Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD) PDF Download
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Languages : en
Pages : 0
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Author: Agency For Healthcare Resea And Quality
Publisher: Independently Published
ISBN: 9781090533715
Category : Medical
Languages : en
Pages : 622
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Book Description
Posttraumatic stress disorder (PTSD) involves a group of symptoms experienced after exposure to a potentially traumatic event. Symptoms may include re-experiencing the event; avoiding situations that trigger memories of that event; experiencing increased negative feelings and beliefs; experiencing feelings of hyperarousal; these feelings may include irritability, agitation, anger, or being on alert; and experiencing various combinations of these indicators. The traumatic event (stressor) must involve either witnessing an actual or threatened death or serious injury or other threat to one's physical integrity or witnessing an event that involves death, injury, or a threat to the physical integrity of another person. Alternatively, the event must involve learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate. Some traumatic events that are directly experienced include military combat, violent personal assault, being part of a hostage situation, a terrorist attack, torture, natural or manmade disasters, and being diagnosed with a life-threatening illness. They can also comprise relational trauma such as sexual, physical, and emotional abuse and domestic violence. Not all people exposed to a potentially traumatic event, however, go on to develop posttraumatic stress symptoms and PTSD. This systematic review uses current methods to update a report published in 2013 that evaluated psychological and pharmacological treatments of adults with posttraumatic stress disorder (PTSD). This review focuses on updating the earlier work, expanding the range of treatments examined, addressing earlier uncertainties, identifying ways to improve care for PTSD patients, and reducing variation in existing treatment guidelines.
Author: Dan Jonas
Publisher:
ISBN:
Category :
Languages : en
Pages : 760
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OBJECTIVES: To assess efficacy, comparative effectiveness, and harms of psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD). DATA SOURCES: MEDLINE(r), Cochrane Library, PILOTS, International Pharmaceutical Abstracts, CINAHL(r), PsycINFO(r), Web of Science, Embase, U.S. Food and Drug Administration Web site, and reference lists of published literature (January 1980-May 2012). REVIEW METHODS: Two investigators independently selected, extracted data from, and rated risk of bias of relevant trials. We conducted quantitative analyses using random-effects models to estimate pooled effects. To estimate medications' comparative effectiveness, we conducted a network meta-analysis using Bayesian methods. We graded strength of evidence (SOE) based on established guidance. RESULTS: We included 92 trials of patients, generally with severe PTSD and mean age of 30s to 40s. High SOE supports efficacy of exposure therapy for improving PTSD symptoms (Cohen's d 1.27; 95% confidence interval, 1.54 to 1.00); number needed to treat (NNT) to achieve loss of diagnosis was 2 (moderate SOE). Evidence also supports efficacy of cognitive processing therapy (CPT), cognitive therapy (CT), cognitive behavioral therapy (CBT)-mixed therapies, eye movement desensitization and reprocessing (EMDR), and narrative exposure therapy for improving PTSD symptoms and/or achieving loss of diagnosis (moderate SOE). Effect sizes for reducing PTSD symptoms were large (e.g., 28.9- to 32.2-point reduction in Clinician-Administered PTSD Scale [CAPS]; Cohen's d ~ 1.0 or more compared with controls); NNTs were d 4 to achieve loss of diagnosis for CPT, CT, CBT-mixed, and EMDR. Evidence supports the efficacy of fluoxetine, paroxetine, sertraline, topiramate, and venlafaxine for improving PTSD symptoms (moderate SOE); effect sizes were small or medium (e.g., 4.9- to 15.5-point reduction in CAPS compared with placebo). Evidence for paroxetine and venlafaxine also supports their efficacy for inducing remission (NNTs ~8; moderate SOE). Evidence supports paroxetine's efficacy for improving depression symptoms and functional impairment (moderate SOE) and venlafaxine's efficacy for improving depression symptoms, quality of life, and functional impairment (moderate SOE). Risperidone may help PTSD symptoms (low SOE). Network meta-analysis of 28 trials (4,817 subjects) found paroxetine and topiramate to be more effective than most medications for reducing PTSD symptoms, but analysis was based largely on indirect evidence and limited to one outcome measure (low SOE). We found insufficient head-to-head evidence comparing efficacious treatments; insufficient evidence to verify whether any treatment approaches were more effective for victims of particular trauma types or to determine comparative risks of adverse effects. CONCLUSIONS: Several psychological and pharmacological treatments have at least moderate SOE supporting their efficacy: exposure, CPT, CT, CBT-mixed therapies, EMDR, narrative exposure therapy, fluoxetine, paroxetine, sertraline, topiramate, and venlafaxine.
Author: Dan Jonas
Publisher:
ISBN:
Category : Stress disorders, Traumatic
Languages : en
Pages :
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Book Description
OBJECTIVES: To assess efficacy, comparative effectiveness, and harms of psychological and pharmacological treatments for adults with posttraumatic stress disorder (PTSD). DATA SOURCES: MEDLINE(r), Cochrane Library, PILOTS, International Pharmaceutical Abstracts, CINAHL(r), PsycINFO(r), Web of Science, Embase, U.S. Food and Drug Administration Web site, and reference lists of published literature (January 1980-May 2012). REVIEW METHODS: Two investigators independently selected, extracted data from, and rated risk of bias of relevant trials. We conducted quantitative analyses using random-effects models to estimate pooled effects. To estimate medications' comparative effectiveness, we conducted a network meta-analysis using Bayesian methods. We graded strength of evidence (SOE) based on established guidance. RESULTS: We included 92 trials of patients, generally with severe PTSD and mean age of 30s to 40s. High SOE supports efficacy of exposure therapy for improving PTSD symptoms (Cohen's d 1.27; 95% confidence interval, 1.54 to 1.00); number needed to treat (NNT) to achieve loss of diagnosis was 2 (moderate SOE). Evidence also supports efficacy of cognitive processing therapy (CPT), cognitive therapy (CT), cognitive behavioral therapy (CBT)-mixed therapies, eye movement desensitization and reprocessing (EMDR), and narrative exposure therapy for improving PTSD symptoms and/or achieving loss of diagnosis (moderate SOE). Effect sizes for reducing PTSD symptoms were large (e.g., 28.9- to 32.2-point reduction in Clinician-Administered PTSD Scale [CAPS]; Cohen's d ~ 1.0 or more compared with controls); NNTs were d 4 to achieve loss of diagnosis for CPT, CT, CBT-mixed, and EMDR. Evidence supports the efficacy of fluoxetine, paroxetine, sertraline, topiramate, and venlafaxine for improving PTSD symptoms (moderate SOE); effect sizes were small or medium (e.g., 4.9- to 15.5-point reduction in CAPS compared with placebo). Evidence for paroxetine and venlafaxine also supports their efficacy for inducing remission (NNTs ~8; moderate SOE). Evidence supports paroxetine's efficacy for improving depression symptoms and functional impairment (moderate SOE) and venlafaxine's efficacy for improving depression symptoms, quality of life, and functional impairment (moderate SOE). Risperidone may help PTSD symptoms (low SOE). Network meta-analysis of 28 trials (4,817 subjects) found paroxetine and topiramate to be more effective than most medications for reducing PTSD symptoms, but analysis was based largely on indirect evidence and limited to one outcome measure (low SOE). We found insufficient head-to-head evidence comparing efficacious treatments; insufficient evidence to verify whether any treatment approaches were more effective for victims of particular trauma types or to determine comparative risks of adverse effects. CONCLUSIONS: Several psychological and pharmacological treatments have at least moderate SOE supporting their efficacy: exposure, CPT, CT, CBT-mixed therapies, EMDR, narrative exposure therapy, fluoxetine, paroxetine, sertraline, topiramate, and venlafaxine.
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Category :
Languages : en
Pages :
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Author: National Collaborating Centre for Mental Health (Great Britain)
Publisher: Royal College of Psychiatrists
ISBN: 9781904671251
Category : Medical
Languages : en
Pages : 167
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Book Description
This evidence-based clinical guideline commissioned by NICE (National Institute for Clinical Excellence) presents guidance on the management of post-traumatic stress disorder (PTSD) in primary and secondary care.
Author: Patricia A. Resick
Publisher: Guilford Publications
ISBN: 1462528643
Category : Psychology
Languages : en
Pages : 329
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Book Description
The culmination of more than 25 years of clinical work and research, this is the authoritative presentation of cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD). Written by the treatment's developers, the book includes session-by-session guidelines for implementation, complete with extensive sample dialogues and 40 reproducible client handouts. It explains the theoretical and empirical underpinnings of CPT and discusses how to adapt the approach for specific populations, such as combat veterans, sexual assault survivors, and culturally diverse clients. The large-size format facilitates photocopying and day-to-day use. Purchasers also get access to a Web page where they can download and print the reproducible materials. CPT is endorsed by the U.S. Departments of Veterans Affairs and Defense, the International Society of Traumatic Stress Studies, and the U.K. National Institute for Health and Care Excellence (NICE) as a best practice for the treatment of PTSD.
Author: Lynn F. Bufka
Publisher:
ISBN: 9781433833588
Category : Post-traumatic stress disorder
Languages : en
Pages :
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Book Description
"This casebook offers detailed guidance to help practitioners understand and implement the treatments recommended in the American Psychological Association's Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder in Adults. The authors describe the unique factors involved in PTSD treatment, and core competencies necessary for providers. Chapters then explain each treatment described in the guideline, summarize the empirical evidence for their effectiveness, and offer rich, detailed case examples that demonstrate how readers can use these interventions with real clients. Treatments described include cognitive behavior therapy, cognitive processing therapy, cognitive therapy and prolonged exposure, brief eclectic psychotherapy, eye movement desensitization and reprocessing, and narrative exposure therapy. Medications including fluoxetine, paroxetine, sertraline, and venlafaxine are discussed as well. Intended for use with the Guideline, this book combines the best available research with expert clinical recommendations, to help readers make the clinical decisions that are best for their patients"--
Author: Ulrich Schnyder
Publisher: Springer
ISBN: 3319071092
Category : Medical
Languages : en
Pages : 513
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Book Description
This book offers an evidence based guide for clinical psychologists, psychiatrists, psychotherapists and other clinicians working with trauma survivors in various settings. It provides easily digestible, up-to-date information on the basic principles of traumatic stress research and practice, including psychological and sociological theories as well as epidemiological, psychopathological, and neurobiological findings. However, as therapists are primarily interested in how to best treat their traumatized patients, the core focus of the book is on evidence based psychological treatments for trauma-related mental disorders. Importantly, the full range of trauma and stress related disorders is covered, including Acute Stress Reaction, Complex PTSD and Prolonged Grief Disorder, reflecting important anticipated developments in diagnostic classification. Each of the treatment chapters begins with a short summary of the theoretical underpinnings of the approach, presents a case illustrating the treatment protocol, addresses special challenges typically encountered in implementing this treatment, and ends with an overview of related outcomes and other research findings. Additional chapters are devoted to the treatment of comorbidities, special populations and special treatment modalities and to pharmacological treatments for trauma-related disorders. The book concludes by addressing the fundamental question of how to treat whom, and when.
Author: Nancy C. Bernardy
Publisher: American Psychological Association (APA)
ISBN: 9781433818325
Category : Psychology
Languages : en
Pages : 0
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Book Description
More than 7 million Americans suffer from PTSD, as a consequence of physical or psychological trauma. Thankfully, today's mental health providers have developed increasingly sophisticated tools and techniques to meet this significant challenge, the most effective of which are medications and psychotherapy. Although considerable research in recent years has focused on both approaches to PTSD treatment, few have been able to synthesize that research in a way that is concise and practical, and useful to the wide range of practitioners who treat PTSD. In this handy clinical guide, authors Nancy Bernardy and Matt Friedman show how pharmacological approaches can be integrated with traditional psychotherapy approaches to PTSD. They present common assessment tools and strategies, synthesize implications from research on all existing pharmacologic treatments for PTSD including antidepressants, anxiolytics, and antipsychotic medications, and present clear guidelines for related conditions such as insomnia and substance abuse. Treatment of older adults and others with complicated presentations is also emphasized. The book is suitable for psychologists and social workers who may be unfamiliar with pharmacological approaches to PTSD, as well as psychiatrists and other medical personnel who may be less familiar with the best empirically-validated forms of psychotherapy.
