Post‐traumatic stress disorder: evolving conceptualization and evidence, and future research directions

World Psychiatry, Год журнала: 2025, Номер 24(1), С. 52 - 80

Опубликована: Янв. 15, 2025

The understanding of responses to traumatic events has been greatly influenced by the introduction diagnosis post‐traumatic stress disorder (PTSD). In this paper we review initial versions diagnostic criteria for condition and associated epidemiological findings, including sociocultural differences. We consider evidence reactions occurring in multiple contexts not previously defined as traumatic, implications that these observations have diagnosis. More recent developments such DSM‐5 dissociative subtype ICD‐11 complex PTSD are reviewed, adding there several distinct phenotypes. describe psychological foundations PTSD, involving disturbances memory well identity. A broader focus on identity may be able accommodate group communal influences experience trauma impact resource loss. then summarize current concerning biological with a particular genetic neuroimaging studies. Whereas progress prevention disappointing, is now an extensive supporting efficacy variety treatments established trauma‐focused interventions – cognitive behavior therapy (TF‐CBT) eye movement desensitization reprocessing (EMDR) non‐trauma‐focused therapies, which also include some emerging identity‐based approaches present‐centered compassion‐focused therapies. Additionally, promising neither nor pharmacological, or combine pharmacological approach, 3,4‐methylenedioxymethamphetamine (MDMA)‐assisted psychotherapy. advances priority areas adapting resource‐limited settings across cultural contexts, community‐based approaches. conclude identifying future directions work mental health.

Язык: Английский

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Childhood Maltreatment and Somatic Symptoms in Adulthood: Establishing a New Research Pathway

Neuropsychobiology, Год журнала: 2025, Номер unknown, С. 1 - 15

Опубликована: Янв. 14, 2025

Background: Somatic symptoms, such as chronic pain, fatigue, and gastrointestinal disturbances, are commonly reported in individuals with a history of childhood maltreatment (CM), which includes various forms abuse neglect experienced before age 18. Although CM is strongly associated somatic the specific relationships between subtypes these well mechanisms connecting them, remain insufficiently understood. This review examines complex interaction often coexist mental disorders significantly impact quality life healthcare systems. Summary: frequently mix "explained" "unexplained" conditions, personal distress pose diagnostic challenges. has been linked to symptoms through neurobiological mechanisms, HPA axis dysregulation allostatic load, while theoretical models emphasize roles hyperawareness, cultural factors, vulnerability symptom development. However, existing research fails account for subtypes, full range situational leading inconsistencies findings. Key Messages: Bridging gaps literature requires adopting World Health Organization’s subtype definitions ICD-11 codes (MA00-MH2Y) encompass broader spectrum symptoms. Employing rigorous methodologies, systematic reviews meta-analyses, essential advancing understanding. These approaches can enhance accuracy, support tailored interventions, promote biopsychosocial framework research, ultimately improving patient outcomes alleviating societal burdens.

Язык: Английский

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Body‐and movement‐oriented interventions for posttraumatic stress disorder: An updated systematic review and meta‐analysis

Journal of Traumatic Stress, Год журнала: 2023, Номер 36(5), С. 835 - 848

Опубликована: Сен. 13, 2023

Abstract This study is an update of the meta‐analysis we published in 2019 on effectiveness body‐ and movement‐oriented interventions (BMOIs) for adults with posttraumatic stress disorder (PTSD) decreasing PTSD symptoms secondary outcomes depressive symptoms, sleep disturbance, interoceptive awareness. Search terms BMOIs were combined to identify eligible studies four bibliographical databases. Articles selected if they included adult participants a primary diagnosis PTSD, BMOI as one investigated therapies, designed comparative outcome trial any control condition, involved standardized measure symptom severity. resulted addition 14 new compared study. The meta‐analysis, which 29 total, mean Hedges’ g effect size 0.50, 95% CI [0.22, 0.79], very high heterogeneity, I 2 = 89%. Meta‐analyses sizes 0.37, [0.08, 0.66] symptoms; 0.62, [0.42, 0.81] quality; −0.10, [−0.23, 0.43] risk bias analysis some concerns or almost all studies; only had low bias. We conclude that may be valuable patients PTSD. There is, however, still lack high‐quality proper conditions long‐term follow‐up periods from draw conclusions.

Язык: Английский

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A randomized controlled trial of Deep Brain Reorienting: a neuroscientifically guided treatment for post-traumatic stress disorder

European journal of psychotraumatology, Год журнала: 2023, Номер 14(2)

Опубликована: Авг. 15, 2023

Background: Advanced neuroscientific insights surrounding post-traumatic stress disorder (PTSD) and its associated symptomatology should beget psychotherapeutic treatments that integrate these into practice. Deep Brain Reorienting (DBR) is a neuroscientifically-guided intervention targets the brainstem-level neurophysiological sequence transpired during traumatic event. Given contemporary have non-response rates of up to 50% high drop-out >18%, DBR investigated as putative candidate for effective treatment some individuals with PTSD.Objective: To conduct an interim evaluation effectiveness eight-session clinical trial videoconference-based versus waitlist (WL) control PTSD.Method: Fifty-four PTSD were randomly assigned (N = 29) or WL 25). At baseline, post-treatment, three-month follow-up, participants' symptom severity was assessed using Clinician Administered Scale (CAPS-5). This analysis registered U. S. National Institute Health (NCT04317820).Results: Significant between-group differences in CAPS-total all subscale scores (re-experiencing, avoidance, negative alterations cognitions/mood, arousal/reactivity) found at post-treatment (CAPS-total: Cohen's d 1.17) 3-month-follow-up (3MFU) 1.18). decreases observed within group pre – (36.6% reduction) pre-treatment 3MFU (48.6% reduction), whereas no significant occurred group. After DBR, 48.3% 52.0% longer met criteria. Attrition minimal one participant not completing treatment; eight participants lost 3MFU.Conclusions: These findings provide emerging evidence well-tolerated based on theoretical advances highlighting subcortical mechanisms symptomatology. Additional research utilizing larger sample sizes, neuroimaging data, comparisons adjacencies other approaches warranted.Trial registration: ClinicalTrials.gov identifier: NCT04317820..

Язык: Английский

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A conceptual framework for a neurophysiological basis of art therapy for PTSD

Frontiers in Human Neuroscience, Год журнала: 2024, Номер 18

Опубликована: Апрель 22, 2024

Post-traumatic stress disorder (PTSD) is a heterogeneous condition that affects many civilians and military service members. Lack of engagement, high dropout rate, variable response to psychotherapy necessitates more compelling accessible treatment options are based on sound neuroscientific evidence-informed decision-making. Art therapy incorporates elements proven be effective in psychotherapy, such as exposure, making it potentially valuable option. This conceptual paper aims inform the neurophysiological rationale for use art therapeutic approach individuals with PTSD. A narrative synthesis was conducted using literature review empirical research effects therapy, supporting neuroaesthetics psychotherapies identify factors most pertinent Findings were synthesized through proposed framework triple network model considering network-based dysfunctions due therapy’s active components, concretization metaphor, emotion processing regulation, perspective taking reframing, alliance, may improve symptoms PTSD prompt adaptive brain functioning. Given scarcity rigorous studies effectiveness mechanisms alleviating symptoms, suggested offers future agenda investigate impact

Язык: Английский

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The Stress Phenotyping Framework: A multidisciplinary biobehavioral approach for assessing and therapeutically targeting maladaptive stress physiology

Stress, Год журнала: 2024, Номер 27(1)

Опубликована: Май 6, 2024

Although dysregulated stress biology is becoming increasingly recognized as a key driver of lifelong disparities in chronic disease, we presently have no validated biomarkers toxic physiology; biological, behavioral, or cognitive treatments specifically focused on normalizing processes; and agreed-upon guidelines for treating the clinic evaluating efficacy interventions that seek to reduce improve human functioning. We address these critical issues by (a) systematically describing systems mechanisms are stress; (b) summarizing indicators, biomarkers, instruments assessing response systems; (c) highlighting therapeutic approaches can be used normalize stress-related biopsychosocial also present novel multidisciplinary Stress Phenotyping Framework bring researchers clinicians one step closer realizing goal using precision medicine-based prevent treat stress-associated health problems.

Язык: Английский

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Emotional state as a modulator of autonomic and somatic nervous system activity in postural control: a review

Frontiers in Neurology, Год журнала: 2023, Номер 14

Опубликована: Авг. 31, 2023

Advances in our understanding of postural control have highlighted the need to examine influence higher brain centers modulation this complex function. There is strong evidence a link between emotional state, autonomic nervous system (ANS) activity and somatic (somatic NS) control. For example, relationships been demonstrated threat, anxiety, fear falling, balance confidence, physiological arousal. Behaviorally, increased arousal has associated with changes velocity amplitude sway during quiet standing. The potential links ANS NS, observed posture, are shared neuroanatomical connections within central (CNS). state on likely reflects important limbic these ANS/somatic NS networks. This narrative review will highlight several examples behaviors which routinely require coordination highlighting importance neurofunctional systems. Furthermore, we extend beyond more historical focus threat models how disordered/altered processing may assessment. Finally, paper discuss studies that uncovering modulatory effect including inform disordered control, such as individuals living Parkinson's disease methodological tools advance relationship.

Язык: Английский

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Sensory alterations in post-traumatic stress disorder

Current Opinion in Neurobiology, Год журнала: 2023, Номер 84, С. 102821 - 102821

Опубликована: Дек. 13, 2023

Язык: Английский

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FNDC5/Irisin protects neurons through Caspase3 and Bax pathways

Cell Biochemistry and Function, Год журнала: 2024, Номер 42(1)

Опубликована: Янв. 1, 2024

Abstract Irisin is a glycosylated protein formed from the hydrolysis of fibronectin type III domain‐containing 5 (FNDC5). Recent studies have demonstrated that FNDC5/Irisin involved in regulation glucose and lipid metabolism, it can inhibit inflammation neuroprotective effects. However, effect mechanism on motor neuron‐like cell lines (NSC‐34) not been reported. In this study, we used lipopolysaccharide to construct cellular oxidative stress injury models investigated potential roles neurons by different molecular pathways. Taken together, our findings showed protect neurons, might be associated with Caspase3 Bax These results laid foundation for neuronal protection clinical translation therapy.

Язык: Английский

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A theoretical exploration of polyvagal theory in creative arts and psychomotor therapies for emotion regulation in stress and trauma

Frontiers in Psychology, Год журнала: 2024, Номер 15

Опубликована: Май 22, 2024

Polyvagal theory advocates for working with the body, becoming aware of body and connecting senses. Similarly, paying attention to influencing one’s physical sensory experience is a core aspect creative arts psychomotor therapies. offers opportunities strengthening resilience by treating emotion-regulation problems, stress, trauma, as well restoring regulation autonomic nervous system. Paying experiences are aspects This theoretical paper explores how polyvagal can serve foundational support therapies emotion in stress trauma. A number pillars have links therapies, such an emphasis on situations safety or threat. may offer insight into role stressful situations, co-and self-regulation, thus functioning rationale use Through interventions focused promoting healthy responses regulating physiological responses, clients learn better regulate process their emotional experiences. Although this could be broadly useful, it would seem particularly promising article provides introduction outlines explanatory, hypothetical model mechanisms that underlie The application PVT will explored describing techniques “noticing naming” “learning change,” highlighting therapeutic relationship. It case examples discusses conceptualized line theory.

Язык: Английский

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