ARQ National Psychotrauma Centre

English

Trauma and dissociation: implications for borderline personality disorder

Psychological trauma can have devastating consequences on emotion regulatory capacities and lead to dissociative processes that provide subjective detachment from overwhelming emotional experience during and in the aftermath of trauma. Dissociation is a complex phenomenon that comprises a host of symptoms and factors, including depersonalization, derealization, time distortion, dissociative flashbacks, and alterations in the perception of the self. Dissociation occurs in up to two thirds of patients with borderline personality disorder (BPD).

Towards rational use of benzodiazepines in posttraumatic stress disorder

Lund and colleagues accurately mention that simply advocating against current benzodiazepine use in PTSD, without providing alternative strategies, is not an option. Future research is warranted, finding the optimal memory reactivation length may become a great clinical challenge of trial-and-error, as benzodiazepine administration may time-dependently both inhibit and promote forgetting in PTSD. (from the article)

Three decades of research in circuits and receptor systems in PTSD

Conclusion: There are no specific drugs for PTSD, except for the treatment of irritability and depressive features with SSRI. Atypical neuroleptics have been more recently been introduced as well as mood stabilizers. Other options are specific serotonergic agents such as 5-HT 1A antagonists, NA-blockers, CRF antagonists, GC-receptor antagonists, prazosin and á1-adrenergic blocker with nightmares, use of â-blockers early after trauma exposure are investigated.

The structure of peritraumatic dissociation: a cross validation in clinical and nonclinical samples

Empirical data have challenged the unidimensionality of the Peritraumatic Dissociative Experiences Questionnaire (PDEQ), a widely used measure for peritraumatic dissociation. The aim of this study was to assess the factor structure of the PDEQ in 3 trauma-exposed samples: (a) trauma-exposed police officers (N = 219), (b) trauma-exposed civilians (N = 158), and (c) treatment-seeking trauma-exposed civilians (N = 185). Confirmatory factor analyses using measurement invariance testing supported a 2-factor structure (CFIs .96-.98, RMSEAs .07-.09), but excluded 2 of the original items.

The Role of Injury and Trauma-Related Variables in the Onset and Course of Symptoms of Posttraumatic Stress Disorder

AbstractPosttraumatic stress disorder (PTSD) affects a minority of trauma-exposed persons and is associated with significant impairment. This longitudinal study examined risk factors for PTSD. We tested whether the presence of injuries resulting from trauma exposure predicted the course of PTSD symptoms. In addition, we tested whether gender, trauma type, perceived life threat, and peritraumatic dissociation predicted the onset of PTSD symptoms. 236 trauma-exposed civilians were assessed for PTSD symptoms with a structured interview at four occasions during 6 months posttrauma.

The role of executive function in posttraumatic stress disorder: A systematic review

BackgroundAlthough posttraumatic stress disorder (PTSD) has been associated with disturbances in verbal memory, studies examining executive functioning in PTSD show mixed results.MethodsA systematic review and meta-analysis were performed to compare executive functioning in patients with current PTSD and controls without any psychiatric disorder. Standard mean differences (SMD) in executive functioning scores were calculated using random-effects models. Covariates were added to examine whether differences exist between subgroups.ResultsAcross 18 studies, 1080 subjects were included.

The Most Effective Way of Delivering a Train-the-Trainers Program: A Systematic Review

Introduction:Previous literature has shown that multifaceted, interactive interventions may be the most effective way to train health and social care professionals. A Train-the-Trainer (TTT) model could incorporate all these components. We conducted a systematic review to determine the overall effectiveness and optimal delivery of TTT programs.Methods:We searched 15 databases. Reference lists and online resources were also screened. Studies with an objective follow-up measure collected over 1 week after the intervention were included.

The implementation and evaluation of therapeutic touch in burn patients: An instructive experience of conducting a scientific study within a non-academic nursing setting

AbstractObjectiveEvaluation of therapeutic touch (TT) in the nursing of burn patients, post hoc evaluation of the research process in a non-academic nursing setting.Methods38 burn patients received either TT or nursing presence. On admission, days 2, 5 and 10 of hospitalization, data were collected on anxiety for pain, salivary cortisol, and pain medication. Interviews with nurses were held concerning research in a non-academic setting.ResultsAnxiety for pain was more reduced on day 10 in the TT-group. The TT-group was prescribed less morphine on day 1 and 2.

The impact of early life trauma on health and disease : the hidden epidemic

There is now ample evidence from the preclinical and clinical fields that early life trauma has both dramatic and long-lasting effects on neurobiological systems and functions that are involved in different forms of psychopathology as well as on health in general. To date, a comprehensive review of the recent research on the effects of early and later life trauma is lacking. This book fills an obvious gap in academic and clinical literature by providing reviews which summarize and synthesize these findings.

The dissociative subtype of posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and implications

BackgroundClinical and neurobiological evidence for a dissociative subtype of posttraumatic stress disorder (PTSD) has recently been documented. A dissociative subtype of PTSD is being considered for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to address the symptoms of depersonalization and derealization found among a subset of patients with PTSD.

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