Recent PTSD Studies and Outcomes

anthony · #1 11-05-2006, 10:34 PM

A few studies performed on those with PTSD, and there outcomes

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Study 1: Treatment in the hands of counselors with minimal cognitive-behavioral therapy (CBT) experience was as efficacious as that of CBT experts.

"Female assault survivors (171) with chronic posttraumatic stress disorder (PTSD) were randomly assigned to prolonged exposure (PE) alone, PE plus cognitive restructuring (PE/CR), or wait-list (WL)," scientists in the United States report.

"Treatment," wrote E.B. Foa and colleagues from the University of Pennsylvania, "which consisted of 9-12 sessions, was conducted at an academic treatment center or at a community clinic for rape survivors."
The investigators described, "Evaluations were conducted before and after therapy and at 3, 6, and 12-month follow-ups.

"Both treatments reduced PTSD and depression in intent-to-treat and completer samples compared with the WL condition; social functioning improved in the completer sample."

"The addition of CR did not enhance treatment outcome. No site differences were found: Treatment in the hands of counselors with minimal cognitive-behavioral therapy (CBT) experience was as efficacious as that of CBT experts," reported the scientists.

In conclusion, the authors wrote, "Treatment gains were maintained at follow-up, although a minority of patients received additional treatment."

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Study 2: High rates of physical and sexual abuse reported in forensic psychiatric patients.

A study from England "describes rates of trauma and posttraumatic stress disorder (PTSD) in forensic and non-forensic psychiatric patients, with a primary diagnosis of paranoid schizophrenia."

J. Sarkar and colleagues, St. George Hospital in Abingdon, explained, "Twenty-seven disordered offender patients (forensic) were compared with 28 non-offender (general) psychiatric inpatients. Ninety-three percent of the entire group reported previous trauma, with the forensic group reporting higher rates of physical and sexual abuse.

"The forensic patients had also experienced more multiple traumas then the general psychiatric patients, although the result was nonsignificant."

The authors continued, "There was no difference between the groups with regard to the age of the earliest trauma experienced. PTSD was common, with rates of 27% for current, and 40% lifetime diagnosis in the whole group. Forensic patients had higher rates of both current (33% v 21%) and lifetime (52% v 29%) PTSD.

"Very few patients had received a working diagnosis of PTSD, or were receiving trauma focused psychological therapy."

"Possible reasons for high rates of trauma and PTSD, and implications for treatment are discussed," Sarkar and coauthors said.

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Study 3: Using posttraumatic stress disorder (PTSD) symptom items in cancer patients may lead to an overdiagnosis of PTSD.

"The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of PTSD includes three symptom clusters: re-experiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms," researchers in the United States reported.

"In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample," explained R.A. Shelby and colleagues, Ohio State University.

"Women (148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including re-experiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings."

The researchers concluded, "Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms."

Source: Therapeutics Daily