ARQ National Psychotrauma Centre

Research has shown that developing a Train-the-Trainers (TTT) program is important if agencies are to implement guidelines, but the most effective way to deliver a TTT program remains unanswered. This article presents data from a 3-round Internet-based Delphi process, which was used to help develop consensus-based guidelines for a TTT programme to deliver to health and social care professionals throughout Europe a curriculum on traumatic stress.

ABSTRACTBackground: In this report we describe the development and use of a web portal in the aftermath of the 2004 tsunami. This large scale disaster confronted many displaced people with death, despair and need for information and support. Awareness and insight in the emotional impact of disasters can provide opportunities for surveillance and early treatment.

Millions of children each year are exposed to acute events that affect one individual or family at a time (e.g., car accidents, residential fire, street violence, sudden medical events) (Langeland & Olff, 2008). Less frequent, but with major impact, are terror attacks. Across the world, terrorist groups, single actor terrorists, and perpetrators of school shootings have attacked groups of children and youth in spaces thought to provide safety.

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).

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)

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.

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.

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.

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.

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.