RESUMEN
Experimental findings showing that retrieved memories are labile and vulnerable to disruption have led to important theoretical ideas at a basic science level that have been applied to the clinic at a translational level. At a theoretical level, these findings suggest that retrieved memories can be modulated by behavioral or pharmacological treatments as they are reconsolidated and returned to storage. At a clinical level, these findings suggest that treatments that target reconsolidation may help dampen or even erase especially problematic memories, such as those associated with trauma. However, there are many caveats to these effects and issues that need to be considered when thinking broadly about retrieval-induced plasticity and extensions into the clinic. First, performance during a memory test often does not reflect the entirety of the animal's knowledge about a situation; asking questions in different ways may reveal the presence of a memory that was thought to be eliminated. Second, although reconsolidation and extinction are often treated as competing processes, there is abundant evidence that extinction can progress through associative and nonassociative changes in the original memory that are often described in terms of reconsolidation effects. Third, targeting a reconsolidation process as a therapeutic may not be helpful in disorders like posttraumatic stress disorder, in which traumatic experiences induce a cascade of symptoms that are self-perpetuating and may ultimately maintain themselves long after trauma. Underlying all of these challenges is the need for a rich theoretical framework focused on retrieval-induced plasticity that is informed by developments in associative learning theory. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Consolidación de la Memoria , Plasticidad Neuronal , Animales , Plasticidad Neuronal/fisiología , Plasticidad Neuronal/efectos de los fármacos , Humanos , Consolidación de la Memoria/fisiología , Consolidación de la Memoria/efectos de los fármacos , Extinción Psicológica/fisiología , Extinción Psicológica/efectos de los fármacos , Trastornos por Estrés Postraumático/psicología , Recuerdo Mental/fisiología , Recuerdo Mental/efectos de los fármacos , Investigación Biomédica Traslacional , Memoria/fisiología , Memoria/efectos de los fármacosRESUMEN
Post-traumatic stress disorder (PTSD) presents distinct sex-specific differences in both symptom expression and treatment outcomes, with the underlying biological mechanisms still remain unclear. Epigenetic modifications, particularly histone acetylation, have been increasingly recognized as critical factors in the pathophysiology of PTSD. Valproic acid (VPA), a potent histone deacetylase (HDAC) inhibitor, has shown promise in modulating epigenetic responses and improving therapeutic outcomes is PTSD, though its effect may differ between sexes. This study aimed to explore the sex-specific epigenetic changes in response to trauma and the impact of VPA treatment in a rat model of PTSD induced by predator scent stress. Sprague-Dawley rats of both sexes were randomly assigned to stressed and non-stressed groups and treated with either VPA (100 mg/kg) or vehicle. Anxiety levels were assessed using the elevated plus maze, followed by analysis of histone H3 and H4 acetylation, HDAC activity, and c-fos expression in the hippocampus. Our findings revealed that traumatic stress led to increased freezing time and anxiety levels, with more pronounced effects observed in females. Additionally, we have identified sex-specific differences in hippocampal epigenetic modifications; stressed females exhibited higher H3 acetylation, and VPA-treated stressed males showed increased H4 acetylation. These results highlight the importance of considering sex differences in the epigenetic mechanism underlying PTSD and suggest that personalized therapeutic approaches may be necessary to address these complexities.
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Epigénesis Genética , Inhibidores de Histona Desacetilasas , Ratas Sprague-Dawley , Trastornos por Estrés Postraumático , Ácido Valproico , Animales , Ácido Valproico/farmacología , Trastornos por Estrés Postraumático/tratamiento farmacológico , Trastornos por Estrés Postraumático/genética , Trastornos por Estrés Postraumático/metabolismo , Masculino , Femenino , Epigénesis Genética/efectos de los fármacos , Ratas , Inhibidores de Histona Desacetilasas/farmacología , Inhibidores de Histona Desacetilasas/uso terapéutico , Modelos Animales de Enfermedad , Histonas/metabolismo , Caracteres Sexuales , Hipocampo/metabolismo , Hipocampo/efectos de los fármacos , Acetilación/efectos de los fármacos , Ansiedad/tratamiento farmacológicoRESUMEN
Tobacco-related deaths remain the leading cause of preventable death in the United States. Veterans suffering from posttraumatic stress disorder (PTSD)-about 11% of those receiving care from the Department of Veterans Affairs (VA)-have triple the risk of developing tobacco use disorder (TUD). The most efficacious strategies being used at the VA for smoking cessation only result in a 23% abstinence rate, and veterans with PTSD only achieve a 4.5% abstinence rate. Therefore, there is a critical need to develop more effective treatments for smoking cessation. Recent studies suggest the insula is integrally involved in the neurocircuitry of TUD. Thus, we propose a feasibility phase II randomized controlled trial (RCT) to study a form of repetitive transcranial magnetic stimulation (rTMS) called intermittent theta burst stimulation (iTBS). iTBS has the advantage of allowing for a patterned form of stimulation delivery that we will administer at 90% of the subject's resting motor threshold (rMT) applied over a region in the right post-central gyrus most functionally connected to the right posterior insula. We hypothesize that by increasing functional connectivity between the right post-central gyrus and the right posterior insula, withdrawal symptoms and short-term smoking cessation outcomes will improve. Fifty eligible veterans with comorbid TUD and PTSD will be randomly assigned to active-iTBS + cognitive behavioral therapy (CBT) + nicotine replacement therapy (NRT) (n = 25) or sham-iTBS + CBT + NRT (n = 25). The primary outcome, feasibility, will be determined by achieving a recruitment of 50 participants and retention rate of 80%. The success of iTBS will be evaluated through self-reported nicotine use, cravings, withdrawal symptoms, and abstinence following quit date (confirmed by bioverification) along with evaluation for target engagement through neuroimaging changes, specifically connectivity differences between the insula and other regions of interest.
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Terapia Cognitivo-Conductual , Cese del Hábito de Fumar , Trastornos por Estrés Postraumático , Estimulación Magnética Transcraneal , Veteranos , Humanos , Cese del Hábito de Fumar/métodos , Estimulación Magnética Transcraneal/métodos , Trastornos por Estrés Postraumático/terapia , Terapia Cognitivo-Conductual/métodos , Estudios de Factibilidad , Dispositivos para Dejar de Fumar Tabaco , Masculino , Tabaquismo/terapia , Terapia Combinada , Adulto , Femenino , Persona de Mediana EdadRESUMEN
Background: Posttraumatic stress disorder and medically unexplained pain frequently co-occur. While pain is common during traumatic events, the processing of pain during trauma and its relation to audiovisual and pain intrusions is poorly understood.Objective: Here we investigate neural activations during painful analogue trauma, focusing on areas that have been related to threat and pain processing, and how they predict intrusion formation. We also examine the moderating role of cumulative lifetime adversity.Methods: Sixty-five healthy women were assessed using functional magnetic resonance imaging. An analogue trauma was induced by an adaptation of the trauma-film paradigm extended by painful electrical stimulation in a 2 (film: aversive, neutral) x 2 (pain: pain, no-pain) design, followed by 7-day audiovisual and pain intrusion assessment using event-based ecological momentary assessment. Intrusions were fitted with Bayesian multilevel regression and a hurdle lognormal distribution.Results: Conjunction analysis confirmed a wide network including anterior insula (AI) and dorsal anterior cingulate cortex (dACC) being active both, during aversive films and pain. Pain resulted in activation in areas amongst posterior insula and deactivation in a network around ventromedial prefrontal cortex (VMPFC). Higher AI and dACC activity during aversive>neutral film predicted greater audiovisual intrusion probability over time and predicted greater audiovisual intrusion frequency particularly for participants with high lifetime adversity. Lower AI, dACC, hippocampus, and VMPFC activity during pain>no-pain predicted greater pain intrusion probability particularly for participants with high lifetime adversity. Weak regulatory VMPFC activation was associated with both increased audiovisual and pain intrusion frequency.Conclusions: Enhanced AI and dACC processing during aversive films, poor pain vs. no-pain discrimination in AI and dACC, as well as weak regulatory VMPFC processing may be driving factors for intrusion formation, particularly in combination with high lifetime adversity. Results shed light on a potential path for the etiology of PTSD and medically unexplained pain.
AI and dACC play a common role for both trauma- and pain-processing.In combination with high lifetime adversity, higher AI and dACC aversive film processing was associated with higher audiovisual intrusion frequency, whereas weaker AI and dACC pain discrimination enhanced the chance for pain intrusions.Weak regulatory VMPFC activity in aversive situations increased both audiovisual and pain intrusion formation.
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Imagen por Resonancia Magnética , Dolor , Trastornos por Estrés Postraumático , Humanos , Femenino , Adulto , Dolor/psicología , Dolor/fisiopatología , Trastornos por Estrés Postraumático/fisiopatología , Trastornos por Estrés Postraumático/psicología , Giro del Cíngulo/fisiopatología , Giro del Cíngulo/diagnóstico por imagen , Adulto Joven , Corteza Prefrontal/fisiopatología , Corteza Prefrontal/diagnóstico por imagen , Teorema de BayesRESUMEN
BACKGROUND: While treatment of posttraumatic stress disorder (PTSD) in refugees is generally effective, many refugees remain symptomatic after treatment. Coping styles could be relevant to PTSD treatment response and as such may be a potential focus of PTSD treatment. AIMS: The study aims to examine 1) if baseline coping styles are related to treatment response after EMDR therapy or stabilization, and 2) if coping styles change during these treatments. METHOD: Seventy-two refugees with PTSD were randomly allocated to 12 hours of EMDR therapy or stabilization. A coping questionnaire (COPE-easy) and clinical interview for PTSD (CAPS-IV) were administered before and after treatment and at three-month follow-up. The association between baseline coping styles and PTSD symptom change was examined using regression analysis and a t-test. Changes in coping styles were analyzed using mixed design ANOVA. RESULTS: No significant relations between baseline coping style levels and PTSD symptom changes were found. Additionally, coping style levels did not change significantly after either treatment. CONCLUSION: Contrary to the hypothesis, we did not find any evidence that treatment was related to (changes in) coping style. Addressing pre-treatment coping styles among refugees receiving short-term therapy, may not be required for reducing PTSD. Changing coping styles may need a longer or different type of treatment.
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Adaptación Psicológica , Refugiados , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicología , Refugiados/psicología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Desensibilización y Reprocesamiento del Movimiento Ocular/métodos , Encuestas y Cuestionarios , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: In China, parents who have lost their only child are referred to as Shidu parents (SDPs). This study aimed to investigate the prevalence and risk factors of post-traumatic stress disorder (PTSD) and investigate the influence of depressive and anxiety symptoms on the development of PTSD. METHOD: Four hundred and thirty-six SDPs completed assessments of PTSD (Structured Clinical Interview for DSM-IV Disorders, SCID-IV; The Clinician-Administered PTSD Scale-IV, CAPS-IV), depression (Hamilton depression scale), and anxiety (Hamilton Anxiety Scale) via in-person interviews. Logistic regression and hierarchical multiple linear regression analyses were used to explore the association of demographic characteristics, depression, and anxiety symptoms with PTSD. RESULTS: The prevalence of PTSD in SDPs was 14.45%. The comorbidity of depression and anxiety symptoms was 87.30% in the SDPs with PTSD. The logistic regression model, which included factors of gender, age, education, depression, and anxiety, which contributed to the development of PTSD, was significant [χ² (11) = 122.47, p < 0.001]. The hierarchical multiple linear regression analysis indicated that female gender and the severity of comorbidities (depression and anxiety) were positively associated with the severity of PTSD. CONCLUSION: This study found that the severity of depression and anxiety was closely related to the severity of PTSD, supporting that SDPs are highly prone to the co-occurrence of PTSD, depression, and anxiety after bereavement. Our findings may provide more insights into the development of individualized interventions for parents who have experienced the loss of their only child.
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Padres , Trastornos por Estrés Postraumático , Humanos , Femenino , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Masculino , Estudios Transversales , China/epidemiología , Adulto , Padres/psicología , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Ansiedad/epidemiología , Ansiedad/psicología , Hijo Único/psicología , Depresión/epidemiología , Depresión/psicología , Comorbilidad , Escalas de Valoración Psiquiátrica , NiñoRESUMEN
Post-traumatic stress disorder (PTSD) stands as a pervasive psychiatric condition, exerting a profound impact on millions across the globe. Despite the availability of traditional therapeutic modalities, many individuals continue to grapple with suboptimal treatment outcomes, underscoring the urgent need for novel interventions. In recent years, stellate ganglion blocks (SGBs) have garnered attention as a promising avenue in the treatment landscape for PTSD, showcasing remarkable efficacy in ameliorating symptomatology and enhancing overall quality of life. This comprehensive review seeks to delve into the current landscape of research surrounding SGBs for PTSD, including proposed mechanisms of action, clinical efficacy across diverse patient populations, safety profile, and potential avenues for further exploration and refinement. By synthesizing the latest evidence and insights, this review aims to provide clinicians and researchers with a comprehensive understanding of the role of SGBs in PTSD management, ultimately informing clinical practice and guiding future research endeavors in this area of mental health intervention.
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Bloqueo Nervioso Autónomo , Ganglio Estrellado , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/fisiopatología , Bloqueo Nervioso Autónomo/métodos , Calidad de Vida , Resultado del Tratamiento , AnimalesRESUMEN
There is evidence that vaccine acceptability is strongly associated with mental health. However, no studies assessing intention to vaccinate (ITV) intention toward children of military parents have been documented. The current research aimed to establish the prevalence and factors of ITV children against COVID-19 in military parents in Lambayeque-Peru, 2021. Analysis was conducted with the dependent variable ITV children reported by military parents. The independent variables were history of mental health, searching for mental health support, food insecurity, resilience, anxiety, depression, burnout, posttraumatic stress, and suicidal risk. Prevalence ratios and 95% confidence intervals were estimated. Of 201 military personnel evaluated, 92.5% were male, 82.5% were of the Catholic faith, and the median age was 40.9% of respondents reported seeking mental health help during the COVID-19 pandemic. It was reported anxiety (20.3%), depression (6.5%), and posttraumatic stress disorder (6.5%). Most reported ITV in children against COVID-19 (93%). In the multiple models, we found that Catholics had a 23% higher prevalence of ITV in the children where PR = prevalence ratios and CI = confidence intervals (PR = 1.23; 95% CI: 1.01-1.50). Likewise, seeking mental health support increased the prevalence of ITV by 8% (PR = 1.08; 95% CI: 1.00-1.15). Seeking mental health support and belonging to the Catholic faith had a higher ITV of children of Peruvian military personnel. Finding mental health support, experiencing burnout syndrome, having a relative who suffers from mental health problems, and being part of the Catholic religion were associated with a higher willingness to immunize the children of Peruvian military members.
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Vacunas contra la COVID-19 , COVID-19 , Salud Mental , Padres , Vacunación , Humanos , Masculino , Femenino , COVID-19/prevención & control , COVID-19/epidemiología , COVID-19/psicología , Adulto , Perú/epidemiología , Vacunación/psicología , Vacunas contra la COVID-19/administración & dosificación , Vacunas contra la COVID-19/uso terapéutico , Padres/psicología , Personal Militar/psicología , Niño , SARS-CoV-2 , Intención , Familia Militar/psicología , Ansiedad/epidemiología , Ansiedad/psicología , Persona de Mediana Edad , Depresión/epidemiología , Depresión/psicología , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicologíaRESUMEN
INTRODUCTION: Violence against women (VAW) is a persistent global public health problem that runs across all social classes and ethnicities with a considerable negative influence on women's health and behaviour. Early detection, appropriate interventions and multidisciplinary cooperation are crucial factors in tackling gender violence. OBJECTIVES: This note describes "The Violence against women: long-term health effects for precision prevention" transdisciplinary and multicenter project that aims to implement the National Guidelines with two sets of questions: the European Injury Database (EU-IDB) violence module and the Post-Traumatic Stress Disorder (PTSD) questionnaire for improving innovative approaches to limit the long-term health effect of VAW. Furthermore, the analysis of epigenetic profile in women's DNA may contribute to the knowledge of molecular mechanisms underlying PTSD and other non-communicable diseases. Epigenomic research in parallel with rigourous guidelines and social, educational, clinical and community interventions could accomplish innovative precision prevention protocols. CONCLUSIONS: Public health plays essential role in identifying risk factors and strengthening the support for women victims of violence.
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Trastornos por Estrés Postraumático , Humanos , Femenino , Trastornos por Estrés Postraumático/prevención & control , Trastornos por Estrés Postraumático/genética , Trastornos por Estrés Postraumático/psicología , Violencia de Género/prevención & control , Salud de la Mujer , Salud PúblicaRESUMEN
BACKGROUND: Life with end-stage organ failure is accompanied by an accumulation of traumatic medical or surgical experiences. Despite recovery after solid organ transplantation (SOT), many children and adolescents develop post-traumatic stress symptoms (PTSS). PTSS remain underappreciated as a major comorbidity in SOT programs, despite their association with decreased quality of life. METHODS: We conducted a retrospective, cross-sectional study of 86 pediatric SOT recipients (17 heart, 44 kidney, and 25 liver) to evaluate potential determinants of PTSS. Trauma symptoms were measured by the Child Trauma Screening Questionnaire (CTSQ). Demographic, baseline, and contemporaneous factors were tested for independent association with CTSQ scores. RESULTS: The median post-transplant CTSQ score was 2 (IQR 1-4), and 22% were identified as high risk (score ≥5) for PTSD. Higher CTSQ scores were independently associated with the number of ICU days within the previous 12 months, the number of medications (complexity), and involvement with foster care in the primary model (R2 [adj.] = 0.26). The addition of the Family Impact Module improved the overall model (R2 [adj.] = 0.33), wherein higher family functioning was independently associated with lower CTSQ scores. An exploratory analysis of pre-transplant patients (n = 34) found a median pre-transplant CTSQ of 2 (IQR 1-6), suggesting that PTSS are onset before transplant and persist afterward. CONCLUSIONS: PTSS are highly prevalent in the SOT population. Risk factors include recent adverse medical experiences and complexity, whereas family stability may be protective. Additional research is needed to improve early ascertainment and support for patients at high risk of developing PTSS throughout their transplant journey.
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Trasplante de Órganos , Trastornos por Estrés Postraumático , Receptores de Trasplantes , Humanos , Femenino , Masculino , Trastornos por Estrés Postraumático/etiología , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Estudios Retrospectivos , Niño , Estudios Transversales , Factores de Riesgo , Adolescente , Trasplante de Órganos/psicología , Receptores de Trasplantes/psicología , Preescolar , Calidad de Vida , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/psicología , Complicaciones Posoperatorias/etiología , Encuestas y CuestionariosRESUMEN
Background: Life events are important risk factors for depression and post-traumatic stress disorder (PTSD). Physical activity is a beneficial behavior to physiological and psychological health. While it has not been reported at present the combined effect of physical activity and life events on individual depression and PTSD, and whether it can alleviate the psychological risks induced by life events. Objective: To comprehensively investigate the current status of life events experiences in Chinese students aged 16-24 years and analyze the combined effects of physical activity and life events on their depression and PTSD. Methods: An online cross-sectional survey was conducted on physical activity levels, life events experiences, depression and PTSD of 1,552 Chinese students aged 16-24 using short version of International Physical Activity Questionnaire (IPAQ-S), adolescent self-rating life events checklist (ASLEC), PTSD Check List-Civilian Version (PCL-C) and Patient Health Questionnaire Depression Scale. Then, logistic regression equation and stratified analysis were used to explore the combined effects of physical activity and life events on depression and PTSD. Results: Regression analysis showed that, except for female, <8 h of sleep, smoking, single parent/reorganized families and poor family economic status, experiencing medium-intensity and high-intensity life events were both risk factors for depression. Compared with those who experienced low-intensity life events, those who experienced medium- and high-intensity life events had a 27 and 131% increased risk of depression, respectively. In contrast, medium- and high-level physical activity could reduce the risk of depression by 49 and 53%, respectively. Similar results were obtained with PTSD as a dependent variable. Combined correlation analysis showed that, compared with those with high-level physical activity and low-intensity life events, those with low-level physical activity and high-intensity life events had a 209 and 121% increased risk of depression and PTSD, respectively. Stratified analysis showed that the threshold for life events induced depression and PTSD rose with the increase in the level of physical activity. Conclusion: Lack of physical activity and experience of high-intensity life events are independent risk factors for depression and PTSD, and strengthening physical activity can compensate for the harm of depression and PTSD caused by life events to some extent.
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Depresión , Ejercicio Físico , Acontecimientos que Cambian la Vida , Trastornos por Estrés Postraumático , Estudiantes , Humanos , Femenino , Adolescente , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Masculino , Estudios Transversales , Ejercicio Físico/psicología , Depresión/epidemiología , Depresión/psicología , Adulto Joven , China/epidemiología , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Encuestas y Cuestionarios , Factores de Riesgo , Pueblos del Este de AsiaRESUMEN
BACKGROUND: The incidence of comorbid depression and post-traumatic stress disorder (PTSD) symptoms is higher in snakebite victims. However, the present state and contributing factors of depression and PTSD among Chinese snakebite victims remain unclear. METHODS: A representative sample of 6837 snakebite victims were assessed with the Post-traumatic Stress Disorder Checklist (Civilian Version) and The Center for Epidemiologic Studies Depression Scale. Multivariate analyses, including network analysis, evaluated the contributing factors of PTSD and depression symptoms caused by snake bites, as well as the bridge symptoms of comorbidity networks. RESULTS: Among 6,837 snakebite victims, 79.5% reported PTSD symptoms and 81.4% reported depression symptoms. Comorbidity of PTSD and depression symptoms was found in 75.1%. Key factors included the presence sequelae after snakebite (ORPTSD = 2.31, ORDepression = 1.89), time to medical facilities (6-8 h: ORPTSD = 3.17, ORDepression = 2.46), and marital status (divorced/widowed: ORPTSD = 1.78, ORDepression = 1.76). Symptoms I1 ("Repeated disturbing memories") and D1 ("Bothered by things that don't usually bother me") bridged PTSD and depression networks. CONCLUSION: The primary psychological challenges for snakebite victims in China are PTSD and depression symptoms, which is concerning. Standardized diagnosis and treatments, timely medical care, and stable marital relationships can reduce risks. Additional psychological support and management of negative memories, especially for those with severe bridge symptoms, can be beneficial. Further research should concentrate on understanding victims' psychological states and developing effective interventions.
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Depresión , Mordeduras de Serpientes , Trastornos por Estrés Postraumático , Humanos , Mordeduras de Serpientes/psicología , Mordeduras de Serpientes/epidemiología , Mordeduras de Serpientes/complicaciones , Trastornos por Estrés Postraumático/epidemiología , Trastornos por Estrés Postraumático/psicología , Masculino , Femenino , Adulto , Depresión/epidemiología , Depresión/psicología , Estudios Transversales , Persona de Mediana Edad , China/epidemiología , Adulto Joven , Comorbilidad , Adolescente , AncianoRESUMEN
Background: The complexity of posttraumatic stress disorder (PTSD) symptoms related to childhood abuse (CA) present challenges for effective psychotherapeutic treatment. Consequently, there is great interest in the long-term effectiveness of psychological treatments for this population.Objective: This study aims to investigate the long-term outcomes of Dialectical Behaviour Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT) 9 months after treatment termination.Method: This is a long-term analysis from a randomised-controlled trial of DBT-PTSD versus CPT (registration number DRKS00005578). Initially, 193 individuals with CA-related PTSD were randomly allocated to receive either DBT-PTSD (n = 98) or CPT (n = 95). The primary outcome the Clinician-administered PTSD-Scale for DSM-5 (CAPS-5) was administred at baseline, treatment completion (15 months post-randomization) and at the 9-month follow-up. Secondary outcomes included self-reported PTSD severity (PCL-5), dissociation (DSS), severity of borderline symptoms (BSL-23), and psychosocial functioning (GAF).Results: No significant changes were observed in the primary (CAPS) and all other outcomes from post-intervention to 9-months follow-up in both the DBT-PTSD (CAPS: Mpost = 15.60, Mfollow-up = 14.93) and CPT group (CAPS: Mpost = 18.80, Mfollow-up = 17.41). Between-group analyses at 9-months follow-up were significantly in favour of DBT-PTSD compared to CPT with small to medium effect sizes on all outcomes ranging from d = 0.35 on the CAPS to d = 0.57 on the BSL-23 and GAF.Conclusions: Our results indicate that treatment effects of psychotherapy addressing complex presentations of PTSD persist 9 months after treatment termination. In addition, the superiority of DBT-PTSD as compared to CPT found at treatment termination, was confirmed at 9-months follow-up.Trial registration: German Clinical Trials Register identifier: DRKS00005578..
This study investigates the long-term effects of Dialectical Behaviour Therapy for Posttraumatic Stress Disorder (DBT-PTSD) and Cognitive Processing Therapy (CPT) on complex presentations of PTSD 9 months after treatment termination.In both treatment arms, treatment effects persisted over 9 months post-treatment termination across a wide range of outcomes.DBT-PTSD showed significant superiority over CPT at 9 months follow-up with differential effect sizes between d = 0.35 and d = 0.57.
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Terapia Cognitivo-Conductual , Terapia Conductual Dialéctica , Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/terapia , Femenino , Masculino , Adulto , Resultado del TratamientoRESUMEN
In this paper, the author portrays the psychoanalytic therapy with a twelve-year-old refugee boy and his parents, prior to which the boy had been traumatised by the deaths of both his brothers in the civil war. In 2015 he had travelled with his father to Austria, where he was warmly received in a small community. The author examines how this child reacted to the traumatising experiences, as well as which resilience factors played a role in overcoming them. The psychoanalytic process is illuminated in a detailed analysis of the therapy sessions, which created a space for overcoming the helplessness, mourning the loss and furthering the integration process of the identity, disturbed after the traumatic experiences.
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Terapia Psicoanalítica , Refugiados , Humanos , Refugiados/psicología , Masculino , Terapia Psicoanalítica/métodos , Niño , Trauma Psicológico/terapia , Trauma Psicológico/psicología , Psicoterapia Breve/métodos , Padres/psicología , Austria , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicologíaRESUMEN
BACKGROUND: Most studies about accidents and about PTSD, respectively, have been conducted either on blue-collar workers, or on the entire working population. There are very few such studies on white-collar workers. AIM: To examine diagnosis-specific sickness absence (SA) and disability pension (DP) after a work accident or PTSD, respectively, among white-collar workers in the private retail and wholesale industry. METHODS: A prospective population-based cohort study of all 192,077 such workers aged 18-67 (44% women) in Sweden in 2012, using linked microdata from nationwide registers. We identified individuals who had secondary healthcare due to work-related accidents (n = 1114; 31% women) or to PTSD (n = 216; 79% women) in 2012-2016. Their average number of net days of diagnosis-specific SA (in SA spells > 14 days) and DP were calculated for 365 days before and 365 days after the healthcare visit. RESULTS: 35% of the women and 24% of the men had at least one new SA spell during the 365 days after healthcare due to work accidents. Among women, the average number of SA/DP days increased from 14 in the year before the visit to 31 days the year after; among men from 9 to 21 days. SA days due to fractures and other injuries increased most, while SA days due to mental diagnoses increased somewhat. 73% of women and 64% of men who had healthcare due to PTSD had at least one new SA spell in the next year. Women increased from 121 to 157 SA/DP days and men from 112 to 174. SA due to stress-related disorders and other mental diagnoses increased the most, while DP due to stress-related diagnoses and SA due to musculoskeletal diagnoses increased slightly. CONCLUSIONS: About a quarter of those who had secondary healthcare due to work accidents, and the majority of those with such healthcare due PTSD, had new SA in the following year. SA due to injury and mental diagnoses, respectively, increased most, however, SA/DP due to other diagnoses also increased slightly. More knowledge is needed on factors associated with having or not having SA/DP in different diagnoses after work accidents and among people with PTSD.
Asunto(s)
Accidentes de Trabajo , Ausencia por Enfermedad , Trastornos por Estrés Postraumático , Humanos , Suecia/epidemiología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Ausencia por Enfermedad/estadística & datos numéricos , Trastornos por Estrés Postraumático/epidemiología , Adolescente , Accidentes de Trabajo/estadística & datos numéricos , Estudios Longitudinales , Adulto Joven , Anciano , Estudios Prospectivos , Industrias/estadística & datos numéricos , Pensiones/estadística & datos numéricos , Comercio/estadística & datos numéricosRESUMEN
OBJECTIVE: We aimed to evaluate the frequency of Post Traumatic Stress Disorder (PTSD), to determine the risk factors, and to monitor the change of symptoms after 6 months among individuals who survived the avalanche disaster in Van. METHOD: Face-to-face interviews were conducted with 35 people who were rescued from two consecutive avalanche disasters in Van 2 months and 6 months after the avalanche disaster. The socio-demographic and clinical data of the cases were evaluated. The Post Traumatic Stress Disorder Symptom Scale-Self Report version (PSS-SR) and clinical interviews were used for PTSD diagnosis. The level of trauma was assessed by using the Impact of Event Scale (IES). RESULTS: All participants were rescuers who went to the avalanche site for rescue mission. Of the cases, 16 were volunteers from the local community and 19 were professional rescuers. The frequency of PTSD was 71.4% in the early assessment, and 57.1% in the long term. Staying in avalanche for more than 30 minutes, the absence of a history of disaster exposure and being in the group of volunteers were found to increase the risk for PTSD development. CONCLUSION: There is a high risk of developing PTSD as a result of an avalanche. People who will intervene with the disasters should be educated and prepared in terms of preventing negative psychological consequences of the disaster. The relationship between the severity of trauma and PTSD was replicated in our study.
Asunto(s)
Avalanchas , Trastornos por Estrés Postraumático , Sobrevivientes , Humanos , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/epidemiología , Masculino , Femenino , Adulto , Sobrevivientes/psicología , Estudios de Seguimiento , Persona de Mediana Edad , Factores de Riesgo , Turquía/epidemiología , Desastres , Escalas de Valoración Psiquiátrica , Adulto JovenRESUMEN
The psychological states of hunger and satiety play an important role in regulating human food intake. Several lines of evidence suggest that these states rely upon declarative learning and memory processes, which are based primarily in the medial temporal lobes (MTL). The MTL, and particularly the hippocampus, is unusual in that it is especially vulnerable to insult. Consequently, we examine here the impact on hunger and satiety of conditions that: (1) are central to ingestive behaviour and where there is evidence of MTL pathology (i.e., habitual consumption of a Western-style diet, obesity, and anorexia nervosa); and (2) where there is overwhelming evidence of MTL pathology, but where ingestive behaviour is not thought central (i.e., temporal lobe epilepsy and post-traumatic stress disorder). While for some of these conditions the evidence base is currently limited, the general conclusion is that MTL impairment is linked, sometimes strongly, to dysfunctional hunger and satiety. This focus on the MTL, and declarative learning and memory processes, has implications for the development of alternative treatment approaches for the regulation of appetite.
Asunto(s)
Hambre , Saciedad , Humanos , Hambre/fisiología , Saciedad/fisiología , Obesidad/psicología , Obesidad/fisiopatología , Conducta Alimentaria/psicología , Conducta Alimentaria/fisiología , Lóbulo Temporal/fisiopatología , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/fisiopatología , Epilepsia del Lóbulo Temporal/fisiopatología , Epilepsia del Lóbulo Temporal/psicología , Anorexia Nerviosa/psicología , Anorexia Nerviosa/fisiopatología , Memoria/fisiología , Hipocampo/fisiología , Aprendizaje , Ingestión de Alimentos/psicología , Ingestión de Alimentos/fisiología , Dieta Occidental/efectos adversosAsunto(s)
Psicoterapia Psicodinámica , Trastornos por Estrés Postraumático , Veteranos , Humanos , Veteranos/psicología , Trastornos por Estrés Postraumático/terapia , Trastornos por Estrés Postraumático/psicología , Psicoterapia Psicodinámica/métodos , Masculino , Racismo/psicología , Adulto , Persona de Mediana EdadRESUMEN
Posttraumatic stress disorder (PTSD) is a serious health condition that adversely affects the mind and body. Current first-line treatment for PTSD tends to focus on the mind and overlook the impacts of trauma on the body. Trauma Center Trauma-Sensitive Yoga (TCTSY) is an evidence-based adjunctive therapy for complex trauma and PTSD that uses a body-based approach to trauma healing. Although designed to be used in group or individual contexts, previous studies have focused only on TCTSY facilitated in groups. The present study examined the effects of one-to-one TCTSY (i.e., one participant receiving TCTSY services, not in a group TCTSY context) on anxiety, depression, posttraumatic stress, interoception, substance use, and sleep over time. Using an observational approach, all certified TCTSY facilitators received the study invitation to share with clients who were enrolled in one-to-one TCTSY services. Ten clients participated in the study across four countries (women n = 8; mean age 44.80 ± 11.91; PTSD diagnosis n = 9). Clients completed Qualtrics surveys at TCTSY sessions in June-December 2022. Linear mixed-model analyses found that anxiety, depression, posttraumatic stress symptoms, attention regulation, self-regulation, and body listening significantly improved over time. There were no significant changes in sleep or substance use from pre- to post-study. TCTSY is a somatic approach for managing trauma symptoms and enhancing interoceptive awareness. Extensions of the present study are warranted to further understand the effects of one-to-one TCTSY for trauma care.