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Annual Review of Clinical Psychology May 2023The number of refugees and internally displaced people in 2022 is the largest since World War II, and meta-analyses demonstrate that these people experience elevated... (Review)
Review
The number of refugees and internally displaced people in 2022 is the largest since World War II, and meta-analyses demonstrate that these people experience elevated rates of mental health problems. This review focuses on the role of posttraumatic stress disorder (PTSD) in refugee mental health and includes current knowledge of the prevalence of PTSD, risk factors, and apparent differences that exist between PTSD in refugee populations and PTSD in other populations. An emerging literature on understanding mechanisms of PTSD encompasses neural, cognitive, and social processes, which indicate that these factors may not function exactly as they have functioned previously in other PTSD populations. This review recognizes the numerous debates in the literature on PTSD in refugees, including those on such issues as the conceptualization of mental health and the applicability of the PTSD diagnosis across cultures, as well as the challenge of treating PTSD in low- and middle-income countries that lack mental health resources to offer standard PTSD treatments.
Topics: Humans; Stress Disorders, Post-Traumatic; Refugees; Mental Health
PubMed: 36854285
DOI: 10.1146/annurev-clinpsy-080921-080359 -
American Journal of Psychotherapy 2002Exposure therapy is a well-established treatment for Posttraumatic Stress Disorder (PTSD) that requires the patient to focus on and describe the details of a traumatic... (Review)
Review
Exposure therapy is a well-established treatment for Posttraumatic Stress Disorder (PTSD) that requires the patient to focus on and describe the details of a traumatic experience. Exposure methods include confrontation with frightening, yet realistically safe, stimuli that continues until anxiety is reduced. A review of the literature on exposure therapy indicates strong support from well-controlled studies applied across trauma populations. However, there are many misconceptions about exposure therapy that may interfere with its widespread use. These myths and clinical guidelines are addressed. It is concluded that exposure therapy is a safe and effective treatment for PTSD when applied as directed by experienced therapists.
Topics: Adult; Cognitive Behavioral Therapy; Combat Disorders; Female; Humans; Practice Guidelines as Topic; Psychological Theory; Rape; Stress Disorders, Post-Traumatic; User-Computer Interface
PubMed: 11977784
DOI: 10.1176/appi.psychotherapy.2002.56.1.59 -
Clinics in Geriatric Medicine May 2020Posttraumatic stress disorder (PTSD) can occur at any point in the life span and can last for decades. Chronic PTSD can affect quality of life and have a negative impact... (Review)
Review
Posttraumatic stress disorder (PTSD) can occur at any point in the life span and can last for decades. Chronic PTSD can affect quality of life and have a negative impact on physical function and health in the elderly and may be associated with premature aging and dementia. It is critical that clinicians screen for trauma-based symptoms and to treat as appropriate.
Topics: Aged; Functional Status; Health Status; Humans; Patient Care Management; Quality of Life; Risk Assessment; Stress Disorders, Post-Traumatic
PubMed: 32222307
DOI: 10.1016/j.cger.2019.11.013 -
Psychological Review Oct 1996A cognitive theory of posttraumatic stress disorder (PTSD) is proposed that assumes traumas experienced after early childhood give rise to 2 sorts of memory, 1 verbally... (Review)
Review
A cognitive theory of posttraumatic stress disorder (PTSD) is proposed that assumes traumas experienced after early childhood give rise to 2 sorts of memory, 1 verbally accessible and 1 automatically accessible through appropriate situational cues. These different types of memory are used to explain the complex phenomenology of PTSD, including the experiences of reliving the traumatic event and of emotionally processing the trauma. The theory considers 3 possible outcomes of the emotional processing of trauma, successful completion, chronic processing, and premature inhibition of processing We discuss the implications of the theory for research design, clinical practice, and resolving contradictions in the empirical data.
Topics: Adaptation, Psychological; Attention; Combat Disorders; Emotions; Humans; Mental Recall; Psychotherapy; Stress Disorders, Post-Traumatic
PubMed: 8888651
DOI: 10.1037/0033-295x.103.4.670 -
American Family Physician Mar 2023
Topics: Humans; Stress Disorders, Post-Traumatic
PubMed: 36920822
DOI: No ID Found -
Journal of Psychiatry & Neuroscience :... Jan 2018Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of... (Review)
Review
Mindfulness-based treatments for posttraumatic stress disorder (PTSD) have emerged as promising adjunctive or alternative intervention approaches. A scoping review of the literature on PTSD treatment studies, including approaches such as mindfulness-based stress reduction, mindfulness-based cognitive therapy and metta mindfulness, reveals low attrition with medium to large effect sizes. We review the convergence between neurobiological models of PTSD and neuroimaging findings in the mindfulness literature, where mindfulness interventions may target emotional under- and overmodulation, both of which are critical features of PTSD symptomatology. Recent emerging work indicates that mindfulness-based treatments may also be effective in restoring connectivity between large-scale brain networks among individuals with PTSD, including connectivity between the default mode network and the central executive and salience networks. Future directions, including further identification of the neurobiological mechanisms of mindfulness interventions in patients with PTSD and direct comparison of these interventions to first-line treatments for PTSD are discussed.
Topics: Brain; Humans; Mindfulness; Stress Disorders, Post-Traumatic
PubMed: 29252162
DOI: 10.1503/jpn.170021 -
The Psychiatric Clinics of North America Mar 2018Posttraumatic stress disorder (PTSD) can occur at any point in the life span and can last for decades. Chronic PTSD can affect quality of life and have a negative impact... (Review)
Review
Posttraumatic stress disorder (PTSD) can occur at any point in the life span and can last for decades. Chronic PTSD can affect quality of life and have a negative impact on physical function and health in the elderly and may be associated with premature aging and dementia. It is critical that clinicians screen for trauma-based symptoms and to treat as appropriate.
Topics: Aged; Aging; Comorbidity; Dementia; Humans; Stress Disorders, Post-Traumatic
PubMed: 29412844
DOI: 10.1016/j.psc.2017.10.013 -
American Journal of Obstetrics and... Jun 2024Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these events remains high in the United States. Currently, no recommended treatment exists in routine care to prevent or mitigate maternal childbirth-related posttraumatic stress disorder. We conducted a systematic review and meta-analysis of clinical trials that evaluated any therapy to prevent or treat childbirth-related posttraumatic stress disorder.
DATA SOURCES
PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for eligible trials published through September 2023.
STUDY ELIGIBILITY CRITERIA
Trials were included if they were interventional, if they evaluated any therapy for childbirth-related posttraumatic stress disorder for the indication of symptoms or before posttraumatic stress disorder onset, and if they were written in English.
METHODS
Independent coders extracted the sample characteristics and intervention information of the eligible studies and evaluated the trials using the Downs and Black's quality checklist and Cochrane's method for risk of bias evaluation. Meta-analysis was conducted to evaluate pooled effect sizes of secondary and tertiary prevention trials.
RESULTS
A total of 41 studies (32 randomized controlled trials, 9 nonrandomized trials) were reviewed. They evaluated brief psychological therapies including debriefing, trauma-focused therapies (including cognitive behavioral therapy and expressive writing), memory consolidation and reconsolidation blockage, mother-infant-focused therapies, and educational interventions. The trials targeted secondary preventions aimed at buffering childbirth-related posttraumatic stress disorder usually after traumatic childbirth (n=24), tertiary preventions among women with probable childbirth-related posttraumatic stress disorder (n=14), and primary prevention during pregnancy (n=3). A meta-analysis of the combined randomized secondary preventions showed moderate effects in reducing childbirth-related posttraumatic stress disorder symptoms when compared with usual treatment (standardized mean difference, -0.67; 95% confidence interval, -0.92 to -0.42). Single-session therapy within 96 hours of birth was helpful (standardized mean difference, -0.55). Brief, structured, trauma-focused therapies and semi-structured, midwife-led, dialogue-based psychological counseling showed the largest effects (standardized mean difference, -0.95 and -0.91, respectively). Other treatment approaches (eg, the Tetris game, mindfulness, mother-infant-focused treatment) warrant more research. Tertiary preventions produced smaller effects than secondary prevention but are potentially clinically meaningful (standardized mean difference, -0.37; -0.60 to -0.14). Antepartum educational approaches may help, but insufficient empirical evidence exists.
CONCLUSION
Brief trauma-focused and non-trauma-focused psychological therapies delivered early in the period following traumatic childbirth offer a critical and feasible opportunity to buffer the symptoms of childbirth-related posttraumatic stress disorder. Future research that integrates diagnostic and biological measures can inform treatment use and the mechanisms at work.
Topics: Humans; Stress Disorders, Post-Traumatic; Female; Pregnancy; Parturition; Cognitive Behavioral Therapy
PubMed: 38122842
DOI: 10.1016/j.ajog.2023.12.013 -
The Journal of Clinical Psychiatry 1997This article reviews concepts that help synthesize the data on posttraumatic stress disorder (PTSD), a very complex condition in terms of its etiology, psychobiology,... (Review)
Review
This article reviews concepts that help synthesize the data on posttraumatic stress disorder (PTSD), a very complex condition in terms of its etiology, psychobiology, epidemiology, comorbidity, and treatment. At least four neurobiologic systems are involved in PTSD: the catecholamine, the hypothalamic-pituitary-adrenocortical, the thyroid, and the endogenous opioid systems. Six other systems are probably or possibly implicated as well. The avoidance and hyperarousal of PTSD distort the patient's appraisal of the world. The symptoms of PTSD can be understood through models of learning and memory, which form the basis of behavioral treatments. The concepts of tonic and phasic alteration and of allostasis versus homeostasis also shed light on PTSD. In addition to PTSD, there may be other identifiable posttraumatic syndromes that might be diagnosed separately, such as "complex" PTSD. Cross-cultural issues may also affect clinical phenomenology and thereby confuse the diagnosis. Comorbid disorders may actually be clues to subtypes of PTSD. The fact that victims of PTSD are also more vulnerable to medical illnesses makes a closer relationship with primary care providers and other specialists mandatory. New approaches to prevention, treatment of chronic PTSD, psychotherapy, pharmacotherapy, and research hold promise of an improved prognosis for patients with PTSD.
Topics: Cognitive Behavioral Therapy; Humans; Life Change Events; Psychotherapy; Psychotropic Drugs; Stress Disorders, Post-Traumatic
PubMed: 9329450
DOI: No ID Found -
The Psychiatric Clinics of North America Mar 1985The authors review posttraumatic stress disorder in terms of clinical features, historical development and phenomenology, and relationship to other psychiatric... (Review)
Review
The authors review posttraumatic stress disorder in terms of clinical features, historical development and phenomenology, and relationship to other psychiatric disorders. Treatment modalities are detailed.
Topics: Agoraphobia; Antidepressive Agents, Tricyclic; Anxiety Disorders; Depressive Disorder; Female; Humans; Male; Monoamine Oxidase Inhibitors; Narcotherapy; Panic; Psychotherapy; Schizophrenia; Schizophrenic Psychology; Stress Disorders, Post-Traumatic
PubMed: 3887339
DOI: No ID Found