Tag: PTSD: Post-Traumatic Stress Disorder

Book: The Mindfulness Solution for Intense Emotions

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Book Title:

The Mindfulness Solution for Intense Emotions: Take Control of Borderline Personality Disorder with DBT.

Author(s): Cedar R. Koons.

Year: 2016.

Edition: First.

Publisher: New Harbinger.

Type(s): Paperback and Kindle.

Synopsis:

If you suffer from intense emotions, you are not alone. Millions of Americans are diagnosed with emotion regulation disorders, such as borderline personality disorder (BPD) and other co-morbid conditions like post traumatic stress disorder (PTSD), and severe depression.

Developed by Marsha Linehan, DBT is a clinically proven, evidence-based treatment for intense emotions that can help you start feeling better right away.

This is the first consumer-friendly book to offer Linehan’s new mindfulness skills to help you take control of your emotions, once and for all.

In this book, you will learn seven powerful skills that highlight the unique connection between mindfulness and emotion regulation.

Each skill is designed to help you find focus in the present moment, reduce impulsive behaviour, and increase a sense of connection to your true self, even during times of extreme stress or difficulty.

You can feel calmer, more grounded, and centred. If you are ready, the mindfulness practices in this book will help you move away from a chaotic, emotion-driven life and cultivate a focused, intentional one.

Book: Cognitive Behavioural Therapy

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Book Title:

Cognitive Behavioral Therapy: A Comprehensive Guide to Using CBT to Overcome Depression, Anxiety, Intrusive Thoughts, and Rewiring Your Brain to Regain Control Over Your Emotions and Life.

Author(s): Stuart Watson.

Year: 2020 (Hardcover) and 2019 (Kindle).

Edition: One.

Publisher: Ationa Publications.

Type(s): Hardcover, Paperback, Kindle and Audiobook.

Synopsis:

If you’re looking for an effective method to treat anxiety, depression, phobias and more, then keep reading…

Cognitive-behavioural therapy, otherwise known as “CBT,” is an incredibly well-known therapy method within the field of psychology. Yet, unless you work within this field you likely know very little about CBT, how it works, and why it is one of the best therapy methods around.

In this book you will learn about the amazing affects this therapy has been proven to have. You can learn how to use CBT from within your own home, helping to treat anxiety, depression, post-traumatic stress disorder, panic disorder, obsessive-compulsive disorder, and more. No longer do you have to suffer in silence, simply existing through life. You can learn to heal and begin to actually live a full life again.

Whether you have been diagnosed with social anxiety disorder, major depression, post-traumatic stress disorder, or simply are struggling throughout your daily life without a diagnosis, CBT can help. While it is always best to go to a professional and receive a diagnosis of your condition, you can also use the tools of CBT independently at home, with or without an official diagnosis.

You can learn to better understand your mind, overcome intrusive thoughts, cope with daily stress, and transform your negative thought patterns into something more positive. CBT is truly transformative, and with a little daily effort, you could possibly change your entire life for the better.

The following are some of the critical things explored in the book:

  • The Basic Premise of CBT and how it Can Benefit You in Daily Life.
  • The Fascinating History of CBT.
  • 16 Common Mistakes and Myths about CBT.
  • An In-Depth Look into What CBT Can Treat and Why it Works.
  • The Key Principles of CBT.
  • Overcoming Anxiety and Depression Step-By-Step.
  • 3 Alternative CBT Approaches.
  • Discover 7 Inspiring Tales of CBT Success.
  • And so much more.

Can a New Blood Test Help Identify Troops & Veterans with PTSD?

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Medical professionals could potentially one day identify veterans with post-traumatic stress disorder (PTSD) through a quick blood test instead of complex psychological tests, thanks to new research from the
US Army and outside biometrics experts.

The study, which appeared in the journal Molecular Psychiatry, found a set of 27 blood markers which helped identify patients suffering from PTSD.

Researchers said the findings support past hypotheses that the disorder “affects not just the brain, but the entire body.”

In a statement, US Army Medical Research Systems Biology Chief Scientist Marti Jett said those markers “will continue to be refined and adapted for commercialisation” in coming years.

Researchers are hopeful blood tests can lead not only to more accurate diagnoses but also earlier ones, perhaps indicating signs of problems even before PTSD has fully manifested.

Senior study author Dr. Charles Marmar, chair of the Department of Psychiatry at the New York University School of Medicine, said a blood test could indicate signs of PTSD that veterans are unaware of or deliberately hiding out of fear surrounding the stigma of the diagnosis. It could also more quickly eliminate PTSD as a potential problem for patients with unclear medical issues.

“This is an attempt to take the field of psychiatry from the subjective to the objective,” he said. “It’s a way to start a new conversation about how to find the invisible wounds of war.”

But the study has limits. No women were among the veterans tracked for the research, and no civilians were included. Marmar said creating a simple, inexpensive blood test for widespread use to help diagnose PTSD is likely still years away. But he still lauded the findings as an important medical breakthrough for health experts looking for ways to more accurately track troops’ health.

Defence Department and Veterans Affairs researchers have estimated that as many as 25% of individuals who served in combat zones in Iraq or Afghanistan may suffer from PTSD, marked by uncontrolled anxiety, confusion or anger.

Officials have spent years trying to break down the stigma surrounding the diagnosis, which many service members fear could render them undeployable or otherwise unfit for duty because of the non-physical nature of the symptoms.

The study, the culmination of six years of work, tracked blood samples from 165 veterans, half of whom suffer from PTSD following deployments into war zones.

Scientists studied their medical histories and biochemistry, trimming down the list of potential identifying characteristics in their blood from more
than 1 million to less than 30.

In subsequent tests with other patients, the final set of blood markers showed a 77% accuracy rate in helping identify PTSD. Marmar said that is more than enough for a potential screening test, where medical professionals can follow up with more in-depth
examinations to diagnose the illness.

Past studies have hinted at blood markers as a potential indicator of PTSD, but researchers in the new study which included the Harvard John A. Paulson School of Engineering and Applied Sciences and the US Army Medical Research and Development Command said this is the first time a coherent set of measures has been developed.

Jett said that any screening tool that comes from the research would be used before and after deployments, and treatment for those issues would be provided based on military medical standards.

The full study is available on the journal’s website @ https://www.nature.com/articles/s41380-019-0496-z.

Psychotraumatology: What Have We Learned?

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Research Paper Title

A decennial review of psychotraumatology: what did we learn and where are we going?

Background

On 06 December 2019 the reviewers started the 10th year of the European Journal of Psychotraumatogy (EJPT), a full Open Access journal on psychotrauma.

This editorial is part of a special issue/collection celebrating the 10 years anniversary of the journal where the reviewers will acknowledge some of their most impactful articles of the past decade.

In this editorial the editors present a decennial review of the field addressing a range of topics that are core to both the journal and to psychotraumatology as a discipline.

These include neurobiological developments (genomics, neuroimaging and neuroendocrine research), forms of trauma exposure and impact across the lifespan, mass trauma and early interventions, work-related trauma, trauma in refugee populations, and the potential consequences of trauma such as PTSD or Complex PTSD, but also resilience.

The reviewers address innovations in psychological, medication (enhanced) and technology-assisted treatments, mediators and moderators like social support and finally how new research methods help them to gain insights in symptom structures or to better predict symptom development or treatment success. We aimed to answer three questions

  1. Where did we stand in 2010?
  2. What did we learn in the past 10 years?
  3. What are our knowledge gaps?

The reviewers conclude with a number of recommendations concerning top priorities for the future direction of the field of psychotraumatology and correspondingly the journal.

Reference

Olff, M., Amstadter, A., Armour, C., Birkeland, M.S., Bui, E., Cloitre, M., Ehlers, A., Ford, J.D., Greene, T., Hansen, M., Lanius, R., Roberts, N., Rosner, R. & Thoresen, S. (2019) A decennial review of psychotraumatology: what did we learn and where are we going? European Journal of Psychotraumatology. 10(1):1672948. doi: 10.1080/20008198.2019.1672948. eCollection 2019.

Inter Partner Violence & Post-Traumatic Stress Disorder

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Research Paper Title

An Evidence-Based Assessment Tool for Estimating Future Post-Traumatic Stress Disorder: A 7-Year Follow-Up Study.

Background

Intimate partner violence (IPV) affects up to one in three women across the world.

Post-traumatic stress disorder (PTSD) is a common outcome.

Many, but not all, women suffer long after they first sought help for IPV.

Validated tools for estimating the likelihood of future PTSD are lacking.

Methods

Women who sought IPV support services for the first time in 2011-2012 (N = 300) completed a seven-item screen for the presence or absence of clinically significant PTSD symptoms and the first assessment screening tool for post-traumatic stress disorder (FAST-PTSD), a tool designed to estimate future PTSD among women seeking help for IPV.

Seven years later, in 2018, 271 (90%) women again completed the seven-item screen for clinically significant PTSD symptoms.

A two-step binary logistic regression was conducted to determine the 7-year validity of the FAST for clinically significant symptoms of PTSD while controlling for baseline PTSD symptoms.

Results

More than 25% of the women reported clinically significant PTSD at 7 years. Baseline moderate- and high-risk scores on the FAST-PTSD were associated with clinically significant levels of PTSD.

Moderate risk was associated with nearly two and one-half times (odds ratio [OR] = 2.4) the risk of clinically significant symptoms of PTSD, and high risk with nearly eight times (OR = 7.8) the risk of PTSD at 7 years.

Conclusions

PTSD is commonly associated with IPV and if untreated can compromise functioning of women and their children.

The FAST-PTSD is a valid indicator of significant clinical PTSD symptoms 7 years following first contact with IPV support services.

Using the FAST-PTSD to triage women at risk for sustained PTSD to early, preventive intervention may improve outcomes for women and their children.

Reference

McFarlane, J., Maddoux, J., Paulson, R., Symes, L. & Jouriles, E.N. (2020) An Evidence-Based Assessment Tool for Estimating Future Post-Traumatic Stress Disorder: A 7-Year Follow-Up Study. Journals of Women’s Health. doi: 10.1089/jwh.2019.7699. [Epub ahead of print].

Overview of Trauma- & Stress-Related Disorders

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Trauma- and stress-related disorders result from exposure to a traumatic or stressful event.

Specific disorders include acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). These disorders cause similar symptoms but differ in how long they last.

  • ASD:
    • Typically begins immediately after the event.
    • Lasts from 3 days to 1 month.
  • PTSD:
    • Lasts for more than 1 month.
    • It may develop as a continuation of acute stress disorder or develop separately up to 6 months after the event.

Although depression and anxiety are often prominent, individuals with trauma-related disorders often have a wide variety of symptoms that may not obviously seem related to the traumatic event.

For example, individuals may:

  • Act aggressively;
  • Be unable to experience pleasure; and/or
  • Feel restless, discontented, angry, numb, or disconnected from themselves and others.

What is the Relationship of Post-traumatic Stress Disorder to End-of-life Care Received by Dying Veterans?

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Research Paper Title

The Relationship of Post-traumatic Stress Disorder to End-of-life Care Received by Dying Veterans: a Secondary Data Analysis.

Background

Post-traumatic stress disorder (PTSD) can be exacerbated by subsequent trauma, but it is unclear if symptoms are worsened by impending death

PTSD symptoms, including hyperarousal, negative mood and thoughts, and traumatic re-experiencing, can impact end-of-life symptoms, including pain, mood, and poor sleep.

Thus, increased symptoms may lead to increased end-of-life healthcare utilisation.

Therefore, the purpose of this study was to determine if veterans with PTSD have increased end-of-life healthcare utilisation or medication use and to examine predictors of medication administration.

Methods

Secondary analysis of a stepped-wedge design implementation trial to improve end-of-life care for Veterans Affairs (VA) inpatients. Outcome variables were collected via direct chart review. Analyses included hierarchical, generalized estimating equation models, clustered by medical center.

Veterans, inpatient at one of six VA facilities, dying between 2005 and 2011.

Emergency room (ER) visits, hospitalisations, and medication administration in the last 7 days of life.

Results

Of 5341 veterans, 468 (8.76%) had PTSD.

Of those, 21.4% (100/468) had major depression and 36.5% (171/468) had anxiety. Veterans with PTSD were younger (mean age 65.4 PTSD, 70.5 no PTSD, p < 0.0001) and had more VA hospitalisations and ER visits in the last 12 months of life (admissions: PTSD 2.8, no PTSD 2.4, p < 0.0001; ER visits: 3.2 vs 2.5, p < 0.0001).

PTSD was associated with antipsychotic administration (OR 1.52, 95% CI 1.06-2.18). Major depression (333/5341, 6.2%) was associated with opioid administration (OR 1.348, 95% CI 1.129-1.609) and benzodiazepines (OR 1.489, 95% CI 1.141-1.943).

Anxiety disorders (778/5341, 14.6%) were only associated with benzodiazepines (OR 1.598, 95% CI 1.194-2.138).

Conclusions

PTSD’s association with increased end-of-life healthcare utilisation and increased antipsychotic administration in the final days of life suggests increased symptom burden and potential for terminal delirium in individuals with PTSD.

Understanding the burden of psychiatric illness and potential risks for delirium may facilitate the end-of-life care for these patients.

Reference

Bickel, K.E., Kennedy, R., Levy, C., Burgio, K.L. & Bailey, F.A. (2019) The Relationship of Post-traumatic Stress Disorder to End-of-life Care Received by Dying Veterans: a Secondary Data Analysis. Journal of General Internal Medicine. doi: 10.1007/s11606-019-05538-x. [Epub ahead of print].

A Technique to Help Military Veterans with Nightmares

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Introduction

Justin Havens, a former British Army officer and an Eye Movement Desensitisation and Reprocessing (EMDR) trained psychotherapist has been testing a novel approach to helping veterans resolve traumatic nightmares.

Background

Insomnia, anxiety, and the sheer misery associated with night terrors is a huge problem for many of the people with post-traumatic stress disorder (PTSD).

Consequently, Justin has been testing, since approximately 2014, an approach with veteran groups across the UK as part of a PhD at the Veterans and Families Institute of Anglia Ruskin University.

Early results, in 2016, demonstrated that it had been successful for 16 out of 24 veterans who had completed the programme. They had not only seen dramatic improvements to sleep, but also seen an average 50% reduction in PTSD symptoms, according to Justin’s findings.

What is the Technique?

  • The technique works by helping people imagine a different outcome to their bad dreams.
  • While awake, the individual asks themselves ‘what would I like to happen next in my nightmare that feels good and puts me in control?’
  • For example, a burns victim might have nightmares about being burned.
  • They might imagine a new ending to their dream: standing under a waterfall laughing as all the scabs get washed away.

The idea is that the individual does not wake up, the dream continues and they are able to experience the rapid eye movement (REM) sleep vital for feeling fully rested.

Although not a ‘cure’ for PTSD, the approach – known as Planned Dream Intervention (PDI) – can make life more bearable for people with PTSD, and help stabilise them ahead of further therapy.

The concept was originally developed by a former US Navy psychologist called Beverley Dexter, who has taught this skill to several hundred US service personnel and veterans, though no formal research has been undertaken.

Further Information

Useful Publications

Battling Bad Dreams – How a New Technique helps Veterans Confront their Nightmares (2017) xDownload
No More Nightmares – Testing a Novel Intervention for UK Veterans (Havens, 2018)Download
Planned Dream Interventions – A Pragmatic RCT to Evaluate a Psychological Treatment for Traumatic Nightmares in UK Military Veterans (Havens et al., 2018)Download

Useful Links

Dexter, B.A. (2018) No more nightmares: how to use planned dream intervention to end nightmares? International Conference on Psychiatric & Geriatrics Nursing and Stroke. 19-20 November, 2018. Available from World Wide Web: https://www.longdom.org/proceedings/no-more-nightmares-how-to-use-planned-dream-intervention-to-end-nightmares-45944.html. [Accessed: 20 November, 2019].

Havens, J. (2015) No More Nightmares – A Revolution for Sleep/PTSD. Available from World Wide Web: https://www.crowdfunder.co.uk/no-more-nightmares. [Accessed: 20 November, 2019].

King, H. (2016) The New Treatment Hoping To End PTSD Nightmares. Available from World Wide Web: https://www.forces.net/services/tri-service/new-treatment-hoping-end-ptsd-nightmares. [Accessed: 20 November, 2019].

Is There a Link between News Coverage & Trauma Symptoms?

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When something terrible happens in the world, it’s not uncommon to scroll through social media or flip through television channels in search of news coverage. But such media exposure may fuel post-traumatic stress symptoms for years afterwards – and could also drive someone to consume further distressing media.

With high-consequence events where we do not know why they happened, there is a fundamental drive to want to consume information until you get your head around it. Research suggests it may be a function of threat avoidance or wanting to return to some kind of rational understanding of the world around us.

Roxane Silver at the University of California, Irvine, and her colleagues surveyed a representative sample of more than 4400 US residents in the days after the 2013 Boston Marathon bombing. Each person was also asked how many hours of related media coverage they consumed in three follow-up periods:

  • Six months after the bombing;
  • On its second anniversary; and
  • Five days after the 2016 mass shooting in the Pulse nightclub in Florida.

On average, the people surveyed consumed about 6 hours of media a day about the Boston bombing immediately after the event and a little more than 3 hours per day of media about the Pulse shooting.

Those who sought out more media about the bombing – whether or not they had a history of mental health conditions – were more likely to have trauma-related stress symptoms, such as upsetting thoughts, flashbacks and emotional distress, six months later (Thompson et al., 2019).

Two years after the bombing, such people were also more likely to worry about other events of mass violence occurring in the future, and consumed more coverage of the subsequent Pulse shooting.

References

Thompson, R.R., Jones, N.M., Holman, E.A. & Silver, R.C. (2019) Media Exposure to Mass Violence Events can Fuel a Cycle of Distress. Science Advances. 5(4), eaav3502. DOI: 10.1126/sciadv.aav3502.

Whyte, C. (2019) New Coverage Link to Trauma Symptoms. New Scientist. 27 April 2019, pp.16.