Treatment Of Trauma-related Disorders Research Articles

The Possibilities OF Transcultural Positive Psychotherapy in Supporting the Development of Post-Traumatic Growth (PTG)

Technological and sociocultural changes taking place over the last decades have, on the one hand, increased the probability of experiencing trauma during human life, and on the other, contributed to the development of neuroscience, and thus to expanding knowledge about the symptoms, diagnosis and treatment of trauma-related disorders. Attention began to be drawn to the fact that experiencing trauma can not only lead to negative consequences, but also can be a source of positive changes in an individual. This phenomenon is defined as post-traumatic growth, which may manifest itself in one (or more) of the four areas of human life. As a result of a traumatic experience, some people may increase the sense of self-confidence and trust in their own abilities, may become convinced of their personal strength and effectiveness, may improve relationships with other people, or begin to appreciate life and have hope for the future’s changes. Post-traumatic growth is more than an adaptive strategy to a post-traumatic situation. Growth means development, i.e. achieving a better level of functioning of the individual than before experiencing the trauma. The development of an individual is part of the Transcultural Positive Psychotherapy (PPT after Peseschkian) objective, which focuses on developing human potential by changing the perspective, enhancing hope, differentiating capabilities, discovering coping skills and finding a sense of meaning even in the most extreme life events. This article aims to show the usefulness of Positive Psychotherapy after Peseschkian in supporting post-traumatic growth. Starting with the characteristics of the post-traumatic growth phenomenon, will discuss the factors correlating with the emergence of positive post-traumatic changes and will finally show how the main principles and tools of this method can be helpful in reinforcing post-traumatic growth.

1.7 Cultural Considerations and Response to Trauma Exposure for Latina/o Children at the Border

The objectives are to review the diversity of ethnicities and languages that exist in the Latina/o population, review common traumatic experiences, and address the importance of various cultural factors pertinent to the engagement and treatment of trauma-related disorders in these youth. The circumstances of unaccompanied migrant children (UMC) will be discussed.

Characterizing Typologies of Polytraumatization: A Replication and Extension Study Examining Internalizing and Externalizing Psychopathology in an Urban Population.

A person-centered approach to examining trauma has uncovered typologies of polytraumatization that are differentially associated with psychopathology. However, previous research is limited by narrow conceptualizations of trauma, limited distal outcomes, and underrepresentation of minorities. To address these gaps, we used latent profile analyses to uncover distinct polytraumatization typologies and examine four symptom-based (PTSD, depression, aggression, and substance abuse) and two behavior-based (self-harm, jail counts) outcomes in a sample of low-income adults (n = 7,426, 94% African American). The models were indicated by 19 traumatic experiences (e.g., accident, sexual assault, witnessing/experiencing violence). The best fitting model uncovered five classes: minimal trauma, physical abuse, violence exposure, sexual abuse, and polytrauma. Classes characterized by significant and varied trauma were higher on both internalizing and externalizing psychopathology, while those characterized by specific types of trauma were only higher on one type of psychopathology. Implications for the assessment and treatment of trauma-related disorders are discussed.

Digital Media in Psychotherapy - New Approaches and Perspectives in the Treatment of Trauma-Related Disorders

This article provides an insight into novel approaches and perspectives using digital technologies in the treatment of trauma-related disorders. Therapy options for patients with trauma-related disorders are not easily available on a global scale and there is a search for new specific therapeutic strategies. In the first part of this article, examples of digital approaches are provided that are based on established analogue treatments and are designed mainly to increase availability and cost-effectiveness of these treatments. In the second part, the focus lies on digital treatments that employ novel approaches, which are e. g. informed by cognitive science, to specifically target particular symptoms in clinical populations after their development in lab studies. Examples given are visuospatial interventions used to reduce intrusive symptoms, or training programmes to increase levels of interference control (to control trauma-related stimuli), or to change automatic dysfunctional cognitions. These interventions will be presented with their respective theoretical frameworks, along with results from first (partially clinical) studies, which are promising concerning acceptance, applicability and effectiveness.

Social Work and Psychedelic-Assisted Therapies: Practice Considerations for Breakthrough Treatments

The re-emergence of therapeutic uses for mind-altering, psychedelic drugs has brought the field of mental health to a new frontier in research, practice, and policymaking. In the past two decades dozens of clinical trials investigating therapeutic applications of psychedelics—including MDMA, psilocybin, and ketamine—have shown promising results in the treatment of trauma-related disorders, some forms of anxiety, and depression. These substances have also garnered preliminary support from the Food and Drug Administration, which has fast-tracked their development. As the field of psychedelic science continues to grow, a serious consideration of these novel treatments in the context of social work practice and values is imperative. This paper offers a brief overview of MDMA-, psilocybin-, and ketamine-assisted treatments, and presents an initial discussion of questions pertinent to social work practice raised by their use, including: safety, efficacy, theory of change, training needs, and social justice considerations.

Effectiveness of a Multimodal, Day Clinic Group-Based Treatment Program for Trauma-Related Disorders: Differential Therapy Outcome for Complex PTSD vs. Non-Complex Trauma-Related Disorders.

Background: The effectiveness of the psychotherapeutic treatment of posttraumatic stress disorder is evidence-based and generally considered proven. However, the effectiveness of multimodal, group-based day clinic treatment programs has rarely been investigated. Moreover, there is no consensus in the literature concerning the question whether psychotherapeutic approaches for trauma-related disorders are also applicable for patients with complex PTSD (cPTSD). The aim of the study was to evaluate our multimodal group-based treatment program regarding a change of psychiatric burden, a change of protective factors, and possible differences in therapy outcome for patients with or without cPTSD.Methods: The group-based treatment for patients with trauma-related disorders was examined in 66 patients who filled out the following questionnaires in the first and in the last week of treatment: Essen Trauma Inventory (ETI), Screening for complex PTSD (SkPTBS), Patient Health Questionnaire—somatization module (PHQ-15), Beck Depression Inventory—Revised (BDI-II), Posttraumatic Growth Inventory (PTGI), and Questionnaire on social support (F-SozU).Results: The treatment was shown to significantly reduce depressive symptoms (p < 0.001, d = -0.536) and increase posttraumatic growth (New Possibilities: p = 0.004, d = 0.405; Personal Strength: p = 0.005, d = 0.414). For patients with cPTSD, depressive (p = 0.010, d = -0.63) as well as cPTSD symptoms (p = 0.020, d = -0.796) were significantly reduced; perceived social support was increased after day clinic treatment (p = 0.003, d = 0.61). Contrary to our expectations, somatoform symptoms were increased after therapy.Conclusions: The present work expands previous research by demonstrating that multimodal group-based, day clinic treatment is effective in the treatment of trauma-related disorders, also in their complex form.

Music, Music Therapy and Trauma

This special issue of ‘Music and Medicine’ entitled ‘Music, Music Therapy and Trauma’ highlights the important role that music therapy may play in the treatment of trauma-related disorders...

Cultural Identity Among Afghan and Iraqi Traumatized Refugees: Towards a Conceptual Framework for Mental Health Care Professionals

Cultural identity in relation with mental health is of growing interest in the field of transcultural psychiatry. However, there is a need to clarify the concept of cultural identity in order to make it useful in clinical practice. The purpose of this study is to unravel the complexity and many layers of cultural identity, and to assess how stress and acculturation relate to (changes in) cultural identity. As part of a larger study about cultural identity, trauma, and mental health, 85 patients from Afghanistan and Iraq in treatment for trauma-related disorders were interviewed with a Brief Cultural Interview. The interviews were analysed through qualitative data analysis using the procedures of grounded theory. The analysis resulted in three domains of cultural identity: personal identity, ethnic identity and social identity. Within each domain relationships with stress and acculturation were identified. The results offer insight into the intensity of changes in cultural identity, caused by pre-and post-migration stressors and the process of acculturation. Based on the research findings recommendations are formulated to enhance the cultural competency of mental health workers.

Preferences for trauma treatment: A systematic review of the empirical literature.

The prevalence of trauma histories and related psychological problems is high in general clinical settings, but little is known about trauma patient preferences for mental health treatment. The purpose of this article is to systematically review and synthesize the literature on treatment preferences in survivors of traumatic events. Studies were identified using comprehensive searches of PsycINFO, Medline, PubMed, Published International Literature on Traumatic Stress, and Cumulative Index to Nursing and Allied Health Literature databases. Included in the review were articles published between January 1980 and September 2014, in English that reported patient preference of treatment for trauma related disorders in either clinical or nonclinical (e.g., analog) samples. The total number of individual participants was 6,091. Of the identified studies, 35 were quantitative and 6 were qualitative. Methodological concerns included the use of analog samples, small sample sizes, and the assessment of a limited number of treatment options (e.g., asking about only 1 type of psychotherapy or medication). Overall, participants expressed a preference for psychotherapy over medication and for talking about their trauma. Understanding and addressing trauma patient preferences may assist in improving treatment initiation as well as facilitate engagement, retention and outcome.

Clinical assessment of PTSD in children with mild to borderline intellectual disabilities: A pilot study

Objective: There are few studies regarding assessment and treatment of trauma-related disorders in people with intellectual disabilities (ID). The aims of this study were to determine (1) the feasibility of an adapted version of a post-traumatic stress disorder (PTSD)-clinical interview and (2) to what extent manifestation of PTSD in a sample of children with mild to borderline ID corresponds with four existing PTSD algorithms.Method: Fifteen children who visited a special need school were interviewed.Results: In all children, the full interview could be completed. Potentially traumatic events (A1 criterion), and PTSD symptoms for children with mild to borderline ID were similar to those observed in children without ID.Conclusions: The manifestation of PTSD in children with mild to borderline ID corresponds with the manifestation of PTSD in children without ID. The data provide no reason to broaden PTSD criterion A1 for children with mild to borderline ID.

An examination of structural dissociation of the personality and the implications for cognitive behavioural therapy

AbstractThe aim of this review was to ascertain whether an examination of the theory of structural dissociation of the personality (TSDP) and its treatment may lead to recommendations in the treatment of dissociative identity disorder (DID) and other trauma-related disorders utilizing CBT. An analysis of the neurobiology of trauma will aid this process. The literature review considers a variety of literature on TSDP. Several themes were identified which suggested that dissociation refers to a structural dividedness of the personality and that there is a psychobiological pathway for all trauma-related disorders. Additionally the role of bottom-up vs. top-down processing was explored. Recommendations for the treatment of trauma-related disorders using CBT have been made.

Feeling Better and Smoking Less: The Relationship Between Trauma Symptoms and Smoking Over Time

Although it is well documented that individuals who have experienced traumatic events smoke cigarettes at significantly higher rates than individuals without exposure to trauma, the longitudinal relationship between smoking and trauma-related symptoms remains unclear. The present study examined this issue among 288 female veterans receiving treatment for trauma-related disorders over a period of up to 3 years. Consistent with previous cross-sectional research, across time points more symptomatology was associated with higher rates of smoking. Longitudinally, decreases in symptoms of negative affect over time were associated with decreases in smoking.

A Model for Brief Assessment of Attachment and Its Application to Women in Inpatient Treatment for Trauma-Related Psychiatric Disorders

We adapted self-report measures of attachment style to the psychological assessment of women in specialized inpatient treatment for trauma-related disorders. The study employed 2 measures of adult attachment style, the Relationship Questionnaire (Bartholomew & Horowitz, 1991) and the Adult Attachment Scale (Collins & Read, 1990) as well as our Current Attachment Relationships questionnaire, which assesses the extent of social support in secure attachments. We administered these measures to 99 patients and to a convenience sample of 154 women in the community. We found modest correspondence between the 2 attachment style measures and substantial relations between attachment styles and range of secure attachment relationships. Women in the trauma sample reported insecure attachment styles and relatively few secure attachment figures. We discuss the implications of these findings for clinical assessment.

Memories of childhood abuse: dissociation, amnesia, and corroboration.

This study investigated the relationship between self-reported childhood abuse and dissociative symptoms and amnesia. The presence or absence of corroboration of recovered memories of childhood abuse was also studied. Participants were 90 female patients admitted to a unit specializing in the treatment of trauma-related disorders. Participants completed instruments that measured dissociative symptoms and elicited details concerning childhood physical abuse, sexual abuse, and witnessing abuse. Participants also underwent a structured interview that asked about amnesia for traumatic experiences, the circumstances of recovered memory, the role of suggestion in recovered memories, and independent corroboration of the memories. Participants reporting any type of childhood abuse demonstrated elevated levels of dissociative symptoms that were significantly higher than those in subjects not reporting abuse. Higher dissociative symptoms were correlated with early age at onset of physical and sexual abuse and more frequent sexual abuse. A substantial proportion of participants with all types of abuse reported partial or complete amnesia for abuse memories. For physical and sexual abuse, early age at onset was correlated with greater levels of amnesia. Participants who reported recovering memories of abuse generally recalled these experiences while at home, alone, or with family or friends. Although some participants were in treatment at the time, very few were in therapy sessions during their first memory recovery. Suggestion was generally denied as a factor in memory recovery. A majority of participants were able to find strong corroboration of their recovered memories. Childhood abuse, particularly chronic abuse beginning at early ages, is related to the development of high levels of dissociative symptoms including amnesia for abuse memories. This study strongly suggests that psychotherapy usually is not associated with memory recovery and that independent corroboration of recovered memories of abuse is often present.