[Social support and psychological consequences of sexual assault: a literature review]

Treatment of acute stress disorder for victims of violent crime

BACKGROUND

Victims of violent crime are at elevated risk of developing acute stress disorder (ASD) as well as subsequent post-traumatic stress disorder (PTSD), both of which are linked to severe psychological distress. The aim of this 12-month prospective study was to evaluate the efficacy of cognitive-behavioral therapy (CBT) vs. cognitive-behavioral therapy with a significant other (CBT-SO), relative to usual care (UC), for the improvement of post-traumatic, depression and anxiety symptoms and the prevention of PTSD among victims of violent crime with ASD.

METHODS

A total of 166 victims of violent crime with ASD were assigned to CBT (n = 54), CBT-SO (n = 52) or UC (n = 60). Self-report assessments and diagnostic interviews were completed at pre-treatment and post-treatment as well as at 6-month and 12-month follow-ups.

RESULTS

CBT and CBT-SO participants had fewer depression symptoms than those in the UC group up to 12 months post-event. Significantly fewer participants in the CBT condition met criteria for PTSD than in the UC group up to 12 months post-event. The CBT group did not differ from the CBT-SO group on any variable at any assessment time.

LIMITATIONS

Findings must be interpreted in light of the quasi-experimental nature of the study and limitations concerning the management of missing data.

CONCLUSIONS

Further research is warranted in order to assess whether more extensive involvement of a significant other in therapy may lead to better outcomes for victims of violent crime with ASD.

Abnormal ECG patterns in chronic post-war PTSD patients: a pilot study

BACKGROUND

Posttraumatic stress disorder (PTSD) is a psychiatric syndrome associated with high levels of sympathetic activation of the autonomic nervous system. Individuals diagnosed with PTSD have a high propensity for electrocardiogram (ECG) abnormalities, atrioventricular conductive defects, and cerebrovascular incidents.

PURPOSE

The aim of this study was to investigate ECG abnormalities in post-war PTSD patients.

METHOD

This pilot study compared patients diagnosed with chronic post-war PTSD (n = 30) to patients diagnosed with major depressive disorder (MDD; n = 24) and healthy controls (n = 20). Following the completion of the Structured Clinical Interview for the DSM (SCID), participants were assessed with a standard 12-lead ECG.

RESULTS

ECG abnormalities were observed in 66.7% of PTSD patients and 70.8% of MDD patients. In contrast, only 28.6% of the healthy control group showed ECG abnormalities. Multivariate logistic regression was used to adjust for participants' sex, smoking rate, education level, disease duration, and marital status. The results indicated that PTSD and MDD patients were more likely to have ECG abnormalities than the normal population (odds ratio for PTSD = 12.7, 95% confidence interval 1.9-83.9; and odds ratio for MDD = 14.9, 95% confidence interval 1.3-170.5).

CONCLUSION

PTSD and MDD patients showed elevated rates of ECG abnormalities compared to healthy controls. These findings have important implications for the medical treatment of PTSD and MDD given that both of these patient groups appear to be at increased risk of cardiovascular disorder.

How Do Social Interactions with a Significant Other Affect PTSD Symptoms? An Empirical Investigation with a Clinical Sample

Social support and coping are both related to posttraumatic stress disorder (PTSD) symptoms, but the mechanisms underlying their relationships remain unclear. This study explores these relationships by examining the perceived frequency of supportive and countersupportive interactions with a significant other in PTSD patients. Ninety-six participants with PTSD were recruited and completed questionnaires assessing social interactions, ways of coping, and PTSD symptoms. Associations of social interactions (r² = 4.1%-7.9%, p < .05) and coping (r² = 15.9%-16.5%, p < .001) with symptoms were independent, and suggested a direct association between social interactions and PTSD. Countersupportive interactions were more associated to symptoms than supportive interactions. Our findings suggest the development of psychotherapies that integrate social support interventions.