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1. van der Kolk, B. A. (1994, January). The body keeps the score: Memory and the evolving psychobiology of posttraumatic stress. Harvard Review of Psychiatry, 1(5), 253-265. doi:10.3109/10673229409017088.

Language: English

Format: Journal

Abstract:
Ever since people's responses to overwhelming experiences have been systematically explored, researchers have noted that a trauma is stored in somatic memory and expressed as changes in the biological stress response. Intense emotions at the time of the trauma initiate the long-term conditional responses to reminders of the event, which are associated both with chronic alterations in the physiological stress response and with the amnesias and hypermnesias characteristic of posttraumatic stress disorder (PTSD). Continued physiological hyperarousal and altered stress hormone secretion affect the ongoing evaluation of sensory stimuli as well. Although memory is ordinarily an active and constructive process, in PTSD failure of declarative memory may lead to organization of the trauma on a somatosensory level (as visual images or physical sensations) that is relatively impervious to change. The inability of people with PTSD to integrate traumatic experiences and their tendency, instead, to continuously relieve the past are mirrored physiologically and hormonally in the misinterpretation of innocuous stimuli as potential threats. Animal research suggests that intense emotional memories are processed outside of the hippocampally mediated memory system and are difficult to extinguish. Cortical activity can inhibit the expression of these subcortically based emotional memories. The effectiveness of this inhibition depends, in part, on physiological arousal and neurohormonal activity. These formulations have implications for both the psychotherapy and the pharmacotherapy of PTSD.[MLM MEDLINE]

Keywords: Neurobiology  Posttraumatic Stress Disorder  Practice  PTSD  Theory  

Accuracy Verified: Yes

2. Shepherd. J., & Stein, K. (1998). Eye movement desensitization and reprocessing in the treatment of post traumatic stress disorder. Development and Evaluation Committee (Report No. 91). Bristol, UK: South and West Regional Health Authority [Southampton]: Wessex Institute for Health Research and Development.

Language: English

Format: Publication

Abstract:
Objective/Purpose: Eye Movement Desensitization and Reprocessing (EMDR) is a relatively new form of psychotherapy designed to alleviate symptoms of anxiety, depression, avoidance of trauma related thoughts and intrusive memories associated with Post Traumatic Stress Disorder (PTSD). Under therapist instruction, the patient makes rhythmic eye movements while imagining the traumatic event, designed to facilitate cognitive reprocessing to alleviate stress. Methods: Electronic searching of Medline, PsyClit, Health Star, CCTR, The National Research Register and a range of other databases was conducted. Once trials had been identified, data were extracted and methodological quality assessed. Cost-utility was estimated indirectly through consultation with expert clinicians. Costs per Quality Adjusted Life Year (QALY) gained were also calculated. Results: 12 randomised controlled trials (RCTs) were identified, comparing EMDR to alternative psychotherapy treatments; variants of EMDR; and to delayed treatment groups in various combinations. The trials are generally small, with partial blinding of outcome assessors, and in some cases with high attrition. Results suggest the EMDR may be effective at reducing symptoms up to 3 months after treatment in comparison to delayed treatment groups. Two studies suggest that EMDR is as effective as other psychotherapy treatments for PTSD, and 3 claim greater effectiveness. Cost per QALY ranged from Pounds 983 to Pounds 20,568. CONCLUSIONS: Further trials are needed with larger samples, and longer post-intervention measurement to assess maximum length of treatment effect, as well as to ascertain the effectiveness of different treatment components.

Keywords: Posttraumatic Stress Disorder  PTSD  Therapy  

Accuracy Verified: Yes

3. Stergiopoulos, E., Cimo, A., Cheng, C., Bonato, S., & Dewa, C. S. (2011, October). Interventions to improve work outcomes in work-related PTSD: A systematic review. BMC Public Health, 11(1), 838. doi:10.1186/1471-2458-11-838.

Language: English

Format: Journal

Abstract:
Background: Posttraumatic stress disorder acquired at work can be debilitating both for workers and their employers. The disorder can result in increased sick leave, reduced productivity, and even unemployment. Furthermore, workers are especially unlikely to return to their previous place of employment after a traumatic incident at work because of the traumatic memories and symptoms of avoidance that typically accompany the disorder. Therefore, intervening in work-related PTSD becomes especially important in order to get workers back to the workplace. Methods: A systematic literature search was conducted using Medline, PsycINFO, Embase, and Web of Science. The articles were independently screened based on inclusion and exclusion criteria, followed by a quality assessment of all included articles. Results: The systematic search identified seven articles for inclusion in the review. These consisted of six research articles and one systematic review. The review focused specifically on interventions using real exposure techniques for anxiety disorders in the workplace. In the research articles addressed in the current review, study populations included police officers, public transportation workers, and employees injured at work. The studies examined the effectiveness of EMDR, cognitive-behavioural techniques, and an integrative therapy approach called brief eclectic psychotherapy. Interestingly, 2 of the 6 research articles addressed add-on treatments for workplace PTSD, which were designed to treat workers with PTSD who failed to respond to traditional evidence-based psychotherapy. Conclusions: Results of the current review suggest that work-related interventions show promise as effective strategies for promoting return to work in employees who acquired PTSD in the workplace. Further research is needed in this area to determine how different occupational groups with specific types of traumatic exposure might respond differently to work-tailored treatments.

Keywords: Employees  Posttraumatic Stress Disorder  PTSD  Workers  

Accuracy Verified: Yes

4. Lapp, L. K., Agbokou, C., Peretti, C. S., & Ferreri, F. (2010, September). Management of post traumatic stress disorder after childbirth: A review. Journal of Psychosomatic Obstetrics & Gynecology, 31(3), 113-122. doi:10.3109/0167482X.2010.503330.

Language: English

Format: Journal

Abstract:
Prevalence and risk factors for the development of post traumatic stress disorder (PTSD) after childbirth is well described in the literature. However, its management and treatment has only begun to be investigated. The aim of this article is to describe the studies that examine the effects of interventions on PTSD after childbirth. MedLine, PILOTS, CINAHL and ISI Web of Science databases were systematically searched for randomised controlled trials, pilot studies and case studies using key words related to PTSD, childbirth, treatment and intervention. The reference lists of the retrieved articles were also used to supplement the search. A total of nine studies were retrieved. Seven studies that examined debriefing or counselling were identified; six randomised controlled trials and one pilot study. Also found were one case report describing the effects of cognitive behavioural therapy (CBT) on two women, and one pilot study of eye movement desensitisation and reprocessing (EMDR). Overall, there is limited evidence concerning the management of women with PTSD after childbirth. The results agree with the findings from the non-childbirth related literature: debriefing and counselling are inconclusively effective while CBT and EMDR may improve PTSD status but require investigation in controlled trials before conclusions could be drawn.

Keywords: Childbirth  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

5. Devilly, G. J. (2005, June). Power therapies and possible threats to the science of psychology and psychiatry. Australian & New Zealand Journal of Psychiatry, 39(6), 437-445. doi:10.1111/j.1440-1614.2005.01601.x .

Language: English

Format: Journal

Abstract:
Objective: Advocates of new therapies frequently make bold claims regarding therapeutic effectiveness, particularly in response to disorders which have been traditionally treatment-refractory. This paper reviews a collection of new therapies collectively self-termed "The Power Therapies", outlining their proposed procedures and the evidence for and against their use. These therapies are then put to the test for pseudoscientific practice. Method: Therapies were included which self-describe themselves as "Power Therapies". Published work searches were conducted on each therapy using Medline and PsychInfo databases for randomized controlled trials assessing their efficacy, except for the case of Eye Movement Desensitization and Reprocessing (EMDR). Eye Movement Desensitization and Reprocessing has more randomized controlled studies conducted on its efficacy than any other treatment for trauma and thus, previous meta-analyses were evaluated. Results and conclusions: It is concluded that these new therapies have offered no new scientifically valid theories of action, show only non-specific efficacy, show no evidence that they offer substantive improvements to extant psychiatric care, yet display many characteristics consistent with pseudoscience. [Author Abstract]

Keywords: Commentary  Energy Psychotherapy  Literature Review  Neurolinguistic Programming  NLP  Psychotherapeutic Processes  TFT: Thought Field Therapy  TIR: Traumatic Incident Reduction  Treatment Effectiveness  

Accuracy Verified: Yes

6. Gillies, D., Taylor, F., Gray, C., O’Brien, L., & D’Abrew, N. (2012). Psychological therapies for the treatment of post-traumatic stress disorder in children and adolescents (Review). Cochrane Database of Systematic Reviews (Online), 12, CD006726. doi:10.1002/14651858.CD006726.pub2.

Language: English

Format: Journal

Abstract:
Background: Post-traumatic stress disorder (PTSD) is highly prevalent in children and adolescents who have experienced trauma and has high personal and health costs. Although a wide range of psychological therapies have been used in the treatment of PTSD there are no systematic reviews of these therapies in children and adolescents. Objectives: To examine the effectiveness of psychological therapies in treating children and adolescents who have been diagnosed with PTSD. Search methods: We searched the Cochrane Depression, Anxiety and Neurosis Review Group’s Specialised Register (CCDANCTR) to December 2011. The CCDANCTR includes relevant randomised controlled trials fromthe following bibliographic databases: CENTRAL (the Cochrane Central Register of Controlled Trials) (all years), EMBASE (1974 -), MEDLINE (1950 -) and PsycINFO (1967 -). We also checked reference lists of relevant studies and reviews. We applied no date or language restrictions. Selection criteria: All randomised controlled trials of psychological therapies compared to a control, pharmacological therapy or other treatments in children or adolescents exposed to a traumatic event or diagnosed with PTSD. Data collection and analysis: Two members of the review group independently extracted data. If differences were identified, they were resolved by consensus, or referral to the review team. We calculated the odds ratio (OR) for binary outcomes, the standardised mean difference (SMD) for continuous outcomes, and 95% confidence intervals (CI) for both, using a fixed-effect model. If heterogeneity was found we used a random-effects model. Main results Fourteen studies including 758 participants were included in this review. The types of trauma participants had been exposed to included sexual abuse, civil violence, natural disaster, domestic violence and motor vehicle accidents. Most participants were clients of a traumarelated support service. The psychological therapies used in these studies were cognitive behavioural therapy (CBT), exposure-based, psychodynamic, narrative, supportive counselling, and eye movement desensitisation and reprocessing (EMDR). Most compared a psychological therapy to a control group. No study compared psychological therapies to pharmacological therapies alone or as an adjunct to a psychological therapy. Across all psychological therapies, improvement was significantly better (three studies, n = 80, OR 4.21, 95% CI 1.12 to 15.85) and symptoms of PTSD (seven studies, n = 271, SMD -0.90, 95% CI -1.24 to -0.42), anxiety (three studies, n = 91, SMD -0.57, 95% CI -1.00 to -0.13) and depression (five studies, n = 156, SMD -0.74, 95% CI -1.11 to -0.36) were significantly lower within a month of completing psychological therapy compared to a control group. The psychological therapy for which there was the best evidence of effectiveness was CBT. Improvement was significantly better for up to a year following treatment (up to one month: two studies, n = 49, OR 8.64, 95% CI 2.01 to 37.14; up to one year: one study, n = 25, OR 8.00, 95% CI 1.21 to 52.69). PTSD symptom scores were also significantly lower for up to one year (up to one month: three studies, n = 98, SMD -1.34, 95% CI -1.79 to -0.89; up to one year: one study, n = 36, SMD -0.73, 95% CI -1.44 to -0.01), and depression scores were lower for up to a month (three studies, n = 98, SMD -0.80, 95% CI -1.47 to -0.13) in the CBT group compared to a control. No adverse effects were identified. No study was rated as a high risk for selection or detection bias but a minority were rated as a high risk for attrition, reporting and other bias. Most included studies were rated as an unclear risk for selection, detection and attrition bias. Authors’ conclusions: There is evidence for the effectiveness of psychological therapies, particularly CBT, for treating PTSD in children and adolescents for up to a month following treatment. At this stage, there is no clear evidence for the effectiveness of one psychological therapy compared to others. There is also not enough evidence to conclude that children and adolescents with particular types of trauma are more or less likely to respond to psychological therapies than others. The findings of this review are limited by the potential for methodological biases, and the small number and generally small size of identified studies. In addition, there was evidence of substantial heterogeneity in some analyses which could not be explained by subgroup or sensitivity analyses. More evidence is required for the effectiveness of all psychological therapiesmore than one month after treatment.Much more evidence is needed to demonstrate the relative effectiveness of different psychological therapies or the effectiveness of psychological therapies compared to other treatments. More details are required in future trials in regards to the types of trauma that preceded the diagnosis of PTSD and whether the traumas are single event or ongoing. Future studies should also aim to identify the most valid and reliable measures of PTSD symptoms and ensure that all scores, total and sub-scores, are consistently reported.

Keywords: Adolescents  Children  Posttraumatic Stress Disorder  PTSD  Review  

Accuracy Verified: Yes

7. Simonson, E. L. (2009). School-based intervention programs for symptoms of traumatic stress. Universitetet i Stavenger, Stavenger, Norway.

Language: English

Format: Dissertation/Thesis

Abstract:
This thesis attempts to provide an up-to-date overview of school-based intervention programs for symptoms of traumatic stress. The objectives were: 1) to identify school-based intervention programs for preventing or reducing symptoms of traumatic stress, 2) to examine the effectiveness of the intervention programs, and 3) to identify the accordance of the intervention programs with three current theories of posttraumatic stress disorder (PTSD). The three main academic databases used to locate the studies for this thesis were ERIC, PsycINFO, and MEDLINE. Inclusionary/exclusionary criteria included: 1) use of a control group, 2) use of randomized/quasi-experimental design, 3) school setting, 4) participant exposure to a traumatic event, 5) targeted at the prevention/ reduction of symptoms of traumatic stress, 6) use of standardized instruments, and 7) not targeted Type II trauma. Using these criteria, 19 studies conducted in 11 different countries were selected. Unfortunately, school-based studies conducted in Norway were not located. The selected studies dealt with various types of trauma exposure such as natural disasters, community violence, and war. Fourteen of the studies used cognitive-behavioral therapy (CBT) methods as the main treatment approach. Other treatment approaches used included Eye Movement Desensitization and Reprocessing (EMDR), mind-body techniques (e.g., guided imagery, relaxation techniques, and meditation), play therapy, art therapy, and drama. The findings of this thesis suggest that intervention provided within the school setting can be effective in helping children and adolescents following a variety of traumatic events. The majority of the studies had good results in relation to reducing symptoms of PTSD. Of the 19 studies, 14 had effect sizes in the medium to large range. Most of the intervention programs were found to be in accordance with the treatment recommendations of the three theories presented; however, none appeared to be explicitly based on the theories.

Keywords: Posttraumatic Stress Disorder  PTSD  School Intervention  Trauma  

Accuracy Verified: Yes

8. Rubin, A. (2003, March). Unanswered questions about the empirical support for EMDR in the treatment of PTSD: A review of research. Traumatology, 9(1), 4-30. doi:10.1177/153476560300900102 .

Language: English

Format: Journal

Abstract:
A literature review was conducted to examine whether EMDR should be considered an empirically-supported treatment for PTSD. Relying largely but not exclusively on electronic data bases such as Medline and PsycInfo, journal articles published through April 2003 were identified which reported a randomized experimental evaluation of the effectiveness of EMDR in treating PTSD. EMDR appears to be an empirically supported treatment for adults with single-trauma civilian PTSD. However, the evidence supporting the effectiveness of EMDR is much less compelling when we focus on children, combat PTSD, multiple-trauma PTSD, and whether EMDR is more effective than exposure therapies. Proponents of EMDR hotly debate proponents of exposure therapy regarding methodological issues, with each side in the debate frequently employing a double standard. Clinicians are advised to use either EMDR, exposure therapy, or stress-inoculation therapy when treating civilian adults with single-trauma PTSD. They may also want to employ EMDR when treating children with PTSD or clients with multiple-trauma or chronic PTSD. But if they do, they should do so in light of the inadequate evidence base, be guided by future evaluations of EMDR with these populations, and recognize that many more sessions of EMDR, with less robust effects, may be required than what they might currently expect. [Author Abstract]

Keywords: Literature Review  Posttraumtic Stress Disorder  PTSD  Treatment Effectiveness  

Accuracy Verified: Yes