Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review

Current Neuropharmacology, Год журнала: 2023, Номер 22(4), С. 557 - 635

Опубликована: Май 3, 2023

Abstract: This narrative state-of-the-art review paper describes the progress in understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over last four decades, scientific landscape has matured, with many interdisciplinary contributions to its diagnosis, etiology, epidemiology. Advances genetics, neurobiology, stress pathophysiology, brain imaging have made it apparent that chronic PTSD is a systemic disorder high allostatic load. The current state includes wide variety pharmacological psychotherapeutic approaches, which are evidence-based. However, myriad challenges inherent disorder, such as individual barriers good outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, trauma-related guilt shame, often render response suboptimal. These discussed drivers for emerging novel including early interventions Golden Hours, interventions, medication augmentation use psychedelics, well targeting nervous system. All this aims improve symptom relief clinical outcomes. Finally, phase orientation recognized tool strategize position step progression pathophysiology. Revisions guidelines systems care will be needed incorporate innovative treatments evidence emerges they become mainstream. generation well-positioned address devastating disabling impact traumatic events through holistic, cutting-edge efforts research.

Язык: Английский

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Prevalence of post-traumatic symptomatology and anxiety among residential nursing and care home workers following the first COVID-19 outbreak in Northern Italy

Royal Society Open Science, Год журнала: 2020, Номер 7(9)

Опубликована: Сен. 1, 2020

The current COVID-19 pandemic has been officially linked to the deaths of hundreds thousands people across globe in just a few months. It is particularly lethal for elderly general, as well populations residing long-term stay facilities. By this time, those working and caring high-risk have exposed very intense sudden levels physical psychological strain. situation taken tragic turn residential nursing care homes (NCH), which were hit hard by pandemic. In NCH, neither residents nor workers tend immediate access same expertise, medication equipment hospitals, exacerbates an already tense situation. Among mental health conditions related exposure potentially traumatic events, post-traumatic stress disorder anxiety are most prevalent scientifically recognized. survey-based epidemiological study, we test prevalence symptomatology home workers-a group individuals that largely neglected but who nonetheless plays important sensitive role our society. We do focusing on North Italy, affected region during first outbreak Italy. Using single-stage cluster design, study returns estimate moderate-to-severe and/or 43% (s.e. = 3.09; 95% CI [37-49]), with 18% 1.83; [14-22]) comorbidity among Northern Italian NCH between 15 June 25 July 2020 (i.e. 12-52 days after end national lockdown). Women had recently contact COVID-19-positive patients/colleagues more likely report symptoms, odds ratios 2.2 1.7, respectively.

Язык: Английский

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Are psychological interventions for adult PTSD more efficacious and acceptable when treatment is delivered in higher frequency? A meta-analysis of randomized controlled trials

Journal of Anxiety Disorders, Год журнала: 2023, Номер 95, С. 102684 - 102684

Опубликована: Фев. 20, 2023

Язык: Английский

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More is not always better: 2 weeks of intensive cognitive processing therapy-based treatment are noninferior to 3 weeks.

Psychological Trauma Theory Research Practice and Policy, Год журнала: 2022, Номер 15(1), С. 100 - 109

Опубликована: Май 13, 2022

Although there is mounting evidence that massed treatment for PTSD both feasible and effective, many questions remain about the optimal length of intensive programs (ITPs), as well role adjunctive services, such psychoeducation, mindfulness, yoga. Our setting recently transitioned from a three-week ITP to two-week program. Adjunctive services were reduced, but amount individual CPT between remained similar. The present study examined effectiveness based on twice daily sessions evaluated program's noninferiority an established using Bayesian analytical approach.

Язык: Английский

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Reducing posttraumatic stress symptoms by mitigating anxiety sensitivity through a computerized intervention

Journal of Affective Disorders, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

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Fully remote intensive trauma-focused treatment for PTSD and Complex PTSD

European journal of psychotraumatology, Год журнала: 2022, Номер 13(2)

Опубликована: Сен. 22, 2022

It is unknown whether remotely delivered intensive trauma-focused therapy not only an effective treatment for PTSD, but also Complex PTSD.

Язык: Английский

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Adding physical activity to intensive trauma-focused treatment for post-traumatic stress disorder: results of a randomized controlled trial

Frontiers in Psychology, Год журнала: 2023, Номер 14

Опубликована: Июль 20, 2023

Introduction This randomized controlled trial examined the effectiveness of physical activity added to an intensive trauma-focused treatment (TFT) for post-traumatic stress disorder (PTSD) in comparison adding non-physical control activities. Methods A total 119 patients with PTSD were randomly assigned a condition (PA; n = 59) or (nPA; 60). The 8-day TFT programme consisted daily prolonged exposure, EMDR therapy, and psychoeducation, which was complemented activities versus mixtures guided (creative) tasks. As primary outcome, change clinician self-reported symptoms from pre-to post-treatment at 6 months follow-up measured. Results Intent-to-treat linear mixed-effects models showed no significant differences between PA nPA conditions on severity. Clinician significantly decreased both conditions, large effect sizes (e.g., CAPS-5 d pre-post 2.28). At post-treatment, 80.0% PA, 82.7% longer met diagnostic criteria PTSD. Regarding loss Complex diagnoses this 92.5% 95.0%, respectively. Conclusion Either additional activities, is very effective (Complex) PTSD, as reflected by status groups. Clinical registration Trialregister.nl Identifier: Trial NL9120.

Язык: Английский

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Effectiveness of an intensive outpatient treatment programme combining prolonged exposure and EMDR therapy for adolescents and young adults with PTSD in a naturalistic setting

European journal of psychotraumatology, Год журнала: 2025, Номер 16(1)

Опубликована: Янв. 21, 2025

Background: Psychotherapeutic interventions aimed at treating posttraumatic stress disorder (PTSD) in adolescents and young adults are hampered by high dropout rates. Looking the results from adult treatments, short, intensive, outpatient treatment programmes may offer a promising alternative, but it has yet to be tested this population.

Язык: Английский

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Collaborative, Trauma-Focused Occupational Therapy and Psychotherapy for Work-Related PTSD: Two Case Studies

Clinical Case Studies, Год журнала: 2025, Номер unknown

Опубликована: Фев. 27, 2025

Emergency and critical care personnel face a heightened risk of occupational trauma exposure. Practitioners lack clear guidance on how to support individuals who are off work with work-related posttraumatic stress disorder (PTSD), particularly those receiving treatment in the context claim workers’ compensation board. While trauma-focused psychotherapies recommended as first-line interventions for PTSD, there is an ongoing discourse about address increased functional impairments work, best struggling in-vivo exposures return work. This article utilizes case studies involving intensive unit nurse emergency dispatcher, demonstrate therapists can collaborate psychotherapists impairment following workplace clients their mental health recovery workplace. Beyond traditional focus non-trauma-related domains, uniquely positioned aspects therapy. Strengthening partnership between has potential improve outcomes, promote reintegration, provide comprehensive holistic that addresses clients’ full spectrum needs.

Язык: Английский

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Low rates of symptom exacerbation during and after massed cognitive processing therapy across veteran and community samples

Journal of Traumatic Stress, Год журнала: 2025, Номер unknown

Опубликована: Апрель 8, 2025

Abstract Clinicians have expressed concerns that symptoms may worsen during evidence‐based treatments for posttraumatic stress disorder (PTSD), such as cognitive processing therapy (CPT). The current study examined rates of symptom exacerbation in two samples undergoing massed CPT: veterans ( N = 499) and community members 69). Posttraumatic Stress Disorder Checklist DSM‐5 (PCL‐5) was administered throughout treatment both samples, calculated based on changes from one assessment point to the next treatment. Clinically reliable exacerbation, defined a PCL‐5 score increase greater than 8.83 points consecutive measurements taken treatment, observed at least once 27.3% 21.7% Only 1.4% 5.8% reported reliably elevated baseline end findings suggest low clinically meaningful CPT, highlighting its utility across diverse populations formats. These results can inform clinician‐patient discussions, alleviate about worsening symptoms, assuage clinician CPT.

Язык: Английский

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