes


3. Russell, M. (2012, March 23). War atrocities in Afghanistan: Who is blameworthy?. Huffington Post. Retrieved from http://www.huffingtonpost.com/mark-c-russell-phd-abpp/robert-bales-mental-health-_b_1371478.html on 3/26/2012.

Language: English

Format: Other

Abstract:
When Politics Trumps Science in Military Mental Health Care In January 2011, the Government Accountability Office (GAO) investigated the DVA's indefensible decision to limit veterans' access to two of its homegrown PTSD treatments --Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT) -- while excluding external competitors, like EMDR, developed outside the DVA. For instance, despite billions of dollars spent by the DVA/DoD to research PTSD treatments (e.g., massage, art therapy, marijuana derivatives, etc.), no EMDR research has been conducted since the wars began -- a blatant disregard of military medicine's mission to ensure that all war veterans have unrestricted access to the highest quality mental health treatment possible. Scientific and personal bias should never enter into the equation. The status quo is even more inexplicable when in February, 2012, the DVA informs the Congressional Budget Office that only 40 percent of VA PTSD patients successfully complete PTSD treatment -- a 60 percent wash-out rate! In stark contrast, randomized controlled trials of EMDR in 1998 with Vietnam combat veterans demonstrated that 77 percent of veterans no longer had PTSD diagnosis after 12 sessions -- with no drop-out [2]. Promising results; however, 1998 marked the last EMDR research trial the DVA has funded. [Excerpt]

Keywords: Afghanistan  Blog  Military  Posttraumatic Stress Disorder  PTSD  Veterans  War  

Accuracy Verified: Yes


4. Figgess, S. (2009). Working with trauma. A journey towards integration: Gestalt and EMDR. British Gestalt Journal, 18(1), 34-41.

Language: English

Format: Journal

Abstract:
This article explores points of convergence and divergence between EMDR and Gestalt in the context of one Gestalt therapist's experience in integrating EMDR and its derivatives into her practice. A longer case example illustrates the power of an EMDR-derived approach to facilitate a client's personal integration of traumatic material.

Keywords: Body Sensation  Gestalt  Inter-Psychic  Intersubjective  Neural Integration  Self-Integration  Unfinished Business  

Accuracy Verified: Yes