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First Published Thursday, 19 March 2009


PTSD

Facts & Statistics

  • Families of those who suffer extreme traumatic stress can also develop Post-Traumatic Stress Disorder. (U.S. Surgeon Generalís Report, 1999).
  • Approximately 9% of those exposed to extreme trauma develop Post-Traumatic Stress Disorder. (U.S. Surgeon Generalís Report, 1999)
  • Approximately 15% of Vietnam veterans are suffering from Post-Traumatic Stress Disorder 19 years after combat exposure (U.S. Surgeon Generalís Report, 1999)
  • Women who are victims of crime, and torture and concentration camp survivors suffer the highest rates of Post-Traumatic Stress Disorder (U.S. Surgeon Generalís Report, 1999)
  • Approximately 50% of Post-Traumatic Stress Disorder cases remit within one year (U.S. Surgeon Generalís Report, 1999)
  • An estimated 8% of those who served in the Persian Gulf War in 1991 have developed Post-Traumatic Stress Disorder (National Institutes of Mental Health)
  • Approximately 30% of those who have spent time in war zones experience Post-Traumatic Stress Disorder. (National Institutes of Mental Health)
  • About 5.2 million U.S. adults ages 18 to 54 have Post-Traumatic Stress Disorder in any given year. (National Institutes of Mental Health)
  • The prevalence of Post-Traumatic Stress Disorder in women is twice that of men, 10% v. 5% (National Comorbidity Survey).
  • 61% of men and 51% of women have experienced traumas linked to Post-Traumatic Stress Disorder. (National Comorbidity Survey).

Latest Research

The Scream, Edvard Munch

Weakening Traumatic Memories By Disrupting The Emotional Bond

Imagine that you have been in combat and that you have watched your closest friend die in front of you. The memory of that event may stay with you, troubling you for the rest of your life. Posttraumatic stress disorder (PTSD) is among the most common and disabling psychiatric casualties of combat and other extremely stressful situations. People suffering from PTSD often suffer from vivid intrusive memories of their traumas.


Current medications are often ineffective in controlling these symptoms and so novel treatments are needed urgently. In a recent issue of the journal Biological Psychiatry a group of basic scientists shed new light on the biology of stress effects upon memory formation. In so doing, they suggest new approaches to the treatment of the distress related to traumatic memories. Their work is based on the study of a drug, RU38486, that blocks the effects of the stress hormone cortisol.


Using an animal model of traumatic memory, investigators at the Mount Sinai School of Medicine show that treatment with RU38486 selectively reduces stress-related memories, leaving other memories unchanged. They also found that the effectiveness of the treatment is a function of the intensity of the initial “trauma.” Although this particular study was performed in rats, their findings help to set the stage for trials in humans.


Cristina Alberini, PhD, corresponding author on this article, explains how their findings will translate into developing clinical parameters: “First, the drug should be administered shortly before or after recalling the memory of the traumatic event. Second, one or two treatments are sufficient to maximally disrupt the memory. Third, the effect is long lasting and selective for the recalled memory. Finally, the time elapsing between the traumatic experience and the treatment seems to be an important parameter for obtaining the most efficacious treatment.


Dr John Krystal, Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, said of the findings: “When treating PTSD, clinicians often attempt to reduce the negative distortions of traumatic memories so that people can better cope with their traumas. The new study by Taubenfeld and colleagues suggests that blocking the effects of cortisol may be one strategy to promote the ‘normalization’ of traumatic memories.” Dr Alberini agrees, noting that “these results suggest that carefully designed combinations of behavioral and pharmacological therapies may represent novel, effective treatments for PTSD or other anxiety disorders.


Taubenfeld SM, Riceberg JS, New AS, Alberini CM. Preclinical assessment for selectively disrupting a traumatic memory via postretrieval inhibition of glucocorticoid receptors. Biol Psychiatry. 2009 Feb 1;65(3):249-57   [Abstract]

Quetiapine monotherapy provides benefit for patients with chronic post-traumatic stress disorder: Presented at ADAA


By Mary Beth Nierengarten


SANTA ANA PUEBLO, NM — March 16, 2009 — Monotherapy with quetiapine may provide benefit to patients with chronic post-traumatic stress disorder (PTSD), researchers reported here at the Anxiety Disorders Association of America (ADAA) 29th Annual Conference.


More…


Copyright © 1995-2009 Doctor’s Guide Publishing Limited. All rights reserved.

Ecstasy may enhance psychotherapy for PTSD


Treatment with a pharmacological version of the drug ecstasy makes PSTD patients more receptive to psychotherapy, and contributes to lasting improvement say Norwegian researchers.


People who have survived severe trauma – such as war, torture, disasters, or sexual assault – will often experience after-effects such as posttraumatic stress disorder (PTSD). The symptoms can include anxiety, uncontrolled emotional reactions, nightmares, intrusive memories, sleep and concentration difficulties, evasion of situations that resemble the trauma, and feelings of shame or amnesia.


For many, the condition gradually goes away by itself. Other individuals experience PTSD as a chronic condition that needs treatment, which typically involves drugs that help with anxiety and depression, and/or psychotherapy.


A type of psychological treatment called exposure therapy – where the patient repeatedly recalls the traumatic experience or is repeatedly exposed to situations that are safe but still trigger their traumatic feelings – can be effective in relieving stress responses in patients with post-traumatic stress disorder (PTSD) and other anxious conditions. The therapy works by helping the patient to re-learn the appropriate response to the trigger situation, a process known as extinction learning. The patient realizes that the memories of the traumatic event and the situation surrounding it are not dangerous and learns to to deal with the traumatic incident as a painful memory, and not as if it will happen again.


Studies show that exposure therapy can be a very effective treatment of post traumatic disorders. Yet far too many patients receive treatment only with drugs. But anxiety reducing drugs and antidepressants may work against our efforts and reduce the patient’s emotional learning,” says Pål-Ørjan Johansen, a psychologist at the Norwegian University of Science and Technology.


However, psychotherapy can take some time, and 40% of patients continue to experience post-traumatic stress even after treatment.


To improve outcomes, scientists have been investigating the use of drug therapies to enhance the effect of exposure therapy, making the result of exposure to the fear trigger easier, faster, and more effective. MDMA (the pharmaceutical version of Ecstasy) is one such drug.


Psychiatrists that have administered MDMA to anxiety patients have noted that it promotes emotional engagement; strengthens the bond between the patient and doctor, known as the therapeutic alliance; decreases emotional avoidance; and improves tolerance for recall and processing of painful memories.


Along with neurobiologist Teri Krebs, Johansen is now exploring what happens when chronic trauma patients are treated with a combination of psychotherapy and pharmacological versions of ecstasy, MDMA (3,4 methylenedioxy-N-methyl-amphetamine). A U.S. study, recently conducted by psychiatrist Michael Mithoefer, has shown remarkable success with this combination.


Mithoefer took 21 people with chronic PTSD, all of whom had been subjected to documented abuse. All had also been through six months of treatment with traditional therapy, in addition to a three-month treatment with drugs. None, however, had shown any improvement from the treatment.


Under Mithoefer’s treatment, the patients stopped their usual anxiety-reducing drugs, and began a new treatment with twelve sessions of psychotherapy. During two of these therapy sessions, some patients were given doses of MDMA, while the others were given a placebo.


Two months after the treatment, 92 percent of MDMA patients had clinically significant improvement in their conditions: They were more open to therapy and were able to process the trauma. They managed to escape from their shells and shame, and to see lifelong patterns of behavior. They were less dispirited, evasive and afraid. In contrast, only 25 percent of the patients in the placebo group showed progress. Everyone in this group was subsequently offered treatment with MDMA, and the results have been good, with no serious or lasting side effects.


Neuropsychological tests suggested that patients had improved mental ability after treatment. None of MDMA patients continued to take the drug after treatment. But many of them had managed to transform a crippling trauma into “only” a memory — a painful memory, but still more manageable than before.


This was a small study, and it must be followed up by more. But the results are promising, both in terms of safety and the effects of treatment. It is also important to stress that this is not about daily medication, but short-term, controlled use,” Johansen and Krebs say.


The Norwegian scientists have investigated both this and a number of other studies, and suggest the following explanation:


Firstly, “MDMA contributes to increasing the level of oxytocin in the brain. This hormone stimulates emotions such as connection, proximity and trust. In a therapeutic context, it means that the patient may be better able to open up and have confidence in the therapist.

Secondly, “MDMA increases activity in the ventromedial prefrontal cortex. This is an area in the anterior part of the brain that processes fear, lowers stress, and enables us to see events in perspective. This is where decisions are taken and feelings are regulated. Activity here is closely linked to activity in the amygdala, the area of the brain that is the center for feeling fear. You could say that fear is formed in the amygdala, but is processed in the ventromedial prefrontal cortex. While activity in the cortex is increased with MDMA, the drug simultaneously reduces activity in the amygdala. We believe this will help improve the regulation of emotions, allay fears and reduce evasive behaviors in a therapy situation.


Thirdly, “MDMA triggers the ‘stress’ hormones noradrenalin and cortisol. These hormones are necessary to activate the emotional learning that leads to long-term reduction of fear.

In summary, we suggest that MDMA is an emotional enhancer that helps the patient feel safer and in control, better able to connect with memories, and more capable of the emotional processing that is needed for improvement.

The use of MDMA might also help ameliorate feelings of being emotionally disconnected and unable to benefit from the supportive presence of family and friends which are often reported by people with PTSD.


P Johansen PØ, Krebs TS. How could MDMA (ecstasy) help anxiety disorders? A neurobiological rationale. J Psychopharmacol 2009 Mar 9; doi:10.1177/0269881109102787   [Abstract]


Comment:


While MDMA may prove to be a beneficial adjunct to therapy under controlled conditions, self-medication with illicit ecstasy is unwise. Not only is this illegal in most jurisdictions, the street grade drug is often adulterated with other chemicals. Even pharmaceutical grade MDMA may permanently damage neurons if taken incorrectly

 

How to help when smoking, alcohol complicate PTSD


By LAURAN NEERGAARD, AP Medical Writer


WASHINGTON – Reaching for a cigarette to cope with a flashback is all too common among sufferers of post-traumatic stress disorder. The nicotine hit may feel good but scientists say its brain action probably makes their PTSD worse in the long run.


Here’s the rub: At least half of PTSD sufferers smoke, and others wind up dependent on alcohol, anti-anxiety pills, sometimes even illegal drugs. Yet too few clinics treat both PTSD and addictions at the same time, despite evidence they should.


More…


© 2009 Associated Press

Medication for PTSD: A Leap of Faith?


By Sherry Boschert, [CPS] San Francisco Bureau

Conflicting reports about the efficacy of pharmacologic therapy for posttraumatic stress disorder leave clinicians in limbo, with more questions than answers on the subject.


Two selective serotonin reuptake inhibitors (SSRIs)-paroxetine (Paxil) and sertraline (Zoloft)-are the only medications approved in the United States specifically to treat posttraumatic stress disorder (PTSD).


More… (Free registration required to view)

© 2009 Elsevier Inc. All rights reserved.

Abstract+: Risk factors predict PTSD differently in men and women


Christiansen DM, Elklit A.


Background: About twice as many women as men develop post-traumatic stress disorder (PTSD), even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable.


Methods: The present work examines the effect of age, previous trauma, negative affectivity (NA), anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident.


Results: Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than in men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender.


Conclusions: Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.


Source… Full text… (PDF)

© 1999-2008 BioMed Central Ltd

Suicide Risk 15 Times Higher for PTSD Patients: Survey of 36,000 French citizens supports psychotraumatism screening in psychiatric evals.


Clinical Psychiatry News 2008 Oct;36(10):5

MICHELE G. SULLIVAN


BARCELONA – The risk of attempting suicide increases by up to 15 times for patients with posttraumatic stress disorder, compared with those in the general population, a national French mental health survey has found.


Although the survey of 36,000 citizens found a low rate of full-blown posttraumatic stress disorder (PTSD), those with any lifetime exposure to psychotraumatic events were significantly more likely to have had suicidal thoughts or attempts in the previous month, Dr Louis Jehel said at the annual congress of the European College of Neuropsychopharmacology.


More…

© 2008 Elsevier Inc. All rights reserved.

NAMI releases new PTSD brochure


The U.S. National Alliance on Mental Illness (NAMI) has released a new 14-page brochure on posttraumatic stress disorder (PTSD), treatment and recovery for Veterans Day.


It is intended to help individuals experiencing symptoms or diagnosed with the illness, along with their families and caregivers.


PTSD affects individuals and families,” said NAMI medical director Ken Duckworth, MD “Traumatic events produce biological responses that affect the mind, brain, and body. Those changes involve everyone.


Over a lifetime, approximately 5 percent of men and 10 percent of women are diagnosed with PTSD,” Duckworth said. “Risk factors include the type of trauma, degree of exposure and any prior history of trauma. In most cases, there is a direct physical impact. Proximity in witnessing violent, life-threatening events also makes a difference.


 

An estimated 14 percent of American soldiers returning from Afghanistan and Iraq will experience PTSD. Symptoms include poor concentration, sleeplessness, nightmares, flashbacks, heightened fear, anxiety and disassociation (feeling “unreal” or cut off from emotions).


But PTSD is not limited to military veterans.


Natural disasters and sexual assault, including child abuse, are among other examples of traumatic events that can cause PTSD. Following Hurricane Katrina, many children in Gulf Coast communities experienced the same kinds of symptoms as soldiers who fought in war.


Family members often are distressed to find loved ones “different” following a traumatic experience. Many feel overwhelmed and experience “caregiver burnout.” Others, especially children, may find themselves developing similar fears or symptoms, in what sometimes has been called the “transmission of trauma” across generations.


Treatment may involve a combination of medication and therapy, including group therapy. “Support systems are critical to healing,” Duckworth said.


The NAMI brochure includes the following sections:


  • *Psychological Trauma & PTSD
  • *Risk Factors for Developing PTSD
  • *The Neurobiology of PTSD
  • *What is PTSD?
  • *PTSD & Co-Occurring Disorders
  • *Combat Veterans & Trauma
  • *Children & Trauma
  • *Trauma & the Mental Health System
  • *Family Impact of PTSD
  • *Recovery and Coping
  • *Treatment for PTSD
  • *Medications
  • *Resources, including Family-to-Family Education and NAMI Connection programs.

NAMI is America’s largest grassroots organization dedicated to improving the lives of individuals and families affected by serious mental illnesses.


 

Understanding Posttraumatic Stress Disorder and Recovery


Fewer criteria needed to detect PTSD in children


News Author: Pauline Anderson
CME Author: Laurie Barclay, MD


October 16, 2008 – New research suggests an alternative approach to diagnosing posttraumatic stress disorder (PTSD) that requires fewer avoidance and numbing criteria is more sensitive than standard Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), criteria in detecting this condition in preschool children.


However, the DSM-IV criteria are still preferable for children older than 7 years as are symptom reports from both the parent and child.


More… (Medscape – Free registration required)


Childhood abuse, hippocampal atrophy and PTSD


 

While debate continues over the effects of post-traumatic stress disorder, a new study indicates traumatic events and PTSD symptoms may be followed in some cases by a size reduction in the hippocampus, a part of the brain that regulates emotions and short term memory.


Though most attention surrounding PTSD focuses on war veterans, the advance by Brigham Young University researchers examined a larger population at risk: abused children.


The size reduction in the hippocampus seems to occur sometime after the initial exposure to stress or trauma in childhood, strengthening the argument that it has something to do with PTSD itself or the stress exposure,” said Dawson Hedges, a BYU neuroscientist and an author on the study.


The study, which appears in the August issue of the neuroscience journal Hippocampus, provides further evidence for a neurological component for this mental disorder.


Most people exposed to traumatic events do not develop PTSD,” Hedges said. “However, those that do may show certain changes in their brains.


The hippocampus is involved with learning and memory. More than a decade ago, neuroscientists noted that it could be smaller in some people with post-traumatic stress disorder. Since then they have puzzled over which came first, the small hippocampus or the traumatic events leading to PTSD.


The question is not easily answered because brain scans are expensive and usually only performed after the fact.


That’s why Hedges and grad student Martin Woon combined analyses of two groups: abused children with PTSD and adults with PTSD stemming from childhood abuse. The BYU researchers pooled data from 19 previously published studies in which MRIs were obtained from people who had experienced childhood trauma.


The big question about which came first, much like the chicken and the egg, has persisted,” said Woon, the lead author on the paper. “We found children’s hippocampi were intact after the onset of abuse, but somehow there was shrinkage in the group that had reached adulthood.


The federal government reported 905,000 children were victims of abuse or neglect in 2006. That figure is considered lower than the actual total because it does not include unreported cases of abuse.


The prevalence of abuse in this country is staggering,” Hedges said. “With what we have found, the effects of childhood abuse may have neurological ramifications well into adult life. Boiling it down, people should be nice to their children.


The extent to which the lost brain matter affects brain functioning is still unknown. Hedges plans to examine whether PTSD relates to learning and memory deficits in a follow-up study. While he sees the potential for intervention to lessen the consequences of PTSD, other priorities include prevention and early identification.


Woon FL, Hedges DW. Hippocampal and amygdala volumes in children and adults with childhood maltreatment-related posttraumatic stress disorder: A meta-analysis. Hippocampus 2008 Aug;18(8):729-736   [Abstract]

PTSD common after serious injury


PTSD linked to substantial functional impairment including difficulties returning to work


Suffering a traumatic injury can have serious and long-lasting implications for a patient’s mental health, according to the largest-ever U.S. study evaluating the impact of traumatic injury.


Researchers from the Harborview Injury Prevention and Research Center, the University of Washington, and the John Hopkins Bloomberg School of Public Health found that post-traumatic stress disorder and depression were very common among patients assessed one year after suffering a serious injury. They also found that injured patients diagnosed with PTSD or depression were six times more likely to not have returned to work in the year following the injury.


The study followed 2707 injured patients from 69 hospitals across the country, and found 20.7% had post-traumatic stress disorder and 6.6% had depression one year after the injury. Both disorders were independently associated with significant impairments across all functional outcomes: activities of daily living, health status, and the return to usual activities, including work. Patients who had one disorder were three times less likely to be working one year after injury, and patients with both disorders were five to six times less likely to have returned to work.


The findings have important implications for acute care hospitals. Smaller scale investigations in acute care medical settings suggest that evidence-based psychotherapy and collaborative care interventions can reduce the symptoms of PTSD and related conditions among injured trauma survivors. “This study highlights the importance of ongoing studies of PTSD and depression screening, and intervention procedures for injured patients treated in acute care hospitals nationwide,” said Douglas Zatzick, MD, principal investigator and a psychiatrist at the University of Washington. “If studies of PTSD and depression establish the effectiveness of screening and intervention procedures, American College of Surgeons policy requirements similar to the recent mandate for alcohol screening and brief intervention could be considered.


The American College of Surgeons currently requires that level I trauma centers must have on-site alcohol screening and brief intervention services as a requisite for trauma center accreditation.


The research was funded by the National Center for Injury Prevention and Control and the Centers for Disease Control and Prevention, the National Institute of Aging, and the National Institute of Mental Health.


Zatzick D, Jurkovich GJ, Rivara FP, et al. A National US Study of Posttraumatic Stress Disorder, Depression, and Work and Functional Outcomes After Hospitalization for Traumatic Injury. Ann Surg. 2008 Sep;248(3):429-437   [Abstract]

Sudden parental death can be double whammy for children’s mental health


Children who had a parent who died suddenly have three times the risk of depression than those with two living parents, along with an increased risk for post-traumatic stress disorder (PTSD) according to a report in the May issue of Archives of Pediatrics & Adolescent Medicine.


About 4 percent of children in Western countries experience the death of a parent, according to background information in the article.


Parents who have psychiatric disorders, including mood disorders and substance abuse, are more likely to die from suicide, accidents and heart disease. The same psychiatric factors that increase parents’ risk of sudden death also predispose their children to developing similar mental health problems.


Nadine M. Melhem, PhD, of the University of Pittsburgh School of Medicine, and colleagues identified 140 families in which one parent died of suicide, accident or sudden natural death. They were compared with 99 control families in which two parents were living and no first-degree relatives had died within the past two years. The offspring, ages 7 to 25, underwent interviews and assessments for psychiatric disorders, as well as a review of their parents’ psychiatric history.


Children whose parents had died, along with their surviving caregivers, were at higher risk for depression and post-traumatic stress disorder (PTSD) than those in control families. This association remained after controlling for psychiatric disorders in the deceased parent. Children and caregivers bereaved by suicide showed similar outcomes compared with those bereaved by other types of death. Children’s symptoms of depression, anxiety, PTSD, suicidal behavior and complicated grief (severe, lasting unhappiness) were associated with similar symptoms in surviving caregivers.


Our findings have important clinical and public health implications,” the authors conclude. “The best way to attenuate the effect of parental bereavement among offspring is to prevent early death in their parents by improving the detection and treatment of bipolar illness, substance and alcohol abuse and personality disorders, and by addressing the lifestyle correlates of these illnesses that lead to premature death.


When parents die, surviving caregivers should be monitored for depression and PTSD, since their psychiatric health affects that of children. “Given the increased risk of depression and PTSD, bereaved offspring should be monitored and, if needed, referred and treated for their psychiatric disorder,” the authors write. “Further studies are needed to examine the course and long-term effect of bereavement on offspring and their surviving caregivers, to test the mechanisms by which parental bereavement exerts these effects and to identify the subset of bereaved families who may require treatment, which can then frame targets for intervention and prevention efforts.


The study authors’ “findings that sudden parental death is associated with an increased risk for child mental health problems as well as increased mental health problems for the surviving parent have significant implications for pediatric practice,” write Irwin Sandler, Ph.D, and Thomas F. Boat, M.D., of Arizona State University, Tempe, in an accompanying editorial.


First, a pediatrician should be aware that parental death, as well as other family adversities, is a risk factor for childhood mental disorders,” they write. “The second implication for pediatric practice is that once the pediatrician becomes aware of increased risk of children due to parental death or other family adversities, the pediatrician may have a responsibility to help link children and/or their parents with appropriate services. To do this effectively, pediatricians should become familiar with the kinds of services offered in their community and the evidence for their effectiveness.


The study was supported by a grant from the National Institute of Mental Health (Dr Brent) and a Young Investigator Award and a Travel Award from the American Foundation for Suicide Prevention (Dr Melhem). Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.


Melhem NM, Walker M, Moritz M, Brent DA. Antecedents and Sequelae of Sudden Parental Death in Offspring and Surviving Caregivers. Arch Pediatr Adolesc Med. 2008 May;162(5):403-410. [Full text]

Bereaved children may develop PTSD


Post traumatic stress disorder is commonly thought to effect victims of major trauma and those who witness violence, but a new University of Georgia study finds that it also can affect children who have lost a parent expectedly to diseases such as cancer.


The study has major implications for helping children cope with grief, said lead author Rene Searles McClatchey.


Often children who have lost a parent are given grief therapy, and we’ve found that grief therapy doesn’t help if you don’t take care of post-traumatic stress disorder (PTSD) symptoms first,” said McClatchey, an adjunct professor in the UGA School of Social Work. McClatchey co-authored the study with UGA associate professor Elizabeth Vonk and University of California, Riverside assistant professor Gregory Palardy.


McClatchey is also founder and director of Camp Magik, a non-profit organization that provides weekend camps for children that blend traditional camp activities such as canoeing and hiking with therapy for PTSD and grief. McClatchey and her colleagues studied 100 children to test the effectiveness of the camp-based intervention.



They found that:


  • *The odds of continuing to experience severe PTSD were 4.5 times higher for children who did not attend the camp compared to those who did; and
  • *The odds of experiencing severe grief were 3.6 times greater for children who did not attend the camp than for those who did.


McClatchey said that in addition to showing that camp-based interventions work, the study found a link between post-traumatic stress disorder and grief. She explains that a previous study she conducted in 2005 in which children attended camp and underwent grief counseling without PTSD treatment found that the children didn’t improve or, in some cases, fared worse after the camp.


Delving into their grief without addressing their PTSD got them thinking about their loss,” McClatchey said, “but we didn’t teach them the coping mechanisms to deal with the PTSD symptoms that were stirred up.


Few studies have examined the effectiveness of camp-based interventions and most studies on overcoming grief have focused on children who have lost family members to sudden death resulting from violence or accidents. Until now, researchers have overlooked the post-traumatic stress and grief of children whose parents died expectedly after a long illness. The new study finds that both groups can benefit from PTSD treatment followed by grief counseling.


Vonk said the PTSD treatment consisted of exposure therapy, in which the children talk about their loss repeatedly until their fear diminished, and cognitive restructuring, in which children learn to modify negative thoughts, such as feelings of guilt, about their loss. The grief treatment portion included cognitive restructuring as well as lessons on coping skills.


The camp allows kids to process their grief and go on with their lives,” Vonk said. “They can attend to everyday activities in a way that they weren’t able to before and can concentrate better in school.


McClatchey said the average cost per camper is about $250 for the three-day weekend, making it more cost effective than individual counseling, which costs an average of $100 per hour and requires multiple sessions to be effective (Camp Magik is supported by donations so that children and their families never pay to attend).


Another benefit of the camp setting is that it gives children around-the-clock access to counselors so that those who don’t open up during group sessions can have their needs addressed individually. The researchers add that attending such camps with other children that have experienced a loss has benefits that individual therapy can’t provide.


They see that other kids are having the same kinds of thoughts and feelings,” Vonk said, “and that in and of itself is healing.


The study gives statistical evidence that the campers benefit from the intervention, but numbers don’t tell the whole story. McClatchey recalls one child who left Camp Magik and told her parents that she learned that it was okay to have fun again. Another went home and told her family that it was okay to talk about their loss. One child hadn’t spoken for a year before going to camp but went home talking. One young boy had refused to leave his mother’s side after the sudden heart attack of his father six months earlier. He returned home from camp insisting on sleeping in his own bed again. He went off to school without objection and resumed play dates with his friends.


There’s really no way of describing the difference between how they are when they arrive on Friday and how much better they are when they leave on Sunday,” McClatchey said.


McClatchey IS, Vonk ME, Palardy G. Efficacy of a Camp-Based Intervention for Childhood Traumatic Grief. Soc Work Practise 2008 May;doi:10.1177/1049731508314276   [Abstract]

Jury duty may be PTSD risk


A new report by psychologists at the University of Leicester warns of the dangers of jurors facing trauma because of their exposure to harrowing and gruesome evidence.


In the first study of its kind, the research highlights how women jurors are more vulnerable, particularly if the trial covers material that resonates with their personal histories.


The research confirms that jury service, particularly for crimes against people, can cause significant anxiety, and for a vulnerable minority it can lead to severe clinical levels of stress or the symptoms of post traumatic stress disorder.


The study led by clinical psychologist Dr Noelle Robertson has been published in The Howard Journal of Criminal Justice. It warns of the perils of undergoing jury service- and the fact that people cannot talk about their experiences for fear of being held in contempt of court.


Dr Robertson, with University of Leicester colleagues Professor Emeritus Graham Davies and graduate student Alice Nettleingham, is the first UK exploratory study to look at the possible traumatisation of jurors.


The report claims jury service can be a significant stressor for a vulnerable minority and goes on to debate whether screening might be employed to eliminate jurors from potentially traumatizing trials.


Dr Robertson said: “Recent research on post-traumatic stress disorder has revealed that it is not only victims of violence or crime that suffer trauma, but that those who interact with them may also be affected.


If called to jury service, citizens of Britain, as well as the US and most Commonwealth countries, are obliged to serve and may be exposed to gruesome exhibits and harrowing stories, which, the study shows, can lead to traumatization for some of them.


An average of 390,000 British citizens serve on juries each year and, after no other preparation than a film outlining their duties, may be exposed to the distress of witnesses or required to handle repellant exhibits and examine graphic and shocking photographs.


When they retire to reach their verdict they have to discuss and weigh up the evidence and may be under pressure to change their own views or to try and change the views of others.


All this can lead to short-term or long-term distress.


The times during trials when jurors were required to make decisions were cited as the most stressful, but having to deal with evidence that might be horrific was also a source of concern, particularly for women, who were also more adversely affected by dissension and questioning in the jury room.


While Dr Robertson urges caution in the interpretation of what was a small-scale Leicester study, it does bear out research from North America, and confirms that jury service can be a source of stress, which for some people can be overwhelming.


The report recommends more support for jurors, including more comprehensive preparation, briefing and clear directions, as well as guidelines for the decision process in the jury room. It also recommends that Crown Courts could provide a supporter for jurors, who might lessen the sense of isolation jurors can feel, since they are unable to discuss the court case outside the jury room.


Currently, people called for jury service are allocated by lot to juries, and the report also calls for use of a questionnaire highlighting past experiences which would save jurors from the trauma of cases that might resonate with their own past experiences.


Dr Robertson commented: “Jury service is a civic duty, yet we know little about its consequences for the individual. At present, anyone who talks openly about their experiences runs the risk of being charged with contempt of court.


 

Robertson N, Davies G, Nettleingham A. Vicarious Traumatisation as a Consequence of Jury Service. Howard J Crim Justice 2009;48(1):1-12   [Abstract]

By Harold Cohen, Ph.D.

While the symptoms of posttraumatic stress disorder (PTSD) may seem similar to those of other disorders, there are differences. For example, PTSD symptoms may seem similar to those of anxiety disorders, such as acute stress disorder or obsessive-compulsive disorder. However, there are distinct differences between these disorders.


In general, the symptoms of acute stress disorder must occur within four weeks of a traumatic event and come to an end within that four-week time period. If symptoms last longer than one month and follow other patterns common to PTSD, a person’s diagnosis may change from acute stress disorder to PTSD.


While both PTSD and obsessive-compulsive disorder have recurrent, intrusive thoughts as a symptom, the types of thoughts are one way to distinguish these disorders. Thoughts present in obsessive-compulsive disorder do not usually relate to a past traumatic event. With PTSD, the thoughts are invariably connected to a past traumatic event.


PTSD symptoms can also seem similar to adjustment disorder because both are linked with anxiety that develops after exposure to a stressor. With PTSD, this stressor is a traumatic event. With adjustment disorder, the stressor does not have to be severe or outside the “normal” human experience.


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“Moderate Drinking Before Trauma Leads To More Flashbacks”:

MindApps Releases eCBT Trauma”:

“Virtual Reality For PTSD”:

“PTSD: Intrusive Images and Intrusive Verbal Thoughts Are Different Phenomena”:

“PTSD: Trauma: A Mindful Dialogue”:

“By Measuring Magnetic Fields In Brain, Researchers Identify PTSD Biomarker”:

“APA Offers Resources On Managing Traumatic Stress In Wake Of Haiti Earthquake”:

“Coping With Trauma – Lessons From Resilient Individuals”:

“LA Times: Morphine Shows Promise Against PTSD”:

“Itchy Skin Linked To Psychological Stress”:

“PTSD: New Techniques To Assess PTSD, Smaller Brain Linked To PTSD Risk, Military Children Face Challenges & Children’s PTSD”:

“Abstract: Empirically Supported Psychological Treatments For Adult Acute Stress Disorder”:

“In Honor of Veterans, 2009/Most Returning Veterans Won’t Seek Treatment”:

“PTSD: Forget All About It: Erasing Traumatic Memories”:

“Synthetic Cannabinoids May Help PTSD Patients”:

“PTSD: Genes & Environment May Interact To Influence Risk For Post-Traumatic Stress Disorder/Associated Conditions of PTSD”:

“PTSD: Scientists Find New Research On The Brain And Fear That Could Help Victims Of PTSD & Further Research”:

“In Future, Science Could Erase Traumatic Memories”:

“PTSD: Ground Zero-Scale Trauma Can Spur Psychological Growth”:

“Abstract: Reliving and Disorganization in PTSD and Panic Disorder Memories”:

“Psychological Interventions Deemed Ineffective at Preventing PTSD”:

“[Australia] University Pioneers Online PTSD Therapy”:

“Research brings diagnostic brain scans for PTSD, depression a step closer”:

“PTSD Can Attack Years Later”:

“PTSD: Concussed, Stressed Or Just Sick Of War?”:

“Mental Health Needs Must Not Be Neglected After A Disaster”:

PTSD Poster

 

PTSD Combat: Winning the War Within

http://ptsdcombat.blogspot.com/

 

Post Traumatic Stress Disorder Gateway

http://www.ptsdinfo.org/

 

Award Winning Site

David Baldwin’s Trauma Information Pages

Comprehensive Resources on Traumatic-Stress, PTSD & Dissociation

http://www.trauma-pages.com/

 

Mayo Clinic – PTSD

http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246

 

Army Behavioral Health: PTSD Information

http://www.behavioralhealth.army.mil/ptsd/index.html

 

Gift From Within – Article: “Partners With PTSD”

http://www.giftfromwithin.org/html/partners.html

 

Dissociation

http://www.panicanxietydisorder.org.au/7_Dissociation symptoms.htm

 

“PTSD & Military Injury Claims” ~ with Special Thanks to Paul for sharing the following link and outstanding Infographic:

http://blackwaterlaw.co.uk/military-injury-claims/

 

“PTSD & Military Injury Claims Infographic”

http://www.aspie-editorial.com/wp-content/uploads/2011/01/PTSD-INFOGRAPHIC_600px.jpg

 

comments (1)


1. Nora left…

Wednesday, 3 March 2010 3:02 am

Don’t know that i see what is likely to be the biggest PTSD creator of all, childhood abuse : physical, sexual and even psychological mentioned by those who track such things. Children have not the psychological resources notr the understanding of the world to cope and so many adult have unresolved PTSD and are treated for all sorts of other diagnoses when treating the PTSD would be more valuable. Interesting