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1. スペイツ C.リチャード コッチ エレン I. [Spates, C. R., and Koch, E. I.] (2003). 眼球運動脱感作と再処理(Reprocessing)から表出(Exposure)セラピーまで : 共通するメカニズムへの証拠に対する再考と概観 [From eye movement desensitization and reprocessing to exposure therapy: A review of the evidence for shared mechanisms]. 行动分析学研究18(2)、62から76 [Japanese Journal of Behavior Analysis, 18(2), 62-76].
Language: Japanese
Format: Journal
Abstract:
心的外傷後ストレス障害は、(心的外傷後ストレス障害)のすべての文化と生涯を通じて人々に影響を与える条件である。診断実践心的外傷後ストレス障害の導入以来、多くの研究は、疫学、病態生理、心理的、生理的メカニズムだけでなく、その治療に対処しています。障害の行動製剤は、分野の研究をリードの間に浸透して、効果的な治療につながるなど、暴露療法するヒューリスティックを証明されています。眼球運動脱感作は、サービス(EMD/ R)の再処理は、この定式化から出発すると主張している最近開発された介入は、その有効性の実証的な支持を受けています。本記事では、眼球運動脱感作と再処理の行動策定を支持する証拠をレビューし、それが暴露療法と行動の一般的なメカニズムを共有していることを示唆している。以上の研究関心は心的外傷後ストレス障害より寛容と、クライアントと実務に受け入れられるのレンダリング露出ベースの治療法の検討方法に与えられるべきである。
Posttraumatic stress disorder (PTSD) is a condition that affects people in all cultures and throughout the lifespan. Since the introduction of posttraumatic stress disorder into diagnostic practice, a great deal of research has addressed its epidemiology, pathophysiology, and psychological and physiological mechanisms, as well as its treatment. A behavioral formulation of the disorder has prevailed among leading researchers in the field, and has proved heuristic in leading to efficacious treatments, e.g., exposure therapy. Eye movement desensitization and reprocessing (EMD/R), a recently developed intervention that claims to be a departure from this formulation, has received empirical support for its efficacy. The present article reviews the evidence supporting a behavioral formulation of eye movement desensitization and reprocessing, and suggests that it shares common mechanisms of action with exposure therapy. Greater research attention should be given to examining ways of rendering exposure-based therapies for posttraumatic stress disorder more tolerant and acceptable to clients and practitioners. (PsycINFO Database Record (c) 2008 APA, all rights reserved)
Keywords: Exposure Therapy Literature Review Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
2. Zdravkovic, J. (1994). Behavioural-cognitive therapy of posttraumatic stress disorder. Psihijatrija Danas, 26(2-3), 129-146.
Language: English
Format: Journal
Abstract:
The basic theoretical postulations on PTSD are given in the first part of the work. Hypotheses are given on PTSD as being a kind of conditioned emotional reaction to trauma and, possibly, an illness that has disturbed REM sleep mechanism at its roots. The second part describes behavioural and cognitive techniques that have been proven empirically to be successful in the treatment and the prevention of this disorder. [Author Abstract]
Keywords: Behavior Therapy Cognitive Therapy Epidemiology Etiology Nosology Psychophysiology Posttraumatic Stress Disorder PTSD Relaxation Therapy
Accuracy Verified: No
3. Errebo, N. (2010, July). A decade of EMDR humanitarian trainings in Asia. Presentation at the 1st EMDR Asia Conference, Bali, Indonesia.
Language: English
Format: Conference
Abstract:
In 1999, EMDR Humanitarian Assistance Programs (HAP) began its work in Asia in Bangladesh. Since then HAP teams have
trained clinicians in India, Indonesia, China, Thailand, Sri Lanka. This presentation will summarize what has been learned
from ten years of experience in Asia. The EMDR HAP training in Sri Lanka following the 2004 tsunami will be presented in
detail. Issues addressed will include needs assessment, organization, collaboration among organizations, ethics, cultural
competence ,and program evaluation. Videotapes will show training and sessions of trainees with tsunami survivors. The
presentation will show how to train participants to think, write, and speak about EMDR as well as how to competently and
ethically utilize EMDR with clients.
An EMDR training program was conducted as a joint project of three organizations: EMDR Humanitarian Assistance Programs
(HAP), International Relief Teams (IRT), and the Sri Lankan National Counselors Association (SRILNAC). Between March and
December 2005, 30 Sri Lankan counselors were trained in EMDR. These counselors demonstrated competence in EMDR on
several measures, treated more than 1,000 children and more than 350 adult tsunami victims with EMDR in 2005, provided
narrative reports and outcome measures for most of their clients, and formed the Sri Lanka EMDR Association (SEA). The
crucial steps in establishing and implementing this training program are explained, with a summary of the subjective
impressions and learning experiences most valued by the training team, including an excerpt from a trainer’s journal. This
information may be useful to future cross-cultural humanitarian efforts following large-scale disasters.
This article summarizes the crucial steps in establishing and carrying out this training program as well. Previous HAP programs
in Bangladesh and Turkey (Konuk et al., 2006) had led to the development of a model of therapist training and service delivery
following large-scale natural disasters. Great need for mental health treatment in developing countries following a disaster
and the even greater challenge of delivering effective, culturally competent mental health treatment in these situations.
Silove and Bryant (2006) praised the rapid needs assessment after the tsunami as an important advancement in psychiatric
epidemiology that demonstrated the value of such assessment in guiding mental health interventions after disasters.They
pointed out that the controversy over whether to offer psychological treatment after disasters confuses funding agencies
and those planning mental health programs after disasters. Their concerns were echoed in Raphael and Stevens’s (2006)
delineation of the emerging consensus about good mental health practice after disasters in an article that was not a part of
the Bangkok symposium. IRT directors, EMDR-HAP staff, and SRILNAC leaders discussed crucial political, ethical, economic,
and logistical decisions in conference calls and e-mails. They outlined a program that would be responsive to the culture and
needs of Sri Lanka, would provide world-class EMDR training and consultation, and would follow International Society for
Traumatic Stress Studies (ISTSS) guidelines for mental health programs in post disaster situations (Weine et al., 2002). Following
the funding mandate of IRT, the HAP team took responsibility for ensuring that services would in fact be delivered to tsunami
survivors and that those services would be clinically effective. Therefore, requirements for continuing participation were quite
specific, and trainees were more thoroughly evaluated than in previous HAP projects. These 30 counselors treated more than
1,350 tsunami survivors with EMDR between March and December 2005 and submitted outcome reports on these sessions
that show marked improvement in PTSD symptoms. We know from e-mail contact that a number of participants continue
to use EMDR effectively. As mentioned Important elements of the HAP training program in Sri Lanka included (a) adequate
funding, (b) selection of trainees, (c) negotiation of objectives among HAP,IRT, and SRILNAC, (d) the pre-EMDR training in
traumatology, (e) the consultation between trainings,(f ) the requirements for ongoing participation in the training, (g) a
variety of measures of competence in EMDR, (h) the continuing, ongoing consultation with trainees, and (i) dedication. A
project like this is expensive. IRT received.
Keywords: Asia HAP Humanitarian Assistance Programs Trainings
Accuracy Verified: Yes
4. Freyberger, H. J., & Spitzer, C. (2005, Juli). Dissoziative störungen [Dissociative disorders]. Der Nervenarzt, 76(7), 893-900. doi:10.1007/s00115005-1956-z .
Language: German
Format: Magazine
Abstract:
Die dissoziative Störungen und Konversion sind mit erheblichen klassifikatorischen, diagnostische und therapeutische Schwierigkeiten, die nur in den historischen Kontext der Diskussion über die Hysterie verstanden werden kann, verbunden. Auch die Einstufung in die ICD-10 und DSM-IV ist heterogen. Prävalenzraten zwischen etwa 3% in der allgemeinen Bevölkerung und bis zu 30% in klinischen Populationen, jedoch beziehen sich auf die große klinische Bedeutung. Realtraumatisierungen eine wichtige Rolle in der Pathogenese. High Komorbiditätsraten mit anderen psychischen Störungen eine Tendenz zu chronischen somatischen Erkrankung und ein Konzept (insbesondere bei Patienten mit Erkrankungen erschweren Umwandlung) der psychotherapeutischen Behandlung. Dies erlaubt die Behandlung Ziele sind sowohl psychodynamische und kognitiv-verhaltenstherapeutischen in Abhängigkeit entwickelt, möglicherweise mit den Techniken der Trauma-Therapie, wie EMDR (Springer).
The dissociative and conversion disorders are associated with significant classificatory, diagnostic and therapeutic difficulties that can be understood only in the historical context of the discussion on hysteria. Even the classification in ICD-10 and DSM-IV is heterogeneous. Prevalence rates of between about 3% in the general population and up to 30% in clinical populations, however, refer to the great clinical significance. Realtraumatisierungen have an important role in the pathogenesis. High Komorbiditätsraten with other mental disorders, a tendency to chronic somatic disease and a concept (especially in patients with conversion disorders complicate) the psychotherapeutic treatment. This allows the treatment goals are designed both psychodynamic and cognitive-behavioral dependence in, possibly with the techniques of trauma therapy such as EMDR (Springer).
Keywords: Chronicity (Disorders) Comorbidity Conversion Disorder Diagnosis Dissociative Disorders Epidemiology Etiology Psychotherapy Somatization
Accuracy Verified: Yes
5. Sack, M., Lempa, W., & Lamprecht, F. (1999). Eine neue psychotherapeutische behandlungsmethode für patienten mit posttraumatischer belastungsstörung: EMDR. Behandlungsdurchführung und ergebnisse einer pilotstudie [A new psychotherapy treatment for patients with Post-Traumatic Stress Disorder: EMDR. Treatment implementation and results of a pilot study]. Psychomed, 11, 164-169 .
Language: German
Format: Journal
Abstract:
Nicht erst seit dem Zugunglück von Eschede und den damit im Zusammenhang stehenden Medienberichten wird zunehmend auch in der Öffentlichkeit bekannt, daß psychische Traumatisierungen zu einer tiefen und anhaltenden Verletzung des Gefühls der persönlichen Sicherheit und Unverletzbarkeit führen können. Dies wird oft wie ein Riß im Selbstverständnis oder wie ein Zusammenbruch des persönlichen Weltbildes beschrieben. Plötzlich wird die Welt als bedrohlich erlebt. Der Betroffene fühlt sich schutzlos und ausgeliefert. Typische Symptome, die in der Folge von belastenden Ereignissen auftreten, sind Schlafstörungen und Alpträume, quälende Wiedererinnerungen, Ängste und situationsbezogenes Vermeidungsverhalten sowie erhöhte Schreckhaftigkeit und Konzentrationsstörungen. Normalerweise bilden sich diese Symptome innerhalb einiger Tage bis einiger Wochen zurück. Bleiben diese psychischen und psychosomatischen Beeinträchtigungen jedoch bestehen, so ist bei einem Vorliegen von länger als 3 Monaten eine Posttraumatische Belastungsstörung zu diagnostizieren.
In den letzten Jahren wurde die Forschung über Traumafolgen erheblich intensiviert. Es wurden neue Erkenntnisse gewonnen, die dazu beigetragen haben, daß die psychotherapeutischen Verfahren zur Behandlung traumatisierter Menschen erheblich verbessert werden konnten. Seit vier Jahren behandelt die Abteilung Psychosomatik und Psychotherapie der MHH Menschen mit Posttraumatischen Belastungsstörungen im Rahmen einer Traumasprechstunde und erforscht die psychischen und biologischen Auswirkungen von Traumatisierungen.
Epidemiologie
Nach Ergebnissen einer Vielzahl von epidemiologischen Studien, ist die Posttraumatische Belastungsstörung (Posttraumatic stress disorder, kurz PTSD) infolge von Traumatisierungen in der Kindheit oder im späterem Leben, eine in ihrer Häufigkeit und sozioökonomischen Bedeutung lange unterschätzte Erkrankung. Unter Zugrundelegen der Diagnosekriterien der Posttraumatischen Belastungsstörung nach DSM-III-R liegt die Lebenszeitprävalenz in den USA für beide Geschlechter bei 7,8 Prozent bis 12,3 Prozent, wobei etwa doppelt so viele Frauen betroffen sind wie Männer (5). Für die deutsche Bevölkerung gib es noch keine epidemiologisch gesicherten Prävalenzzahlen, aber die Bedeutung von "Traumatisierungen" für die Entstehung oder für die erhebliche Verschlechterung psychischer Störungen wird immer deutlicher. Ein Beispiel hierfür ist die lebhafte Diskussion in den Medien über die psychischen Folgen von Traumatisierungen für Unfallopfer und Rettungskräfte in der letzten Zeit.
Die empirischen und klinischen Befunde zu Traumatisierungen in der Kindheit haben Egle, Hoffmann & Joraschky jüngst in einer Monographie zusammengestellt (1). Danach ist die Rolle von Vernachlässigung, Mißbrauch und Mißhandlung für eine Reihe von psychischen Störungen wie Selbstverletzendem Verhalten, Borderline-Störungen und Dissoziativen Störungen mittlerweile unstrittig und scheint auch für Subgruppen von Patienten mit Eßstörungen, Angststörungen, Persönlichkeitsstörungen und Somatisierungsstörungen von erheblicher Relevanz zu sein.
Weit unterschätzt ist zudem die Häufigkeit von Posttraumatischen Belastungsstörungen infolge von Unfällen oder Einsätzen in Krisengebieten. 20 Jahre nach dem Vietnamkrieg leiden noch immer ca. 15 Prozent aller Vietnamkriegsveteranen an einer PTSD. Opfer von Gewaltverbrechen und Überfällen sowie auch Zeugen von Gewalttaten, wie z.B. Rettungspersonal und Feuerwehrangehörige, stellen eine weitere Risikogruppe für die Entwicklung einer PTSD dar.
Not since the train wreck of Eschede and the related media reports, is increasingly known to the public that psychological trauma can lead to a deep and persistent breach of the feeling of personal safety and invulnerability. This is often described as a crack in the self or as a breakdown of the personal worldview. Suddenly the world is experienced as threatening. The person concerned feels defenseless and delivered. Typical symptoms that occur as a result of stressful events are insomnia and nightmares, distressing recollections, fears and situational avoidance behavior and increased nervousness and difficulty concentrating. Usually these symptoms are back within a few days to a few weeks. But they remain psychological and psychosomatic disturbances exist, so with a presence of more than 3 months is a post-traumatic stress disorder to diagnose.
In recent years, research on consequences of trauma was significantly intensified. It gained new insights that have contributed to the psychotherapeutic method for the treatment of traumatized people could be greatly improved. For four years, the Department of Psychosomatic Medicine and Psychotherapy, MHH treats people with post-traumatic stress disorder in a trauma clinic and explores the psychological and biological effects of trauma.
Epidemiology
According to results of a large number of epidemiological studies, post-traumatic stress disorder (Post Traumatic Stress Disorder, PTSD short) as a result of trauma in childhood or in later life, a decrease in frequency and socio-economic importance of long underestimated disease. Inter alia with the diagnostic criteria of posttraumatic stress disorder according to DSM-III-R lifetime prevalence in the U.S. is for both sexes at 7.8 percent to 12.3 percent, with about twice as many women are affected as men (5). For the German people give it no epidemiological prevalence data secure, but the meaning of "trauma" in the development or for the serious deterioration of mental disorders is increasingly clear. An example is the lively discussion in the media about the psychological consequences of trauma for victims and rescue workers in recent times.
The empirical and clinical findings concerning traumatic experiences in childhood have Egle, Hoffmann & Joraschky recently compiled in a monograph (1). Then disorders the role of neglect, abuse and mistreatment for a number of mental disorders such as self-injurious behavior, borderline disorders and dissociative now undisputed, and appears to be for subgroups of patients with eating disorders, anxiety disorders, personality disorders and somatization disorders is of considerable relevance.
Also greatly underestimated the incidence of post-traumatic stress disorder as a result of accidents or operations in critical areas. 20 years after the Vietnam War still suffer about 15 percent of Vietnam War veterans in a PTSD. Victims of violent crimes and robberies, as well as witnesses of violence, such as Rescue workers and firefighters, are another risk group for the development of PTSD dar.
Keywords: Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
6. St. André, É. (2010, Avril/Mai). EMDR dans le traitement d’un trouble obsessif compulsif: Une étude de cas [EMDR in the treatment of obsessive compulsive disorder: A case study]. Atelier présenté à la réunion annuelle de l'EMDR Canada, Toronto, Ontario.
Language: French
Format: Conference
Abstract:
Le trouble obsessif compulsif (TOC) est un trouble anxieux généralement chronique se présentant avec des obsessions récurrentes tel des idées persistantes, des images mentales et des compulsions (suivant les obsessions) tel des actes physiques ou mentaux répétitifs.
Dans cet atelier, le médecin fournira des indications cliniques sur son utilisation de l’EMDR dans le traitement d’un patient souffrant de TOC, et donnera quelques exemples tirés de la pratique d’autres cliniciens, en sus d’une révision des notions de base utiles à la compréhension du TOC (théorie neurobiologiques, épidémiologie, etc.).
La présentatrice tentera de souligner ce qu’il y a d’unique dans l’utilisation de l’EMDR dans le traitement de l’OCD, les difficultés rencontrées et les solutions utilisées dans ce cas précis. Elle décrira l’utilisation de la méthode de traitement standard en 8 étapes dans un cas spécifique, et dans les modalités de temps (passé, présent, futur), Nous verrons l’identification des cibles de traitement, et la gestion des symptômes de TOC qui entravent le fonctionnement quotidien des patients affectés. Nous verrons aussi les défis proposés par cette population, en clinique. Les participants pourront utiliser certaines stratégies dans un exercice pratique. (Tous les niveaux)
Obsessive Compulsive Disorder (OCD) is an anxiety disorder typically presenting with chronic recurrent obsessions such persistent ideas, images and mental compulsions (as obsessions) as acts of physical or mental patterns. In this workshop, the doctor will provide information on clinical use of EMDR in treating a patient suffering from OCD, and provide some examples from the practice of other clinicians, in addition to a review of concepts useful background for understanding the TOC (theory neurobiology, epidemiology, etc..). The presenter will attempt to highlight what is unique in the use of EMDR in the treatment of OCD, the difficulties encountered and solutions used in this case. She will describe the use of the method of standard treatment in 8 steps in a specific case and in terms of time (past, present, future), we see the identification of treatment targets, and management of symptoms of OCD which hinder the daily operation of affected patients. We will also see the challenges offered by this population in clinical practice. Participants may use certain strategies in a practical exercise.
Keywords: Case Study Obsessive Compulsive Disorder OCD
Accuracy Verified: Yes
7. Schaal, S. (2007, Februar). Erkrankungen des traumaspektrums bei Ruandischen waisen des genozids - Epidemiologie und behandlung [Trauma spectrum disorders with orphans of the Rwandan genocide - Epidemiology and treatment]. Dissertation Universität Konstanz Fachbereich Psychologie.
Language: German
Format: Dissertation/Thesis
Keywords: Adolescents Children Genocide Orphans Rwanda Trauma
Accuracy Verified: Yes
8. Wylie, M. S. (1996, July/August). Going for the cure. Family Therapy Networker, 20(4), 20-37 .
Language: English
Format: Magazine
Abstract:
This article discusses the challenges that working with PTSD clients present to therapists who wish to avoid vicarious traumatization. In addition, the work of Charles Figley and Joyce Carbonell to further understanding and treatment of PTSD is addressed, with particular emphasis on eye movement desensitization, traumatic incident reduction, visual kinesthetic dissociation, and thought field therapy.
Keywords: Behavior Therapy Commentary Epidemiology Neurolinguistic Programming NLP Posttraumatic Stress Disorder Psychotherapeutic Processes PTSD Research Needs TFT Thought Field Therapy TIR Traumatic Incident Reduction Treatment Effectiveness
Accuracy Verified: Yes
9. Noorthoorn, E. O., Havenaar, J. M., de Haan, H. A., van Rood, Y. R., & van Stiphout, W. A. (2010). Mental health service use and outcomes after the Enschede fireworks disaster: A naturalistic follow-up study. Psychiatric Services, 61(11), 1138-1143. doi:10.1176/appi.ps.61.11.1138 .
Language: English
Format: Journal
Abstract:
Objective: This study documented the number of people seeking help for mental health problems after a fireworks disaster in Enschede, the Netherlands. It describes their diagnostic characteristics, interventions provided, and their results. Methods: Researchers coded data from intakes and medical charts of all patients who sought help (N=1,659) and entered treatment (N=663) at a disaster relief service between May 13, 2000 (day of the disaster), and June 1, 2004. Patients who received more than eight treatment sessions (N=394) and were in treatment one year after the disaster were interviewed with the Composite International Diagnostic Interview (CIDI) (N=228, response rate, 58%) and other questionnaires (N=271, response rate, 69%). Results: In the population probably exposed, the cumulative referral-incidence for disaster-related mental health problems over four years was approximately 10%; in terms of referrals to the mental health facility over five years, the proportion of disaster-related referrals was 5.7%. Among adults, posttraumatic stress disorder (PTSD) was the most common clinical diagnosis (53%, chart sample). However, depression was the most common CIDI diagnosis (58%, CIDI interview sample). The recovery rate was about 50% on the basis of clinical judgment (chart sample), between 69% and 76% on the basis of "healthy" scores on symptoms, and between 39% and 60% in social and physical functioning (interview sample). Conclusions: Apart from persons seeking support during the first weeks postdisaster, the largest influx occurred after about one year and was limited in size. Clinicians in specialized services should be aware that conditions other than PTSD, such as depression, anxiety, substance abuse, and somatoform disorders, are also quite common after disasters. (Psychiatric Services 61:1138—1143, 2010)
On the afternoon of May 13, 2000, a fireworks deposit situated in a residential area exploded, killing 22 people and injuring about 1,000 in the center of Enschede, a town in the east of the Netherlands. As a result approximately 1,500 houses were damaged, of which 498 had to be demolished, leading to displacement of 4,163 inhabitants (1). An estimated 17,000 individuals were probably exposed in one way or another to this disaster (1). The event was immediately declared a national disaster. In response, a nationwide support effort was launched and funds were allocated for research to document health consequences of this disaster. As a result, data about health, well-being, and medical service use have been systematically collected since the early days after this event (2,3,4,5).
In contrast to the wealth of publications about the epidemiology of mental health problems after a disaster (6,7), there are only few studies that describe help-seeking behavior for these problems in a population stricken by disaster, or the outcomes of interventions. In this article we present the results of a chart study and interviews in early and later phases of treatment of adults who sought help from mental health services for disaster-related problems. The aim of the study was to evaluate mental health service delivery to persons affected by the fireworks disaster in Enschede during the period from May 2000 to May 2005. This study documented the number of people seeking help for disaster-related psychological problems, their sociodemographic and diagnostic characteristics, the interventions that they received, and some results of these interventions. To our knowledge this is the first systematic investigation of all adults seeking specialized mental health care in a disaster-stricken area.
Keywords: Enschede Fireworks Disaster
Accuracy Verified: Yes
10. Yule, W. (1999) . Post-traumatic stress disorders: Concepts and therapy. Chichester, England: John Wiley and Sons.
Language: English
Format: Book
Abstract:
This book, written by contributors from the Institute of Psychiatry in London, represents the fruits of ten years of working with survivors of accidents and disasters. It contains a coherent approach to the psychology underpinning their stress reactions, and places these disorders within a broad social psychological perspective. It applies many of the latest insights from experimental cognitive psychology to the experiences of the survivors. [Adapted from Preface]
Keywords: PTSD Treatment Adults Children Survivors Adolescents Coping Behavior Social Support Networks Personality Traits Psychobiology Intrusive Thoughts Cognitive Processes Cognitive Therapy Behavior Therapy Research Needs Epidemiology Etiology
Accuracy Verified: Yes
11. Brewin, C. R., Scragg, P., Robertson, M., Thompson, M., D'Ardenne, P., & Ehlers, A. (2008, February). Promoting mental health following the London bombings: A screen and treat approach. Journal of Traumatic Stress, 21(1), 3-8.
Language: English
Format: Journal
Abstract:
Following the 2005 London bombings, a novel public health program was instituted to address the mental health needs of survivors. In this article, the authors describe the rationale for the program, characteristics of individuals assessed within the program, and preliminary outcome data. In addition to validated screening instruments and routine service usage data, standardized questionnaire outcome measures were collected. 71% of individuals screened positive for a mental disorder. Of those receiving a more detailed clinical assessment, PTSD was the predominant diagnosis. Preliminary outcome data on 82 patients revealed large effect sizes for treatment comparable to those previously obtained in randomized controlled trials. The program succeeded in its aim of generating many more referrals of affected individuals than came through normal referral channels. [Author Abstract]
Keywords: Adults British Cognitive Therapy Epidemiology London Transport Bombings (2005) Posttraumatic Stress Disorder Psychiatric Disorders PTSD Survivors Terrorism Treatment Effectiveness Victim Services
Accuracy Verified: Yes
12. Keane, T. M. (1998). Psychological and behavioral treatments of post-traumatic stress disorder. In P. E. Nathan, & J. M. Gorman (Eds.), A guide to treatments that work (pp. 398-407). New York: Oxford University Press.
Language: English
Format: Book Section
Abstract:
Several Type 1 and Type 2 random clinical trials (RCTs) have confirmed exposure therapy (including systematic desensitization, flooding, prolonged exposure, and implosive therapy) and, to a lesser extent, anxiety management techniques (using both cognitive and behavioral strategies) as the psychosocial treatments of choice for PTSD.Eye-movement desensitization and reprocessing (EMDR), a recently introduced approach to the treatment of PTSD, has shown some promise, although its research base to date, consisting largely of open clinical trials, is inadequte. [Author Abstract]
Keywords: Cognitive Therapy Epidemiology Exposure Therapy Literature Review Posttraumatic Stress Disorder PTSD Treatment Effectiveness
Accuracy Verified: Yes
13. van Loey, N. E. E., & van Son, M. J. M. (2003). Psychopathology and psychological problems in patients with burn scars: Epidemiology and management. American Journal of Clinical Dermatology, 4(4), 245-272.
Language: English
Format: Journal
Abstract:
Burn injury is often a devastating event with long-term physical and psychosocial effects. Burn scars after deep dermal injury are cosmetically disfiguring and force the scarred person to deal with an alteration in body appearance. In addition, the traumatic nature of the burn accident and the painful treatment may induce psychopathological responses. Depression and PTSD, which are prevalent in 13-23% and 13-45% of cases, respectively, have been the most common areas of research in burn patients. Risk factors related to depression are pre-burn depression and female gender in combination with facial disfigurement. Risk factors related to PTSD are pre-burn depression, type and severity of baseline symptoms, anxiety related to pain, and visibility of burn injury. Neuropsychological problems are also described, mostly associated with electrical injuries. Social problems include difficulties in sexual life and social interactions. Quality of life initially seems to be lower in burn patients compared with the general population. Problems in the mental area are more troublesome than physical problems. Over a period of many years, quality of life was reported to be rather good. Mediating variables such as low social support, emotion and avoidant coping styles, and personality traits such as neuroticism and low extraversion, negatively affect adjustment after burn injury. Few studies of psychological treatments in burn patients are available. From general trauma literature, it is concluded that cognitive (behavioral) and pharmacological (selective serotonin reuptake inhibitors) interventions have a positive effect on depression. With respect to PTSD, exposure therapy and eye movement reprocessing and desensitization [EMDR] are successful. Psychological debriefing aiming to prevent chronic post-trauma reactions has not, thus far, shown a positive effect in burn patients. Treatment of problems in the social area includes cognitive-behavioral therapy, social skills training, and community interventions. Sexual health promotion and counseling may decrease problems in sexual life. In conclusion, psychopathology and psychological problems are identified in a significant minority of burn patients. Symptoms of mood and anxiety disorders (of which PTSD is one) should be the subject of screening in the post-burn phase and treated if indicated. A profile of the patient at risk, based on pre-injury factors such as pre-morbid psychiatric disorder and personality characteristics, peri-traumatic factors and post-burn factors, is presented. Finally, objective characteristics of disfigurement appear to play a minor role, although other factors, such as proneness to shame, body image problems, and lack of self-esteem, may be of significance. [Author Abstract]
Keywords: Burns Comorbidity Epidemiology Literature Review Posttraumatic Stress Disorder Predisposition PTSD Survivors Treatment
Accuracy Verified: Yes
14. Vickerman, K. A., & Margolin, G. (2009, July). Rape treatment outcome research: Empirical findings and state of the literature. Clinical Psychology Review, 29(5), 431-448. doi:10.1016/j.cpr.2009.04.004.
Language: English
Format: Journal
Abstract:
This article reviews empirical support for treatments targeting women sexually assaulted during adolescence or adulthood. 32 articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, 3 focused on the acute period post-assault, 2 included women with chronic and acute symptoms, and 3 were secondary prevention programs. The majority of studies focus on PTSD, depression, and/or anxiety as treatment targets. Cognitive Processing Therapy and Prolonged Exposure have garnered the most support with this population. Stress Inoculation Training and Eye Movement Desensitization and Reprocessing also show some efficacy. Of the 4 studies that compared active treatments, few differences were found. Overall, cognitive behavioral interventions lead to better PTSD outcomes than supportive counseling does. However, even in the strongest treatments more than one-third of women retain a PTSD diagnosis at post-treatment or drop out of treatment. Discussion highlights the paucity of research in this area, methodological limitations of examined studies, generalizability of findings, and important directions for future research at various stages of trauma recovery. [Author Abstract]
Keywords: Adults Cognitive Therapy Drug Therapy Epidemiology Exposure Therapy Females Literature Review Posttraumatic Stress Disorder Psychotherapy PTSD Rape Survivors Treatment Treatment Effectiveness
Accuracy Verified: Yes
15. McFarlane, A. (2010, June). Understanding traumatic stress reactions - The linking of phenomenology, aetiology and treatment plan. Preconference presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.
Language: English
Format: Conference
Abstract:
One of the most intriguing aspects of traumatic stress has been the repeated learning and forgetting of lessons about its importance as a cause of psychopathology. It remains the case that the broader body of psychiatry and psychology has an ambivalent relationship with the field of traumatic stress and the nature of posttraumatic stress disorder. The origins of this ambivalence and their impact will be discussed. It is important that practitioners in the field of traumatic stress be aware of these barriers and how to address them in a research setting and clinical practice.
The underlying phenomenology of posttraumatic stress disorder will be explored and its neurobiological origins will be highlighted. It is important to deconstruct posttraumatic stress disorder into the different symptom components, as they have substantially different mechanisms underpinning their intensity and presentation. Posttraumatic stress disorder is a dynamic condition in which symptoms fluctuate with time and are substantially influenced by the environmental demands placed upon the individual.
It is often forgotten that somatic symptoms are a core element of the experience of individuals with PTSD. The nature of these somatic dimensions of distress and their significance will be discussed.
The epidemiology of posttraumatic stress disorder highlights how the prevalence of these conditions is seemingly increasing. However, this reflects the developments in the measurement of the effects of trauma in research settings. This has major implications for clinicians as to how best take a history about exposures to traumatic events. The evidence is that systematic investigation is critical and that unless questions are asked, symptoms will frequently go unreported. Recent evidence suggests that PTSD may be in fact more common than major depressive disorders. Equally, it should not be forgotten that depression is an important dimension of posttraumatic reactions. There is also an associated comorbidity with substance abuse. The risks associated with trauma exposure have a long tale of effect and these will be described.
The challenges of treatment will be discussed in the context of early intervention and workplace intervention. Treatment needs to be a sequential process where there are a variety of strategies, including EMDR, which can be used in treatment. The sequence of these strategies in treatment is a challenging question that has not been systematically addressed in research.
It remains the case that one of the primary issues in treatment is early identification, and this raises questions about the importance of screening in at-risk populations. Again, there are significant differences in opinion; however, the militaries around the world are now regularly screening populations returning from deployment. A recent novel approach to considering the issues of treatment is whether a staging approach should be used for conditions such as PTSD.
In summary, it is critical that clinicians have an explicit model of the mind and its neurobiology. Posttraumatic stress disorder can best be understood as an information processing disorder, which both impacts upon an individual's ability to engage with their day to day environment as well as integrate past experiences as a source of information to influence current behaviour. The integration and modulation of neural systems that manage environmental input is critical to adaptive functioning. The ways that these systems become dysregulated in PTSD will be highlighted and how these underlying deficits can be addressed in treatment will be focused upon.
A further issue that needs to be considered in the treatment of PTSD is the long-term risk of individuals, who have developed this condition, to have relapses after a successful intervention. Some long-term treatment outcome data will be presented.
Keywords: Posttraumatic Stress Disorder PTSD Traumatic Stress
Accuracy Verified: Yes
16. St. Andre, É. (2010, April/May). Use of EMDR in the treatment of obsessive compulsive disorder: a case study. Presentation at the annual meeting of EMDR Canada, Toronto, Ontario.
Language: English
Format: Conference
Abstract:
Obsessive compulsive disorder (OCD) is a chronic anxiety disorder with recurrent obsessions, like persistent thoughts, mental images, impulses, and compulsions such as repetitive behaviours or mental acts, that are performed after obsessions. This workshop will provide clinical information on the presenter's use of EMDR with a patient with OCD, as well as some examples provided by other clinicians who have worked with patients with OCD. In addition, general information on OCD (e.g., epidemiology, neurobiology) will be discussed. The presenter will highlight what is unique about the use of EMDR with OCD, difficulties she met in using EMDR with an OCD patient, and adaptations she used to improve treatment. She will describe how to use the standard 8 step approach (past, present, future), how to identify targets, managing OCD symptoms and barriers in his day-to-day life. The presenter will look at how to manage challenges that arise for the clinician with this population. Participants will have an opportunity to apply the strategies with a case example exercise. (All Levels)
Keywords: Obsessive Compulsive Disorder OCD
Accuracy Verified: Yes


