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Linden M, Muschalla B. Emphatic Memories and Their Meaning in Societal and Legal Contexts: A Narrative Review and Position Paper. Psychopathology 2024; 57:444-450. [PMID: 38972313 DOI: 10.1159/000539240] [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: 12/30/2023] [Accepted: 05/02/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Many past and ongoing conflicts in the world are associated with memories. The role of emphatic memories is however often neglected in conflict solving. Therefore, this narrative review gives a short introduction to the phenomenon of emphatic memories and implications for counteracting dysfunctional effects of emphatic memories. SUMMARY Memory has two connotations. One is remembering and knowing (I can remember when I got married) and on the other is reminding and emphasizing memories (I remind my partner of our wedding day). Memories are less a report on the past but result of current emotions and motives. Emphatic memories serve for self-portrayal and distinction from others, self-exculpation, accusation of others, justification of claims. They are regularly reproachful, have an aggressive character, and are distorted and pseudologic. This is also true on a societal level, as memories are used for defining social groups, and by this for political purposes, in order to juxtapose one group against the other. If memories are revoked, they are regularly accompanied with the very emotions, which were associated with the past event. Corresponding behavior is motivated. Many people suffer from memories and associated emotions and dysfunctional behavior, as is well described in the context of post-traumatic stress disorders. Also, social groups can as a whole suffer from negative emotions because of memories, which may go back up to thousand years. To ensure that memories do not adversely affect individuals and social groups, they should best be forgotten, or at least rescripted, in a way that they are disentangled from negative emotions and motives. An important psychological process in this regard is wisdom and forgiveness, which must not be confused with understanding, justification, tolerating, or reconciliation. Wisdom and forgiveness allow persons to close the books, act self-determined, find freedom from external events, and end suffering because of the past. It is a rational and emotional act. KEY MESSAGES Emphatic memories can cause that individuals and groups do not find peace and persistently provoke new conflicts. Internal and interactional peace can be found if memories are let alone and fade away. Forgiveness and wisdom describe avenues to let dysfunctional memories go.
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Affiliation(s)
- Michael Linden
- Psychosomatic Clinic, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Beate Muschalla
- Psychotherapy and Diagnostics Unit, Technische Universität Braunschweig, Braunschweig, Germany
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Wang CC, Difede J. A Two-Phased Telehealth Model to Treat Post-Traumatic Stress Disorder in a Health Care Worker due to the COVID-19 Pandemic: A Case Report. Telemed J E Health 2024; 30:601-606. [PMID: 37585569 DOI: 10.1089/tmj.2023.0326] [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] [Indexed: 08/18/2023] Open
Abstract
Background: We report a case describing the use of a two-step telehealth intervention to treat symptoms of post-traumatic stress disorder (PTSD) that developed in a frontline health care worker (HCW) during the COVID-19 pandemic. HCWs are at increased risk of adverse psychological outcomes, including PTSD, due to the nature of their work, which has been exacerbated by the global pandemic. Methods: This case represents the first successfully completed participant in a larger ongoing trial to address psychological distress, PTSD, and comorbidities in HCWs consequent to the COVID-19 pandemic. Following a two-step intervention of self-directed narrative writing delivered entirely online followed by prolonged exposure therapy using videoconferencing, the HCW displayed significant improvement in symptoms of PTSD, depression, anxiety, and substance use. Results: The treatment model described here offers preliminary support for a two-step remote delivery approach to meet the need for scalable self-directed distance technology-based mental health interventions for HCWs. This study is registered on clinicaltrials.gov (NCT04626050).
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Affiliation(s)
- Crystal C Wang
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
| | - JoAnn Difede
- Department of Psychiatry, Weill Cornell Medical College, New York, New York, USA
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Hirai M, Dolma S, Vernon LL, Clum GA. Temporal Associations Between Posttraumatic Stress Symptoms and Depression in Response to Online Expressive Writing Interventions in a Hispanic Sample. Behav Ther 2023; 54:170-181. [PMID: 36608974 DOI: 10.1016/j.beth.2022.08.001] [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: 07/10/2021] [Revised: 06/18/2022] [Accepted: 08/02/2022] [Indexed: 01/11/2023]
Abstract
Some expressive writing (EW) interventions targeting posttraumatic stress symptoms (PTSS) may reduce both PTSS and comorbid depression symptoms. The temporal associations between PTSS and depression symptom levels in response to EW interventions are unknown. This study examined the directionality of PTSS and depression symptom levels from baseline to 1-week, 1-month, and 3-month follow-ups of two online EW interventions in a Hispanic sample with diverse trauma experiences. Participants (n = 70) completed either emotion-focused or fact-focused writing for 3 consecutive days online. A manifest autoregressive model with cross-lagged effects and treatment condition was analyzed. All but one first-order autoregressive path were statistically significant, with later PTSS and depression scores significantly predicted by those scores at preceding time points. The cross-lagged effects findings suggest that earlier PTSS levels influenced later depression levels, but earlier depression did not influence later PTSS, demonstrating a unidirectional temporal association. Severe PTSS may hinder EW treatment gains in depression. Superior outcomes for emotion-focused writing relative to fact-focused writing were also found.
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The experience of south Korean railroad drivers exposed to "person under train" incidents: A qualitative study. Arch Psychiatr Nurs 2022; 41:188-194. [PMID: 36428047 DOI: 10.1016/j.apnu.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 05/28/2022] [Accepted: 07/03/2022] [Indexed: 11/24/2022]
Abstract
A "person under train" (PUT) incident is a suicidal action involving a person throwing themselves at a moving train. This may cause trauma, including post-traumatic stress disorder (PTSD), to railroad drivers. This study investigated the experiences of railroad drivers of a PUT incident. Data were obtained from two drivers through in-depth interviews and personal narratives regarding their PUT experience and personal lives after the incident. Expressing thoughts through writing was an effective intervention that provided insights into their experience. Thus, an educational program combining mental health management and PTSD treatment is recommended for workers who experience such trauma.
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Abstract
Finding healing and improved communication through imagining another's perspective.
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Affiliation(s)
- Mark Darby
- Mark Darby is an instructor and codirector of the Creative Writing Project at University of Nebraska Medical Center (UNMC) College of Nursing in Omaha, and clinical director at North Omaha Area Health. Mary C. Petersen is an instructor and codirector of the Creative Writing Project at UNMC College of Nursing. Amelia Stoltman is an administrator and Margaret Gilmore is a project researcher at UNMC College of Nursing. Contact author: Mark Darby, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Levis M, Ludmer DJ, Shiner B. Self-guided online therapeutic assessment in substance abuse care: A Conflict Analysis implementation and feasibility case study. COMPUTERS IN HUMAN BEHAVIOR REPORTS 2022; 6:10.1016/j.chbr.2022.100178. [PMID: 39055610 PMCID: PMC11271748 DOI: 10.1016/j.chbr.2022.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
"Michael" is a 60-year-old Black male receiving substance abuse treatment at a Veterans Affairs hospital. As part of Michael's care, he participated in an implementation and feasibility trial evaluating Conflict Analysis (CA), a self-guided online therapeutic assessment. CA leverages innovative diagnostic and therapeutic resources to improve client engagement and therapeutic achievement. CA employs narrative formats, encouraging patients to frame experiences within personal vocabulary, and provides personalized feedback automatically extracted from patient responses. CA is self-guided, widely accessible, and has few costs. Paper presents Michael's protocol, associated therapeutic outcome measures, and psychologist's evaluation of CA benefits. Michael completed brief online CA deployment containing a wellness-based personality inventory, four narrative tasks, and an interactive feedback template. Michael completed insight, stress, depression, wellbeing, and perceived diagnostic and therapeutic benefit measures at baseline, post, and three-week follow-up. Interventions took 2.5 h. Attending psychologist reviewed CA protocols and completed diagnostic and therapeutic questionnaires. Michael's record identifies elevated dominance. Protocol highlights Michael's drinking as mechanism to lessen social anxieties, anger, and competitiveness. Results suggest CA encouraged increased motivation to change, treatment engagement, and reduced depression. Psychologist rated benefit at maximum threshold. Implications include improving assessment efficacy, increasing online care opportunities, and expanding CA research.
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Affiliation(s)
- Maxwell Levis
- Veterans Affairs Medical Center, White River Junction, VT, USA
- Department of Psychiatry, Geisel School of Medicine, Hanover, NH, USA
| | - Dana J. Ludmer
- Clinical Psychology, Antioch University of New England, Keene, NH, USA
| | - Brian Shiner
- Veterans Affairs Medical Center, White River Junction, VT, USA
- Department of Psychiatry, Geisel School of Medicine, Hanover, NH, USA
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Karakurt G, Koç E, Katta P, Jones N, Bolen SD. Treatments for Female Victims of Intimate Partner Violence: Systematic Review and Meta-Analysis. Front Psychol 2022; 13:793021. [PMID: 35185725 PMCID: PMC8855937 DOI: 10.3389/fpsyg.2022.793021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/03/2022] [Indexed: 01/14/2023] Open
Abstract
Intimate partner violence (IPV) is an important problem that has significant detrimental effects on the wellbeing of female victims. The chronic physical and psychological effects of intimate partner violence (IPV) are complex, long-lasting, chronic, and require treatments focusing on improving mental health issues, safety, and support. Various psycho-social intervention programs are being implemented to improve survivor wellbeing. However, little is known about the effectiveness of different treatments on IPV survivors' wellbeing. For this purpose, we conducted a systematic review and meta-analysis to assess the effectiveness of interventions on improving outcomes that describe the wellbeing of adult female survivors of IPV. We searched PubMed, PsycINFO, and Cochrane Library. We explored the effectiveness of available interventions on multiple outcomes that are critical for the wellbeing of adult female victims of IPV. To provide a broad and comprehensive view of survivors' wellbeing, we considered outcomes including mental health, physical health, diminishing further violence, social support, safety, self-efficacy, and quality of life. We reviewed 2,770 citations. Among these 25 randomized-controlled-study with a total of 4,683 participants met inclusion criteria. Findings of meta-analyses on interventions indicated promising results in improving anxiety [standardized mean difference (SMD) -7.15, 95% confidence interval (CI) -8.39 to -5.92], depression (SMD -0.26, CI -0.56 to -0.05), safety (SMD = 0.43, CI 0.4 to -0.83), violence prevention (SMD = -0.92, CI -1.66 to -0.17), health (SMD = 0.39, CI 0.12 to 0.66), self-esteem (SMD = 1.33, CI -0.73 to 3.39), social support (SMD =0.40, CI 0.20 to 0.61), and stress management (SMD = -8.94, CI -10.48 to -7.40) at the post-test. We found that empowerment plays a vital role, especially when treating depression and Post-Traumatic Stress Disorder (PTSD), which are difficult to improve across interventions. We found mixed findings on self-efficacy and quality of life. The effects of IPV are long-lasting and require treatments targeting co-morbid issues including improving safety and mental health issues.
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Affiliation(s)
- Günnur Karakurt
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, United States
| | - Esin Koç
- Department of Psychology, Başkent University, Ankara, Turkey
| | - Pranaya Katta
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, United States
| | - Nicole Jones
- Department of Psychiatry, University Hospitals Cleveland Medical Center, Cleveland, OH, United States
| | - Shari D. Bolen
- Population Health Research Institute, MetroHealth Medical Center, Cleveland, OH, United States
- Center for Health Care Research and Policy, Case Western Reserve University at the MetroHealth Medical Center, Cleveland, OH, United States
- Department of Medicine, MetroHealth Medical Center, Cleveland, OH, United States
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH, United States
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Levis M, Ludmer DJ, Cornelius S, Scott R, Watts BV, Shiner B. An implementation and effectiveness study evaluating Conflict Analysis in VA residential substance abuse services: Whole Health informed self-guided online care. Explore (NY) 2022; 18:688-697. [DOI: 10.1016/j.explore.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 11/16/2022]
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Levis M, Levis A. Contrasting narratives: a randomised control study comparing Conflict Analysis and narrative disclosure. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2021. [DOI: 10.1080/03069885.2021.1970111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Maxwell Levis
- White River Junction VA Medical Center, Hartford, VT, USA
- Psychiatry Department, Dartmouth College, Hanover, NH, USA
- Museum of the Creative Process, Manchester, VT, USA
| | - Albert Levis
- Museum of the Creative Process, Manchester, VT, USA
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Writing Technique Across Psychotherapies-From Traditional Expressive Writing to New Positive Psychology Interventions: A Narrative Review. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2021; 52:23-34. [PMID: 34538888 PMCID: PMC8438907 DOI: 10.1007/s10879-021-09520-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2021] [Indexed: 11/09/2022]
Abstract
Writing Therapy (WT) is defined as a process of investigation about personal thoughts and feelings using the act of writing as an instrument, with the aim of promoting self-healing and personal growth. WT has been integrated in specific psychotherapies with the aim of treating specific mental disorders (PTSD, depression, etc.). More recently, WT has been included in several Positive Interventions (PI) as a useful tool to promote psychological well-being. This narrative review was conducted by searching on scientific databases and analyzing essential studies, academic books and journal articles where writing therapy was applied. The aim of this review is to describe and summarize the use of WT across various psychotherapies, from the traditional applications as expressive writing, or guided autobiography, to the phenomenological-existential approach (Logotherapy) and, more recently, to the use of WT within Acceptance and Commitment Therapy (ACT). Finally, the novel applications of writing techniques from a positive psychology perspective will be analyzed. Accordingly, the applications of WT for promoting forgiveness, gratitude, wisdom and other positive dimensions will be illustrated. The results of this review show that WT yield therapeutic effects on symptoms and distress, but it also promotes psychological well-being. The use of writing can be a standalone treatment or it can be easily integrated as supplement in other therapeutic approaches. This review might help clinician and counsellors to apply the simple instrument of writing to promote insight, healing and well-being in clients, according to their specific clinical needs and therapeutic goals.
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Orap MO. Involuntary narratives of decreasing anxiety in breast cancer patients: Study in Ukraine. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Maryna O. Orap
- Department of Psychology Ternopil Volodymyr Hnatiuk National Pedagogical University Ternopil Ukraine
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Levis M, Levis AJ. Contextual assessment: evaluating a novel self-guided online therapeutic assessment. Int J Psychiatry Clin Pract 2021; 25:206-215. [PMID: 32701050 PMCID: PMC11151187 DOI: 10.1080/13651501.2020.1794010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 05/20/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Paper introduces Conflict Analysis (CA), an online self-guided therapeutic assessment. CA combines a diagnostic self-report scale with narrative exercises and self-analytical tasks. CA automatically generates detailed diagnostic records and frameworks for changes. OBJECTIVE To evaluate therapeutic and diagnostic benefits associated with CA over time. METHODS This online study compared CA over 2 weeks on outcome measures predicting psychotherapy outcome. Novel scale measuring perceived diagnostic benefit and perceived therapeutic benefit was delivered at post and follow-up. Cohort (n = 59, average age = 35, 50% female) was either in therapy or interested to start therapy in near future. RESULTS Repeated-measure ANOVAs suggest that scores significantly changed on measures predicting negative affect, depression, performance and appearance self-esteem, insight, and growth initiative. Agreement rates on items measuring perceived diagnostic and therapeutic benefits were at least 74.5% for both post and follow-up. CONCLUSIONS Evidence supports further exploration of CA as a self-guided diagnostic and therapeutic resource.Key pointsResults demonstrate feasibility and utility of online self-guided therapeutic assessment.Described model is associated with increased perceived diagnostic and therapeutic benefits.Described model illustrates therapeutic benefits over time.Results demonstrate that even self-guided assessment can have therapeutic implications.
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Affiliation(s)
- Maxwell Levis
- White River Junction VA Medical Center, White River Junction, VT, USA
- Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, NH, USA
- Museum of the Creative Process, Manchester, VT, USA
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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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Primary care community engagement – delivery of an enhanced and brief homogeneous group TF-CBT intervention for trauma from a single-incident road traffic accident: a case study. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The main current intervention for post-traumatic stress disorder (PTSD) in adult primary care is individual trauma-focused cognitive behavioural therapy (TF-CBT). Group TF-CBT for PTSD has been advocated in order to improve access and cost. Barriers to the development of group TF-CBT include the need for a large number of sessions and therapist input in order to manage high levels of affect, possible dissociation and secondary traumatisation. This case study was prompted via our community engagement project when local women who had been involved in a single road traffic accident requested group therapy. The aim was to develop a NICE guideline-compliant brief 8-session group TF-CBT intervention that circumvented the above-mentioned barriers and is described in detail. In order to improve access, the group was delivered in the community. Standard and PTSD-specific measures were administered pre-therapy and post-therapy. Eight clients were offered treatment: two dropped out and six completed treatment. At the end of treatment, 3/6 clients attained reliable improvement in their PTSD symptoms. Two of these three clients also reached recovery. This change was maintained at 3-month follow-up where 4/6 clients attained reliable improvement, with three maintaining recovery. The remaining two clients showed minimal change in their PTSD symptoms. Overall, clients reported high-level satisfaction with the treatment protocol. This case study demonstrates a potentially clinically effective and cost-effective group TF-CBT intervention for non-complex single-incident PTSD.
Key learning aims
It is hoped that the reader of this case study will increase their understanding of the following:
(1)
Use of a brief group TF-CBT protocol to treat homogeneous single incident trauma in adults.
(2)
Adaptations to overcome barriers to group TF-CBT in adults.
(3)
Implementation of individualised reliving based on written-narrative rather than spoken-narrative.
(4)
Focus on the processes of PTSD, whilst using content as a theme to contextualise the symptoms.
(5)
Emphasis on the use of homework in order to enhance group affect-modulation and individual learning.
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Hirai M, Dolma S, Vernon LL, Clum GA. A longitudinal investigation of the efficacy of online expressive writing interventions for Hispanic students exposed to traumatic events: competing theories of action. Psychol Health 2020; 35:1459-1476. [DOI: 10.1080/08870446.2020.1758324] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Michiyo Hirai
- University of Texas Rio Grande Valley, Edinburg, TX, USA
| | | | | | - George A. Clum
- Virginia Polytechnic Institute and State University, Blacksburg, VA, USA
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Steele E, Wood DS, J Usadi E, Applegarth DM. TRR's Warrior Camp: An Intensive Treatment Program for Combat Trauma in Active Military and Veterans of All Eras. Mil Med 2019; 183:403-407. [PMID: 29635563 DOI: 10.1093/milmed/usx153] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Indexed: 11/13/2022] Open
Abstract
Effective treatments for combat trauma in military service members exist, but barriers to care abound, including poor access, stigma, and dropout. Although the effects of post-traumatic stress disorder (PTSD) can be severe, recovery is possible when proper treatment is implemented. Trauma and Resiliency Resources, Inc.'s Warrior Camp (WC) program is designed to address the effects of combat trauma in military service members and veterans. This intensive, 7-d treatment incorporates eye movement desensitization and reprocessing therapy, equine-assisted psychotherapy, yoga, and narrative writing in context of community. This single-group pretest-posttest design included paired t-tests and effect size analyses for 85 participants of WC. Outcome measures included the Mississippi Scale for Combat-related PTSD, the Patient Health Questionnaire, the Revised Adult Attachment Scales, and the Moral Injury Events Scale. Clinician-administered measures included the Davidson Trauma Scale and the Dissociative Experiences Scale. All measures showed statistically significant reductions in distress. The effect sizes ranged from small to large. Results suggest that WC participants experienced significant improvement in PTSD, depression, moral injury, dissociation and adult attachment. Clinicians should consider the potential benefits of this short-term, intensive treatment when addressing combat-related PTSD among military service members and veterans.
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Affiliation(s)
- Emily Steele
- School of Social Work, Brigham Young University, 2190 JFSB, Provo, UT 84602
| | - David S Wood
- School of Social Work, Brigham Young University, 2190 JFSB, Provo, UT 84602.,Utah Army National Guard, 17800 Camp Williams Road, Bluffdale, UT 84065
| | - Eva J Usadi
- Trauma and Resiliency Resources, Inc., 26 West 9th Street, Suite 5-E, New York, NY 10011
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Kim J, Hartzell G, Dawson V, Furman A. Teaching Trauma and Narrative: Using Salinger's For Esmé-with Love and Squalor. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2017; 41:737-740. [PMID: 28597410 DOI: 10.1007/s40596-017-0727-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 05/07/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Jungjin Kim
- Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Andrew Furman
- Emory University School of Medicine, Atlanta, GA, USA.
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Pérez S, Peñate W, Bethencourt JM, Fumero A. Verbal Emotional Disclosure of Traumatic Experiences in Adolescents: The Role of Social Risk Factors. Front Psychol 2017; 8:372. [PMID: 28352242 PMCID: PMC5348519 DOI: 10.3389/fpsyg.2017.00372] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 02/27/2017] [Indexed: 12/04/2022] Open
Abstract
It is well-known that traumatic events and adverse life situations are very important in both physical and psychological health. Prevalence studies suggested that adolescents experience at least one potentially traumatic event before reaching age 18. The paradigm of research centered on expressive writing has evidenced the beneficial effects that the emotional disclosure of previous traumas produces on physical health and psychological adjustment. The aims of the study are threefold: determining the prevalence of adverse or traumatic events; examining the extent to which psychopathological symptoms developed in those exposed to traumatic events; and exploring an verbal emotional disclosure (VED) paradigm in which variations on time spent talking about traumatic experiences to others resulted in a reduction of the psychological impact of trauma in a sample of Spanish adolescents. 422 volunteer adolescents participated, 226 boys and 192 girls, from 10 to 19 years old, all of them living in Tenerife. The mean age was 14.8 years (SD = 1.83). All of them completed the instruments used to assess the psychological impact of traumatic experiences and VED. The main results indicated that 77% of the participants had suffered a traumatic situation. The participants who have been exposed to traumatic events scored significantly higher in measures of post-traumatic stress, disorder, intrusive thoughts, avoidance behaviors, anxiety and depression, compared to those without trauma. Furthermore, results show a decrease in symptomatology scores as a function of time spent disclosing emotional experiences to others, particularly when disclosure occurred several times. In conclusion, stressful events or traumatic experiences and their concomitant emotional effects are highly prevalent in adolescents, and repeated VED to others appears to ameliorate their impact. VED shows greater therapeutic benefits when adolescents narrate the experience on several occasions and in an extensive way.
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Affiliation(s)
- Silvia Pérez
- Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna La Laguna, Spain
| | - Wenceslao Peñate
- Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna La Laguna, Spain
| | - Juan M Bethencourt
- Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna La Laguna, Spain
| | - Ascensión Fumero
- Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna La Laguna, Spain
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Matthieu MM, Lawrence KA, Robertson-Blackmore E. The impact of a civic service program on biopsychosocial outcomes of post 9/11 U.S. military veterans. Psychiatry Res 2017; 248:111-116. [PMID: 28039802 PMCID: PMC5250576 DOI: 10.1016/j.psychres.2016.12.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Revised: 12/19/2016] [Accepted: 12/22/2016] [Indexed: 11/30/2022]
Abstract
Volunteering as a health promotion intervention, improves physical health, mental health, and social outcomes particularly in older adults, yet limited research exists for veterans. We conducted a preliminary study to explore whether volunteering impacts a variety of biopsychosocial outcomes, including symptoms of post-traumatic stress disorder (PTSD) and depression, among returning military veterans from Iraq and Afghanistan. A survey enrolling a prospective cohort of United States (U.S.) veterans who served in the military after 11 September 2001 and who participated in a national civic service program was conducted. A total of 346 veterans completed standardized health, mental health, and psychosocial self-report measures before and after the program. Statistically significant differences were detected in overall health rating, level of emotional difficulty, PTSD and depression symptoms, purpose in life, self-efficacy, social isolation, and the perceived availability of social support at program completion. Screening positive for probable PTSD predicted improved perceived self-efficacy while probable depression predicted a decrease in loneliness, an increase in purpose in life, and an increase in perceived social support, at program completion. Volunteering was associated with significant improvements in health, mental health and social outcomes in returning veterans.
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Affiliation(s)
- Monica M. Matthieu
- Saint Louis University, College for Public Health and Social Justice, School of Social Work, Saint Louis, MO, USA
| | - Karen A. Lawrence
- University of Kentucky, School of Social Work, Lexington, KY; formerly affiliated with Washington University, George Warren Brown School of Social Work, Saint Louis, MO, USA
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McLean CP, Fitzgerald H. Treating Posttraumatic Stress Symptoms Among People Living with HIV: a Critical Review of Intervention Trials. Curr Psychiatry Rep 2016; 18:83. [PMID: 27439305 PMCID: PMC5568823 DOI: 10.1007/s11920-016-0724-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The prevalence rate of posttraumatic stress disorder (PTSD) among people living with HIV (PLWH) is significantly higher than the rate among the general population. Moreover, PTS symptoms have been linked with numerous negative health-related outcomes in PLWH. While these findings suggest that studies evaluating the efficacy of treatments for PTS symptoms among PLWH are sorely needed, according to prior reviews, such studies are lacking. The purpose of the present systematic review was to provide an updated critical evaluation of treatment studies that targeted PTS among PLWH. Following PRIMSA guidelines, we searched PubMed and PsycINFO and identified eight articles (representing seven studies) evaluating the impact of various individual and group treatments on PTS symptoms. The limited evidence base to date precludes clinical recommendations for this population. Future studies should examine the efficacy of existing evidence-based treatments for PTSD among PLWH and then, if necessary, evaluate the impact of any treatment modifications for this population.
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Affiliation(s)
- Carmen P. McLean
- Department of Psychiatry, University of Pennsylvania, Center for the Treatment and Study of Anxiety, 3535 Market St., Suite 600 North, Philadelphia, PA 19104, USA
| | - Hayley Fitzgerald
- Department of Psychiatry, University of Pennsylvania, Center for the Treatment and Study of Anxiety, 3535 Market St., Suite 600 North, Philadelphia, PA 19104, USA
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