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Post-traumatic stress disorder
\"Three distinguished experts share cutting-edge insights on Post-Traumatic Stress Disorder (PTSD), showing why it occurs, how it affects the development and existence of those it impacts, and how it can be treated\"-- Provided by publisher.
Book
MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study
Post-traumatic stress disorder (PTSD) presents a major public health problem for which currently available treatments are modestly effective. We report the findings of a randomized, double-blind, placebo-controlled, multi-site phase 3 clinical trial (NCT03537014) to test the efficacy and safety of 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy for the treatment of patients with severe PTSD, including those with common comorbidities such as dissociation, depression, a history of alcohol and substance use disorders, and childhood trauma. After psychiatric medication washout, participants (n = 90) were randomized 1:1 to receive manualized therapy with MDMA or with placebo, combined with three preparatory and nine integrative therapy sessions. PTSD symptoms, measured with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5, the primary endpoint), and functional impairment, measured with the Sheehan Disability Scale (SDS, the secondary endpoint) were assessed at baseline and at 2 months after the last experimental session. Adverse events and suicidality were tracked throughout the study. MDMA was found to induce significant and robust attenuation in CAPS-5 score compared with placebo (P < 0.0001, d = 0.91) and to significantly decrease the SDS total score (P = 0.0116, d = 0.43). The mean change in CAPS-5 scores in participants completing treatment was -24.4 (s.d. 11.6) in the MDMA group and -13.9 (s.d. 11.5) in the placebo group. MDMA did not induce adverse events of abuse potential, suicidality or QT prolongation. These data indicate that, compared with manualized therapy with inactive placebo, MDMA-assisted therapy is highly efficacious in individuals with severe PTSD, and treatment is safe and well-tolerated, even in those with comorbidities. We conclude that MDMA-assisted therapy represents a potential breakthrough treatment that merits expedited clinical evaluation.
Journal Article
Journalists under Fire
As journalists in Iraq and other hot spots around the world continue to face harrowing dangers and personal threats, neuropsychiatrist Anthony Feinstein offers a timely and important exploration into the psychological damage of those who, armed only with pen, tape recorder, or camera, bear witness to horror. Based on a series of recent studies investigating the emotional impact of war on the profession, Journalists under Fire breaks new ground in the study of trauma-related disorders.
Feinstein opens with an overview of the life-threatening hazards war reporters face—abductions, mock executions, the deaths of close colleagues—and discusses their psychological consequences: post-traumatic stress disorder, depression, deterioration of personal relationships, and substance abuse. In recounting the experiences of reporters who encounter trauma on the job, Feinstein observes that few adequate support systems are in place for them. He tells the stories of media veterans who have seen it all, only to find themselves and their employers blindsided by psychological aftershocks.
The book explores the biological and psychological factors that motivate journalists to take extraordinary risks. Feinstein looks into the psyches of freelancers who wade into war zones with little or no financial backing; he examines the different stresses encountered by women working in a historically male-dominated profession; and he probes the effects of the September 11 attacks on reporters who thought they had sworn off conflict reporting. His interviews with many of this generation's greatest reporters, photographers, and videographers often reveal extraordinary resilience in the face of adversity.
Journalists under Fire is a look behind the public persona of war journalists at a time when the profession faces unprecedented risk. Plucking common threads from disparate stories, Feinstein weaves a narrative that is as fascinating to read as it is sobering to contemplate. What emerges are unique insights into lives lived dangerously.
eBook
The PTSD workbook : simple, effective techniques for overcoming traumatic stress symptoms
In the third edition of the best-selling The PTSD Workbook, psychologists and trauma experts Mary Beth Williams and Soili Poijula offer readers the most effective tools available for treating post-traumatic stress disorder (PTSD). In this fully revised and updated workbook, readers will learn how to move past the trauma they have experienced; manage symptoms such as insomnia, anxiety, and flashbacks; and find important updates reflecting the new DSM-V definition of PTSD.
Book
Culture and PTSD
Since the 1970s, understanding of the effects of trauma, including flashbacks and withdrawal, has become widespread in the United States. As a result Americans can now claim that the phrase posttraumatic stress disorder (PTSD) is familiar even if the American Psychiatric Association's criteria for diagnosis are not. As embedded as these ideas now are in the American mindset, however, they are more widely applicable, this volume attempts to show, than is generally recognized. The essays inCulture and PTSDtrace how trauma and its effects vary across historical and cultural contexts.
Culture and PTSDexamines the applicability of PTSD to other cultural contexts and details local responses to trauma and the extent they vary from PTSD as defined in the American Psychiatric Association'sDiagnostic and Statistical Manual. Investigating responses in Peru, Indonesia, Haiti, and Native American communities as well as among combat veterans, domestic abuse victims, and adolescents, contributors attempt to address whether PTSD symptoms are present and, if so, whether they are a salient part of local responses to trauma. Moreover, the authors explore other important aspects of the local presentation and experience of trauma-related disorder, whether the Western concept of PTSD is known to lay members of society, and how the introduction of PTSD shapes local understandings and the course of trauma-related disorders.
By attempting to determine whether treatments developed for those suffering PTSD in American and European contexts are effective in global settings of violence or disaster,Culture and PTSDquestions the efficacy of international responses that focus on trauma.
Contributors:Carmela Alcántara, Tom Ball, James K. Boehnlein, Naomi Breslau, Whitney Duncan, Byron J. Good, Mary-Jo DelVecchio Good, Jesse H. Grayman, Bridget M. Haas, Devon E. Hinton, Erica James, Janis H. Jenkins, Hanna Kienzler, Brandon Kohrt, Roberto Lewis-Fernández, Richard J. McNally, Theresa D. O'Nell, Duncan Pedersen, Nawaraj Upadhaya, Carol M. Worthman, Allan Young
eBook
Protective effects of elevated anandamide on stress and fear-related behaviors: translational evidence from humans and mice
Post-traumatic stress disorder (PTSD) is a common, debilitating condition with limited treatment options. Extinction of fear memories through prolonged exposure therapy, the primary evidence-based behavioral treatment for PTSD, has only partial efficacy. In mice, pharmacological inhibition of fatty acid amide hydrolase (FAAH) produces elevated levels of anandamide (AEA) and promotes fear extinction, suggesting that FAAH inhibitors may aid fear extinction-based treatments. A human FAAH 385C->A substitution encodes an FAAH enzyme with reduced catabolic efficacy. Individuals homozygous for the FAAH 385A allele may therefore offer a genetic model to evaluate the impact of elevations in AEA signaling in humans, helping to inform whether FAAH inhibitors have the potential to facilitate fear extinction therapy for PTSD. To overcome the challenge posed by low frequency of the AA genotype (appr. 5%), we prospectively genotyped 423 individuals to examine the balanced groups of CC, AC, and AA individuals (n = 25/group). Consistent with its loss-of-function nature, the A allele was dose dependently associated with elevated basal AEA levels, facilitated fear extinction, and enhanced the extinction recall. Moreover, the A-allele homozygotes were protected against stress-induced decreases in AEA and negative emotional consequences of stress. In a humanized mouse model, AA homozygous mice were similarly protected against stress-induced decreases in AEA, both in the periphery, and also in the amygdala and prefrontal cortex, brain structures critically involved in fear extinction and regulation of stress responses. Collectively, these data suggest that AEA signaling can temper aspects of the stress response and that FAAH inhibition may aid the treatment for stress-related psychiatric disorders, such as PTSD.
Journal Article
Treating the trauma survivor : an essential guide to trauma-informed care
\"Treating the Trauma Survivor is a practical guide to assist mental health, health care, and social service providers in providing trauma-informed care. This resource provides essential information in order to understand the impacts of trauma by summarizing key literature in an easily accessible and user-friendly format. Providers will be able to identify common pitfalls and avoid re- traumatizing survivors during interactions. Based on the authors extensive experience and interactions with trauma survivors, the book provides a trauma-informed framework and offers practical tools to enhance collaboration with survivors and promote a safer helping environment. Mental health providers in health care, community, and addictions settings as well as health care providers and community workers will find the framework and the practical suggestions in this book informative and useful\"- Provided by publisher.
Book
Trial of Prazosin for Post-Traumatic Stress Disorder in Military Veterans
In a trial involving 304 veterans with stable PTSD, prazosin did not alleviate distressing dreams and did not improve sleep quality or overall clinical symptoms over 10 or 26 weeks. This result is in contrast to findings in several previous smaller or briefer trials.
Journal Article