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Martin S, La Monica C, Soto L, Latocha V. Feldenkrais method and clinical psychology: A systematic literature review exploring the potential of Feldenkrais Method in psychiatric care. Complement Ther Med 2024; 85:103073. [PMID: 39151592 DOI: 10.1016/j.ctim.2024.103073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 06/13/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND In psychotherapy, physical exercise has gained recognition and extensive research attention, displaying promise in various mental health conditions. Practices such as yoga, tai chi, and the Feldenkrais Method® (FM) have also emerged as effective mental health interventions. OBJECTIVES This systematic literature review (SLR) explores the applicability of FM, a somatic practice, in psychiatric care and emotional regulation, as it emphasizes the interplay between bodily sensations, action patterns, and cognitive processes. METHODS Following PRISMA guidelines, a systematic search was conducted across selected databases from 2000 to 2022, identifying 14 articles, including randomized controlled trials, cohort studies, narrative papers, and SLRs. Thematic analysis was conducted. RESULTS The findings indicate global FM adoption, primarily in studies related to pain conditions, musculoskeletal disorders, and neurological disorders. Various measures were used, covering quality of life, psychological dimensions, self-image, self-efficacy, mindfulness, and interoception. However, direct application of FM in psychiatric care remains limited, with few studies addressing psychological issues. This review calls for more comprehensive investigations of FM's potential in psychiatric contexts, advocating precise measures and a dimensional approach to assessing psychological outcomes. CONCLUSION Further research is needed to explore the application of FM in psychiatric care. While existing research suggests potential benefits, especially in enhancing body awareness and emotional regulation, robust studies are necessary to establish its effectiveness in treating specific mental health conditions. This review serves as the foundation for future research into the potential role of FM in enhancing psychiatric care and emotional well-being.
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Affiliation(s)
- Sylvia Martin
- Center for research and bioethics, Uppsala University, Sweden & Psycho.Tcce, Clinical Psychology Private Practice, Montpellier, France.
| | - Clara La Monica
- Center for addiction care, support, and prevention, Association Addictions France, France & Clinical Psychology Private Practice, Le Grau-du-Roi, France
| | - Laura Soto
- Lycée Français de Castilla-y-Leon, Valladolid, Spain
| | - Vladimir Latocha
- Feldenkrais Practitioner, French Feldenkrais Guild (Feldenkrais France), Nancy, France
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Burback L, Brémault-Phillips S, Nijdam MJ, McFarlane A, Vermetten E. Treatment of Posttraumatic Stress Disorder: A State-of-the-art Review. Curr Neuropharmacol 2024; 22:557-635. [PMID: 37132142 PMCID: PMC10845104 DOI: 10.2174/1570159x21666230428091433] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 05/04/2023] Open
Abstract
This narrative state-of-the-art review paper describes the progress in the understanding and treatment of Posttraumatic Stress Disorder (PTSD). Over the last four decades, the scientific landscape has matured, with many interdisciplinary contributions to understanding its diagnosis, etiology, and epidemiology. Advances in genetics, neurobiology, stress pathophysiology, and brain imaging have made it apparent that chronic PTSD is a systemic disorder with high allostatic load. The current state of PTSD treatment includes a wide variety of pharmacological and psychotherapeutic approaches, of which many are evidence-based. However, the myriad challenges inherent in the disorder, such as individual and systemic barriers to good treatment outcome, comorbidity, emotional dysregulation, suicidality, dissociation, substance use, and trauma-related guilt and shame, often render treatment response suboptimal. These challenges are discussed as drivers for emerging novel treatment approaches, including early interventions in the Golden Hours, pharmacological and psychotherapeutic interventions, medication augmentation interventions, the use of psychedelics, as well as interventions targeting the brain and nervous system. All of this aims to improve symptom relief and clinical outcomes. Finally, a phase orientation to treatment is recognized as a tool to strategize treatment of the disorder, and position interventions in step with the progression of the pathophysiology. Revisions to guidelines and systems of care will be needed to incorporate innovative treatments as evidence emerges and they become mainstream. This generation is well-positioned to address the devastating and often chronic disabling impact of traumatic stress events through holistic, cutting-edge clinical efforts and interdisciplinary research.
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Affiliation(s)
- Lisa Burback
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | | | - Mirjam J. Nijdam
- ARQ National Psychotrauma Center, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | | | - Eric Vermetten
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Department of Psychiatry, New York University Grossman School of Medicine, New York, USA
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3
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van de Kamp MM, Scheffers M, Emck C, Fokker TJ, Hatzmann J, Cuijpers P, Beek PJ. Body-and movement-oriented interventions for posttraumatic stress disorder: An updated systematic review and meta-analysis. J Trauma Stress 2023; 36:835-848. [PMID: 37702005 DOI: 10.1002/jts.22968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 09/14/2023]
Abstract
This study is an update of the meta-analysis we published in 2019 on the effectiveness of body- and movement-oriented interventions (BMOIs) for adults with posttraumatic stress disorder (PTSD) in decreasing PTSD symptoms and secondary outcomes of depressive symptoms, sleep disturbance, and interoceptive awareness. Search terms for BMOIs and PTSD were combined to identify eligible studies in four bibliographical databases. Articles were selected if they included adult participants with a primary diagnosis of PTSD, included BMOI as one of the investigated therapies, were designed as a comparative outcome trial with any control condition, and involved a standardized outcome measure for PTSD symptom severity. This resulted in the addition of 14 new studies compared to the 2019 study. The meta-analysis, which included 29 studies in total, resulted in a mean Hedges' g effect size of 0.50, 95% CI [0.22, 0.79], in decreasing PTSD symptoms, with very high heterogeneity, I2 = 89%. Meta-analyses of secondary outcomes resulted in Hedges' g effect sizes of 0.37, 95% CI [0.08, 0.66] for depressive symptoms; 0.62, 95% CI [0.42, 0.81] for sleep quality; and -0.10, 95% CI [-0.23, 0.43] for interoceptive awareness. The risk of bias analysis resulted in some concerns or high risk of bias in almost all included studies; only one study had a low risk of bias. We conclude that BMOIs may be valuable for patients with PTSD. There is, however, still a lack of high-quality studies with proper control conditions and long-term follow-up periods from which to draw conclusions.
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Affiliation(s)
- Minke M van de Kamp
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Mia Scheffers
- School of Health, Movement & Education, Windesheim University of Applied Sciences, Zwolle, the Netherlands
| | - Claudia Emck
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Ties J Fokker
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Janneke Hatzmann
- School of Health, Movement & Education, Windesheim University of Applied Sciences, Zwolle, the Netherlands
| | - Pim Cuijpers
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
| | - Peter J Beek
- Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, the Netherlands
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4
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Greaves-Lord K, Alma M, de Graaff B, Landsman J, van der Weide K, Jagersma G, Beskers T, Wubs M, Mandemaker H, van Daalen E, van der Linde J, Stapert AF, Bekius J, Piening S, Landlust A, van Balkom IDC. Clinical stance on response initiation in autistic adults: co-creating an integrative approach based on theory and lived experiences to act from language, via motor movement to wellbeing. Front Psychol 2023; 14:1229596. [PMID: 37780169 PMCID: PMC10539615 DOI: 10.3389/fpsyg.2023.1229596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 08/09/2023] [Indexed: 10/03/2023] Open
Abstract
Getting 'stuck', literally and figuratively, is a common experience for autistic people. Literally 'stuck' means exhibiting limited response initiation due to immobility with tense muscles and inability to move. Figuratively 'stuck' means loneliness, passivity or captivity in activities that do not offer long-term satisfaction. To further conceptualize this complex phenomenon of limited response initiation in autistic individuals, we performed qualitative interviews and focus groups with autistic people and their family members, followed by brainstorm sessions and a Delphi study with input from a larger panel of experts from multiple backgrounds. We aimed to co-create the outline of an integrative approach to support autistic people in moving away from this 'stuck state' to more flexible, limber 'supple states' in order to live freer, more meaningful, satisfying and peaceful lives. Over time, in interaction with all participants, our shared insight grew. Based on this, we here stipulate a conceptual framework, in which the described 'stuck state' at the micro-level of the muscles/behavior of one individual, probably is caused by feeling/being 'stuck' or 'cramped' at several overarching (i.e., meso and macro) levels. For instance, stuck in relationships with unhealthy dynamics, stuck at home creating short-term calm, trance-like states (e.g., gaming), stuck at an educational level that might fit the individuals' current social-emotional state rather than their potential cognitive level, stuck in a job that pays the bills but does not feel meaningful, nor contributes to a satisfying life with opportunities for personal development. Stuck in a mental/public health care system where ever ongoing changes in policies hinder sustained support to suit care-needs. Stuck in a regulated societal system making it likely to repeatedly get stuck. Is this phenomenon specific to autism? Formally we have only conducted interviews with this population, but in another smaller, related project we also spoke to people from the general population with careers that are considered successful in the general society. These people actually voiced similar experiences. Therefore, we hypothesize that this numbing state of being or feeling 'stuck' may be a prevalent phenomenon that needs to be addressed. In this article, we discuss several types of interventive approaches (i.e., language-based talking therapies, affective experiential expressive therapies, physical therapies and systemic therapies), prevention as well as intervention programs, directed at different primary stakeholders, that can complement and enrich each other in an integrative policy, that leads to tailor-made, personalized trajectories of interdisciplinary support to enable people to live satisfying, meaningful, dignified and peaceful lives.
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Affiliation(s)
- Kirstin Greaves-Lord
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychology, Clinical Psychology and Experimental Psychopathology Unit, University of Groningen, Groningen, Netherlands
| | - Manna Alma
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Benjamin de Graaff
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Jeanet Landsman
- Department of Health Sciences, Applied Health Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Klaske van der Weide
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | | | | | | | | | - Emma van Daalen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, Sophia’s Children’s Hospital, Rotterdam, Netherlands
| | - Joost van der Linde
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Anne Fleur Stapert
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Jeroen Bekius
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
| | - Sigrid Piening
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychiatry, Rob Giel Research Centre, University Medical Center Groningen, Groningen, Netherlands
| | - Annemiek Landlust
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Genetics, University of Groningen, University Medical Centre Groningen, Groningen, Netherlands
| | - Ingrid D. C. van Balkom
- Jonx, Department of (Youth) Mental Health and Autism, Autism Team Northern-Netherlands, Lentis Psychiatric Institute, Groningen, Netherlands
- Department of Psychiatry, Rob Giel Research Centre, University Medical Center Groningen, Groningen, Netherlands
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Vagnini D, Grassi MM, Saita E. Evaluating Somatic Experiencing ® to Heal Cancer Trauma: First Evidence with Breast Cancer Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6412. [PMID: 37510644 PMCID: PMC10380079 DOI: 10.3390/ijerph20146412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/30/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
Somatic Experiencing® is a bio-psychological method for the treatment and prevention of trauma and chronic stress, which has never been investigated with breast cancer (BC) survivors. Eight weeks of web-based synchronous group sessions were structured between April and June 2022. Potential participants were recruited using a convenience sampling approach and through the collaboration of a public hospital in northern Italy and a non-profit association of BC women. Thirty-five eligible participants were enrolled and divided into an intervention group (n = 21) and a control group (n = 14). Anxiety, depression, distress (HADS), coping strategies (Mini-MAC), trauma reworking skills (PACT), and body image (BIS) were assessed at T0 and after 8 weeks (T1). Qualitative items concerning the most significant moments and learnings were completed at T1 by the intervention group. An independent t-test confirmed no between-group psychological differences at T0. As hypothesized, paired-sample t-tests showed decreases in anxiety, depression, distress (p < 0.05), and anxious preoccupation coping strategy (p < 0.001), but also improvements in forward focus (p < 0.05) and body image (p < 0.001) in the intervention group. The controls worsened over time with increases in hopeless/helplessness (p < 0.001) and avoidance (p < 0.05) coping strategies. Textual analyses extracted five dominant themes that summarized the meaning of the experience for participants. The preliminary results suggest the effectiveness of the intervention.
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Affiliation(s)
- Denise Vagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
| | | | - Emanuela Saita
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milan, Italy
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6
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Imach S, Deschler A, Sammito S, Reis M, Michaelis S, Marche B, Paffrath T, Bouillon B, Tjardes T. Performing Advanced Trauma Life Support (ATLS) across Borders: Midterm Follow-Up of the Aeromedical Evacuation after Civilian Bus Accident at Madeira. J Clin Med 2023; 12:4556. [PMID: 37510671 PMCID: PMC10380882 DOI: 10.3390/jcm12144556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
On 17 April 2019, a coach with tourists from Germany crashed in Madeira, requiring repatriation by the German Air Force. The Advanced Trauma Life Support (ATLS) concept was the central component of patient care. Data in Madeira were collected through a structured interview. The analysis of the Aeromedical Evacuation was based on intensive care transport records. In Germany, all available medical data sheets were reviewed for data collection. Quality of life (HRQoL) was evaluated by the 12-item Short Form Health Survey (SF-12). Twenty-eight prehospital patients were transported to the Level III Trauma Center in Funchal (Madeira). Five operative procedures were performed. Fifteen patients were eligible for Aeromedical Evacuation (AE). In the second hospital phase in Germany, in total 82 radiological images and 9 operations were performed. Hospital stay lasted 11 days (median, IQR 10-18). Median follow-up (14 of 15 patients) was 16 months (IQR 16-21). Eighty percent (8 out of 10) showed an increased risk for post-traumatic stress disorder (PTSD). Six key findings were identified in this study: divergent injury classification, impact of AE mission on health status, lack of communication, need of PTSD prophylaxis, patient identification, and media coverage. Those findings may improve AE missions in the future, e.g., when required after armed conflicts.
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Affiliation(s)
- Sebastian Imach
- Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, 51109 Cologne, Germany
| | - Andreas Deschler
- Special Air Mission Wing, Federal Ministry of Defence, 51147 Cologne, Germany
- Department of Anesthesiology, Intensive Care, Emergency Medicine and Pain Therapy, Bundeswehr Central Hospital, 56072 Koblenz, Germany
| | - Stefan Sammito
- Experimental Aerospace Medicine Research, German Air Force Centre of Aerospace Medicine, 51147 Cologne, Germany
- Department of Occupational Medicine, Medical Faculty, Otto von Guericke University, 39106 Magdeburg, Germany
| | - Miguel Reis
- Department of Surgery, Serviço Regional de Saúde da Madeira, 6180 Funchal, Portugal
| | - Sylta Michaelis
- Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, 51109 Cologne, Germany
| | - Beneditk Marche
- Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, 51109 Cologne, Germany
| | - Thomas Paffrath
- Department of Trauma Surgery, Hospital of the Augustinerinnen, 50678 Cologne, Germany
| | - Bertil Bouillon
- Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, 51109 Cologne, Germany
| | - Thorsten Tjardes
- Department of Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), University Witten/Herdecke, 51109 Cologne, Germany
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Utilization of Presence Awareness in Trauma Therapy. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2040049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Trauma can result in many long-term symptoms including emotional dysregulation, depression, addiction, and PTSD. When triggered by trauma, patients typically experience the world through a myopic lens. Helping clients observe and sense their trauma sequelae in the broader sensory awareness of Presence appears to help clients more easily process and resolve traumatic experience. The Presence Psychotherapy Trauma Protocol (PPTP) provides specific open-ended questions in session to help clients orient to Presence Awareness which can then be utilized to resolve trauma. Options to help clients sense their traumatic experience in the expansive awareness of Grounded Presence, Spacious Presence, Relational Presence, or Transcendent Presence create multiple regulating, processing, and attachment healing opportunities. PPTP’s concept of Reflective View is introduced which provides the clinician with prompts to help the client identify who they are as Presence Awareness early in session. This paper demonstrates, through a case example, how Presence Awareness and specifically Reflective View help clients access, tolerate, and process trauma in a broader sense of Presence Awareness.
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Samuel RD, Brom D. Potential Applications of Somatic Experiencing ® in Applied Sport Psychology. JOURNAL OF SPORT PSYCHOLOGY IN ACTION 2022. [DOI: 10.1080/21520704.2022.2119318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
| | - Danny Brom
- METIV The Israel Psychotrauma Center, Jerusalem, Israel
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9
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Rudstam G, Elofsson UO, Söndergaard HP, Bonde LO, Beck BD. Trauma-focused group music and imagery with women suffering from PTSD/Complex PTSD: A randomized controlled study. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2022.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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10
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Exploration of Trauma-Oriented Retreats: Quantitative Changes in Mental Health Measures for Canadian Military Members, Veterans and Royal Canadian Mounted Police with Posttraumatic Stress Disorder and Moral Injury. TRAUMA CARE 2022. [DOI: 10.3390/traumacare2020010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Military members, veterans, and public safety personnel have been noted to have a higher risk of exposure to potentially traumatic events and potentially morally injurious events resulting in operational stress injuries (OSI) such as posttraumatic stress disorder (PTSD) and moral injury (MI). Treatments that can quickly and effectively address these conditions are desperately needed. The purpose of this research was to identify the impact of participation in a non-evidence-based trauma-oriented retreat for the above populations experiencing PTSD and MI. Methods: This study was an embedded mixed-methods longitudinal study with parallel repeated quantitative measures designed to evaluate outcomes at 1, 3, 6, and 12 months after completion of the retreat. Results: Analysis showed a statistically significant reduction in self-reported symptoms of PTSD, anxiety, stress, depression, MI, anger, and emotional dysregulation pre/post-retreat, and an increase in resilience. Self-reported longitudinal results did not see a change in symptom scores, with participants continuing to maintain their clinical diagnoses post-retreat. Conclusions: The results from this study illustrate that trauma-oriented retreats may be a complementary treatment modality for OSI-related conditions but should not be seen as a first-line treatment option. Program evaluation, determination of the evidence-based nature of retreats, and standardization are yet needed.
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Stokar YN, Pat-Horenczyk R. Themes of end-of-life care in memorable cases of medical health professionals: A mixed methods approach. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02566-x] [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]
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12
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Davis AK, Mangini P, Xin Y. Ketamine-assisted psychotherapy for trauma-exposed patients in an outpatient setting: A clinical chart review study. JOURNAL OF PSYCHEDELIC STUDIES 2021. [DOI: 10.1556/2054.2021.00179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Abstract
Trauma exposure across the lifespan produces risks for posttraumatic stress disorder (PTSD), depression, anxiety, as well as global disability in functioning. This retrospective clinical chart review is the first of its kind to assess the utility of sublingual ketamine-assisted body-centered psychotherapy in trauma-exposed patients in a real world clinic setting. De-identified clinical records data on self-reported symptom measures were retrospectively analyzed for patients (N = 18; M
age = 45.22, SD = 12.90) entering ketamine-assisted psychotherapy treatment in an outpatient clinic between 2018 and 2020. Patients who completed six sessions of ketamine therapy reported meaningful (e.g., medium effect size) improvements in PTSD symptoms (P = 0.058; d = −0.48) and global disability in functioning (P = 0.050; d = −0.52) and statistically significant and meaningful improvements in depression (P = 0.019; d = −0.53). There were no improvements in anxiety symptoms. Sublingual ketamine-assisted psychotherapy was associated with heterogenous clinical utility among patients with trauma-exposure in an outpatient setting. This study was underpowered and unrepresentative of the population of ketamine patients in the United States. Replication of these findings is needed with larger and more diverse patient samples.
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Affiliation(s)
- Alan K. Davis
- 1 College of Social Work, Ohio State University, Columbus, OH, USA
- 2 Center for Psychedelic and Consciousness Research, Johns Hopkins University, Baltimore, MD, USA
| | - Pratheek Mangini
- 3 Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Yitong Xin
- 1 College of Social Work, Ohio State University, Columbus, OH, USA
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13
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Treating PTSD with connected breathing: A clinical case study and theoretical implications. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2021. [DOI: 10.1016/j.ejtd.2020.100152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Darnell C. Sexuality, sex therapy & somatics. In bed with the most likely bedfellows. So why aren’t they? SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1882672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Cyndi Darnell
- Independent Sexologist & Practitioner, New York, NY, USA
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15
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Classen CC, Hughes L, Clark C, Hill Mohammed B, Woods P, Beckett B. A Pilot RCT of A Body-Oriented Group Therapy For Complex Trauma Survivors: An Adaptation of Sensorimotor Psychotherapy. J Trauma Dissociation 2021; 22:52-68. [PMID: 32419670 DOI: 10.1080/15299732.2020.1760173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study is a pilot randomized controlled trial that examined the efficacy of a body-oriented group therapy designed to address chronic fear states in the body due to complex trauma. The Trauma and the Body Group (TBG) is a 20-session group psychotherapy that draws upon the principles and techniques of sensorimotor psychotherapy. Thirty-two women with a history of childhood trauma were randomized to immediate treatment or a waitlist control condition. Assessments were conducted one month prior to treatment, immediately after treatment, and six months post-treatment. Significant improvements were found in body awareness, anxiety, and soothing receptivity when comparing treatment to no treatment. The TBG appears to be a valuable tool for helping clients acquire mindfulness and self soothing skills that they can use to reduce posttraumatic symptoms. This study provides preliminary evidence that the TBG provides complex trauma survivors an opportunity to challenge their avoidance of two prominent trauma-related triggers - their bodies and interpersonal relationships - and in so doing may help survivors develop greater body awareness, increase their capacity for self and relational soothing, and reduce their anxiety symptoms.
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Affiliation(s)
- Catherine C Classen
- Department of Psychiatry, University of Toronto , Toronto, Canada.,Women's College Research Institute, Women's College Hospital , Toronto, Canada.,Department of Psychiatry, University of California , San Francisco, USA
| | - Lesley Hughes
- Women's Mental Health Program, Women's College Hospital , Toronto, Canada
| | - Carrie Clark
- Women's Mental Health Program, Women's College Hospital , Toronto, Canada
| | | | - Patricia Woods
- Women's Mental Health Program, Women's College Hospital , Toronto, Canada
| | - Brendan Beckett
- Women's College Research Institute, Women's College Hospital , Toronto, Canada.,Research Analyst Program, Humber College , Toronto, Canada
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Bornemann J, Close JB, Spriggs MJ, Carhart-Harris R, Roseman L. Self-Medication for Chronic Pain Using Classic Psychedelics: A Qualitative Investigation to Inform Future Research. Front Psychiatry 2021; 12:735427. [PMID: 34867525 PMCID: PMC8632941 DOI: 10.3389/fpsyt.2021.735427] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background: Chronic Pain is among the leading causes of disability worldwide with up to 60% of patients suffering from comorbid depression. Psychedelic-assisted therapy has recently been found effective in treating a host of mental health issues including depression and has historically been found to be useful in treating pain. Reports of self-medication for chronic pain using psychedelic drugs have been widely documented, with anecdotal evidence indicating widespread success in a range of pathologies. Aims: In preparation for an upcoming trial, to better understand how those with lived experience of chronic pain self-medicate with psychedelic drugs, and to establish, in detail, their therapeutic protocols and practices for success. Methods: As part of patient-involvement (PI) for an upcoming trial in this population, 11 individuals who reported self-medicating with psychedelic drugs took part in a 1-h semi-structured discussion, which was then transcribed and thematically analyzed. Results: Across a range of psychedelic substances and doses, reported pain scores improved substantially during and after psychedelic experiences. Two processes, Positive Reframing and Somatic Presence, were reliably identified as playing a role in improvements in mental wellbeing, relationship with pain, and physical (dis)comfort. Inclusion of other strategies such as mindfulness, breathwork, and movement were also widely reported. Due to the data's subjective nature, this paper is vulnerable to bias and makes no claims on causality or generalisability. Together, these results have been used to inform study design for a forthcoming trial. Conclusion: This pre-trial PI work gives us confidence to test psychedelic therapy for chronic pain in a forthcoming controlled trial. The results presented here will be instrumental in improving our ability to meet the needs of future study participants.
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Affiliation(s)
- Julia Bornemann
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - James B Close
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Meg J Spriggs
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
| | - Robin Carhart-Harris
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom.,Psychedelics Division, Neurology, Psychiatry and Behavioral Sciences Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Leor Roseman
- Centre for Psychedelic Research, Division of Brain Sciences, Imperial College London, London, United Kingdom
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Kuhfuß M, Maldei T, Hetmanek A, Baumann N. Somatic experiencing - effectiveness and key factors of a body-oriented trauma therapy: a scoping literature review. Eur J Psychotraumatol 2021; 12:1929023. [PMID: 34290845 PMCID: PMC8276649 DOI: 10.1080/20008198.2021.1929023] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The body-oriented therapeutic approach Somatic Experiencing® (SE) treats post-traumatic symptoms by changing the interoceptive and proprioceptive sensations associated with the traumatic experience. Filling a gap in the landscape of trauma treatments, SE has attracted growing interest in research and therapeutic practice, recently. OBJECTIVE To date, there is no literature review of the effectiveness and key factors of SE. This review aims to summarize initial findings on the effectiveness of SE and to outline method-specific key factors of SE. METHOD To gain a first overview of the literature, we conducted a scoping review including studies until 13 August 2020. We identified 83 articles of which 16 fit inclusion criteria and were systematically analysed. RESULTS Findings provide preliminary evidence for positive effects of SE on PTSD-related symptoms. Moreover, initial evidence suggests that SE has a positive impact on affective and somatic symptoms and measures of well-being in both traumatized and non-traumatized samples. Practitioners and clients identified resource-orientation and use of touch as method-specific key factors of SE. Yet, an overall studies quality assessment as well as a Cochrane analysis of risk of bias indicate that the overall study quality is mixed. CONCLUSIONS The results concerning effectiveness and method-specific key factors of SE are promising; yet, require more support from unbiased RCT-research. Future research should focus on filling this gap.
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Affiliation(s)
- Marie Kuhfuß
- Department for Differential Psychology, Personality Psychology and Psychological Diagnostics, University of Trier, Trier, Germany
| | - Tobias Maldei
- Department for Differential Psychology, Personality Psychology and Psychological Diagnostics, University of Trier, Trier, Germany
| | - Andreas Hetmanek
- School of Education, Technical University of Munich(TUM), Munich, Germany
| | - Nicola Baumann
- Department for Differential Psychology, Personality Psychology and Psychological Diagnostics, University of Trier, Trier, Germany
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Ahlmark NG, Dahl A, Andersen HS, Tjørnhøj-Thomsen T, Andersen S. Body therapy versus treatment as usual among Danish veterans with PTSD: Study protocol for a randomised controlled trial combined with a qualitative study. Contemp Clin Trials Commun 2020; 19:100596. [PMID: 32617435 PMCID: PMC7322676 DOI: 10.1016/j.conctc.2020.100596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/05/2020] [Accepted: 06/14/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Many veterans suffer from Post-Traumatic Stress Disorder (PTSD) after returning from military missions. This implies complex physical and psychosocial problems for veterans and their families. Treatment options today are primarily medically and psychologically founded but treatment response is incomplete. Body therapy for PTSD is scarcely researched though subject of increased attention. In 2015, a Danish pilot study was conducted exploring body therapy for PTSD. The study showed positive results and formed basis for a randomised controlled trial. This paper outlines the protocol for this trial. METHODS The intervention will be evaluated in a two-arm randomised controlled trial (1:1). The trial will include 42 veterans with PTSD recruited by the Danish Military Psychiatric Centre. The intervention group receives treatment as usual and weekly body therapy treatment as add-on. The control group receives treatment as usual (TAU). Participants will complete four questionnaires assessing PTSD, depression, quality of life, function level and body awareness: at baseline, and at 3 months, 6 months and 12 months post baseline. Linear regression models and mixed effects models will be used to assess intervention effects. Furthermore, an ethnographic study will examine how the participants experience the treatment and changes in their everyday life. The ethnographic study is based on in-depth interviews, participant observations and focus groups. A mixed method, convergent parallel design will be applied. DISCUSSION This study examines the efficacy of body therapy for veterans with PTSD and how the treatment is experienced and affects daily life. The study will contribute with important knowledge on an alternative treatment for PTSD. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03777800.
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Affiliation(s)
- Nanna Gram Ahlmark
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Anders Dahl
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Henrik Steen Andersen
- Danish Military Psychiatric Center, Capital Region of Denmark, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Tine Tjørnhøj-Thomsen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
| | - Susan Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestræde 6, DK-1455, Copenhagen, Denmark
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Bisson JI, van Gelderen M, Roberts NP, Lewis C. Non-pharmacological and non-psychological approaches to the treatment of PTSD: results of a systematic review and meta-analyses. Eur J Psychotraumatol 2020; 11:1795361. [PMID: 33029330 PMCID: PMC7473142 DOI: 10.1080/20008198.2020.1795361] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/18/2020] [Accepted: 07/02/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Non-pharmacological and non-psychological approaches to the treatment of post-traumatic stress disorder (PTSD) have often been excluded from systematic reviews and meta-analyses. Consequently, we know little regarding their efficacy. OBJECTIVE To determine the effect sizes of non-pharmacological and non-psychological treatment approaches for PTSD. METHOD We undertook a systematic review and meta-analyses following Cochrane Collaboration guidelines. A pre-determined definition of clinical importance was applied to the results and the quality of evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. RESULTS 30 randomised controlled trials (RCTs) of a range of heterogeneous non-psychological and non-pharmacological interventions (28 in adults, two in children and adolescents) were included. There was emerging evidence for six different approaches (acupuncture, neurofeedback, saikokeishikankyoto (a herbal preparation), somatic experiencing, transcranial magnetic stimulation, and yoga). CONCLUSIONS Given the level of evidence available, it would be premature to offer non-pharmacological and non-psychological interventions routinely, but those with evidence of efficacy provide alternatives for people who do not respond to, do not tolerate or do not want more conventional evidence-based interventions. This review should stimulate further research in this area.
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Affiliation(s)
- Jonathan I. Bisson
- National Centre for Mental Health (NCMH), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Marieke van Gelderen
- Department of Psychology, ARQ Centrum 45, Diemen, Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, Netherlands
| | - Neil P. Roberts
- National Centre for Mental Health (NCMH), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Psychology and Psychological Therapies, Cardiff & Vale University Health Board, Cardiff, UK
| | - Catrin Lewis
- National Centre for Mental Health (NCMH), Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
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Andersen TE, Ellegaard H, Schiøttz-Christensen B, Mejldal A, Manniche C. Somatic Experiencing® for patients with low back pain and comorbid posttraumatic stress symptoms - a randomised controlled trial. Eur J Psychotraumatol 2020; 11:1797306. [PMID: 33029333 PMCID: PMC7473216 DOI: 10.1080/20008198.2020.1797306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Low back pain (LBP) and comorbid post-traumatic stress symptoms (PTSS) are common after traumatic injuries, and a high level of PTSS is associated with more severe pain and pain-related disability. Few randomised controlled trials (RCT) exist targeting comorbid PTSS and chronic pain, and only one has assessed the effect of Somatic Experiencing®. OBJECTIVE The aim of this study was to assess the effect of Somatic Experiencing® (up to 12 sessions) + physiotherapeutic intervention (4-8 sessions) (SE+PT) compared with the physiotherapeutic intervention alone (4-8 sessions) (PT) for pain-related disability in LBP with comorbid PTSS. METHODS The study was a two-group RCT in which participants (n = 114) were recruited consecutively from a large Danish Spine Centre. Patients were randomly allocated to either SE+PT or PT alone. Outcomes were collected at baseline before randomisation, 6 and 12-month post-randomisation. The primary outcome was pain-related disability as measured with the modified version of the Roland Morris Disability Questionnaire at 6-month post-randomisation. Secondary outcomes were PTSS, pain intensity, pain-catastrophising, kinesiophobia, anxiety and depression. RESULTS No significant group differences were found on any of the outcomes at any timepoints. Both groups achieved a significant reduction in pain-related disability (20-27%) as measured by the Roland Morris Disability Questionnaire at 6 and 12-month follow up. Also, both groups achieved a small reduction in PTSS. CONCLUSIONS Although significant effects were achieved for both groups, the additional SE intervention did not result in any additional benefits in any of the outcomes.
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Affiliation(s)
| | - Hanne Ellegaard
- Spine Centre of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | | | - Anna Mejldal
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Claus Manniche
- Spine Centre of Southern Denmark, University of Southern Denmark, Odense, Denmark
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Uthaug MV, Lancelotta R, Ortiz Bernal AM, Davis AK, Ramaekers JG. A comparison of reactivation experiences following vaporization and intramuscular injection (IM) of synthetic 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT) in a naturalistic setting. JOURNAL OF PSYCHEDELIC STUDIES 2020. [DOI: 10.1556/2054.2020.00123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
AbstractBackgroundPrevious research suggests a therapeutic potential of 5-methoxy-N,N-dimethyltryptamine (5-MeO-DMT). However, online anecdotal reports have described a phenomenon following cessation of the acute effects of 5-MeO-DMT use which has been termed reactivation (i.e., re-experiencing [“flashback”]). To date, no research has investigated whether different routes of administration may confer different reactivation rates, effects and experiences.AimsWe aimed to assess whether intramuscular injection (IM) and vaporization of 5-MeO-DMT conferred different reactivation rates, changes in satisfaction with life as well as ratings of the experience with ego dissolution and the mystical.MethodsUsing internet-based advertisements, 27 respondents (Mage = 32. SE = 1.43; males = 18; North America = 19) completed an online-based survey.ResultsOf the 14 participants in the IM group, 3 (21%) reported reactivations; in contrast, of the 13 participants in the vaporization group, 9 (69%) reported reactivations. Redosing (more than 1 dose) occurred more frequently in the vaporization group (N = 8) (1–6 times with 3–35 mg of 5-MeO-DMT), relative to the IM group (N = 2) (1–5 times with 5–10 mg of 5-MeO-DMT). All participants in the IM group experienced release of physical tension, compared to 8 participants in the vaporization group. Participants in the IM group reported longer time of onset of acute effects (between 1 and 3 [N = 6] and 4–6 min [N = 6]), relative to the vaporization group where the majority (N = 11) reported a rapid onset of 1–50 s.ConclusionFindings suggest that compared to vaporization, the IM route of administering 5-MeO-DMT is associated with lower and less doses, lower frequencies of reporting reactivation, a higher frequency of physical tension release, and a slower onset of acute effects.
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Affiliation(s)
- Malin V. Uthaug
- 1Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | | | - A. M. Ortiz Bernal
- 3School of Human Ecology, Human Development and Family Studies, University of Wisconsin, Madison, WI, USA
| | - A. K. Davis
- 4College of Social Work, The Ohio State University, Columbus, 43210, OH, USA
- 5Center for Psychedelic and Consciousness Research, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, 21224, MD, USA
| | - Johannes G. Ramaekers
- 1Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
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Trauma-informed care and practice for eating disorders: personal and professional perspectives of lived experiences. Eat Weight Disord 2019; 24:329-338. [PMID: 30565188 DOI: 10.1007/s40519-018-0628-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/11/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Learning about the life stories of patients who have experienced a severe eating disorder (ED), but also traumas that led to PTSD, dissociative disorders, and other comorbidities, has great value to clinicians in their efforts to deliver trauma-informed care (TIC). Many investigators have been researching and writing about these issues for years, and strong scientific evidence has emerged, indicating that trauma is a significant risk factor for the development of EDs, particularly in its bulimic forms. PURPOSE Peer-reviewed literature contains scarce input from people with "lived experiences". Hearing and "sitting with" such individuals are extremely useful in clinical practice and research. Further, encouraging patients to put words to their pain has recognized therapeutic effects. These lived experiences are often demonstrative of key elements of what professionals need to know about evaluating and treating patients with EDs and co-occurring trauma-related disorders. METHOD/RESULTS The principal author invited two courageous recovered ED advocates and writers (June Alexander and Jenni Schaefer), who have gone public about their ED-PTSD experiences, to recount their life stories and treatment experiences (both positive and negative). Dr. Brewerton then offers his professional perspectives on the course of their treatment experiences put in the context of ongoing relevant clinical research. CONCLUSION Their and other patients' experiences have great power to guide professionals toward trauma-informed care, more integrated practice, and theoretically improved outcomes. LEVEL OF EVIDENCE Level V.
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Abstract
PURPOSE OF REVIEW Posttraumatic stress disorder is a chronic, heterogeneous disorder for which a multitude of psychotherapies, pharmaceuticals, and immerging treatment programs are available. Majority of efficacy studies focus on Caucasian male military populations, which may be a reason why not all patients respond to treatment with long-term positive outcomes. Additionally, effects of treatment on symptom clusters have been neglected. This work reviews treatment of PTSD and its symptom clusters exclusively in civilian populations, which have been historically under-examined in the literature. RECENT FINDINGS Exposure therapy stands at the forefront of successful PTSD treatment and offers a more cost-effective solution to pharmacotherapy; however, refugees and patients with comorbid depression may not experience such strong benefits. For exposure therapy and other forms of psychotherapy, non-inferiority studies point to promise of internet-delivered and telemedicine-based methods for reaching populations that may not have access to in-person care. SSRIs are the most widely used pharmaceutical treatment for PTSD; moderate initial benefits are observed yet long-term retention and outcomes may be enhanced by adjunct treatment. Again, refugees are a group that experiences lesser benefit. Research has begun to explore efficacy of treatments for individual symptom clusters, with hyperarousal benefiting most from currently available modalities. Avoidance, intrusion, negative thoughts and beliefs, and dissociation are symptoms requiring more research for focused interventions. Treatment of PTSD has evolved to (1) include equivalent proportions of men and women, along with focused female-exclusive cohorts; (2) explore novel methods of treatment online and in various cultural contexts; and (3) less focus on medication as evidenced by current clinical trials. In addition to further efficacy and safety studies in more diverse ethnic populations, work is needed to examine what therapies are best for targeting specific symptom clusters of PTSD. This research will drive precision treatment, and such research is beginning to point towards underlying mechanisms of pathology and change.
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Holt R, McLean L. Australian Psychotherapy for Trauma Incorporating Neuroscience: Evidence- and Ethics-Informed Practice. NEUROETHICS-NETH 2019. [DOI: 10.1007/s12152-019-09398-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Andersen TE, Ellegaard H, Schiøttz-Christensen B, Manniche C. Somatic experiencing® for patients with low back pain and comorbid posttraumatic stress disorder - protocol of a randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:308. [PMID: 30466429 PMCID: PMC6251218 DOI: 10.1186/s12906-018-2370-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 11/05/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Research has almost exclusively focused on the neck in order to explain the mechanisms of persistent pain after motor vehicle collisions (MVC). However, studies have shown that low back pain after MVC is as common as neck pain. Also, posttraumatic stress disorder (PTSD) is common after MVCs, and evidence indicate that PTSD may be linked to the development of pain and disability. PTSD has even been proposed as "the missing link" for some in the development of chronic low back pain. Unfortunately, PTSD often goes unattended in low back pain rehabilitation and very few randomized controlled studies exists targeting both conditions. Hence, the aim of the present study is to investigate the potential additional effect of the trauma therapy "Somatic Experiencing®" (SE) in addition to physiotherapy (PT) compared to PT alone for patients with chronic low back pain and comorbid PTSD. METHODS The study is a two-group randomized controlled clinical trial in which participants (n = 140) are recruited consecutively from a large Danish spine center in the Region of Southern Denmark, between January 2016 and December 2017. Patients are randomly allocated to one of the two conditions: SE + PT or PT alone. Measurements of effect are carried out at baseline before randomization, post-intervention, 6 and 12 months post-randomization. The primary outcome is a 20% reduction in disability (Rolland Morris Disability Questionnaire) at 6 months post-randomization. Secondary outcomes are: PTSD symptoms, pain intensity, pain-catastrophizing, fear of movement, anxiety and depression. DISCUSSION Comorbid PTSD is currently not targeted in back pain rehabilitation although highly prevalent. If the SE intervention shows to have an additional effect on disability and pain, the study is likely to have a positive impact on the management of chronic low back pain and will have immediate clinical applicability. TRIAL REGISTRATION Current Controlled Trials Registration August 4, 2017: NCT03244046 . Retrospectively registered.
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Affiliation(s)
- Tonny Elmose Andersen
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Hanne Ellegaard
- Spine Centre of Southern Denmark and University of Southern Denmark, Middelfart, Denmark
| | | | - Claus Manniche
- Spine Centre of Southern Denmark and University of Southern Denmark, Middelfart, Denmark
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Levine PA, Blakeslee A, Sylvae J. Reintegrating Fragmentation of the Primitive Self: Discussion of “Somatic Experiencing”. PSYCHOANALYTIC DIALOGUES 2018. [DOI: 10.1080/10481885.2018.1506216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Briggs PC, Hayes S, Changaris M. Somatic Experiencing ® Informed Therapeutic Group for the Care and Treatment of Biopsychosocial Effects upon a Gender Diverse Identity. Front Psychiatry 2018; 9:53. [PMID: 29535648 PMCID: PMC5835108 DOI: 10.3389/fpsyt.2018.00053] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 02/07/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Somatic Experiencing® (SE™) is a resiliency-based treatment for autonomic nervous systems dysregulation syndromes, such as posttraumatic stress disorder, anxiety, depression, and physical syndromes like chronic pain, migraines, and fibromyalgia. "Transgender/gender non-conforming/gender variant" describes people whose gender identity/expression is different, at least part of the time, from the sex assigned at birth. Research indicates transgender individuals have a higher incidence of depression, anxiety, victimization, and discrimination. SE™ tools may support transgender/gender non-conforming individuals to increase resilience in the face of discrimination and social injustice. METHODS This study is a pretest posttest within group (N = 7) pilot study assessing the impact of a 10 session SE™ based group treatment on depression (PHQ-9), anxiety (GAD-7), somatic symptoms (PHQ-15), quality of life (QoL) (WHOQoL-BREF), and coping with discrimination (CDS) for a cohort of seven individuals identifying as transgender/gender non-conforming. Materials were created in collaboration with members of the LGBTQIA community. Care was taken to be inclusive of gender non-conforming identities and culturally responsive in design. RESULTS Participants described their gender identities as: non-binary, female to male, male to female, and gender fluid. Participants had significant increase in psychological QoL (psychological well-being) (WHOQoL-BREF) p = 0.004, SD = 2.31, with a modest effect size of d = 0.71. Some likely impacts of historical effect discussed. No other clinical or QoL outcomes were statistically significant. However, one outlier was identified in the dataset. When this outlier was excluded there was a trend toward significant reduction in depression symptoms (PhQ-9) p = 0.097, SD = 3.31 and a modest effect size of d = 0.68; somatic symptoms (PhQ-15) p = 0.093, SD = 3.52 and a modest effect size of d = 0.72. CONCLUSION These data indicate that a brief 10 session intervention of SE™ could have a meaningful impact on symptoms of depression, somatization, and QoL for gender non-conforming individuals. Further research is warranted. LIMITATIONS First, this study has a small sample size limiting statistical power and generalizability. Second is a history effect. Less than 1 week prior to final data collection, there was a significant hate-motivated act in Florida targeting the LGBTQIA community.
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Affiliation(s)
| | - Sage Hayes
- Embodied Liberation, South Portland, ME, United States
| | - Michael Changaris
- Integrated Health Psychology Training Program, Wright Institute, Berkeley, CA, United States
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Winblad NE, Changaris M, Stein PK. Effect of Somatic Experiencing Resiliency-Based Trauma Treatment Training on Quality of Life and Psychological Health as Potential Markers of Resilience in Treating Professionals. Front Neurosci 2018; 12:70. [PMID: 29503607 PMCID: PMC5820455 DOI: 10.3389/fnins.2018.00070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 01/29/2018] [Indexed: 12/18/2022] Open
Abstract
Background: Individuals who treat trauma are at significant risk of vicarious traumatization and burnout. Somatic Experiencing® (SE®) is a resiliency-focused trauma treatment modality designed to address autonomic nervous system (ANS) dysregulation and its impacted physical health and mental health symptoms e.g., anxiety, depression, post-traumatic stress disorder, migraines, fibromyalgia, and chronic fatigue, etc. The SE® training supports the development of clinical skills to reduce physical health/mental health symptoms as well as increase clinician resilience. Individuals who display resilience often have increased experiences of well-being (quality of life) and decreased levels of self-reported psychological symptoms. Greater resilience could mitigate the risks to providers and the clients they treat. Materials and Methods: This within-groups, longitudinal study assessed students (N = 18) over the course of a 3-year SE® practitioner training. This training focuses on increased ANS, physical, and emotional regulation skills. The convenience of a web-based survey allowed for: measures of a general quality of life (WHOQOL-BREF), psychological symptoms, somatic, anxiety, and depressive symptoms (PHQ-SADS), as well as a measure of early life exposure to adversity (CDC/Kaiser Permanente ACE Score Calculator Questionnaire). The clinician survey was conducted yearly for 3 years. Future studies would do well to also include laboratory-based objective measures of ANS functioning. Results: ANOVA with repeated measures showed that there were significant reductions in anxiety symptoms (GAD7, p < 0.001) and somatization symptoms (PHQ15, p < 0.001). Health-related quality of life (a measure of physical well-being) and social quality of life (a measure of interpersonal well-being) both increased significantly (Health QoL p = 0.028; Social QoL p = 0.046). Conclusions: Results suggest that professionals attending the 3-year SE® training course experience a significant improvement in self-reported measures associated with resiliency including: quality of life (well-being) and psychological symptoms (anxiety and somatization). Our results support the importance of future research in a larger sample and support the exploration, cross-sectionally and prospectively, of the relationship of clinician resiliency and changes in clinician resiliency with SE® training and clinical outcomes. These data have implications for other professions at risk of exposure to vicarious trauma (VT) including nurses, medical providers, and paramedics.
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Affiliation(s)
- Neal E Winblad
- Private Pracitce Truama and Developmental Trauma Specialist, Pleasanton, CA, United States
| | - Michael Changaris
- Health Psychology Department, Integrated Health Psychology Training Program, The Wright Institute, Berkeley, CA, United States
| | - Phyllis K Stein
- Heart Rate Variability Laboratory, Cardiovascular Division John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
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