Researchers from Cardiff University in Wales performed a systematic review of RCTs (randomized, controlled trials) of various psychological treatments for PTSD. The study looked at trauma-focused cognitive behavioral therapy/exposure therapy (TFCBT); stress management (SM – this is where guided imagery would mostly fit); supportive therapy; non-directive counseling; psychodynamic therapy; hypnotherapy; group cognitive behavioural therapy; and eye movement desensitization and reprocessing (EMDR).

Thirty-three studies wound up qualifying for inclusion in the review. There was no significant difference between TFCBT (cognitive behavioral therapy) and SM (stress management) – both did significantly better than wait-list controls and than the other therapies.  EMDR also did significantly better.

 

A reviewer at the Michael E. DeBakey Veterans Administration Medical Center in Houston, Texas, reports on the value of pharmaceuticals for posttraumatic stress, and particularly of alpha-blockers for PTSD-related sleep disturbances. 

The article reports that an estimated 70-87% of patients who suffer from posttraumatic stress experience sleep disruption – difficulty falling asleep and staying asleep, as well as distressing nightmares in which the traumatic event is reexperienced.  Selective serotonin reuptake inhibitors (SSRI’s such as Zoloft, Prozac, Luvox, Celexa, Paxil, etc) are the pharmaceutical treatment of choice for PTSD, but with the exception of fluvoxamine (Luvox), they are often ineffective or only partially effective for sleep problems.

A group of Japanese public health researchers from Kyoto University investigated the effects of autogenic training on firefighters with and without posttraumatic stress. Twenty-two male firefighters were in this pilot study - ten with PTSD and 12 without. They all were given autogenic training two or three times a week for two months. Heart rate variability was measured, and a Japanese language version of the IES (Impact of Events) Scale - a commonly used PTSD measure - was also used.

We have strong indications that our Healing Trauma imagery gives an assist to existing cognitive behavioral and multi-modal programs for PTSD in recovering vets, but Leslie Root, PhD, Ellen Koch, PhD & colleagues at the VA Gulf Coast Veterans Health Care System in Biloxi, Mississippi, wanted to measure the effects of the trauma-specific imagery as the only add-on intervention after each of 5 group treatment sessions for PTSD. This breaks new ground.

A survey of the emergence of stress symptoms in U.S. citizens since the terror attacks of September 11th showed that 44% of adults reported at least one substantial new symptom; 68% reported the emergence of at least one moderate symptom; and 90% a more minor symptom. Reactions varied by sex, race/ethnicity, presence or absence of prior emotional problems, distance from the locus of the attack and by region of the country. Rates of stress were higher with women, nonwhites; in people with previous psychological problems and in people closest to New York City. Stress levels were also associated with extent of television viewing immediately following the attacks. People most typically responded to their upset by turning to religion, turning to one another for support, checking on the safety of others, talking about their thoughts and feelings, participating in vigils and other community rituals, and making donations and doing charitable acts. Some found that to stop watching TV was helpful.

A new review of the literature by Jonathan Bisson of University Hospital in Cardiff, Wales, examines the results of 13 randomized, controlled trials of single session interventions shortly after a traumatic event, to see whether or not symptoms of PTSD were prevented or reduced. As was the case with previous reviews over the past 2 years, this study showed no clinical effect. “With the present evidence”, Bisson writes, “the routine use of single-session interventions following traumatic events cannot be justified. This does not mean that there should be nothing offered, as many individuals involved in traumatic events clearly have emotional needs. Hopefully, future research will identify alternative forms of early intervention that prove useful to those individuals who would otherwise develop more significant psychological difficulties.”

Citation: Bisson, Jonathan I. Single-session early psychological interventions following traumatic events. Clinical Psychology Review (ISSN: 0272-7358), v. 23, no. 3, pp