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1. McFarlane, A. (2003, October-November). CBT vs. EMDR in the treatment of PTSD. In B. A. van der Kolk (Chair), Treatment outcome studies of PTSD. Symposium conducted at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL .
Language: English
Format: Conference
Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment
outcome studies using four different treatment modalities (CBT,
EMDR, psychopharmacology and Cognitive Processing) and presents
data on comparative efficacy, treatment responsiveness and
resistance, effects on comorbidity, quality of life, and biological
changes that accompany symptom improvement.
CBT vs. EMDR in the treatment of PTSD: 114 subjects were randomized into the study, but only 45 completed
up to week 10. The subjects in the study comprise 45 sufferers of
Post traumatic stress disorder as defined by the Clinician
Administered PTSD Scale (CAPS) (caps score > 50, and who satisfied
criteria A,B,C and D for PTSD diagnosis) and the PCL-C (PCL-C>50).
All subjects were victims of a traumatic experience and were
recruited through newspaper or radio advertisements, referrals from
private practitioners (18 subjects) or through the State Government
Insurance Commission (SGIC) (27 subjects). Subjects were randomised
into one of three treatments. Fourteen subjects received
EMDR, 21 received CBT and 10 were control subjects. The mean
age of the sample was 41.38 (SD=11.55) with the minimum age of
19 and the maximum age of 61. Sixteen of the subjects were male
and 29 were female. During the treatment period 17 of the subjects
were taking antidepressants and 6 were taking anxiolytics.
Approximately half of the sample was married (22 subjects 48.9%),
12 had never married, 4 were separated, 1 was defacto and 6 were
divorced. The mean number of treatment sessions for the entire
sample was 8.53 (SD 1.65). Out of the 45 participants in the study, 26
had suffered only one single trauma in their lives, 11 had experienced
several single traumas, 3 had suffered one ongoing trauma
and 5 individuals had suffered at least one ongoing and one specific
trauma. The following results were performed on the treatment
groups (total 35 subjects), with the control group being excluded
from all analyses. All subjects, were aged between 18 and 65, lived
in metropolitan Adelaide and had an adequate command of
English (reading and writing).All subjects gave informed consent to
the study and expressed their willingness to comply with the protocol.
Subjects with a history of adult seizure disorder, organic brain
disease or who were assessed to be at significant suicide risk (a
score of 3 or more on suicide question in HAM-D), were excluded
from the study, as were subjects taking psychotropic drugs (anticonvulsive/
antipsychotic) or sedatives more than 4 times a week. All
assessment and treatment sessions were conducted at the
University of Adelaide Department of Psychiatry at the Queen
Elizabeth Hospital. Assessment sessions were conducted by trained
research assistants and all therapy sessions were conducted by a
clinical psychologist, trained in both EMDR and CBT. Subjects were
assessed for suitability to enter the study via an initial screening
instrument (sent out to subjects in the post) and an initial screening
interview. Patients were further evaluated at week 0
(baseline/immediately prior to commencement of treatment), 3, 4,
6, 8 10, 20 (10 week followup).
Keywords: CBT Cognitive Behavioral Therapy Symposium
Accuracy Verified: Yes
2. Sharpless, B. A., & Barber, J. P. (2011). A clinician’s guide to PTSD treatments for returning veterans. Professional Psychology: Research and Practice, 42(1), 8–15. doi:10.1037/a0022351.
Language: English
Format: Journal
Abstract:
What options are available to mental health providers helping clients with posttraumatic stress disorder
(PTSD)? In this paper we review many of the current pharmacological and psychological interventions
available to help prevent and treat PTSD with an emphasis on combat-related traumas and veteran populations.
There is strong evidence supporting the use of several therapies including prolonged exposure (PE), eye
movement desensitization and reprocessing (EMDR), and cognitive processing therapies (CPT), with PE
possessing the most empirical evidence in favor of its efficacy. There have been relatively fewer studies of
nonexposure based modalities (e.g., psychodynamic, interpersonal, and dialectical behavior therapy perspectives),
but there is no evidence that these treatments are less effective. Pharmacotherapy is promising
(especially paroxetine, sertraline, and venlafaxine), but more research comparing the relative merits of
medication vs. psychotherapy and the efficacy of combined treatments is needed. Given the recent influx of
combat-related traumas due to ongoing conflicts in Iraq and Afghanistan, there is clearly an urgent need to
conduct more randomized clinical trials research and effectiveness studies in military and Department of
Veterans Affairs PTSD samples. Finally, we provide references to a number of PTSD treatment manuals and
propose several recommendations to help guide clinicians’ treatment selections.
Keywords: Posttraumatic Stress Disorder Psychotherapy Psychopharmacology PTSD
Accuracy Verified: Yes
3. Otto, M. W., Penava, S. J., Pollack, R. A., & Smoller, J. W. (1996). Cognitive-behavioral and pharmacologic perspectives on the treatment of posttraumatic stress disorder. In M. H. Pollack, M. W. Otto, & J. F. Rosenbaum (Eds.). Challenges in clinical practice: Pharmacologic and psychosocial strategies (pp. 219-260). New York: Guilford Press.
Language: English
Format: Book Section
Abstract:
The following sections consider biologic and cognitive-behavioral perspectives on PTSD and strategies for its treatment. Pharmacologic strategies examined to date have included treatment with beta-adrenergic blockers and alpha-adrenergic agonists, benzodiazepines, antikindling agents, mood stabilizers, and various antidepressants. Exposure-based treatments have been included in a number of approaches to the disorder, but have received the most direct attention in cognitive-behavioral conceptualizations. Each of these interventions has the potential to change one aspect or a constellation of PTSD symptoms, and must be evaluated relative to the number of symptom domains that each affects. [Text, p. 222]
Keywords: Behavior Therapy Cognitive Therapy Drug Therapy Literature Review Neurobiology Psychopharmacology PTSD Stressors Survivors Treatment Effectiveness
Accuracy Verified: Yes
4. Hopper, J., Spinazzola, J., Blaustein, M., Yehuda, R., van der Kolk, B. A., & Simpson, W. (2003, October-November). Differential biological outcomes of EMDR and fluoxetine for PTSD. In B. A. van der Kolk (Chair), Treatment outcome studies of PTSD. Symposium conducted at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.
Language: English
Format: Conference
Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment
outcome studies using four different treatment modalities (CBT,
EMDR, psychopharmacology and Cognitive Processing) and presents
data on comparative efficacy, treatment responsiveness and
resistance, effects on comorbidity, quality of life, and biological
changes that accompany symptom improvement.
Differential Biological Outcomes of EMDR and Fluoxetine for PTSD: Two major developments in PTSD research have been the development
of effective treatments and the delineation of pathophysiology.
While major gains have been made in both of these areas, they
have occurred in parallel. There is a need for investigations of possible
differential effects of different treatment modalities on biological
aspects of PTSD. In this randomized controlled trial (N = 105), we
compared the exposure treatment Eye Movement Desensitization
and Reprocessing, the serotonergic reuptake inhibitor fluoxetine,
and pill placebo for their effects on both PTSD symptoms and biological
parameters. The outcome measures were severity of reexperiencing,
avoidant/numbing, and hyperarousal symptoms; psychophysiological
reactivity to script-driven imagery; basal salivary
cortisol and dexamethasone suppression test (DST). At pre-treatment,
post-treatment and 3-month follow-up, saliva samples were
acquired at 8 a.m., 11 p.m. (immediately followed by dexamethasone)
and 8 a.m.. Participants also underwent a script-driven
imagery protocol utilizing four 30s scripts, each followed by a 60s
script imaging period and 2 minute recovery periods (fixed order:
neutral, trauma, neutral, trauma). Preliminary analyses partially support
hypothesizes concerning differential efficacies of pharmacological
and psychological treatments on different symptom clusters
and biological markers of the disorder, at post-treatment and 3-
month follow-up. Potential implications for treatment and future
research will be discussed.
Keywords: Fluoxetine Posttraumatic Stress Disorder PTSD Symposium
Accuracy Verified: Yes
5. Grbesa, G., Simonovic, M., & Jankovic, D. (2010, April). Electrophysiological changes during EMDR treatment in patients with combat-related PTSD. Annals of General Psychiatry, 9(Supplement 1), S209. doi:10.1186/1744-859X-9-S1-S209.
Language: English
Format: Journal
Abstract:
1st International Congress on Neurobiology and Clinical Psychopharmacology and European Psychiatric Association Conference on Treatment Guidance
Background
Efficiency of the EMDR procedure is based on a presumption of neuropsychological changes in therapeutic process.The aim of the investigation is to scann and give evidence of electroactivity changes, during the process of EMDR procedure and after finishing it.
Materials and methods
We have recorded a continual polygraph EEG, before, during and after EMDR therapy, in patient with combat-related PTSD.
Results
Before the treatment, EEG recorded basic activity of low voltage (attenuation) of 20 μV, frequency of beta range (17-26 Hz), bioccipital, with no pathologic activity. Patient had prominent vegetative symptoms (anxiety, heart rate 100/min). Background activity immediately after the treatment records the amplitude values of around 50 μV, frequency of around 11-12 Hz. After the end of the treatment background activity possesses the amplitude value of about 37 μV, holding the persistence in frequency.
Conclusions
If the EMDR treatment is successful, sudden increase of amplityde activity is noted imensly. This sharp border line, which signifies normal activity, appears in 2-3 seconds affter the desensitize phase. The investigation suggest that from neurophysiological point of view, cortex (in EMDR procedure), works according to the principle "all or nothing". If there is processing of traumatic memory, the activity gets completly normal. If the therapy is not successful, there are numerous artefacts, because of increased muscle activity. This kind of activity, in our investigation is marked as "Artefact therapy".
The results, indicate maintaining low level of amplitude values of electrocortical activities during the treatment, as well as increase after successful treatment. The increase of amlitude is corelated to decrease of anxiety after the successful treatment.
Acknowledgements
The results, indicate maintaining low level of amplitude values of electrocortical activities during the treatment, as well as increase after successful treatment. The increase of amlitude is corelated to decrease of anxiety after the successful treatment.
References
EEG Asymmetry and its Clinical Correlates in PTSD, Steven Silverstein, Stewart Shankman Lea Williams, Patrick Hopkinson, Richard Bryant
Keywords: Combat Electrophysiological Change Posttraumatic Stress Disorder PTSD
Accuracy Verified: Yes
6. Cukor, J., Olden, M., Lee, F., & Difede, J. (2010, October). Evidence-based treatments for PTSD, new directions, and special challenges. Annals of the New York Academy of Sciences, 1208(1), 82-89. doi:10.1111/j.1749-6632.2010.05793.x.
Language: English
Format: Journal
Abstract:
This paper provides a current review of existing evidence-based treatments for posttraumatic stress disorder (PTSD), with a description of psychopharmacologic options, prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing, especially as they pertain to military populations. It further offers a brief summary of promising treatments with a developing evidence base, encompassing both psychotherapy and pharmacotherapy. Finally, challenges to the treatment of PTSD are summarized and future directions suggested.
Keywords: Cognitive Processing Therapy CPT Evidence-Based Treatment Military PE Posttraumatic Stress Dsorder PTSD Prolonged Exposure Psychopharmacology
Accuracy Verified: Yes
7. Barker, S. (2010, November). Eye movement desensitization and reprocessing (EMDR) in the treatment of trauma-based disorders. Presentation at the 23rd Annual U.S. Psychiatric and Mental Health Congress Conference and Exhibition, Orlando, Florida.
Language: English
Format: Conference
Abstract:
EMDR is a recommended treatment for PTSD by the APA, DOD, and other professional bodies, yet many clinicians are unaware of this approach or question its efficacy. With accumulating research documenting the efficiency of EMDR, clinicians may be overlooking an effective treatment option for their patients. This session explains the 8-stage EMDR process summarizing efficacy research and demonstrating through case examples.
Learning Objectives:
After completing this activity, participants should be able to:
1.Assess and identify appropriate patients for EMDR when determining treatment of trauma-based disorders.
2.Describe the EMDR process and when to appropriately incorporate the therapy into practice.
3.Monitor therapy progress and patient improvement with evidence-based patient outcomes of EMDR.
Keywords: Psychiatric Disorders & Diagnosis Psychopharmacology Psychotherapy
Accuracy Verified: Yes
8. Lustig, S., Smrz, A., Sladen, P., Sellers, T. D., & Hellman, S. (2000, January-February). It takes a village: Caring for a traumatized art student. Harvard Review of Psychiatry, 7(5), 290-298. doi:10.3109/hrp.7.5.290.
Language: English
Format: Journal
Abstract:
One of the fascinating developments in mental health care in the last decade has been the appearance of specific psychotherapies for various psychiatric illnesses. Perhaps the best known of these is dialetical behavior therapy (DBT), pioneered by Linehan and colleagues for borderline personality disorder and consisting of rigorous group and individual cognitive-behavioral therapy within an empathetic and validating psychotherapy setting. Another is eye-movement desensitization and reprocessing (EMDR), described by Shapiro and coworkers as a treatment for PTSD and other anxiety disorders.The following case study involves a patient in a team-treatment setting who benefitted significantly from the use of DBT and EMDR, as well as a complex psychopharmacology regimen, after receiving an extensive battery of psychological tests. The clinicians who were involved with the patient will discuss the aspects of her care for which they were responsible. We do not endeavor to isolate which modality was the "right" one; rather, we are looking at the manner in which each potentiated the others. [Introduction] [Pilots]
Keywords: Borderline Personality Disorder Case Report Child Abuse Cognitive Therapy College Students Drug Therapy European Americans Females Incest Individual Psychotherapy Partial Hospitalization Psychotherapeutic Processes PTSD Rape Survivors Young Adults
Accuracy Verified: Yes
9. Miti, G., & Onofri, A. (2011, Guigno). La psicoterapia dei disturbi dissociativi: Dalle tecniche cognitivo-comportamentali all'approccio EMDR [Psychotherapy of dissociative disorders: From cognitive-behavioral techniques to the EMDR approach]. Cognitivismo Clinico, 8(1), 73-91 .
Language: Italian
Format: Journal
Abstract:
Gli Autori illustrano i princìpi fondamentali nel trattamento dei Disturbi Dissociativi, nell’ottica della psicoterapia cognitivo-evoluzionista. Descrivono la cosiddetta “Terapia per fasi”, caratterizzata dalla iniziale ricerca della stabilizzazione del paziente e da una riduzione sintomatologica; quindi da una fase centrale di elaborazione dei traumi relazionali e complessi considerati frequentemente alla base degli stati dissociativi; infine dalla integrazione e ricerca di una “crescita post-traumatica”. Gli Autori prendono in esame le diverse strategie e tecniche più frequentemente utilizzate, da quelle legate al lavoro terapeutico sul corpo ai gruppi di mutuo aiuto, dalla psicofarmacologia all’ipnosi. Una parte significativa dell’articolo è dedicata all’uso dell’approccio EMDR nel trattamento degli stati dissociativi.
The Authors show the fundamental principles in the treatment of the Dissociative Disorders, in the perspective of the Cognitive-Evolutionary Psychotherapy. They describe the so called “Staged Therapy”, characterized by a starting phase toward the stabilization of the patient and the symptomatology’s reduction; by a central phase of processing of the relational and complex traumas often grounding the dissociative states; and then by an integration and a “post-traumatic growing”. The Authors examine the different strategies and techniques, most frequently used, from the therapeutical body work till self-help groups, from psychopharmacology till hypnosis. A significant part of the article show the importance of the EMDR approach in the treatment of dissociative states.
Keywords: Dissociative Disorders
Accuracy Verified: Yes
10. Watson, P. J., Friedman, M. J., Ruzek, J. I., & Norris, F. (2002, August). Managing acute stress response to major trauma. Current Psychiatry Reports, 4(4), 247-253. doi:10.1007/s11920-996-0043-x.
Language: English
Format: Journal
Abstract:
In this article, the authors review the current empiric literature on early interventions. Findings on the effects, course, help-seeking, and recovery from disasters are first reviewed, with recommendations given that are pertinent to intervention following mass casualties. In reviewing the most commonly used interventions, it is clear that evidence from well-controlled studies showing that early intervention can help prevent longer-term problems is limited. The authors discuss the approaches that have received the most attention or empiric support as early interventions following trauma, which include psychologic debriefing, cognitive-behavioral interventions, eye movement desensitization and processing (EMDR) and other neoteric approaches, and psychopharmacology. At this time, the most promising results for prevention of psychopathology have been achieved with brief four- or five-session cognitive-behavioral therapy. In contrast, randomized clinical trials on psychologic debriefing currently suggest that this approach is either ineffective at preventing psychopathology, or contributive to PTSD symptoms. Research support is currently lacking for EMDR and pharmacotherapy as early interventions. A major challenge to the field is to integrate the practical experience and knowledge of professional responders with well-controlled, timely intervention research, and to effectively disseminate these findings to practitioners in the field. [Author Abstract]
Keywords: Critical Incident Stress Debriefing Effects Literature Review Negative Research Needs Review Posttraumatic Stress Diorder Psychological Debriefing PTSD Stressors Survivors Therapeutic Reaction Treatment Effectiveness
Accuracy Verified: Yes
11. Ferrie, R. K. (2004, September). Problems with SSRIs in the treatment of traumatic syndromes. Presentation at the annual meeting of the EMDR International Association, Montréal, Quebec Canada.
Language: English
Format: Conference
Abstract:
This workshop will focus on the biological and clinical evidence supporting
the notion that depression, dissociation, somatization, and PTSD may be
symptomatic responses to traumatic events which affect the brain. The safety of SSRls and their application for the treatment of PTSD will be
discussed as will the complications arising from their short and long lerm
use. Single system designated case studies, will be used to demonstrate how
treatment with EMDR allows one to arrive at successful outcomes in
trauma spectrum disorders, with or without psychopharmacology.
Keywords: SSRIs
Accuracy Verified: Yes
12. Hopper, E., Simpson, W., Blaustein, M., & Spinazzola, J. (2004, November). Self-perception of symptom change in the treatment of PTSD. Presentation at the 20th annual meeting of the International Society of Traumatic Stress Studies, New Orleans, LA.
Language: English
Format: Conference
Abstract:
The current study examined client self-perception of change in posttraumatic
stress symptoms during and after treatment in three treatment conditions:
psychopharmacology (fluoxetine), an exposure-based psychotherapeutic
treatment (EMDR), and a pill placebo. Subjects were 88 patients with
mixed-trauma exposure and primarily chronic trauma response. Subjects
completed the Davidson Trauma Scale (DTS) prior to beginning treatment,
during the treatment phase, and during follow-up. In all conditions, selfreported
symptoms of posttraumatic stress decreased during the treatment
phase. After treatment, average DTS score for subjects in the therapy condition
continued to decrease, while mean score for subjects who received
pharmacological treatment increased slightly. Two months after termination
of treatment, the average DTS score was 21 for the EMDR condition and 43
for the fluoxetine condition. Results revealed that subjects perceived themselves
as improving steadily during the course of treatment, regardless of
treatment condition. These results support the idea that there are non-specific
factors in therapy (perhaps including factors such as instillation of
hope, treatment expectations, and empathy) that lead to self-perceived
improvement in symptoms. However, maintenance of perceived gains did
appear to favor exposure-based therapy as a treatment for posttraumatic
stress disorder.
Keywords: Posttraumatic Stress Disorder PSTD Self-Perception Symptom Change
Accuracy Verified: Yes
13. Greenwald, R., Stain, M., Allen, R., Azubuike, A., & Borgen, R. (2004, November). Trauma-informed treatment for incarcerated youth: A controlled study. Presentation at the 20th annual meeting of the International Society for Traumatic Stress Studies, New Orleans, LA .
Language: English
Format: Conference
Abstract:
The current study examined client self-perception of change in posttraumatic
stress symptoms during and after treatment in three treatment conditions:
psychopharmacology (fluoxetine), an exposure-based psychotherapeutic
treatment (EMDR), and a pill placebo. Subjects were 88 patients with
mixed-trauma exposure and primarily chronic trauma response. Subjects
completed the Davidson Trauma Scale (DTS) prior to beginning treatment,
during the treatment phase, and during follow-up. In all conditions, selfreported
symptoms of posttraumatic stress decreased during the treatment
phase. After treatment, average DTS score for subjects in the therapy condition
continued to decrease, while mean score for subjects who received
pharmacological treatment increased slightly. Two months after termination
of treatment, the average DTS score was 21 for the EMDR condition and 43
for the fluoxetine condition. Results revealed that subjects perceived themselves
as improving steadily during the course of treatment, regardless of
treatment condition. These results support the idea that there are non-specific
factors in therapy (perhaps including factors such as instillation of
hope, treatment expectations, and empathy) that lead to self-perceived
improvement in symptoms. However, maintenance of perceived gains did
appear to favor exposure-based therapy as a treatment for posttraumatic
stress disorder.
Keywords: Incareration Trauma Youth
Accuracy Verified: Yes
14. Hodes, M., & Diaz-Caneja, A. (2007). Treatment options for young people and refugees with post-traumatic stress disorder II. In A. A. Hosin (Ed.), Responses to traumatized children, (pp. 40-65). Basingstoke, England: Palgrave Macmillan.
Language: English
Format: Book Section
Abstract:
This chapter focuses on the effective treatments for PTSD which are used with young people, particularly young refugees. Comprehensive accounts of treatments and treatment efficacy for PTSD in young people have been provided elsewhere. The aims of this chapter are therefore twofold: first to describe the more established treatments for young people with PTSD, and second to look at all innovative treatment approaches that have been developed for young refugees. The chapter has an evidence-based perspective, and so provides data regarding the efficacy of the treatments described.In order to achieve these aims, it was felt necessary to describe the background to evidence-based practice. This will be followed by a summary of children's and adolescents' reactions to traumatic events, and salient developmental factors. The description of treatments begins then with the therapies for which there is currently most evidence, e.g. cognitive behavioural and related treatments, including group CBT and exposure therapy. Two other individual treatments -- EMDR and psychopharmacology -- will also be described in this chapter. There is then consideration of some innovative therapies that have been used for young refugees with PTSD, such as testimony therapy and narrative exposure therapy. Non-directive therapies such as art therapy are highlighted and discussed alongside the role of the family and its potential for involvement in treatment and any proposed management plan. Finally, attention is given to some contextual factors that will influence choice of treatments. [Text, p. 40][Pilots]
Keywords: Posttraumatic Stress Disorder PTSD Refugees Treatment Young People
Accuracy Verified: Yes
15. van der Kolk, B. A., Hopper, J., Spinazzola, J., Blaustein, M., Hopper, E., & Simpson, W. (2003, October/November). Treatment outcome of fluoxetine vs. EMDR in PTSD. Symposium conducted (B. A. van der Kolk, Chair) at the 19th annual meeting of the International Society for Traumatic Stress Studies, Chicago, IL.
Language: English
Format: Conference
Abstract:
Treatment Outcome Studies of PTSD: This symposium presents three large carefully controlled treatment
outcome studies using four different treatment modalities (CBT,
EMDR, psychopharmacology and Cognitive Processing) and presents
data on comparative efficacy, treatment responsiveness and
resistance, effects on comorbidity, quality of life, and biological
changes that accompany symptom improvement.
Treatment outcome of fluoxetine vs. EMDR in PTSD: This NIMH funded study compared the efficacy of two widely different
treatment approaches for treating patients with PTSD: fluoxetine,
which acts directly on biological systems (N=30), and Eye
Movement Desensitization and Reprocessing (EMDR) (N=30). There
also was a pill placebo control group (N=30). We assessed subjects
with a multi-modal biological and psychological assessment, in
order to determine whether treatment efficacy is associated with
changes: 1) social adjustment, 2) psychophysiological reactivity to
personalized trauma scripts (heart rate and skin conductance), and
3) basal salivary cortisol. We also tracked the stability of symptom
change for nine months following the cessation of active treatment.
Preliminary results suggest that at the end of 8 weeks of treatment,
there is a 30% improvement in the pill placebo condition, while both
active treatments demonstrate additional symptom improvement,
with EMDR being most effective for the treatment of acute PTSD,
and Prozac for subjects with prolonged childhood histories of trauma.
Clinically significant improvement in CAPS scores is accompanied
by an increase in basal cortisol and improvement in social and
occupational functioning. We will also present data on the differential
rates of symptom change in the different PTSD symptom clusters
between the two treatment groups during the nine months of follow-
up after cessation of the acute treatment phase.
Keywords: Fluoxetine Posttraumatic Stress Disorder PTSD Symposium
Accuracy Verified: Yes


