Researchers from the San Diego V.A. system examined the efficacy of Imagery Rehearsal Therapy or IRT (a kind of nightmare reprocessing therapy that trains people to use a variety of “lucid dreaming” to change or control the content of the nightmare) on reducing nightmares in veterans seeking outpatient treatment for chronic, trauma-related nightmares.

Of those offered IRT, veterans who completed a full course of treatment for PTSD in the past year were more likely to initiate treatment.  However, completion of IRT was not related to previous treatment, demographic variables, or nightmare severity as reported at the first treatment session.

Treatment completers reported significant reductions in nightmare frequency and intensity, severity of insomnia, and subjective daytime PTSD symptoms.  Insomnia and PTSD symptoms, on average, were below clinical cutoffs following treatment, and 23% of patients showed a complete treatment response (defined as one or no nightmares per week).

Researchers from the University of Southern California’s Department of Psychology performed a meta-analysis of what treatment approaches work best for women who have been sexually assaulted during adolescence or adulthood.
 
Altogether, 32 articles were located using data from 20 separate samples. Of the 20 samples, 12 targeted victims with chronic symptoms, three focused on the acute period post-assault, two included women with chronic and acute symptoms, and three were secondary prevention programs.

Researchers from the Department of Psychology at the University of Pennsylvania, investigated the impact of mindfulness training (MT) on working memory capacity (WMC) and affective experience of reservists during their high-stress, pre-deployment phase.  They hypothesized that MT may bolster working memory and mitigate the deleterious effects of high stress.  (Working memory capacity is used in managing cognitive demands and regulating emotions.  High levels of stress may deplete it, leading to cognitive failures and emotional disturbances.)

The study recruited 2 military cohorts during the high-stress pre-deployment interval, and provided MT to 1 group (MT, n = 31) but not the other group (military control group, MC, n = 17). Additionally, the study used another control group of civilians (n = 12) for comparison.

Researchers from the Department of Mental Health at the Naval Medical Center in San Diego compared the effectiveness of Exposure Therapy (ET) to Virtual Reality (VR) in the treatment of combat-related posttraumatic stress in theater at Camp Fallujah in Iraq.

This case series documents the first use of VR-based therapy in the treatment of PTSD in a combat theater.  Results of therapy are being reported from a mental health clinic in Camp Fallujah, Iraq.

Combat PTSD constituted a relatively small percentage of overall mental health patients seen. Those who did present with PTSD were offered either VR-based ET or traditional ET.  

A new study from researchers at C.C.N.Y. (City College of New York) examined the connection between improvements in posttraumatic stress and improvement in substance abuse over the course of time in 353 women diagnosed with both conditions.

Participants were randomly assigned to 12 sessions of either trauma-focused treatment or health education.  Assessments were made on the PTS and the substance use during treatment at 1 week and posttreatment after 3, 6, and 12 months.

Subjects showing no improvement, an improvement in the substance use only, or a total, global improvement early on, tended to maintain their original diagnosis over time; but subjects initially exhibiting improvement in their PTSD symptoms were significantly more likely to transition into a global response over time, indicating that they maintained their PTSD improvement, and that it was associated with subsequent improvements in substance use.
 

We thought, given the terrible situation in Haiti, it might be useful to post the results of this classic study of survivors of the great Turkish earthquake of 1999, which points to what makes survivors more vulnerable to PTSD.  Subsequent surveys from China, Japan, Italy, El Salvador and Iceland support these findings. , Additional factors appear to be dislocation, subsequent financial difficulties, disruption of social networks, injury, the intensity of fear and/or presence of dissociation at the time of the trauma. Loss of family and friends appear to be more associated with depression rather than posttraumatic stress.  Difficulties appear to be fairly longstanding, according to most of these surveys.

Researchers from King's College at the University of London in the UK examined the incidence of posttraumatic stress disorder (PTSD) and depression in 586 earthquake survivors living in prefabricated housing, an average of 20 months after the 1999 Marmara earthquake in Turkey. 

In a really fascinating and important meta-analysis, researchers from Tufts University studied identical twins to see whether resting functional brain abnormalities found in combat-related PTSD are acquired characteristics or familial risk factors.

Recent neuroimaging research has shown functional abnormalities in the anterior cingulate cortex, amygdala, and hippocampus in people with posttraumatic stress disorder (PTSD).

This study compares the PET scans (of resting regional cerebral metabolic rate for glucose) in fourteen combat-exposed veterans with PTSD and their fourteen identical co-twins, not exposed to combat, as well as nineteen combat-exposed veterans without PTSD (n = 19) and their nineteen identical co-twins, not exposed to combat.

A research team from New York University and the University of Texas at Austin demonstrated that timing is critical in extinguishing a fear response – and this has groundbreaking potential for the treatment of phobias, anxiety disorders and posttraumatic stress.  Evidently, there’s a brief window of opportunity for rewriting painful emotional memories immediately after re-activating them, when the imprinted memory becomes labile and open to change.

Simple fear was created in 65 subjects by giving them a mild electrical shock on the wrist one third of the time when shown a colored square appear on a computer screen (Earlier research in conditioned learning shows that this is the frequency of ‘punishment’ that creates a lasting association).

Researchers from the University of Bielefeld in Germany compared the efficacy of two different treatments for children in a refugee camp in Sri Lanka with severe PTSD, in the acute aftermath of the Tsunami of 2004.

Thirty-one children were randomly assigned to one of two pragmatic, short-term interventions, delivered by trained local counselors: either 6 sessions of Narrative Exposure Therapy for children (KIDNET) or six sessions of meditation-relaxation (MED-RELAX).