Francine Shapiro Library - EMDR Bibliography Links

 

 

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1. Schubert, S., & Lee, C. W. (2009). Adult PTSD and its treatment with EMDR: A review of controversies, evidence, and theoretical knowledge. Journal of EMDR Practice and Research, 3(3), 117-132. doi:10.1891/1933-3196.3.3.117.

Language: English

Format: Journal

Abstract:
This article provides an overview of selective issues relating to adult posttraumatic stress disorder (PTSD) and its treatment with eye movement desensitization and reprocessing (EMDR). The article begins by providing a historical overview of PTSD, and debates about the etiology and definition of PTSD are discussed. The most predominant theories of PTSD are summarized by highlighting how they have evolved from traditional behavioral accounts based on the assumption that PTSD is an anxiety disorder to theories that now incorporate information-processing models. This article then examines the development of EMDR and the corresponding body of research that clearly demonstrates its efficacy for the treatment for adult PTSD. The underlying mechanisms of EMDR are discussed, with a focus on the importance of the eye movement component and how the therapeutic processes in EMDR differ from those of traditional exposure therapy. Finally, the adaptive information-processing (AIP) model that underlies EMDR is outlined, and evidence for the model is summarized. The article concludes by suggesting future research based on questions raised about PTSD and its treatment with EMDR when the AIP model is compared to other information-based theories of PTSD.

Keywords: Adult  Mechanism of Action  Review  Posttraumatic Stress Disorder  PTSD  Theory  

Accuracy Verified: Yes

2. Becker, C. B., Darius, E., & Schaumberg, K. (2007, December). An analog study of patient preferences for exposure versus alternative treatments for posttraumatic stress disorder. Behaviour Research and Therapy, 45(12), 2861-2873. doi:10.1016/j.brat.2007.05.006.

Language: English

Format: Journal

Abstract:
Although several efficacious treatments for PTSD exist, these treatments are currently underutilized in clinical practice. To address this issue, research must better identify barriers to dissemination of these treatments. This study investigated patient preferences for PTSD treatment given a wide range of treatment options in an analog sample. 160 individuals, with varying degrees of trauma history, were asked to imagine themselves undergoing a trauma, developing PTSD, and seeking treatment. Participants evaluated 7 different treatment descriptions, which depicted treatment options that they might encounter in a clinical setting. Participants rated their most and least preferred treatments along with their personal reactions to and the perceived credibility of each treatment. Participants also completed a critical thinking skills questionnaire. Participants predominantly chose exposure or another variant of cognitive-behavioral therapy as their most preferred therapy, and those who chose exclusively empirically supported treatments evidenced higher critical thinking skills. The present study contributes to a growing literature indicating that patients may be more interested in these therapies than indicated by utilization rates. The problem of underutilization of empirically supported treatments for PTSD in clinical practice may be due to therapist factors. [Author Abstract]

Keywords: Adults  Americans  Cognitive Processes  Cognitive Therapy  College Students  Evidence Based Treatment  Exposure  Empirically Supported Treatment  Patient Preference  Posttraumatic Stress Disorder  Posttraumatic Stress Disorder  Psychoanalytic Psychotherapy  Psychotherapeutic Processes  PTSD  Selective Serotonin Reuptake Inhibitors  Stressors  Survivors  TFT  Thought Field Therapy  

Accuracy Verified: Yes

3. Saint Paul, N. V. (2002, May). Aus der fülle ... Ressourcen- und Korperorientierung in der traumatherapeutischen arbeit [Out of the abundance ... Resource and body orientation in trauma therapy]. Presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany.

Language: German

Format: Conference

Abstract:
This paper describes how trauma therapy including body awareness can reduce the impact of the traumatic memory and can efficiently prevent retraumatization. The goal is to achieve the ability to self-regulate activation of the autonomic nervous system and hence, to attain access to states in which patients can maximize their resources. This procedure is based on neurobiological findings and exemplified with case studies. The approach complements other trauma therapeutic interventions, regardless of the theoretical orientation, and can be combined with techniques like, for instance, EMDR.

Keywords: Neurobiology  Psychotherapy  Psycho Trauma  Resource Orientation  Selective Mutism  

Accuracy Verified: Yes

4. Saint Paul, N. V. (2008). Aus der fülle ... Ressourcen- und körperorientierung in der traumatherapeutischen arbeit [Out of the abundance ... Resource and body orientation in trauma therapy]. Interdisziplinär, 16(3), 166-175 .

Language: German

Format: Magazine

Abstract:
In diesem Beitrag wird beschrieben, wie Traumatherapie unter Einbeziehung der Körperwahrnehmung schonend gestaltet und so einer Retraumatisierungsgefahr wirksam begegnet wird. Ziel ist das Erlangen der Fähigkeit, den Aktivierungszustand des autonomen Nervensystems zu regulieren und auf diese Weise Zugang zu ressourcenvollen Ich-Zuständen zu erlangen. Das Vorgehen wird durch neurobiologische Erkenntnisse begründet und anhand von Fallbeispielen veranschaulicht. Der Ansatz wird als Ergänzung zu anderen traumatherapeutischen Verfahren, gleich welcher Schule, verstanden und lässt sich gut mit speziellen Methoden, wie beispielsweise EMDR, verbinden.

Summary: This paper describes how trauma therapy including bodyawareness can reduce the impact of the traumatic memory and can efficiently prevent retraumatization. The goal is to achive the ability to self-regulate activation of the atuonomic nervous system and hence, to attain access in states in which patients can maximize their resources. This proceedure is based on neurobiological findings and exemplified with case studies. The approach compliments other trauma therapeutic interventions, regardless of the theoretical orentation, and can be combined with techniques like, for instance, EMDR.

Keywords: Neurobiology  Psychotherapy  Psycho Trauma  Resource Orientation  Selective Mutism  

Accuracy Verified: Yes

5. Forbes, D., Creamer, M., Phelps, A., Bryant, R., McFarlane, A., Devilly, G. J., Lynda Matthews, L., Raphael, B., Doran, C., Merlin, T., & Skye N. (2007, August). Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Australian & New Zealand Journal of Psychiatry, 41(8), 637-648. doi:10.1080/00048670701449161.

Language: English

Format: Journal

Abstract:
Over the past 2-3 years, clinical practice guidelines (CPGs) for post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) have been developed in the USA and UK. There remained a need, however, for the development of Australian CPGs for the treatment of ASD and PTSD tailored to the national health-care context. Therefore, the Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis. [InformaWorld]

Keywords: ASD  Guidelines  Posttraumatic Stress Disorder  PTSD  Trauma  Treatment  

Accuracy Verified: Yes

6. Australian Centre for Posttraumatic Mental Health (2007, February). Australian Guidelines for the treatment of Adults with Acute Stress disorder and posttraumatic stress disorder. Melbourne, Victoria: ACPMH.

Language: English

Format: Other

Abstract:
The Australian Centre for Posttraumatic Mental Health in collaboration with national trauma experts, has recently developed Australian CPGs for adults with ASD and PTSD, which have been endorsed by the National Health and Medical Research Council (NHMRC). In consultation with a multidisciplinary reference panel (MDP), research questions were determined and a systematic review of the evidence was then conducted to answer these questions (consistent with NHMRC procedures). On the basis of the evidence reviewed and in consultation with the MDP, a series of practice recommendations were developed. The practice recommendations that have been developed address a broad range of clinical questions. Key recommendations indicate the use of trauma-focused psychological therapy (cognitive behavioural therapy or eye movement desensitization and reprocessing in addition to in vivo exposure) as the most effective treatment for ASD and PTSD. Where medication is required for the treatment of PTSD in adults, selective serotonin re-uptake inhibitor antidepressants should be the first choice. Medication should not be used in preference to trauma-focused psychological therapy. In the immediate aftermath of trauma, practitioners should adopt a position of watchful waiting and provide psychological first aid. Structured interventions such as psychological debriefing, with a focus on recounting the traumatic event and ventilation of feelings, should not be offered on a routine basis. [InformaWorld]

Keywords: Treatment Guidelines  

Accuracy Verified: Yes

7. Christman, S. D., Garvey, K. J., Propper, R. E., & Phaneuf, K. A. (2003, April). Bilateral eye movements enhance the retrieval of episodic memories. Neuropsychology, 17(2), 221-229. doi:10.3758/PBR.15.3.515.

Language: English

Format: Journal

Abstract:
Two experiments examining effects of eye movements on episodic memory retrieval are reported. Thirty seconds of horizontal saccadic eye movements (but not smooth pursuit or vertical eye movements) preceding testing resulted in selective enhancement of episodic memory retrieval for laboratory (Experiment 1) and everyday (Experiment 2) events. Eye movements had no effects on implicit memory. Eye movements were also associated with more conservative response biases relative to a no eye movement condition. Episodic memory improvement induced by bilateral eye movements is hypothesized to reflect enhanced interhemispheric interaction, which is associated with superior episodic memory (S. D. Christman & R. E. Propper. 2001). Implications for neuropsychological mechanisms underlying eye movement desensitization and reprocessing (F. Shapiro, 1989, 2001), a therapeutic technique for posttraumatic stress disorder, are discussed. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

Keywords: Bilateral Eye Movements  Episodic Memory Retrieval  Saccadic Eye Movements  

Accuracy Verified: Yes

8. Morris-Smith, J. (2002, May). Breaking the silence - EMDR for children suffering from selective mutism. Presentation at the annual meeting of the EMDR Europe Association, Frankfurt, Germany.

Language: English

Format: Conference

Keywords: Children  Selective Mutism  

Accuracy Verified: Yes

9. Rossello-Mir, J., Revert-Vidal, X., Obrador, P., & Cardell, E. (2007, June). Brief EMDR protocol versus bilateral stimulation in the treatment of spider phobia. Presentation at the annual meeting of the EMDR Europe Association, Paris, France.

Language: English

Format: Conference

Abstract:
EMDR, that includes bilateral stimulation, causes the desensitization and reprocessing of traumatic memories, thus reducing anxiety, distress, fear, and other symptoms related with several anxiety disorders. Previous results show it is effective in reducing symptoms of PTSD, panic disorder, public speaking anxiety, etc. Relying on some previous results we think that a brief EMDR protocol could be applied to relieve symptoms of specific phobias.
To investigate this issue, we study the efficacy of a new brief EMDR protocol in the treatment of spider phobia. Furthermore, our design tries to clarify the controversy about which components of the EMDR procedure are relevant for patient’s improvement. More specifically, we compare the effectiveness of our brief procedures with that of simple bilateral stimulation that is, without eye movements, which necessity to obtain therapeutic outcome has been questioned.
We randomly assign twenty volunteers, female university students with spider phobia to one of three groups. We applied the brief EMDR protocol to the first one and bilateral stimulation to the second one, being the third group the control one. To assess the effectiveness of both treatments, in addition to apply traditional questionnaires, we designed a specific emotional Stroop task in order to make use of this tool to evaluate, before and after each treatment, the selective attentional biases, that seem to play an important role in the etiology and maintenance of anxiety disorders. We discuss the differences found in our results in reference to the controversy aforementioned and how they can help to understand the EMDR mechanism of action.

Keywords: Bilateral Stimulation  BLS  Brief EMDR  Spider Phobia  

Accuracy Verified: Yes

10. Holmes, E. A., James, E. L., Coode-Bate, T., & Deeprose, C. (2009). Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science. PLoS ONE, 4(1): e4153. doi:10.1371/journal.pone.0004153 .

Language: English

Format: Journal

Abstract:
Background. Flashbacks are the hallmark symptom of Posttraumatic Stress Disorder (PTSD). Although we have successful treatments for full-blown PTSD, early interventions are lacking. We propose the utility of developing a ‘cognitive vaccine’ to prevent PTSD flashback development following exposure to trauma. Our theory is based on two key findings: 1) Cognitive science suggests that the brain has selective resources with limited capacity; 2) The neurobiology of memory suggests a 6-hr window to disrupt memory consolidation. The rationale for a ‘cognitive vaccine’ approach is as follows: Trauma flashbacks are sensory-perceptual, visuospatial mental images. Visuospatial cognitive tasks selectively compete for resources required to generate mental images. Thus, a visuospatial computer game (e.g. “Tetris”) will interfere with flashbacks. Visuospatial tasks post-trauma, performed within the time window for memory consolidation, will reduce subsequent flashbacks. We predicted that playing “Tetris” half an hour after viewing trauma would reduce flashback frequency over 1-week.
Methodology/Principal Findings. The Trauma Film paradigm was used as a well-established experimental analog for Post-traumatic Stress. All participants viewed a traumatic film consisting of scenes of real injury and death followed by a 30-min structured break. Participants were then randomly allocated to either a no-task or visuospatial (“Tetris”) condition which they undertook for 10-min. Flashbacks were monitored for 1-week. Results indicated that compared to the no-task condition, the “Tetris” condition produced a significant reduction in flashback frequency over 1-week. Convergent results were found on a clinical measure of PTSD symptomatology at 1-week. Recognition memory between groups did not differ significantly. Conclusions/Significance. Playing “Tetris” after viewing traumatic material reduces unwanted, involuntary memory flashbacks to that traumatic film, leaving deliberate memory recall of the event intact. Pathological aspects of human memory in the aftermath of trauma may be malleable using non-invasive, cognitive interventions. This has implications for a novel avenue of preventative treatment development, much-needed as a crisis intervention for the aftermath of traumatic events.

Keywords: Flashbacks  Tetris  

Accuracy Verified: Yes

11. Greenwald, R. (1999, June). Child trauma measures for research and practice. Poster presented at the annual meeting of the EMDR International Association, Las Vegas, NV.

Language: English

Format: Conference

Abstract:
This is a practical guide to objectively scored measures of child/adolescent post-traumatic stress symptoms. It is geared to the field-based researcher and the practicing clinician, who must balance scientific value with the limitations inherent in clinical practice settings. This is not a comprehensive review, but rather a selective sampling of those instruments most likely to be usefbl in the above contexts. Additional information on child trauma assessment is available at www.childtrauma.com or by contacting the author.

Keywords: Children  Poster  Practice  Research  

Accuracy Verified: Yes

12. 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

13. Perkins, B., & Rouanzoin, C. (2002, January). A critical evaluation of current views regarding eye movement desensitization and reprocessing (EMDR):  Clarifying points of confusion. Journal of Clinical Psychology, 58(1), 77-97. doi:10.1002/jclp.1130.

Language: English

Format: Journal

Abstract:
EMDR is an active psychological treatment for PTSD that has received widely divergent reactions from the scientific and professional community. This article examines points of confusion in the published literature on EMDR, including the theoretical, empirical, and historical issues around EMDR and placebo effects, exposure procedures, the eye movement component, treatment fidelity issues, and outcome studies. It also examines historical information relevant to the scientific process and charges of "pseudoscience" regarding EMDR. We conclude that the confusion in the literature is due to (a) the lack of an empirically validated model capable of convincingly explaining the effects of the EMDR method, (b) inaccurate and selective reporting of research, (c) some poorly designed empirical studies, (d) inadequate treatment fidelity in some outcome research, and (e) multiple biased or inaccurate reviews by a relatively small group of authors. Reading the original research articles frequently helps to reduce the confusion arising from the research review literature. [Author Abstract]

Keywords: Literature Review  Methodology  Posttraumatic Stress Disorder  Professional Criticism  PTSD  Treatment Effectiveness  

Accuracy Verified: Yes

14. van der Vleugel, B. (2013, April). De behandeling van PTSS bij mensen met een psychotische stoornis [The treatment of PTSD in people with a psychotic disorder]. In Onderzoek track 1 and 2. Presentatie op Het congres EMDR Vereniging EMDR Nederland, Nijmegen, Nederland.

Language: Dutch

Format: Conference

Abstract:
Trauma is een risicofactor voor het ontwikkelen van psychose. Het hebben van een ernstige psychiatrische aandoening verhoogt de kans op het ontwikkelen van een co-morbide posttraumatische stress stoornis. Desondanks wordt een co-morbide PTSS zelden gediagnostiseerd en wanneer dit wél gebeurt is behandeling van deze PTSS bepaald niet vanzelfsprekend. Behandelaren vrezen vaak dat het openlijk bespreken van traumatische levenservaringen zal leiden tot decompensatie, heropname, middelenmisbruik, zelfbeschadigend gedrag en / of suïcidaliteit. Ondertussen werken de PTSS klachten als olie op het vuur van de psychose. Omdat mensen met psychotische klachten over het algemeen werden uitgesloten van deelname aan onderzoek naar de effecten van PTSS behandeling was lang niet bekend of psychologische behandeling conform de Richtlijn Angststoornissen ook bij deze populatie veilig en effectief is. Hier begint verandering in te komen. In deze presentatie komen achtereenvolgens aan bod: - De resultaten van een pilot onderzoek naar de effecten van EMDR bij mensen met een psychotische stoornis en een co-morbide PTSS (Van den Berg & Van der Gaag, 2012). - De resultaten van een gecontroleerde multiple baseline study naar de effecten van EMDR en Prolonged Exposure bij mensen met een psychotische stoornis en een comorbide PTSS (De Bont, Van Minnen & De Jongh, submitted). - De opzet en eerste bevindingen van het onderzoeksproject Treating Trauma in Psychosis (T.TIP), een multicenter RCT naar de behandeling van PTSS bij mensen met een psychotische Trauma is a risk factor for the development of psychosis. Having a severe psychiatric condition increases the chance of the development of a co-morbid post-traumatic stress disorder. Nevertheless, a co-morbid PTSD rarely diagnosed and when this happens, treatment of these PTSD determined not obvious. Clinicians often fear that openly discussing traumatic life experiences will lead to decompensation, reuptake, substance abuse, self-injurious behavior and / or suicidality. Meanwhile, the PTSD symptoms as fuel to the fire of the psychosis. Because people with psychotic symptoms were generally excluded from research into the effects of PTSD treatment was long unknown or psychological treatment in accordance with Directive Anxiety disorders also in this population safely and effective. Here begins to be changing. This presentation will subsequently be discussed: - The results of a pilot study on the effects of EMDR in people with a psychotic disorder and comorbid PTSD (Van den Berg and Van der Gaag, 2012) . - The results of a controlled multiple baseline study on the effects of EMDR and Prolonged Exposure to people with a psychotic disorder and comorbid PTSD (De Bont, Van Minnen & De Jongh, submitted). - The design and initial findings of the research Treating Trauma in Psychosis (T.TIP), a multicenter RCT on the treatment of PTSD in people with a psychotic disorder (De Bont et al, submittedstoornis (De Bont et al., submitted).

Keywords: Posttraumatic Stress DIsorder  PSTD  Psychotic Disorders  

Accuracy Verified: Yes

15. van Eijk, M. & ter Braak, A. (2008, Maart). De noodkreet van het lijf: Het lichaam spreekt [The cry of the body: The body speaks]. Presentatie aan de derde congres van de Vereniging EMDR Nederland, Ede, The Netherlands.

Language: Dutch

Format: Conference

Abstract:
De gevolgen van psychotrauma manifesteren zich in de meeste gevallen in de vorm van herbelevingen, vermijding, emotionele ontregeling, concentratiestoornissen en dergelijke. Lichamelijke klachten worden inmiddels ook steeds vaker herkend als een van de gevolgen van PTSS. In deze workshop wordt naast aandacht voor de theoretische achtergrond van psychofysiologische reacties, ingegaan op wat men als EMDR- therapeut in de praktijk kan tegenkomen: dit kan variëren van selectief mutisme tot stigmata en van verlammingsverschijnselen tot visus uitval. Een en ander wordt geïllustreerd aan de hand van voorbeelden en videomateriaal.

The effects of psychotrauma manifest themselves in most cases in the form of reexperiencing, avoidance, emotional disturbance, impaired concentration and the like. Physical symptoms are also now increasingly being recognized as one of the effects of PTSD. This workshop will next focus on the theoretical background of psycho-physiological responses, discuss what they like EMDR therapist in practice may encounter: this may range from selective mutism to stigmata and paralysis to vision loss. This is illustrated by examples and video material.

Keywords: Body  Psychophysiological Responses  Somatic  

Accuracy Verified: Yes

16. Softic, R, & Becirovic, E, (2009, Septembra). Desenzitizacija pokretima ociju i reprocesiranje (EMDR): Kada su rijeci nemocne [Desensitization of eye movements and reprocessing (EMDR): When words are disabled]. Prvi Psihoterapijski Simpozijum Bosne I Hercegovine Sarajevo, Bosnia and Herzegovina.

Language: Serbian

Format: Conference

Abstract:
Neki ljudi doţive traumatska stanja koja ne mogu u potpunosti opisati rijeĉima. Mnogi od njih nikada ni ne progovore o tome što su doţivjeli. Ali patnja se u njima nastavlja i organizam, a ĉesto i okolina plaćaju ogromnu cijenu. U takvim sluĉajevima psihoterapija koja koristi rijeĉi je nemoćna. Istraţivanja upućuju da jedna, relativno nova psihoterapijska metoda desenzitizacija pokretima oĉiju i reprocesiranje (EMDR), moţe pomoći i takvim osobama. Kada neko iskusi ozbiljnu psihološku traumu, ĉini se da dolazi do narušavanja ravnoteţe u nervnom sistemu. Ta ravnoteţa je, moguće, narušena i posredstvom razliĉitih medijatora poput adrenalina, serotonina, dopamina, kortizola itd. Zbog takve neravnoteţe onemogućeno je optimalno funkcioniranje sistema za procesiranje informacija, a informacije vezane uz traumatiĉan dogaĊaj poput slika, zvukova, afekata i fiziĉkih senzacija se zadrţavaju u disfunkcionalnom, uznemirujućem obliku. Danas izranja shvatanje da postoji неуролошки balans u razliĉitim fiziološkim sistemima što omogućuje da informacije budu procesirane na adaptivan naĉin. EMDR kod nekih traumatiziranih djeluje ĉak i kada osoba ne moţe govoriti o tome što je preţivjela. Ono što je bitno jeste da se fokusira na traumatski dogaĊaj i da suraĊuje sa terapeutom u procesu stimulisanja dualne paţnje što omogućava adaptivno procesiranje informacija. Adaptivno procesiranje znaĉi uspostavljanje adekvatnih asocijacija i pojavu da iskustvo biva konstruktivno ugraĊeno u pozitivne kognitivne i emocionalne sheme pojedinca. Odnosno, oslobaĊa od simptoma i omogućava da se nova iskustva doţive bez blokirajućeg uticaja traume.

Some people doţive traumatic conditions that can not fully describe in words. Many of them never to speak of it as doţivjeli. But the suffering in them continues and the body, and environment, and often pay a huge price. In such cases psychotherapy that uses words of the powerless. Research suggests that a relatively new psychotherapeutic methods desensitization and reprocessing eye movement (EMDR), and can help such people. When someone has experienced serious psychological trauma, it seems that there is a violation of equilibrium in the nervous system. This equilibrium is possible, and disrupted through a variety of mediators such as adrenaline, serotonin, dopamine, cortisol, etc.. Because of such imbalance prevented the optimal functioning of the system for information processing and information related to traumatic an event such as images, sounds, physical sensations and affects it retains in the dysfunctional, disturbing form. It emerges that there is understanding of neurological balance in different physiological systems, which allows information to be processed on adaptive manner. EMDR works by some traumatized even when the person can not talk about what is preţivjela. What is important is to focus on the traumatic events and to co-operate with the therapist in the process of stimulating the attention of the dual provides adaptive information processing. Adaptive processing means getting the right associations and the emergence of the experience of being a built-in positive constructive cognitive and emotional schemas of the individual. That is, oslobaĊa of symptoms and allows for new experiences doţive without blocking effects of trauma.

Keywords: Doţ  ivjeli  Preţ  ivjela  

Accuracy Verified: Yes

17. 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

18. Capezzani, L. (2012, June). EMDR and cancer patients: Effetcts on PTSD and their illness coping strategies [EMDR y pacientes con cáncer: Efectos sobre el TEPT y sus estrategias de afrontamiento de la enfermedad]. Presentation at the Annual Meeting of the EMDR Europe Association, Madrid Spain.

Language: English

Format: Conference

Abstract:
The nature of this study is both observational and clinical. On the one hand it’s aimed to see how the criteria of PTSD (DSM-­‐IV, 2000) are represented in traumatized cancer patients in between two different illness stages -­‐ medical treatments and medical follow-­‐up stages, -­‐ and to see witch coping strategies are used by these patients with PTSD in each stage. On the other hand it’s aimed to know: a) whether CBT integrated with EMDR produces different effects on PTSD in between the two illness stages and their specific coping strategies; b) whether CBT with EMDR and CBT without EMDR produce different effects on PTSD and on the coping strategies within the only medical follow-­‐up stage. All 31 subjects were recruited randomly, 10 for treatment stage, 11 for follow-­‐up stage, both receiving CBT and EMDR, and 10 for a follow-­‐up stage treaty with CBT and no EMDR. CAPS and COPE were used to assess PTSD and coping strategies respectively. Results show similar changes in between the two illness stages after CBT with EMDR, and different ones within the follow-­‐up stage depending on whether CBT with EMDR or without EMDR was used. This may suggest considering PTSD such a disorder that removes specific stage demands/threats of cancer illness, just described in literature, as well as the more functional coping for each of them. You may instead claim that only CBT with EMDR allows cancer patients to overcome the PTSD and consequently retrieve selective specificity in coping strategies for each stage.

La naturaleza de este estudio es tanto observacional como clínica. Por un lado, pretende ver como se representan los criterios del TEPT (DSM-­‐IV, 2000) en pacientes con cáncer traumatizados entre dos fases diferentes de la enfermedad – fases de tratamientos médicos y seguimientos médicos -­‐ , y ver qué estrategias de afrontamiento son usadas por estos pacientes con TEPT en cada una de estas fases. Por otro lado, pretende saber: a) si la TCC integrada con EMDR produce efectos diferentes sobre el TEPT entre las dos fases de la enfermedad y sus estrategias de afrontamiento específicas; b) si la TCC con EMDR y la TCC sin EMDR producen efectos diferentes sobre el TEPT y sobre las estrategias de afrontamiento tan sólo dentro de la fase de seguimiento. Cada uno de los 31 sujetos fueron seleccionados aleatoriamente, 10 para la fase de tratamiento, 11 para la fase de seguimiento, ambos grupos recibiendo TCC y EMDR, y 10 para la fase de seguimiento con TCC y sin EMDR. Se utilizaron CAPS y COPE para evaluar el TEPT y las estrategias de afrontamiento respectivamente. Los resultados muestran cambios similares entre las dos fases de la enfermedad después de la TCC con EMDR, y cambios diferentes en la fase de seguimiento en función de si se utilizaba la TCC con o sin EMDR. Esto puede sugerir que se ha de considerar al TEPT como un trastorno que quita específicas demandas/amenazas de cada una de las fases de la enfermedad del cáncer, tal y como se describe en la literatura, así como el afrontamiento más funcional para cada una de ellas. En vez de eso, se puede afirmar que tan sólo la TCC con EMDR permite a los clientes superar el TEPT y consecuentemente recuperar especificidad selectiva en estrategias de afrontamiento para cada fase.

Keywords: Cancer  Coping Strategies  Illness  

Accuracy Verified: Yes

19. van Rood,Y., & de Roos, C. (2010, June). EMDR in the treatment of body dysmorphic disorder. Presentation at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
Body dysmorphic disorder (BDD) is defined in the Diagnostic and Statistical Manual IV-TR (DSM-IV-TR) as a disorder characterised by a preoccupation with an imagined defect in one's appearance (American Psychiatric Association (APA), 1994). BDD can be treated effectively with selective serotonin reuptake inhibitors (SSRls) or cognitive behaviour therapy (CBT) (Williams et al.. 2006). CBT interventions which are most often described in the literature are exposure and response prevention (ERP) and cognitive techniques. These interventions successfully weaken the catastrophic expectations of the patients. However, they do not affect the negative valence of patients' appearance. This negative meaning is not inborn but acquired during life through association with distressful or even traumatic events. Patients with BDD often report stressful events as the starting point of their complaints (Buhlmann et al., 2007) as well as PTSS like symptoms. i.e. intrusions (Osman et al.. 2004). Processing of these unprocessed memories might free the way to the development of a more positive meaning of their appearance. Indeed, case series have been described in which EMDR has been successfully applied in the treatment of BDD (Brown et al , 1997). In the first part of this workshop background information will be presented which might help identifying BDD patients who might profit from EMDR and planning subsequent EMDR treatment. In the second part of the workshop we share our experiences treating BDD patients with EMDR. Clinical issues will be analysed using videotaped cases of patients for illustration. The goal of this workshop is to increase knowledge and understanding of the use of EMDR in the treatment for BDD. American Psychiatric Association (APA) (1994). Diagnostic and statistical manual of mental disorders. (4th ed.) Washington DC. American Psychiatric Association. Brown, K. W., McGoldrick, T., & Buchanan, R. (1997). Body dysmorphic disorder: Seven cases treated with eye movement desensitization and reprocessing. Behavioural and Cognitive Psychotherapy. 25(2), 203-207 Buhlmann, U., Cook, L. M., Fama, 1. M., & Wilhelm, 5. (2007). Perceived teasing experiences in body dysmorphic disorder. Body Image. 4, 381-385. Osman. S., Cooper, M., Hackmann, A,, & Veale, D. (2004). Spontaneously occurring images and early memories in people with body dysmorphic disorder Memory, 12, 428-436. Williams, J., Hadjistavropoulos, T., & Sharpe, D. (2006). A meta- analysis of psychological and pharmacological treatments for Body Dysmorphic Disorder. Behaviour Research and Therapy. 44, 99-111.

Keywords: Body Dysmorphic Disorder  

Accuracy Verified: Yes

20. Jacobs, S., Rackowitz, M., Strack, M., & de Jongh, A. (2009). EMDR und biofeedback in der behandlung der posttraumatischen belastungsstorung - Erweiterung der evaluation des neuropsychotherapeutischen behandlungsprogramms [EMDR and biofeedback in the treatment of post traumatic stress disorder - extension of the evaluation of the neuropsychological treatment program]. In S. Jacobs, (Hrsg.), Neurowissenschaften und Traumatherapie. Grundlagen und Behandlungskonzepte [Neurosciences and Trauma Therapy, Bases and treatment approaches] (pp. 51-81). Göttingen: Universitätsverlag.

Language: German

Format: Book Section

Abstract: In the year (2007) the manual of the neuropsychotherapeutic intervention program EMDR and biofeedback in the therapy of posttraumatic stress disorder by Jacobs and de Jong was published. The therapeutic concept based on new neuroscienctific findings, which declare a dissociation of implicit and explicit traumamemory as one reason for emergence a PTSD. On this background the treatment program integrates selective modules. The allocation of information carried out by an educational movie for patients, specific cognitive-behavioural intervention techniques, which are supplemented by biofeedback-supported Eye Movement Desensitisation and Reprocessing (EMDR). During the treatment the skin conductance (electrodermal activity), which is a stress parameter, is mesured. This program was already evaluated in the pilot-study. The patient pool could be enlarged, so that 28 patients were available for the evaluation. Additionally the educational movie was examined on efficiency. The total feedback was positive. After therapy-end the PTSD-symptomatology decreased consistently (demp=2.48), as well as the psychological stress in another problem areas (demp=1.30). Moreover the EMDR-method achieved objective a significant decrease of the autonomic arousal (demp=.79) and subjective an explicit reduction of the felt stress (demp=2.40), while growth of the coherence of a worked out positive cognition (demp=2.52). Three- and 12-month follow-up analysis could demonstrate the stability and sustainability of the changes. The intervention program EMDR and biofeedback was also proved to be efficient ( 19 sessions) and effective (demp=1.39) in the enlarged sample, with high

Keywords: Biofeedback  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

21. D‘Hooghe, D. (2010, June). EMDR‘s application in the treatment of children with selective mutism. In Experimental use of EMDR. Symposium presented at the annual meeting of the EMDR Europe Association, Hamburg, Germany.

Language: English

Format: Conference

Abstract:
This case concerns a 4,5 year old girl with Selective Mutism. In this particular case. I considered Selective Mutism a symptom of an attachment trauma. Since the trauma wasn't accessible seeing her age and the complexity of the trauma, I used the symptom as a target. I applied EMDR within a phase model: the preparation phase, confrontation phase and integration phase. During these three phases I continuously worked with bilateral stimulation It is my hypothesis that in this case the bilateral stimulation: 1. stimulated and strengthened positive links in the adaptive network. 2 synchronized the activity of both cerebral hemispheres, resulting in a connection between the primary emotions of traumatic experiences and rational insights and language. 3. unblocked the traumatic information and reactivated the natural healing process of the brain. I used several forms of bilateral stimulation as visual stimulation, tactile stimulation and the butterfly hug. Because of her lack of words, she wasn't able to tell me anything. So through storytelling I offered her different themes to which she could respond by making drawings, figures in clay, etc. During the preparation phase, I focused on safety, ego strengthening and affect management to reduce the fear to speak. 1. Working with safety : the eye movements were first accomplished using a safe Image which brought up her own sense of security. Then, after imagining this safe place, the child was willing to play tapping games to strengthen feelings of safety. 2. Ego strengthening : to feel as strong as possible by installing resources and positive cognitions, and guiding the child towards acceptance and development of its unique being. Bilateral stimulation was used to strengthen the positive experiences. 3. Affect management: in the process of strengthening affect management, the child was given access to her anxiety by storytelling linked to visualization, the use of images and bodywork. Again, bilateral stimulation was used to strengthen the positive experiences/skills. After a few sessions. I introduced the use of language and stimulated her to make sounds, followed by pronouncing places of words and finally the pronunciation of complete words and sentences. Through this whole process, 1 combined the specific exercises to learn how to speak with bilateral stimulations. During the twelfth session, the child started talking spontaneously Given the fact that there wasn't any direct confrontation work during the sessions, we are left to wonder whether there has or hasn't occurred any trauma processing. The symptom came to a halt, together with the disappearance of other symptoms that were Inked to the trauma. The question is whether it is necessary to confront young children with their trauma in order to heal. Nevertheless, it seems like the combination of bilateral stimulation with storytelling, art therapy, play therapy and visualization speeded up the elimination of the child's trauma symptoms considerably.

Keywords: Experimental Use  Selective Mutism  

Accuracy Verified: Yes

22. Corrigan, F. M., & Jennett, J. (2004, August). Ephedra alkaloids and brief relapse in EMDR-treated obsessive compulsive disorder. Acta Psychiatrica Scandinavica, 110(2), 158. doi:10.1111/j.1600-0047.2004.00368.x.

Language: English

Format: Journal

Abstract:
Letter to the editor commenting on an article by E. Ernst (see record 2003-05653-002). We report the case of a patient who was effectively treated for severe obsessive compulsive disorder but relapsed briefly following ingestion of herbal products containing ephedra alkaloids that she bought to facilitate weight loss. The patient was a 29-year-old woman with a 10-year history of obsessive compulsive disorder who was referred for Eye Movement Desensitisation and Reprocessing (EMDR) when her condition had not responded to cognitive behavior therapy nor to various medications including Fluoxetine, Paroxetine, Clomipramine and Amitriptyline. Her score on the Dissociative Experiences Scale was low and there was nothing in the clinical history to suggest major dissociative disorder, so after preparation with mindfulness, relaxation and safe place imagery she proceeded to treatment with EMDR. Nine months later she reported a relapse into increased anxiety with a partial return to compulsive thoughts and behaviours after she had obtained a herbal health product sold to promote weight loss. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Keywords: Comment  Desensitization  Ephedra  Letter  Luvoxamine  Obsessive Compulsive Disorder  OCD  Plant Preparations  Relapse  Reply  Review  Serotonin Uptake Inhibitors  

Accuracy Verified: Yes

23. Greenwald, R. (2001, 1999). Eye movement desensitization and reprocessing (EMDR) in child and adolescent psychotherapy. Northvale, New Jersey: Jason Aronson.

Language: English

Format: Book

Abstract:
This book serves several functions. First, it provides an introduction to a trauma-based integrative approach to child and adolescent psychotherapy, incorporating the selective use of EMDR. It also provides a practical reference for clinicians seeking both theoretical and technical guidance on how to use EMDR with children and adolescents, and it serves as a documented standard of care for training and research purposes. [Text, p. xxvi] [Pilots]

Keywords: Adolescents  Children  Stressors  Survivors  

Accuracy Verified: Yes

24. Ohtani, T., & Matsuo, K. (2006). Functional abnormality of the prefrontal cortex in posttraumatic stress disorder: Psychophysiology and treatment studies assessed by near-infrared spectroscopy. In N. Kato; M. Kawata, & Pitman, R. K (Eds.), PTSD: Brain mechanisms and clinical implications (pp. 235-245). Tokyo: Springer-Verlag.

Language: English

Format: Book Section

Abstract:
A growing number of functional neuroimaging studies on PTSD have described the abnormal response of amygdala and prefrontal cortex to traumatic stimuli. Abnormal activation of some parts of the prefrontal cortex might possibly be involved in the pathophysiology of PTSD. [Adapted from Text, pp. 235-236]TOPICS TREATED: Near-infrared spectroscopy (NIRS); NIRS studies in PTSD; Neuroimaging studies of treatment in PTSD (Selective-serotonin reuptake inhibitor [SSRI] and Eye movement desensitization and reprocessing [EMDR].([Adapted from Text, pp. 235-236] [Pilots]

Keywords: Brain Imaging  Neuroanatomy  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

25. Burne, J. (2004). Healing without Freud or prozac. London, England:  The Independent.

Language: English

Format: Newspaper

Abstract:
Where do you get the blues? Most people would say in the head. That's where we look for mental problems. Depression, anxiety, distress are all the result of brain chemistry going wrong - not enough serotonin, for example. And that's why we treat them with talking therapies and "serotonin reuptake inhibitors" such as Prozac.

Keywords: General  London  Overview  

Accuracy Verified: Yes

26. Occhi, S., Albiol, L. M., & Cicognani, E. (2007). Il disturbo post-traumatico da stress: Una rassegna [Post-traumatic stress disorder: A review]. Psicoterapia Cognitiva e Comportamentale, 13(3), 323-344.

Language: Italian

Format: Journal

Abstract:
Questo articolo presenta una rassegna aggiornata teorico del Post-Traumatico da Stress Disorder (PTSD) concetto, un disturbo mentale che può comparire dopo essere stato esposto direttamente o indirettamente, ad un evento traumatico. L'articolo inizia con una descrizione della sintomatologia, suddivisi in: rivivere l'evento traumatico, evitamento, ottundimento reattività generale e ipervigilanza. Questo è seguito da una presentazione dei più recenti studi che indicano la presenza di disordine da stress post-traumatico nella popolazione, sia nella popolazione generale e nei soggetti direttamente coinvolti in un evento traumatico. Post-traumatico da stress sintomi del disturbo sono identificati mediante questionari specifici descritti nella sezione riferimento a strumenti di indagine. Lo studio delle basi biologiche per il PTSD è diventata particolarmente significativo negli ultimi anni, e abbiamo analizzato questo contesto in modo più approfondito per questo motivo, con particolare riferimento al ruolo dell'asse ipotalamo-ipofisi-surrene. Un impulso importante dello studio del PTSD è dovuto alla crescente importanza dato alla prevenzione, intesa come riduzione dell'impatto dei disturbi psichiatrici che concentrandosi su Eye Movement Desensibilizzazione e ritrattamento (EMDR), il trattamento psicologico, con il supporto di tecniche che riguarda la terapia cognitivo comportamentale e il trattamento farmacologico che prevede l'uso di inibitori della ricaptazione della serotonina selettiva, quali siano le forme più studiate. (PsycINFO record del database (c) 2008 APA, tutti i diritti riservati)

This article presents an updated theoretical review of the Post-Traumatic Stress Disorder (PTSD) concept, a mental disorder that can appear after being exposed directly or indirectly to a traumatic event. The article begins with a description of the symptomatology, divided in: re-living the traumatic event, avoidance, dulling general reactivity and hyperarousal. This is followed by a presentation of the most recent studies which indicate the presence of post-traumatic stress disorder in the population, both in the general population and in subjects directly involved in a traumatic event. Post-traumatic stress disorder symptoms are identified by using specific questionnaires described in the section referring to investigation instruments. The study of the biological bases for PTSD has become particularly significant in recent years, and we analysed this context in greater detail for this reason, with particular reference to the role of the hypothalamo-pituitary-adrenocortical axis. An important boost of the study of PTSD is due to the increasing importance placed on prevention, understood as a reduction of the impact of psychiatric disorders which focusing on Eye Movement Desensitisation and Reprocessing (EMDR), on psychological treatment, with the support of techniques that concerns cognitive behavioral therapy and pharmacological treatment that involves the use of serotonin selective reuptake inhibitors, which are the forms studied most. (PsycINFO Database Record (c) 2008 APA, all rights reserved)

Keywords: Posttraumatic Stress Disorder  PTSD  Review  

Accuracy Verified: No

27. Knipe, J. (1998). It was a golden time...: Treating narcissistic vulnerability. In P. Manfield (Ed.), Extending EMDR: A casebook of innovative applications, (1st ed.) (pp. 232-255), New York: Norton.

Language: English

Format: Book Section

Abstract:
This chapter focuses on EMDR-enhanced therapeutic protocols to treat individuals whose painful life experience is separated from consciousness by complex defensive structures, particularly those associated with narcissistic and avoidance defenses.In many of the clients I have worked with, the healing power of EMDR is prevented or impaired by unresolved positive feelings that block the client's full awareness of the negative experience associated with trauma. This can occur when the overall complex of posttraumatic images, self-defeating cognitions, unpleasant feelings and sensations (what Francine Shapiro calls the unprocessed "memory network") contains embedded strong positive affect that is highly valued by the client. In the case of a person with narcissistic defenses, the positive material may block awareness of negative memories, especially if the positive experience occurred in the larger context of trauma and neglect. In such instances the positive part of the experience is idealized through selective memory and strengthened in intensity, because it serves as a defense against the core PTSD. The negative part of the memory is partially or wholly dissociated and is thus less accessible to processing. [Adapted from Text, pp. 232, 233-234]

Keywords: Adults  Americans  Case Report  Defense Mechanisms  Life Experiences  Males  Posttraumatic Stress Disorder  PTSD  Self Concept  Survivors  Treatment Effectiveness  

Accuracy Verified: Yes

28. Bryant, R. A., & Friedman, M. J. (2001, March). Medication and non-medication treatments of post-traumatic stress disorder. doi:10.1097/00001504-200103000-00004. Current Opinion in Psychiatry, 14(2), 119-123. doi:10.1097%2F00001504-200103000-00004.

Language: English

Format: Journal

Abstract:
Recent developments in the psychological and pharmacological management of post-traumatic stress disorder are reviewed. This review of controlled outcome studies indicates that: (i) cognitive behavior therapy is the psychological treatment of choice; (ii) different components of cognitive behavior therapy can be effective; (iii) eye movement desensitization and reprocessing is not as effective as cognitive behavior therapy; (iv) selective serotonin re-uptake inhibitors are the pharmacological treatment of choice; and (v) there is increasing support for nefazadone but not for cyproheptadine in reducing the symptoms of post-traumatic stress disorder. The need for increased treatment effectiveness and the integration of recent findings into clinical practice is discussed. [Author Abstract]

Keywords: Atypical Antidepressants  Cognitive Therapy  Drug Therapy  Literature Review  Posttraumatic Stress Disorder  PTSD  Selective Serotonin Reuptake Inhibitors  Treatment  Treatment Effectiveness  

Accuracy Verified: Yes

29. Bossini, L., Poliziotto, N., Tavanti, M., Calossi, S., Lombardelli, A., Vatti, G., & Castrogiovanni, P. (2006, Febbraio). Neuroimaging e PTSD: Dati morfovolumetrici e loro variazioni dopo trattamento [Neuroimaging and PTSD: Facts morfovolumetrici and their changes after treatment]. Presentazione al Congresso XI SOPSI (Società Italiana di Psicopatologia), Roma, Italia.

Language: Italian

Format: Conference

Abstract:
Introduzione: molti studi concordano sulla riduzione del volume ippocampale nei pazienti affetti da PTSD 1 e che tale alterazione anatomica è correlata con deficit cognitivi e con la gravità dei sintomi. Comunque ad oggi non è stato ancora chiarito se l’atrofia ippocampale rappresenta l’esito di un effetto neurotossico del trauma o, piuttosto, una condizione preesistente che predispone allo sviluppo di alcune patologie psichiatriche. Già da tempo studi su animali dimostrano come lo stress causi atrofia ippocampale e inibizione della neurogenesi, con meccanismi verosimilmente legati ai glucocorticoidi, all’increzione del fattore corticotropo, all’aumento degli aminoacidi eccitatori, all’inibizione fattore neurotrofico cerebrale con perdita della plasticità neuronale. Nell’uomo, tuttavia, i risultati non sono così lineari. Da un lato alcuni studi hanno individuato come fattore principale l’aumento dei glucocorticoidi 2, dall’altro tale teoria è stata fortemente criticata 3. Secondo Yehuda il meccanismo di atrofia ippocampale è dovuto ad un’alterazione dell’asse Ipotalamo-Ipofisi-Surrene (HPA), ma in termini di una bassa increzione di glucocorticoidi che determina un aumento del feedback negativo dell’asse stesso ed un’ipersensibilità recettoriale. Indipendentemente dal meccanismo d’azione, la perdita di neuroni a livello ippocampale nei soggetti che hanno subito eventi traumatici sembra sufficientemente dimostrata e, fino a poco tempo fa, era considerata irreversibile. In realtà l’ippocampo sembra presentare una inusuale e spontanea capacità rigenerativa. Questo dato è stato individuato in molte specie animali e, in un unico studio, anche nell’uomo 4. Inoltre recenti evidenze pre-cliniche e cliniche hanno indicato che gli SSRI (Selective Serotonin Reuptake Inhibitors) promuovono la neurogenesi e riducono l’atrofia ippocampale indotta dallo stress nell’animale 5 e nell’uomo sono in grado di ridurre i sintomi del PTSD, incrementare le dimensioni dell’ippocampo e ridurre i deficit mnesici tipici della patologia 6 7. Un altro fattore che sembra essere in grado di stimolare la neurogenesi negli animali sembra essere “l’ambiente arricchito” verosimilmente tramite i meccanismi molecolari dell’apprendimento che sembrano in grado di attivare la trascrizione dell’mRNA per il Brain Derived Neurotrophic Factor. Questo dato della letteratura supporta il razionale dell’efficacia della psicoterapia anche se l’unico studio che valuta le modificazioni morfostrutturali dopo psicoterapia non ha riportato risultati positivi 8. Gli scopi di questo studio sono: – valutare la presenza di atrofia ippocampale nei pazienti affetti da PTSD (T0-drug-free); – valutare l’effetto della terapia: farmacologica con SSRI e psicoterapica con EMDR (Eye Movement Desensitization and Reprocessing) sia sul piano clinico e neuropsicologico, che sul volume ippocampale, sia sulla memoria (T1). Metodologia: abbiamo analizzato un campione di 20 pazienti, di età compresa tra i 15 ed i 65 anni, reclutati nell’ambulatorio psichiatrico del Policlinico universitario di Siena affetti da PTSD e un gruppo di controllo di soggetti sani appaiati per sesso, età, peso e altezza. I soggetti di entrambi i gruppi sono stati sottoposti ad uno studio morfovolumetrico computerizzato dell’Ippocampo tramite RM (Risonanza Magnetica). Inoltre, i diciassette pazienti con PTSD sono stati valutati tramite la somministrazione di test neuropsicologici e scale psicometriche per approfondire il quadro psicopatologico e valutare l’eventuale presenza di deficit cognitivi. Nei soggetti affetti da PTSD dopo un periodo di sei mesi di terapia psicofarmacologica sono stati ripetuti i test neuropsicologici, le scale psicometriche e l’analisi morfovolumetrica dell’ippocampo tramite RM. Tre pazienti, dopo le valutazioni al T0, hanno effettuato un protocollo terapeutico con solo EMDR e sono stati rivalutati dopo 8 sedute (due mesi). Risultati: i risultati della prima parte sperimentale (T0-drug-free) evidenziano che le dimensioni dell’ippocampo di sinistra nei soggetti affetti da PTSD sono significativamente minori rispetto ai controlli sani. Dai risultati osservati al follow-up (T1-post-terapia) è possibile evincere che la terapia nei soggetti considerati è associata ad un miglioramento della sintomatologia e ad un aumento dei volumi ippocampali, pari al 9,87% per l’ippocampo di destra e dell’8,37% per l’ippocampo di sinistra. Questi dati sono concordi con i dati presenti in letteratura, anche se la percentuale di recupero su base neuroplastica nel nostro studio risulta sensibilmente superiore rispetto ai due studi presenti in letteratura incremento pari al 4,6% 6; pari al 5% 7. I tre pazienti che hanno effettuato terapia con EMDR hanno anch’essi mostrato al T1 un miglioramento sintomatologico (CAPS non più positiva per i criteri diagnostici) ed un aumento medio dei volumi ippocampali pari a 338,25 mm3 per l’ippocampo DX e 357,93 mm3 per l’ippocampo SN. Conclusioni: la terapia nei soggetti considerati si è associata ad un aumento dei volumi ippocampali (9,87%-8,37%). L’aumento dei volumi ippocampali appare rilevante, consistente con i dati in letteratura, sebbene quantitativamente superiore, sottolineando l’efficacia degli SSRI verosimilmente tramite il meccanismo di attivazione della neurogenesi; è ipotizzabile che l’aumento di volume non sia da imputare ad un aumento delle cellule gliali ma ad un aumento di neuroni ippocampali visto il contemporaneo miglioramento clinico. Particolarmente interessante ci sembra il dato relativo all’efficacia clinica e sulla plasticità neurale della EMDR. Questa osservazione su solo tre casi, necessita chiaramente di essere confermata su un campione più ampio ma rappresenta la prima evidenza in letteratura di un’azione della psicoterapia diretta alla struttura cerebrale.

Introduction: Many studies agree on the reduction of hippocampal volume in patients with PTSD and that an anatomical alteration is correlated with cognitive deficits and the severity of symptoms. However to date has not yet been clarified whether hippocampal atrophy is the result of a neurotoxic effect of trauma or, rather, an underlying condition that predisposes to the development of some psychiatric disorders. For some time animal studies show that stress causes hippocampal atrophy and inhibition of neurogenesis, by mechanisms probably related to glucocorticoids, all'increzione corticotropo factor, increased excitatory amino acid, inhibition of brain neurotrophic factor with loss of neuronal plasticity. In humans, however, the results are not so linear. On the one hand, some studies have identified as the main factor increasing glucocorticoid two other such theory was strongly criticized 3. According to Yehuda mechanism of hippocampal atrophy is due to an alteration of hypothalamic-pituitary-adrenal (HPA), but in terms of a low secretion of glucocorticoids leading to an increase of negative feedback axis and the same receptor hypersensitivity . Regardless of the mechanism of action, loss of neurons in hippocampus in people who have suffered traumatic events seems sufficiently established and, until recently, was considered irreversible. In fact, the hippocampus appears to be an unusual and spontaneous regenerative capacity. This figure has been identified in many animal species and in one study in humans 4. Moreover, recent evidence pre-clinical and clinical studies have shown that SSRIs (Selective Serotonin Reuptake Inhibitors) promote neurogenesis and reduce stress-induced hippocampal atrophy in animals 5 and humans are able to reduce symptoms of PTSD, increase the size of the hippocampus and reduce the deficit mnesic typical of the disease 6 7. Another factor that seems to be able to stimulate neurogenesis in animals seems to be "enriched environment" probably through molecular mechanisms of learning that seem able to activate the transcription of mRNA for Brain Derived Neurotrophic Factor. This finding supports the rationale of the literature of the effectiveness of psychotherapy, even if the only study that evaluates changes morphostructural after psychotherapy has shown positive results 8. The aims of this study are: - To evaluate the presence of hippocampal atrophy in patients with PTSD (T0-drug-free) - to assess the effect of therapy: pharmacological SSRI and psychotherapy with EMDR (eye movement desensitization and reprocessing) is a clinical and neuropsychological, and on hippocampal volume, and memory (T1). Methods: We analyzed a sample of 20 patients, aged between 15 and 65, recruited nell'ambulatorio Psychiatric University Hospital of Siena with PTSD and a control group of healthy subjects matched by sex, age, weight and height. Subjects in both groups were subjected to a computerized study morfovolumetrico dell'Ippocampo using MRI (Magnetic Resonance). In addition, seventeen patients with PTSD were assessed through administration of psychometric scales and neuropsychological tests to study the psychopathological picture and evaluate the possible presence of cognitive deficits. In subjects with PTSD after a period of six months of pharmacological therapy were repeated neuropsychological tests, scales psychometric analysis morfovolumetrica hippocampus by MRI. Three patients at T0 after assessments, carried out a treatment protocol with only EMDR and were reassessed after eight sessions (two months). Results: The results of the first experiment (T0-drug-free) show that the size of the left hippocampus in patients with PTSD are significantly lower compared to healthy controls. The results observed during the follow-up (T1-post-therapy) can be inferred that therapy in patients considered to be associated with improvement in symptoms and an increase in hippocampal volume, equal to 9.87% for the right hippocampus and 8, 37% for the left hippocampus. These data are consistent with the data in the literature, although the recovery rate based on neuroplastic in our study is significantly higher than in the two studies in the literature increase of 4.6% 6; 5% 7. The three patients who have treatment with EMDR have also shown an improvement in symptoms at T1 (CAPS no longer positive for the diagnostic criteria) and an average increase in hippocampal volume amounted to 338.25 mm3 for the hippocampus and DX 357, 93 mm3 for the hippocampus SN. Conclusions: Therapy in patients considered was associated with an increase in hippocampal volume (9.87% -8.37%). The increase in hippocampal volume appear to be relevant, consistent with the literature data, although quantitatively greater, stressing the effectiveness of SSRIs probably through the mechanism of activation of neurogenesis, it is conceivable that the increase in volume is attributable to an increase glial cells but an increase of hippocampal neurons seen the simultaneous clinical improvement. Seems particularly interesting given the relative clinical effectiveness of EMDR and neural plasticity. This observation on only three cases, clearly needs to be confirmed on a larger sample but represents the first evidence in the literature of action of psychotherapy directed at brain structure.

Keywords: Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

30. Creamer, M., & O'Donnell, M. (2002). Post-traumatic stress disorder. Current Opinion in Psychiatry, 15(2), 163-168. doi:10.1097/00001504-200203000-00007.

Language: English

Format: Journal

Abstract:
This paper provides an overview of recent developments in the literature on post-traumatic stress disorder. Epidemiological studies indicate that approximately 15-25% of individuals experiencing a significant trauma will go on to develop post-traumatic stress disorder, although approximately half will recover without formal intervention. Potential vulnerability factors for post-traumatic stress disorder have been identified, but the mechanisms and complexities require further exploration, with recent research suggesting that prevalence rates and risk factors may differ across populations. Studies of psychological treatment have demonstrated prolonged exposure and cognitive therapies to be equally beneficial, whereas eye movement desensitization and reprocessing may be useful but perhaps less effective in the long term. Pharmacological treatment studies indicate that selective serotonin reuptake inhibitors may be the first choice of drug treatments for post-traumatic stress disorder. Non-selective primary prevention strategies remain contentious, although secondary prevention, in the form of cognitive behavioural interventions for acutely symptomatic survivors, appears to reduce the subsequent development of post-traumatic stress disorder.

Keywords: Cognitive Therapies  Drug Therapy  Exposure Therapies  Posttraumatic Stress Disorder  Prevention  Primary Prevention  PTSD  Risk Factors  Secondary Prevention  Susceptibility (Disorders)  Treatment  Vulnerability Factors  

Accuracy Verified: Yes

31. Cahill, P. C., Pontoski, K., & D’Olio, C. M. (2005, September). Posttraumatic stress disorder and acute stress disorder II: Considerations for treatment and prevention. Psychiatry, 2(9), 34-46.

Language: English

Format: Journal

Abstract:
Posttraumatic stress disorder is a common and often chronic and disabling anxiety disorder that can develop after exposure to highly stressful events characterized by actual or threatened harm to the self or others. This is the second of two invited articles summarizing the nature and treatment of PTSD and the associated condition of acute stress disorder (ASD). The present article reviews evidence for the efficacy of psychological and pharmacological treatments for PTSD and ASD. In summary, cognitive behavior therapy (CBT) has been found efficacious in the treatment of chronic PTSD as well as the treatment of ASD/prevention of PTSD. The selective serotonin reuptake inhibitors, sertraline, paroxetine, and fluoxetine, have been found efficacious in the treatment of chronic PTSD, with sertraline and paroxetine receiving the FDA indication for this condition. There is less evidence for efficacious medications in the treatment of ASD/prevention of PTSD. At present, hydrocortisone and propranolol show the greatest promise. Limitations of these treatments, including dropout and a significant number of patients showing no or only partial response, are discussed as well as issues related to selecting among efficacious treatments.

Keywords: ASD  Acute Stress Disorder  Posttraumatic Stress Disorder  PTSD  

Accuracy Verified: Yes

32. Davidson, J. R. T., Stein, D. J., Shalev, A.Y., & Yehuda, R. (2004, Spring). Posttraumatic stress disorder:  Acquisition, recognition, course, and treatment. Journal of Neuropsychiatry and Clinical Neuroscience, 16(2), 135-147. doi:10.1176/appi.neuropsych.16.2.135.

Language: English

Format: Journal

Abstract:
Following exposure to trauma, a large number of survivors will develop acute symptoms of posttraumatic stress disorder (PTSD), which mostly dissipate within a short time. In a minority, however, these symptoms will evolve into chronic and persistent PTSD. A number of factors increase the likelihood of this occurring, including characteristic autonomic and hypothalamic-pituitary-adrenal axis responses. PTSD often presents with comorbid depression, or in the form of somatization, both of which significantly reduce the possibilities of a correct diagnosis and appropriate treatment. Mainstay treatments include exposure-based psychosocial therapy and selective serotonin reuptake inhibitors, such as paroxetine and sertraline, both of which have been found to be effective in PTSD. This paper looks at the course of PTSD, its disabling effect, its recognition and treatment, and considers possible new research directions.

Keywords: Comorbidity  Posttraumatic Stress Disorder  PTSD  Recognition and Treatment  SSRIs  

Accuracy Verified: Yes

33. Greenwald, R. (1999, November-December). The power of suggestion - Comment on EMDR and mesmerism: A comparative historical analysis. Journal of Anxiety Disorders, 13(6), 611-615. doi:10.1016/S0887-6185(99)00019-5.

Language: English

Format: Journal

Abstract:
This response to McNally challenges the notion that scientific controversy should be waged with smear tactics. McNally's anti-EMDR conclusions are contested as premature and based on red herrings, selective neglect of the literature, and erroneous application of scientific principles. The importance of treatment fidelity is highlighted as a way of distinguishing between EMDR studies of widely varying quality (ScienceDirect).

Keywords: Franz Anton  Hypnotherapy  Mesmerism  Professional Criticism  

Accuracy Verified: Yes

34. 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. doi:10.2165/00128071-200304040-00004.

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

35. van der Kolk, B. A., Spinazzola, J., Blaustein, M. E., Hopper, J. W., Hopper, E. K., Korn, D. L., & Simpson, W. B. (2007, January). A randomized clinical trial of eye movement desensitization and reprocessing (EMDR), fluoxetine, and pill placebo in the treatment of posttraumatic stress disorder: Treatment effects and long-term maintenance. Journal of Clinical Psychiatry, 68(1), 37-46. doi:10.4088/JCP.v68n0105.

Language: English

Format: Journal

Abstract:
Objective: The relative short-term efficacy and long-term benefits of pharmacologic versus psychotherapeutic interventions have not been studied for PTSD. This study compared the efficacy of a selective serotonin reuptake inhibitor (SSRI), fluoxetine, with a psychotherapeutic treatment, eye movement desensitization and reprocessing (EMDR), and pill placebo and measured maintenance of treatment gains at 6-month follow-up. Method: 88 PTSD subjects diagnosed according to DSM-IV criteria were randomly assigned to EMDR, fluoxetine, or pill placebo. They received 8 weeks of treatment and were assessed by blind raters posttreatment and at 6-month follow-up. The primary outcome measure was the Clinician-Administered PTSD Scale, DSM-IV version, and the secondary outcome measure was the Beck Depression Inventory-II. The study ran from July 2000 through July 2003. Results: The psychotherapy intervention was more successful than pharmacotherapy in achieving sustained reductions in PTSD and depression symptoms, but this benefit accrued primarily for adult-onset trauma survivors. At 6-month follow-up, 75.0% of adult-onset versus 33.3% of child-onset trauma subjects receiving EMDR achieved asymptomatic end-state functioning compared with none in the fluoxetine group. For most childhood-onset trauma patients, neither treatment produced complete symptom remission. Conclusions: This study supports the efficacy of brief EMDR treatment to produce substantial and sustained reduction of PTSD and depression in most victims of adult-onset trauma. It suggests a role for SSRIs as a reliable first-line intervention to achieve moderate symptom relief for adult victims of childhood-onset trauma. Future research should assess the impact of lengthier intervention, combination treatments, and treatment sequencing on the resolution of PTSD in adults with childhood-onset trauma. [Author Abstract]

Keywords: Adults  Depressive Disorders  Empirical Study  Posttraumatic Stress Disorder  PTSD  Quantitative Study  Random Clinical Trial  RCT  Selective Serotonin Reuptake Inhibitors  Stressors  Survivors  Treatment Effectiveness  

Accuracy Verified: Yes

36. 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

37. Weinberg, R. M., & Dye, J. (2002, June). Tina doesn’t talk at school – Utilizing EMDR to treat a child with selective mutism. Presentation at the annual meeting of the EMDR International Association, San Diego, CA.

Language: English

Format: Conference

Abstract:
Selective mutism is a relatively rare disorder in which individuals who have the ability to speak and comprehend spoken language are unable to speak in specific social situations. This condition is typically resistant to intervention, becoming more intractable the longer it persists. Tina Doesn’t Talk At School: Utilizing EMDR Within a Multi-Modal Intervention to Treat a Child with Selective Mutism describes a qualitative research study of a 4th grade student who went almost 5 years of no talking at school despite multiple intervention attempts. Surprisingly rapid results ensued shortly after initializing the EMDR technique, and the goal of speech in the school environment was fully attained.

Keywords: Children  Selective Mutism  

Accuracy Verified: Yes

38. Forbes, D., Creamer, M. C., Phelps, A. J., Couineau, A. L., Cooper, J. A., Bryant, R. A., McFarlane, A. C., Devilly, G. J., Matthews, L. R., & Raphael, B. (2007, July). Treating adults with acute stress disorder and post-traumatic stress disorder in general practice: A clinical update. Medical Journal of Australia, 187(2), 120-123.

Language: English

Format: Journal

Abstract:
General practitioners have an important role to play in helping patients after exposure to severe psychological trauma. In the immediate aftermath of trauma, GPs should offer "psychological first aid", which includes monitoring of the patient's mental state, providing general emotional support and information, and encouraging the active use of social support networks, and self-care strategies. Drug treatments should be avoided as a preventive intervention after traumatic exposure; they may be used cautiously in cases of extreme distress that persists. Adults with acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) should be provided with trauma-focused cognitive behaviour therapy (CBT). Eye movement desensitisation and reprocessing (EMDR) in addition to in-vivo exposure (confronting avoided situations, people or places in a graded and systematic manner) may also be provided for PTSD. Drug treatments should not normally replace trauma-focused psychological therapy as a first-line treatment for adults with PTSD. If medication is considered for treating PTSD in adults, selective serotonin reuptake inhibitor antidepressants are the first choice. Other new generation antidepressants and older tricyclic antidepressants should be considered as second-line pharmacological options. Monoamine oxidase inhibitors may be considered by mental health specialists for use in people with treatment-resistant symptoms.

Keywords: Acute Stress Disorder  Anti-Depressants  ASD  MAO Inhibitors  Posttraumatic Stress Disorder  PSTD  SSRIs  

Accuracy Verified: Yes

39. Fisher, N. (2010, April). Treatment options for combat veterans with PTSD. Poster presented at the 2nd Bi-Annual International European Society for Trauma and Dissociation Conference, Belfast, Northern Ireland.

Language: English

Format: Conference

Abstract:
In this review I explored the most effective treatment options available for military veterans with Post Traumatic Stress Disorder. Specifically, psychotherapy and pharmacotherapy was examined. Psychotherapy encompassed cognitive behavioral therapy, emotional desensitization and reprocessing and exposure therapy. Pharmacotherapy included selective serotonin reuptake inhibitors, tricyclic antidepressants, monoamine oxidase inhibitors, novel antidepressants and benzodiazepines. Meta analyses, literature reviews and research experiments formed the basis for the comparisons between treatments. The main findings include that the psychotherapies cognitive behavioral therapy and eye movement desensitization and reprocessing, and the pharmacotherapy selective serotonin reuptake inhibitors are the most superior treatments for veterans with PTSD. Learning Outcomes
Delegates will learn about the variables which make treating combat veterans with PTSD different than other groups with PTSD. In terms of treatment, psychotherapeutic and psychopharmacologic options will be examined. Delegates will leave the presentation aware of what current research states on treatment efficacy of CBT, EMDR, Exposure Therapy, Antidepressants and Anxiolytics.

Keywords: Poster  Posttraumatic Stress Disorder  PSTD  Veterans  

Accuracy Verified: Yes

40. Cohena, J. A.,  Mannarino, A. P., & Rogal, S. (2001, January). Treatment practices for childhood posttraumatic stress disorder. Child Abuse and Neglect, 25(1), 123-135. doi:10.1016/S0145-2134(00)00226-X.

Language: English

Format: Journal

Abstract:
Objective: This study surveyed practices in treating childhood PTSD among child psychiatrists and non-M.D. therapists with self-identified interest in treating traumatized children. Method: An anonymous survey was mailed to 207 child psychiatrists ("medical") [members of the American Academy of Child and Adolescent Psychiatry] and 460 nonphysician ("non-medical") therapists [members of the International Society for Traumatic Stress Studies] inquiring about current interventions used to treat children with PTSD. Results: 247 responses were received: of 77 medical and 82 nonmedical respondents who currently treat children with PTSD, a wide variety of modalities are used. Most preferred modalities among medical responders were pharmacotherapy, psychodynamic, and cognitive-behavioral therapy. Most preferred modalities among nonmedical respondents were cognitive-behavioral, family, and nondirective play therapy. 95% of medical respondents used pharmacotherapy for this disorder; most preferred medications to treat childhood PTSD were selective serotonin reuptake inhibitors and alpha-adrenergic agonists. Several significant differences between medical and nonmedical practices were identified. Conclusions: There is little clinical consensus regarding the effectiveness of the many modalities used to treat traumatized children who have PTSD symptoms; empirical research is particularly needed to evaluate the efficacy of pharmacotherapy and EMDR. [Author Abstract]

Keywords: Adolescents  Arousal  Avoidance  Children  Drug Therapy  Mental Health Personnel  Reexperiencing  Posttraumatic Stress Disorder  PTSD  Treatment Effectiveness  

Accuracy Verified: Yes