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Dawson RL, Nixon RDV, Calear AL, Sivanathan D, O'Kearney R. Efficacy of two brief trauma-focussed writing interventions in comparison to positive experiences writing: A randomized controlled trial. J Affect Disord 2024; 358:449-457. [PMID: 38734242 DOI: 10.1016/j.jad.2024.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 04/13/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND There is emerging literature regarding the efficacy of trauma-focussed writing therapies (TF-WTs) for posttraumatic stress. Such therapies have the potential to reduce posttraumatic stress symptoms (PTSS) in a brief time frame and can be delivered remotely. There remains a need for further research assessing the efficacy of different types of TF-WTs, as well comparing them to alternative control conditions not previously assessed. The present study assessed two TF-WTs that had differing writing instructions in comparison to an intervention that involved writing about positive experiences. METHODS Adult community participants (n = 83) with subthreshold or clinical PTSD symptoms were randomized to one of three conditions (two of which involved trauma-focussed writing, and the other involved writing about positive experiences). All conditions involved three weekly telehealth-delivered writing appointments. Outcomes were measured using the PTSD Checklist (PCL-5) and the Depression, Anxiety and Stress Scales (DASS-21), and were evaluated at baseline, one-week post-intervention, and five-weeks post-intervention. This trial was registered with the Australian and New Zealand Clinical Trials Registry (ANZCTR Protocol 12620001065987). RESULTS There was no evidence that the two TF-WTs were more efficacious in reducing PTSS or producing clinically meaningful change in comparison to positive experiences writing. Instead, a significant reduction from baseline to follow-up in PTSS, depression, anxiety and stress was observed in all three conditions. LIMITATIONS The results should be interpreted with consideration of the modest sample size and absence of longer-term follow-up. CONCLUSIONS Three-session trauma-focussed writing delivered via telehealth may not be superior to writing about positive experiences.
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Affiliation(s)
- R L Dawson
- School of Medicine and Psychology, Australian National University, Australia.
| | - R D V Nixon
- College of Education, Psychology and Social Work, Flinders University, Australia
| | - A L Calear
- Centre for Mental Health Research, Australian National University, Australia
| | - D Sivanathan
- School of Medicine and Psychology, Australian National University, Australia; Faculty of Health, Charles Darwin University, Australia
| | - R O'Kearney
- School of Medicine and Psychology, Australian National University, Australia
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Rothärmel M, Mekaoui L, Kazour F, Herrero M, Beetz-Lobono EM, Lengvenyte A, Holtzmann J, Raynaud P, Cuenca M, Bulteau S, de Maricourt P, Husson T, Olié E, Gohier B, Sauvaget A, Gaillard R, Richieri R, Szekely D, Samalin L, Guillin O, Moulier V, El-Hage W, Laurin A, Berkovitch L. Esketamine-induced post-traumatic stress disorder flashbacks during treatment-resistant depression indication: is it just a side effect? MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.01.09.24300998. [PMID: 38293161 PMCID: PMC10827260 DOI: 10.1101/2024.01.09.24300998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Background Posttraumatic stress disorder (PTSD) is a severe and frequent affection that is highly comorbid to major depressive disorder. Comorbid PTSD and depression are usually treatment-resistant, with a high risk of functional impairment and suicide. Esketamine nasal spray is a recent validated treatment for treatment-resistant depression (TRD), but its efficacy on comorbid TRD-PTSD remains insufficiently documented. In particular, flashbacks can occur during esketamine administration and their influence on clinical outcomes is unknown. Objectives Our main objective was to describe esketamine-induced traumatic flashbacks and their impact on clinical trajectories within a sample of patients with comorbid TRD-PTSD. Methods We retrospectively collected clinical data of patients receiving esketamine nasal spray for TRD with comorbid PTSD who experienced at least one flashback of their trauma during esketamine sessions across 11 psychiatric departments. Results Between February 2020 and March 2023, 22 adult patients with TRD met inclusion criteria. In sixteen patients (72.7%) flashbacks disappeared as the sessions progressed. In six patients (27.3%), esketamine treatment was stopped because of persistent flashbacks. When esketamine was continued, clinical response was observed both for depression and PTSD (depression response rate: 45.5% and remission rate: 22.7%; PTSD response rate: 45.5% and remission: 18.2%). Limitations The retrospective design of the study and the absence of a comparator group are the main limitations of our study. Conclusions Our results suggest that the occurrence of esketamine-induced traumatic flashbacks does not hinder clinical response. On the contrary, when managed appropriately and combined with targeted psychotherapy, it could even contribute to positive outcomes.
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Affiliation(s)
- Maud Rothärmel
- University Department of Psychiatry, Therapeutic Centre of Excellence, Institute of Psychiatry – Rouvray Hospital Centre, Sotteville-lès-Rouen, France
| | - Lila Mekaoui
- Mental and Brain Illness Clinic, Sainte-Anne Hospital, GHU Paris – Psychiatry and Neurosciences, Paris, France
| | - François Kazour
- Department of Psychiatry and Addictology, CHU Angers, Angers, France
| | - Morgane Herrero
- Department of Psychiatry, CHU Saint Etienne, Saint Etienne, France
| | | | - Aiste Lengvenyte
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Jérôme Holtzmann
- Service de Psychiatrie de l’Adulte, Centre Expert Dépression Résistante FondaMental, CHU de Grenoble, hôpital Nord, Grenoble, France
| | | | - Macarena Cuenca
- University Department of Psychiatry, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France
| | - Samuel Bulteau
- Nantes Université, CHU Nantes, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000 Nantes, France
| | - Pierre de Maricourt
- University Department of Psychiatry, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France
| | - Thomas Husson
- University Department of Psychiatry, Therapeutic Centre of Excellence, Institute of Psychiatry – Rouvray Hospital Centre, Sotteville-lès-Rouen, France
| | - Emilie Olié
- Department of Emergency Psychiatry and Post-Acute Care, CHU Montpellier, France; IGF, Univ. Montpellier, CNRS, INSERM, Montpellier, France
| | - Bénédicte Gohier
- Department of Psychiatry and Addictology, CHU Angers, Angers, France
| | - Anne Sauvaget
- Nantes Université, CHU Nantes, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000 Nantes, France
| | - Raphaël Gaillard
- University Department of Psychiatry, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France
| | - Raphaëlle Richieri
- Service Universitaire de santé mentale et physique, Centre Expert Dépression Résistante, CHU Sainte-Marguerite, APHM, Université Aix-Marseille, Marseille, France; Aix Marseille Univ, CNRS, Centrale Marseille, Institut Fresnel, Marseille, France
| | - David Szekely
- Centre Hospitalier Princesse Grace, Service de psychiatrie, Principauté de Monaco
| | - Ludovic Samalin
- Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, CNRS, Clermont Auvergne INP, Institut Pascal (UMR 6602), Clermont-Ferrand, France
| | - Olivier Guillin
- University Department of Psychiatry, Therapeutic Centre of Excellence, Institute of Psychiatry – Rouvray Hospital Centre, Sotteville-lès-Rouen, France
- CHU Rouen, Normandy University, Rouen, France
| | - Virginie Moulier
- University Department of Psychiatry, Therapeutic Centre of Excellence, Institute of Psychiatry – Rouvray Hospital Centre, Sotteville-lès-Rouen, France
- Unité de Recherche Clinique (URC), EPS Ville Evrard, Neuilly-sur-Marne, France
| | - Wissam El-Hage
- Centre Régional de Psychotraumatologie, Centre Hospitalier Régional
- Universitaire (CHRU) de Tours, Tours, France, 3 INSERM U1253 Imagerie et Cerveau (iBrain), Tours, France
| | - Andrew Laurin
- Nantes Université, CHU Nantes, INSERM, MethodS in Patients-centered outcomes and HEalth Research, SPHERE, F-44000 Nantes, France
| | - Lucie Berkovitch
- University Department of Psychiatry, Pôle Hospitalo-Universitaire Psychiatrie Paris 15, Groupe Hospitalier Universitaire Paris, Paris, France
- Paris Cité University, Paris, France
- Department of Psychiatry, Yale University School of Medicine, 40 Temple Street, New Haven, CT, 06511, United States
- Saclay CEA Centre, Neurospin, Gif-Sur-Yvette Cedex, France
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3
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Yunitri N, Chu H, Kang XL, Wiratama BS, Lee TY, Chang LF, Liu D, Kustanti CY, Chiang KJ, Chen R, Tseng P, Chou KR. Comparative effectiveness of psychotherapies in adults with posttraumatic stress disorder: a network meta-analysis of randomised controlled trials. Psychol Med 2023; 53:6376-6388. [PMID: 36628572 DOI: 10.1017/s0033291722003737] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Evidence on the long-term comparative effectiveness of posttraumatic stress disorder (PTSD) psychotherapies in adults remains unknown. Therefore, we performed an extensive network meta-analysis of randomised controlled trials (RCTs) to determine the comparative effectiveness of psychotherapies for people diagnosed with PTSD. METHODS A comprehensive search was conducted in Cochrane library, Embase, Medline-OVID, PubMed, Scopus, and Psych-Info until March 2021. Studies on the effectiveness of cognitive processing therapy (CPT), cognitive therapy (CT), eye movement desensitisation reprocessing (EMDR), narrative exposure therapy (NET), prolonged exposure (PE), cognitive behavioural therapy (CBT), present-centred therapy (PCT), brief eclectic psychotherapies (BEP), psychodynamic therapy (PDT) or combination therapies compared to no treatment (NT) or treatment as usual (TAU) in adults with PTSD were included. Frequentist and Bayesian approaches were used for analysis in R-software. RESULTS We included 98 RCTs with 5567 participants from 18 897 studies. CPT, EMDR, CT, NET, PE, CBT, and PCT were significant to reduce PTSD symptoms (SMD range: -1.53 to -0.75; Certainty: very low to high) at immediate post-treatment and ranked accordingly. Longitudinal analysis found EMDR (1.02) and CPT (0.85) as the significant therapies with large effect size in short-term and long-term follow-up, respectively. NET and CPT showed higher proportion of loss of PTSD diagnosis (RR range: 5.51-3.45) while there were no significant psychotherapies for retention rate compared to NT. CONCLUSIONS Our findings provide evidence for improving current guidelines and informing clinical decision-making for PTSD management. However, the best PTSD treatment plan should be tailored to patients' needs, characteristics, and clinician expertise. REGISTRATION PROSPERO CRD42020162143.
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Affiliation(s)
- Ninik Yunitri
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Mental Health and Psychiatric Nursing Department, Faculty of Nursing, Universitas Muhammadiyah Jakarta, Indonesia
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Xiao Linda Kang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - Bayu Satria Wiratama
- Department of Biostatistics, Epidemiology and Population Health, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tso-Ying Lee
- Nursing Research Center, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Li-Fang Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Medical Education & Emergency and Critical Care Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Doresses Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum Yogyakarta, Indonesia
| | - Kai-Jo Chiang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- School of Nursing, National Defense Medical Center, Taipei, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Philip Tseng
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taipei, Taiwan
- Brain and Consciousness Research Center, TMU - Shuang Ho Hospital, New Taipei, Taiwan
- Research Center for Mind, Brain & Learning, National Chengchi University, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan
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Sijercic I, Liebman RE, Ip J, Whitfield KM, Ennis N, Sumantry D, Sippel LM, Fredman SJ, Monson CM. A systematic review and meta-analysis of individual and couple therapies for posttraumatic stress disorder: Clinical and intimate relationship outcomes. J Anxiety Disord 2022; 91:102613. [PMID: 35970071 DOI: 10.1016/j.janxdis.2022.102613] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 07/11/2022] [Accepted: 08/04/2022] [Indexed: 10/16/2022]
Abstract
The association between symptoms of posttraumatic stress disorder (PTSD) in adults and difficulties in intimate relationships is well documented. Growing literature suggests that interpersonally-oriented therapies, such as couple and family interventions, may lead to improvements in both PTSD symptoms and intimate relationship functioning. However, it is unknown how individual PTSD treatments compare to couple/family interventions in relational outcomes. The present study was a systematic review and meta-analysis of individual and couple/family treatments to examine changes in PTSD symptoms and intimate relationship functioning. Twelve couple treatment studies with 13 unique samples and 7 individual treatment studies with 9 unique samples met inclusion criteria. No family-based treatments were identified. Meta-analytic findings indicated moderate to large reductions in PTSD symptoms for both couple and individual studies. Small but significant improvements in intimate relationship functioning across individual and couple studies were observed. Moderation analysis suggested that across both individual and couple treatment formats, trauma-focused treatments had larger effects on PTSD symptoms. Trauma-focused treatments had larger effects on intimate relationship functioning for individual studies. Military status did not moderate outcomes. This study supports the utility of both individual and couple treatment formats for treating PTSD and provides preliminary support for these modalities for also enhancing intimate relationship functioning.
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Affiliation(s)
| | - Rachel E Liebman
- Toronto Metropolitan University, Toronto, Canada; University Health Network, Toronto General Hospital, Toronto, Canada
| | - Jennifer Ip
- Toronto Metropolitan University, Toronto, Canada
| | | | - Naomi Ennis
- Toronto Metropolitan University, Toronto, Canada
| | | | - Lauren M Sippel
- National Center for PTSD, USA; Geisel School of Medicine at Dartmouth, NH, USA
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5
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LoSavio ST, Holder N, Wells SY, Resick PA. Clinician Concerns About Cognitive Processing Therapy: A Review of the Evidence. COGNITIVE AND BEHAVIORAL PRACTICE 2022. [DOI: 10.1016/j.cbpra.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Changes in guilt cognitions in intensive PTSD treatment among veterans who experienced military sexual trauma or combat trauma. J Anxiety Disord 2022; 90:102606. [PMID: 35907274 DOI: 10.1016/j.janxdis.2022.102606] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 07/07/2022] [Accepted: 07/14/2022] [Indexed: 11/24/2022]
Abstract
Unresolved trauma-related guilt has been identified as a factor that can intensify posttraumatic stress disorder PTSD symptomology and is associated with many negative mental health outcomes. Evidence-based treatments, such as Cognitive Processing Therapy (CPT), have been shown to successfully reduce trauma-related guilt. However, less is known about how trauma-related guilt cognitions change over the course of PTSD treatment and, more specifically, intensive PTSD treatments. The current study examined whether guilt cognitions (i.e., hindsight bias/responsibility, insufficient justification, wrongdoing) changed over the course of a 3-week CPT-based intensive treatment program (ITP), whether guilt cognition changes predicted PTSD and depression symptom reductions over time, and whether guilt cognition changes and their association with PTSD and depression symptom changes differed based on whether they worked on combat trauma or military sexual trauma. Data were collected from 360 veterans enrolled in a 3-week ITP. Results from linear mixed effects models suggested that trauma-related guilt cognitions reduced significantly over the course of treatment (ps < .001), changes in wrongdoing (p = .032) and hindsight bias/responsibility (p = .003) were significant predictors of PTSD symptom reductions and hindsight bias/responsibility (p = .032) was the only significant predictor of depression symptom reduction. Overall differences in guilt cognitions over time based on cohort type were only significant for insufficient justification (p = .001). These findings suggest that changes in hindsight bias/responsibility demonstrated the largest effect size (d = 0.1.14), implying that hindsight bias/responsibility may be one of the most important guilt cognitions to target. This study also highlights the importance of the relationship between trauma-related guilt and PTSD and depression symptoms. Future research should examine whether changes in guilt cognitions precede changes in PTSD and depression symptoms, and if addressing certain types of guilt cognitions is more important to achieving PTSD and depression symptom reductions.
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7
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Trauma-informed interventions for counselling sex trafficking survivors. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2022. [DOI: 10.1007/s10447-022-09465-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Charbonneau-Lefebvre V, Vaillancourt-Morel MP, Rosen NO, Steben M, Bergeron S. Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia. J Sex Med 2022; 19:479-495. [PMID: 35090839 DOI: 10.1016/j.jsxm.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/24/2021] [Accepted: 12/29/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although distal developmental factors, such as attachment and childhood maltreatment (CM), are associated with the occurrence, severity, and adjustment to provoked vestibulodynia (PVD)-the most prevalent form of vulvodynia-no studies to date have examined whether these variables are related to treatment efficacy in the context of PVD. Attachment and CM may act as moderating variables when examining different treatment modalities, whereby individuals with more insecure attachment orientations (anxiety/avoidance) or a history of CM may benefit less from treatments with higher interpersonal contexts, such as sex and couple therapy-a recommended treatment for PVD. AIM The present randomized clinical trial (RCT) examined attachment and CM as predictors and moderators of sexual satisfaction, distress, and function at post-treatment and 6-month follow-up while comparing 2 treatments for PVD: Topical lidocaine, and a novel cognitive behavioral couple therapy focused on women's pain and partners' sexuality. METHODS One hundred eight women with PVD were randomized to a 12-week treatment of either lidocaine or couple therapy. Women completed questionnaires at pretreatment, post-treatment, and at a 6-month follow-up. OUTCOMES (1) Global Measure of Sexual Satisfaction; (2) Female Sexual Distress Scale-Revised; (3) Female Sexual Function Index. RESULTS Both attachment and CM were significant moderators of treatment outcomes. At either post-treatment or 6-month follow-up, in the couple therapy condition, women with greater attachment avoidance had poorer outcomes on sexual distress, satisfaction and function, whereas women with higher levels of CM had poorer outcomes on sexual satisfaction and sexual function, compared to women in the lidocaine condition. CLINICAL IMPLICATIONS Although these novel findings need further replication, they highlight the importance for clinicians to take into account distal factors, for instance, attachment and CM, when treating sexual difficulties such as PVD, as these variables may affect more interpersonal dimensions of treatment (eg, trust, compliance, etc.) and ultimately, treatment progress. STRENGTHS & LIMITATIONS Using a rigorous RCT study design and statistical approach, this study is the first to examine attachment and CM as moderators in the treatment of sexual difficulties. It is however limited by the use of self-report measures, and further studies are necessary to validate the generalizability of current results to other sexual difficulties. CONCLUSION Findings support the role of interpersonal factors in the treatment of PVD and indicate that short-term psychological interventions, such as couple therapy, may be less beneficial for women with antecedents of CM and attachment insecurity. V Charbonneau-Lefebvre, M-P Vaillancourt-Morel, NO Rosen, et al. Attachment and Childhood Maltreatment as Moderators of Treatment Outcome in a Randomized Clinical Trial for Provoked Vestibulodynia. J Sex Med 2022;19:479-495.
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Affiliation(s)
| | | | - Natalie O Rosen
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Marc Steben
- Department of Social and Preventive Medicine, Groupe de médecine familiale La Cité du Parc Lafontaine, Université de Montréal, Montreal, Canada
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, Montreal, Canada
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9
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Lenz AS, Buckwalter KD, Pester DA, Green K, Reed D. Efficacy of the Developmental Trauma and Attachment Program in a residential setting. JOURNAL OF COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1002/jcad.12419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A. Stephen Lenz
- Department of Counseling Health and Kinesiology at Texas A&M University‐San Antonio San Antonio Texas USA
| | | | - Danielle A. Pester
- Center for the Study of Community Health The University of Alabama at Birmingham Birmingham Alabama USA
| | - Kelly Green
- Chaddock Treatment Center Quincy Illinois USA
| | - Debbie Reed
- Chaddock Treatment Center Quincy Illinois USA
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10
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Abstract
Despite their enormous potential impact on population health and health inequities, police violence and use of excessive force have only recently been addressed from a public health perspective. Moving to change this state of affairs, this article considers police violence in the USA within a social determinants and health disparities framework, highlighting recent literature linking this exposure to mental health symptoms, physical health conditions, and premature mortality. The review demonstrates that police violence is common in the USA; is disproportionately directed toward Black, Latinx, and other marginalized communities; and exerts a significant and adverse effect on a broad range of health outcomes. The state-sponsored nature of police violence, its embedding within a historical and contemporary context of structural racism, and the unique circumstances of the exposure itself make it an especially salient and impactful form of violence exposure, both overlapping with and distinct from other forms of violence. We conclude by noting potential solutions that clinicaly psychology and allied fields may offer to alleviate the impact of police violence, while simultaneously recognizing that a true solution to this issue requires a drastic reformation or replacement of the criminal justice system, as well as addressing the broader context of structural and systemic racism in the USA. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Jordan E DeVylder
- Graduate School of Social Service, Fordham University, New York, NY, USA;
| | - Deidre M Anglin
- Department of Psychology, City College of New York, New York, NY, USA.,Graduate Center, City University of New York, New York, NY, USA
| | - Lisa Bowleg
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA
| | - Lisa Fedina
- School of Social Work, University of Michigan, Ann Arbor, Michigan, USA
| | - Bruce G Link
- School of Public Policy and Department of Sociology, University of California Riverside, California, USA
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11
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Balkin RS, Lenz AS, Russo GM, Powell BW, Gregory HM. Effectiveness of EMDR for decreasing symptoms of over‐arousal: A meta‐analysis. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Richard S. Balkin
- Department of Leadership and Counselor Education University of Mississippi Oxford Mississippi USA
| | - A. Stephen Lenz
- Department of Leadership and Counselor Education University of Mississippi Oxford Mississippi USA
| | - G. Michael Russo
- Department of Leadership and Counselor Education University of Mississippi Oxford Mississippi USA
| | - Brent W. Powell
- Department of Leadership and Counselor Education University of Mississippi Oxford Mississippi USA
| | - Halie M. Gregory
- Department of Leadership and Counselor Education University of Mississippi Oxford Mississippi USA
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12
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Weber M, Schumacher S, Hannig W, Barth J, Lotzin A, Schäfer I, Ehring T, Kleim B. Long-term outcomes of psychological treatment for posttraumatic stress disorder: a systematic review and meta-analysis. Psychol Med 2021; 51:1420-1430. [PMID: 34176532 PMCID: PMC8311818 DOI: 10.1017/s003329172100163x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 02/11/2021] [Accepted: 04/13/2021] [Indexed: 11/15/2022]
Abstract
Several types of psychological treatment for posttraumatic stress disorder (PTSD) are considered well established and effective, but evidence of their long-term efficacy is limited. This systematic review and meta-analysis aimed to investigate the long-term outcomes across psychological treatments for PTSD. MEDLINE, Cochrane Library, PTSDpubs, PsycINFO, PSYNDEX, and related articles were searched for randomized controlled trials with at least 12 months of follow-up. Twenty-two studies (N = 2638) met inclusion criteria, and 43 comparisons of cognitive behavioral therapy (CBT) were available at follow-up. Active treatments for PTSD yielded large effect sizes from pretest to follow-up and a small controlled effect size compared with non-directive control groups at follow-up. Trauma-focused treatment (TFT) and non-TFT showed large improvements from pretest to follow-up, and effect sizes did not significantly differ from each other. Active treatments for comorbid depressive symptoms revealed small to medium effect sizes at follow-up, and improved PTSD and depressive symptoms remained stable from treatment end to follow-up. Military personnel, low proportion of female patients, and self-rated PTSD measures were associated with decreased effect sizes for PTSD at follow-up. The findings suggest that CBT for PTSD is efficacious in the long term. Future studies are needed to determine the lasting efficacy of other psychological treatments and to confirm benefits beyond 12-month follow-up.
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Affiliation(s)
- Maxi Weber
- Division of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - Sarah Schumacher
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
- Department of Psychology, Philips University of Marburg, Marburg, Germany
| | - Wiebke Hannig
- Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University of Marburg, Marburg, Germany
| | - Jürgen Barth
- Institute for Complementary and Integrative Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Munich, Germany
| | - Birgit Kleim
- Department of Psychology, University of Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
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13
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Morina N, Hoppen TH, Kip A. Study quality and efficacy of psychological interventions for posttraumatic stress disorder: a meta-analysis of randomized controlled trials. Psychol Med 2021; 51:1260-1270. [PMID: 33975654 PMCID: PMC8223238 DOI: 10.1017/s0033291721001641] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 03/09/2021] [Accepted: 04/13/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Research indicates that higher study quality may be associated with smaller treatment effects. Yet, knowledge about the association between study quality and treatment efficacy for posttraumatic stress disorder (PTSD) is limited. We aimed at evaluating the efficacy of psychological interventions for adult PTSD and the association between study quality and treatment effects. METHODS We conducted a systematic search to identify randomized controlled trials (RCTs) that examined the efficacy of psychological interventions for chronic PTSD symptoms in adult samples with at least 70% of patients being diagnosed with PTSD by means of a structured interview. We assessed study quality using the following eight criteria from prior research: N ⩾ 50, all patients met criteria for PTSD, a treatment manual was used, therapists were trained, treatment integrity was checked, intent-to-treat analyses were applied, randomization was conducted by an independent party, and treatment outcome was conducted by blind assessors. RESULTS The search resulted in 136 RCTs with 8978 patients. Active treatment conditions were largely effective in reducing PTSD symptoms at posttreatment and follow-up (Hedges' g = 1.09 and 0.81, respectively) when compared to passive control conditions. The comparison to active control conditions at posttreatment and follow-up resulted in medium effect sizes. A total of 14 trials met all study quality criteria and these trials produced large effect sizes when compared to passive control conditions at posttreatment and follow-up. CONCLUSIONS Overall, study quality was not significantly associated with effect size. The findings indicate that psychological interventions can effectively reduce PTSD symptoms irrespective of study quality.
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Affiliation(s)
- Nexhmedin Morina
- Institute of Psychology, University of Münster, Münster, Germany
| | - Thole H. Hoppen
- Institute of Psychology, University of Münster, Münster, Germany
| | - Ahlke Kip
- Institute of Psychology, University of Münster, Münster, Germany
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14
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Fávero M, Moreira D, Abreu B, Del Campo A, Moreira DS, Sousa-Gomes V. Psychological intervention with adult victims of sexual abuse: A comprehensive review. Clin Psychol Psychother 2021; 29:62-80. [PMID: 33844370 DOI: 10.1002/cpp.2598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/09/2022]
Abstract
Child sexual abuse (CSA) is a phenomenon that is ubiquitous to all cultures and social classes. It has short- and long-term consequences, with specific treatment models that have been developed and adapted from psychological intervention models. A wide variety of studies have sought to evaluate the results of treatments with adult CSA survivors. This study presents an overview of research on the treatment of adult victims of CSA, by reviewing the existing literature on the types of treatment and the most studied psychotherapeutic avenues, and reports the findings related to the efficacy of these treatments. It is possible to conclude that psychological intervention exhibits benefits in the reduction of symptoms resulting from the experience of CSA and demonstrates the need to conduct further research on the effectiveness of intervention.
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Affiliation(s)
- Marisalva Fávero
- Social and Behavioral Sciences Department, University Institute of Maia, Maia, Portugal.,Unit I&D of the Justice and Governance Research Center of the Law School, University of Minho (JusGov/UM), Braga, Portugal
| | - Diana Moreira
- Social and Behavioral Sciences Department, University Institute of Maia, Maia, Portugal.,Institute of Psychology and Neuropsychology of Porto - IPNP Health, Porto, Portugal.,Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Porto, Portugal
| | - Beatriz Abreu
- Social and Behavioral Sciences Department, University Institute of Maia, Maia, Portugal
| | - Amaia Del Campo
- Department of Evolutionary and Educational Psychology, University of Salamanca, Salamanca, Spain
| | - Diana Sá Moreira
- Social and Behavioral Sciences Department, University Institute of Maia, Maia, Portugal.,Institute of Psychology and Neuropsychology of Porto - IPNP Health, Porto, Portugal
| | - Valéria Sousa-Gomes
- Social and Behavioral Sciences Department, University Institute of Maia, Maia, Portugal.,Unit I&D of the Justice and Governance Research Center of the Law School, University of Minho (JusGov/UM), Braga, Portugal.,Institute of Psychology and Neuropsychology of Porto - IPNP Health, Porto, Portugal
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15
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Najavits LM, Clark HW, DiClemente CC, Potenza MN, Shaffer HJ, Sorensen JL, Tull MT, Zweben A, Zweben JE. PTSD / substance use disorder comorbidity: Treatment options and public health needs. CURRENT TREATMENT OPTIONS IN PSYCHIATRY 2020; 7:544-558. [PMID: 35444925 PMCID: PMC9017717 DOI: 10.1007/s40501-020-00234-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Purpose of Review Posttraumatic stress disorder (PTSD) commonly co-occurs with substance use disorder (SUD) and is challenging to treat. We review all behavioral therapy models with at least one randomized controlled trial in a current PTSD/SUD population. We identify factors in selecting a model for clinical use, emphasizing a public health framework that balances the need for evidence with the need for feasibility in frontline settings. Recent Findings Seven published models and 6 unpublished models are reviewed. Public health considerations for choosing a model include: whether it's been studied across a broad range of SUDs and in complex SUD patients; whether it can be conducted in group modality; its appeal to patients and providers; its cost; workforce requirements; and its ability to reduce substance use in addition to PTSD. Summary There are two broad types of models: those that originated in the PTSD field versus the SUD field. Overall, the latter are stronger on public health factors and more feasible in SUD settings. Published models in this category include Relapse Prevention, BRENDA, and Seeking Safety. PTSD/SUD research is at an early stage and there is a need for methodology that quantifies "level of burden" (patients' socioeconomic disadvantages) across trials.
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Affiliation(s)
| | | | | | - Marc N Potenza
- Departments of Psychiatry, Child Study and Neuroscience, Yale University School of Medicine
| | | | - James L Sorensen
- Department of Psychiatry and Behavioral Sciences, University of California at San Francisco, Zuckerberg San Francisco General Hospital and Trauma Center
| | | | | | - Joan E Zweben
- University of California, San Francisco, Veterans Affairs Medical Center, San Francisco
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16
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Smout MF, Harris JK, Furber G. Outcome benchmarks for cognitive behaviour therapy delivered by student psychologist training clinics. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Matthew F. Smout
- Centre for Treatment of Anxiety and Depression, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Jodie K. Harris
- Centre for Treatment of Anxiety and Depression, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Gareth Furber
- Health, Counselling and Disability Services, Flinders University, Adelaide, South Australia, Australia
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17
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VanBergen A, Blalock J, Bryant A, Bortz P, Bartle-Haring S. Couples and Trauma History: A Descriptive Overview of Interpersonal Trauma and Clinical Outcomes. CONTEMPORARY FAMILY THERAPY 2020. [DOI: 10.1007/s10591-020-09548-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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18
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Affiliation(s)
- Eunjung Lee
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Kathryn Bowles
- Day and Residential Program, The Jean Tweed Centre, Toronto, Canada
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19
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Abstract
This case study illustrates a short-term cognitive behavioral therapy (CBT) for a refugee single mother of a 4-year-old son to address depression and anxiety symptoms. Although she has histories of multiple trauma experiences such as sexual abuse and intimate partner violence, the client preferred to focus on current difficulties rather than trauma histories. As such, non-trauma-focused CBT utilizing psychoeducation, skill building, activity monitoring and scheduling, and cognitive restructuring is implemented over 10 individual sessions. The client’s progress was measured by the Depression Anxiety Stress Scale (DASS-21), the Quality of Life Enjoyment and Satisfaction Questionnaire–Short Form (Q-LES-Q-SF), and a full-length Columbia-Suicide Severity Rating Scale (C-SSRS) at the intake, midpoint, and last session. The client showed improvement in all measures after the treatment, which corresponded with the client’s verbal reports during the session. This case illustrates the critical clinical decision-making points made by the therapist, and recommends the evidence-based practice protocol that considers empirically supported treatments for the comorbidity of depression and anxiety with multiple trauma experiences, the client preference, and contextual factors in addressing complex clinical presentations.
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20
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Opheim E, Andersen PN, Jakobsen M, Aasen B, Kvaal K. Poor Quality in Systematic Reviews on PTSD and EMDR - An Examination of Search Methodology and Reporting. Front Psychol 2019; 10:1558. [PMID: 31354575 PMCID: PMC6630178 DOI: 10.3389/fpsyg.2019.01558] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/20/2019] [Indexed: 01/01/2023] Open
Abstract
Background: Different user groups regard systematic reviews as reliable and valuable sources for answering research questions. For systematic reviews to fulfill their purpose, methodological quality in all stages are of importance. The studies identified in a systematic search form the basis of the review, thus the search process methodology is important for both performing and reporting the search. The purpose of the present study was to evaluate the quality of non-Cochrane systematic reviews by analyzing how they perform and report the search. This is exemplified by systematic reviews on eye movement desensitization and reprocessing (EMDR), a trauma-focused therapy commonly used for post-traumatic stress disorder (PTSD). Methods and Results: We examined the method chapters of 20 systematic reviews on the subject, and rated their searches and reporting using relevant elements from the Cochrane Handbook and PRISMA. We found inadequacies in the methods employed for searching and reporting the search strategy, which could have been avoided by greater adherence to guiding documents for performing systematic reviews. Conclusion: Our findings raise important questions for future debate on the risk of omitting studies, thus impairing the conclusions in a systematic review. For clinical purposes, researchers should investigate if, and how, the search strategy in a systematic review affects the body of knowledge and the results.
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Affiliation(s)
- Elin Opheim
- Inland Norway University of Applied Sciences, Elverum, Norway
| | | | - Marianne Jakobsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | | | - Kari Kvaal
- Inland Norway University of Applied Sciences, Elverum, Norway
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21
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Holder N, Holliday R, Wiblin J, LePage JP, Surís A. Predictors of dropout from a randomized clinical trial of cognitive processing therapy for female veterans with military sexual trauma-related PTSD. Psychiatry Res 2019; 276:87-93. [PMID: 31030005 DOI: 10.1016/j.psychres.2019.04.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 04/19/2019] [Accepted: 04/21/2019] [Indexed: 12/30/2022]
Abstract
Many veterans do not complete evidence-based treatments (EBTs) for posttraumatic stress disorder (PTSD). Veterans with military sexual trauma (MST)-related PTSD were shown to have higher than average rates of dropout from PTSD treatment in a national study of EBT implementation. Although predictors of dropout from EBTs have been identified, these factors are largely unmodifiable (e.g., age, service era). The purpose of the present study was to identify dynamic psychosocial predictors of dropout among female veterans from cognitive processing therapy (CPT). Data were utilized from 56 female veterans who participated in a randomized clinical trial investigating the effectiveness of CPT for MST-related PTSD. Dropout was defined continuously (i.e., number of sessions attended) and dichotomously (i.e., attending six or more sessions). Potential predictors included sociodemographic factors, psychotherapist fidelity, PTSD-related service connection, psychiatric symptom severity (i.e., PTSD, depression), trauma-related negative cognitions (about self, self-blame, world), and treatment expectations. Higher trauma-related negative cognitions about self-blame and lower trauma-related negative cognitions about self were protective against dropout. The current study generated testable hypotheses for further research on dynamic predictors of dropout from CPT in female veterans with MST-related PTSD. With replication, results may assist with identifying pre-treatment strategies to reduce dropout in this clinical population.
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Affiliation(s)
- Nicholas Holder
- Veterans Affairs North Texas Health Care System, Research Service (151), 4500 S. Lancaster Rd., Dallas, TX 75216, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390, USA.
| | - Ryan Holliday
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, 1700N Wheeling St (G-3-116M), Aurora, CO 80045, USA; University of Colorado Anschutz Medical Campus, Building 500, Mail Stop F546, 13001 East 17th Place, Aurora, CO 80045, USA
| | - Jessica Wiblin
- Veterans Affairs North Texas Health Care System, Research Service (151), 4500 S. Lancaster Rd., Dallas, TX 75216, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390, USA
| | - James P LePage
- Veterans Affairs North Texas Health Care System, Research Service (151), 4500 S. Lancaster Rd., Dallas, TX 75216, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390, USA
| | - Alina Surís
- Veterans Affairs North Texas Health Care System, Research Service (151), 4500 S. Lancaster Rd., Dallas, TX 75216, USA; University of Texas Southwestern Medical Center, Department of Psychiatry, 5323 Harry Hines Blvd., Dallas, TX 75390, USA
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22
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Mahoney A, Karatzias T, Hutton P. A systematic review and meta-analysis of group treatments for adults with symptoms associated with complex post-traumatic stress disorder. J Affect Disord 2019; 243:305-321. [PMID: 30261446 DOI: 10.1016/j.jad.2018.09.059] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/23/2018] [Accepted: 09/16/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND No previous meta-analyses have specifically investigated the effectiveness of psychological group therapy for symptoms associated with complex interpersonal trauma, including whether trauma memory processing (TMP) therapies are superior to psychoeducational approaches alone. METHODS A systematic review identified 36 randomised control trials (RCTs) which were included in the meta-analysis. RESULTS Large significant effect sizes were evident for TMP interventions when compared to usual care for three outcome domains including: PTSD (k = 6, g = -0.98, 95% CI -1.53, -0.43), Depression (k = 7, g = -1.12, 95% CI -2.01, -0.23) and Psychological Distress (k = 6, g = -0.98, 95% CI 1.66, -0.40). When TMP and psychoeducation interventions were directly compared, results indicated a small non-significant effect in favour of the former for PTSD symptoms, (k = 4, g = -0.34, 95% CI -1.05, 0.36) and small non-significant effect sizes in favour of the latter for Depression (k = 3, g = 0.29, 95% CI -0.83, 1.4) and Psychological Distress (k = 6, g = 0.19, 95% CI -0.34, 0.71). LIMITATIONS Heterogeneity and a limited number of high quality RCTs, particularly in the Substance Misuse and Dissociation domains, resulted in uncertainty regarding meta-analytical estimates and subsequent conclusions. CONCLUSIONS Results suggest that TMP interventions are useful for traumatic stress whereas non-TMP interventions can be useful for symptoms of general distress (e.g. anxiety and depression). Thus, both TMP and psychoeducation can be useful for the treatment of complex interpersonal trauma symptoms and further research should unravel appropriate sequencing and dose of these interventions.
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Affiliation(s)
- Adam Mahoney
- Psychology Department, HMP & YOI Cornton Vale, Stirling, UK; School of Health & Social Science, Edinburgh Napier University, UK.
| | - Thanos Karatzias
- School of Health & Social Science, Edinburgh Napier University, UK; Rivers Centre for Traumatic Stress, NHS Lothian, UK
| | - Paul Hutton
- School of Health & Social Science, Edinburgh Napier University, UK
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23
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Lenz AS, Luo Y. Differential Estimation of Treatment Effect Between Clinician-Administered and Self-Reported PTSD Assessments. JOURNAL OF COUNSELING AND DEVELOPMENT 2019. [DOI: 10.1002/jcad.12230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- A. Stephen Lenz
- Department of Counseling and Educational Psychology, Texas A&M University-Corpus Christi
| | - Ye Luo
- Department of Counseling and Educational Psychology, Texas A&M University-Corpus Christi
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24
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Botsford J, Steinbrink M, Steil R, Rosner R, Renneberg B. „Der Wolf im Schafspelz“. PSYCHOTHERAPEUT 2018. [DOI: 10.1007/s00278-018-0317-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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