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Cognitive behavioural approaches to the understanding and treatment of dissociation
\"The study of dissociation is relevant to anyone undertaking research or treatment of mental health problems. Cognitive Behavioural Approaches to the Understanding and Treatment of Dissociation uses a cognitive approach to de-mystify the processes involved in linking traumatic incidents to their effects. Kennedy, Kennerley and Pearson present a full and comprehensive understanding of mental health problems involving dissociative disorders and their treatment, bringing together an international range of experts. Each chapter addresses a single topic in full, including assessment of previous research from a cognitive perspective, recommendations for treatment and case studies to illustrate clinical approaches. Using an evidence-based scientific approach combined with the wisdom of clinical experience, the authors make the relevance of dissociation immediately recognisable to those familiar with PTSD, dissociative identity disorder, eating disorders, hallucinations and a wide range of psychological and non-organic physical health disorders. Designed to provide new perspectives on both research and treatment, Cognitive Behavioural Approaches to the Understanding and Treatment of Dissociation includes a wide range of material that will appeal to clinicians, academics and students\"-- Provided by publisher.
Book
Psychological interventions for ICD-11 complex PTSD symptoms: systematic review and meta-analysis
The 11th revision to the WHO International Classification of Diseases (ICD-11) identified complex post-traumatic stress disorder (CPTSD) as a new condition. There is a pressing need to identify effective CPTSD interventions.
We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) of psychological interventions for post-traumatic stress disorder (PTSD), where participants were likely to have clinically significant baseline levels of one or more CPTSD symptom clusters (affect dysregulation, negative self-concept and/or disturbed relationships). We searched MEDLINE, PsycINFO, EMBASE and PILOTS databases (January 2018), and examined study and outcome quality.
Fifty-one RCTs met inclusion criteria. Cognitive behavioural therapy (CBT), exposure alone (EA) and eye movement desensitisation and reprocessing (EMDR) were superior to usual care for PTSD symptoms, with effects ranging from g = -0.90 (CBT; k = 27, 95% CI -1.11 to -0.68; moderate quality) to g = -1.26 (EMDR; k = 4, 95% CI -2.01 to -0.51; low quality). CBT and EA each had moderate-large or large effects on negative self-concept, but only one trial of EMDR provided useable data. CBT, EA and EMDR each had moderate or moderate-large effects on disturbed relationships. Few RCTs reported affect dysregulation data. The benefits of all interventions were smaller when compared with non-specific interventions (e.g. befriending). Multivariate meta-regression suggested childhood-onset trauma was associated with a poorer outcome.
The development of effective interventions for CPTSD can build upon the success of PTSD interventions. Further research should assess the benefits of flexibility in intervention selection, sequencing and delivery, based on clinical need and patient preferences.
Journal Article
Break through with breathwork : jump-starting personal growth in counseling and the healing arts
\"When working with trauma and chronic health issues, it can often seem like the healing process gets stuck or is producing only minimal progress. In this groundbreaking book, clinical psychologist Jim Morningstar, PhD, shows therapists, bodyworkers, and other health care professionals how to achieve remarkable breakthroughs with their clients using the power of Therapeutic Breathwork. Unlike more commonly known mindfulness breathwork techniques--which typically only involve slower-than-normal breathing--Therapeutic Breathwork is designed to also include faster-than-normal breathing (35-75 breaths per minute) to enervate the sympathetic nervous system. This is especially useful in helping to release blocks that arise while working through difficult emotional issues, including PTSD, addiction, depression, and anxiety. While traditional talk therapy can take many years, sometimes decades, to produce minimal relief, Therapeutic Breathwork can help facilitate astonishing breakthroughs within a single session. Morningstar explains how therapists can reinforce these breakthroughs with additional techniques for self regulation, dramatically reducing recovery time and often resolving challenges that might never have been worked through in standard practice.Break Through with Breathworkis an accessible and thorough introduction to one of the most powerful tools in supporting health and wellbeing, reducing stress, and stimulating deep emotional and spiritual growth\"-- Provided by publisher.
Book
A psychometric assessment of Disturbances in Self-Organization symptom indicators for ICD-11 Complex PTSD using the International Trauma Questionnaire
Background: Two 'sibling disorders' have been proposed for the 11
th
version of the International Classification of Diseases (ICD-11): Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). To date, no research has attempted to identify the optimal symptom indicators for the 'Disturbances in Self-Organization' (DSO) symptom cluster.
Objective: The aim of the current study was to assess the psychometric performance of scores of 16 potential DSO symptom indicators from the International Trauma Questionnaire (ITQ). Criteria relating to score variability and their ability to discriminate were employed.
Method: Participants (N = 1839) were a nationally representative household sample of non-institutionalized adults currently residing in the US. Item scores from the ITQ were examined in relation to basic criteria associated with interpretability, variability, homogeneity, and association with functional impairment. The performance of the DSO symptoms was also assessed using 1- and 2-parameter item response theory (IRT) models.
Results: The distribution of responses for all DSO indicators met the criteria associated with interpretability, variability, homogeneity, and association with functional impairment. The 1-parameter graded response model was considered the best model and indicated that each set of indictors performed very similarly.
Conclusions: The ITQ contains 16 DSO symptom indicators and they perform well in measuring their respective symptom cluster. There was no evidence that particular indicators were 'better' than others, and it was concluded that the indicators are essentially interchangeable.
Journal Article
Responses to terrorism : can psychosocial approaches break the cycle of violence?
\"Why do responses to terrorist attacks often perpetuate cycles of deadly violence?Can an understanding of the psychology of these cycles help us to break them?Drawing on clinical experience of the care of people and communities affected by violence and disasters and on advances in cognitive and dynamic psychology, attachment theory, group psychology and thanatology, this ground-breaking work by a prominent and varied array of contributors casts light on the causes of terrorism, the reasons why responses to deadly attacks easily give rise to or maintain cycles of violence and some ways to prevent and interrupt these cycles.Using the violence in Northern Ireland and Rwanda as case studies throughout, Part 1, The Context of Terrorism, looks at the psychological and social influences behind extremism, terrorism and conflict. Part 2, Reponses to a Terrorist Attack, examines the responses that can feed a cycle of violence and assesses a range of approaches for their success in ending violence. Part 3, Breaking the Cycle, looks in depth at specific environments, influences and changes that can affect how violence can be prevented or mitigated, including the role of schools and the media and an examination of how peace processes were carried out in Northern Ireland and Rwanda. The book works to demonstrate how psychological responses to a terror attack can trigger unstable emotional responses and override judgement and to identify the five key points in a cycle of violence where change, for better or for worse, is possible.Ideal for psychiatrists, thanatologists, palliative care and bereavement staff, politicians and journalists as well as anyone with an interest in terrorism and its causes, this is a thought-provoking and accessible work on a highly topical subject\"-- Provided by publisher.
Book
Trauma, PTSD, and complex PTSD in the Republic of Ireland: prevalence, service use, comorbidity, and risk factors
PurposeThis study represents the first assessment of the prevalence of trauma exposure, and Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD), ever conducted in the general population of the Republic of Ireland. Additionally, prevalence of past-year mental health service use, comorbidity with major depression and generalized anxiety, and risk factors associated with PTSD and CPTSD were assessed.MethodsA nationally representative sample of non-institutionalized Irish adults (N = 1020) completed self-report measures of trauma history, trauma-related psychopathology, mental health service use, and concurrent mental health problems.ResultsLifetime exposure to one or more traumatic events was 82.3%, and 67.8% reported experiencing two or more traumatic events. Males and females significantly differed in their frequency of exposure to eight of 16 traumatic events. The past-month prevalence for PTSD was 5.0% (95% CI 3.7%, 6.3%) and 7.7% (95% CI 6.1%, 9.4%) for CPTSD. Of those who screened positive for PTSD or CPTSD, 48.6% accessed mental health care in the past year. Comorbidity with major depression and generalized anxiety was high, especially among those with CPTSD. Several unique and shared risk factors for PTSD and CPTSD were identified.ConclusionApproximately one-in-eight Irish adults met diagnostic requirements for PTSD or CPTSD, and comorbidity with other disorders was high. History of interpersonal trauma and exposure to multiple types of trauma in different developmental periods were associated with CPTSD. Many individuals did not access mental health care revealing a substantial mental health treatment gap.
Journal Article
Teaching trauma-sensitive yoga : a practical guide
\"A practical, hands-on, experienced-based guide for teaching trauma-sensitive yoga Canadian Forces veteran turned yoga teacher Brendon Abram combines his first-hand experience with PTSD in the field and years of teaching to offer this practical guide to bringing trauma-sensitive yoga to both clinical and studio settings. Drawing on his work with military veterans, first responders, and survivors of domestic and sexual abuse, Abram emphasizes the importance of respecting the uniqueness of every individual, and demonstrates how to use the foundational principles of yoga to create a safe experience. He explains that basic principles of yoga bring power to the practice and that breath, mindful movement, focused awareness, and acceptance of present moment experience form the foundation of any yoga offering, including trauma-sensitive yoga. He describes approaches to trauma sensitive yoga for both the clinical population and the general population in a studio setting, and delineates the differences between the two\"-- Provided by publisher.
Book
Economic evaluations and cost analyses in posttraumatic stress disorder: a systematic review
Posttraumatic stress disorder is associated with a high economic burden. Costs of treatment are known to be high, and cost-effectiveness has been analysed for several treatment options.
As no review on economic aspects of posttraumatic stress disorder exists, the aim of this study was to systematically review costs-of-illness studies and economic evaluations of therapeutic treatment for posttraumatic stress disorder, and to assess their quality.
A systematic literature search was performed in March 2017 and was last updated in February 2020 in the databases PubMed, PsychInfo and NHS Economic Evaluation Database. Cost-of-illness studies and economic evaluations of treatment for posttraumatic stress disorder were selected. Extracted cost data were categorized as direct costs and indirect costs and inflated to 2015 US-$ purchasing power parities (PPP). Quality was assessed using an adapted cost-of-illness studies quality checklist, the Consensus on Health Economic Criteria list, and the questionnaire to assess relevance and credibility of modelling studies by the International Society for Pharmacoeconomics and Outcome Research.
In total, 13 cost-of-illness studies and 18 economic evaluations were included in the review. Annual direct excess costs ranged from 512 US-$ PPP to 19,435 US-$ PPP and annual indirect excess costs were 5,021 US-$ PPP per person. Trauma-focused cognitive-behavioural therapy (+selective serotonin re-uptake inhibitor) was found to be cost-effective compared with treatment as usual and no treatment. Overall, included studies were of low and moderate quality. Studies used inappropriate economic study designs and lacked information on the economic perspective used.
Posttraumatic stress disorder is a major public health problem that causes high healthcare costs. While trauma-focused cognitive-behavioural therapy was found to be cost-effective, further investigations regarding pharmacotherapy and other treatments are necessary.
Journal Article
Trauma systems therapy for children and teens
\"For too many traumatized children and their families, chronic stressors such as poverty, substance abuse, and family or community violence--coupled with an overburdened care system/m-/pose seemingly insurmountable barriers to treatment. This empowering book provides a user-friendly blueprint for making the most of limited resources to help those considered the \"toughest cases.\" Evidence-based strategies are presented for effectively integrating individualized treatment with services at the home, school, and community levels. Written in an accessible, modular format with reproducible forms and step-by-step guidelines for assessment and intervention, the approach is grounded in the latest knowledge about child traumatic stress. It has been recognized as a treatment of choice by state mental health agencies nationwide\"-- Provided by publisher.
Book
Comparison of DSM-5 and proposed ICD-11 criteria for PTSD with DSM-IV and ICD-10: changes in PTSD prevalence in military personnel
Background: Recently, changes have been introduced to the diagnostic criteria for posttraumatic stress disorder (PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD).
Objectives:This study investigated the effect of the diagnostic changes made from DSM-IV to DSM-5 and from ICD-10 to the proposed ICD-11. The concordance of provisional PTSD prevalence between the diagnostic criteria was examined in a convenience sample of 100 members of the German Armed Forces.
Method: Based on questionnaire measurements, provisional PTSD prevalence was assessed according to DSM-IV, DSM-5, ICD-10, and proposed ICD-11 criteria. Consistency of the diagnostic status across the diagnostic systems was statistically evaluated.
Results: Provisional PTSD prevalence was the same for DSM-IV and DSM-5 (both 56%) and comparable under DSM-5 versus ICD-11 proposal (48%). Agreement between DSM-IV and DSM-5, and between DSM-5 and the proposed ICD-11, was high (both p < .001). Provisional PTSD prevalence was significantly increased under ICD-11 proposal compared to ICD-10 (30%) which was mainly due to the deletion of the time criterion. Agreement between ICD-10 and the proposed ICD-11 was low (p = .014).
Conclusion: This study provides preliminary evidence for a satisfactory concordance between provisional PTSD prevalence based on the diagnostic criteria for PTSD that are defined using DSM-IV, DSM-5, and proposed ICD-11. This supports the assumption of a set of PTSD core symptoms as suggested in the ICD-11 proposal, when at the same time a satisfactory concordance between ICD-11 proposal and DSM was given. The finding of increased provisional PTSD prevalence under ICD-11 proposal in contrast to ICD-10 can be of guidance for future epidemiological research on PTSD prevalence, especially concerning further investigations on the impact, appropriateness, and usefulness of the time criterion included in ICD-10 versus the consequences of its deletion as proposed for ICD-11.
Journal Article