Cardiovascular Correlates of Motor Vehicle Accident Related Posttraumatic Stress Disorder and its Successful Treatment

Rabe, Sirko; Dörfel, Denise; Zöllner, Tanja; Maercker, Andreas; Karl, Anke

doi:10.1007/s10484-006-9027-1

Cited by 34 publications

(39 citation statements)

References 33 publications

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“…For example, a recent randomized trial of CBT for trauma-exposed individuals found efficacy for chronic nightmares, symptoms of depression and PTSD, fear of sleep, and sleep problems as well as improvement in sleep quality and quantity [164]. CBT has been shown to normalize the heightened heart rate reactivity to trauma-related stimuli found in PTSD patients [165].…”

Section: Psychotherapy Interventionsmentioning

confidence: 99%

Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury

Kennedy

Jaffee

Leskin³

et al. 2007

JRRD

239

157

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Abstract-In this article, we review the literature on posttraumatic stress disorder (PTSD) and PTSD-like symptoms that can occur along with mild traumatic brain injury (TBI) and concussion, with specific reference to concussive injuries in the military. We address four major areas: (1) clinical aspects of TBI and PTSD, including diagnostic criteria, incidence, predictive factors, and course; (2) biological interface between PTSD and TBI; (3) comorbidity between PTSD and other mental disorders that can occur after mild TBI; and (4) current treatments for PTSD, with specific considerations related to treatment for patients with mild TBI or concussive injuries.

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Section: Psychotherapy Interventionsmentioning

confidence: 99%

Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury

Kennedy

Jaffee

Leskin³

et al. 2007

JRRD

239

157

View full text Add to dashboard Cite

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“…1). Sixteen concerned 11 RCTs and were used for objectives (1) and (2) [22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37]. The remaining 7 publications reported on 5 trials which were used for objective (3) [38,39,40,41,42,43,44].…”

Section: Resultsmentioning

confidence: 99%

“…Different types of outcome data of a portion of these patients were reported in separate publications [22,28,29] and [24,25,26,30]. The number of people randomized in trials ranged from 12 to 78.…”

Section: Resultsmentioning

confidence: 99%

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Using Neurobiological Measures to Predict and Assess Treatment Outcome of Psychotherapy in Posttraumatic Stress Disorder: Systematic Review

Zantvoord¹,

Diehle²,

Lindauer³

2013

Psychother Psychosom

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Background: Trauma-focused cognitive-behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are effective treatments for posttraumatic stress disorder. However, little is known about their neurobiological effects. The usefulness of neurobiological measures to predict the treatment outcome of psychotherapy also has yet to be determined. Methods: Systematic review of randomized controlled trials (RCTs) focused on neurobiological treatment effects of TF-CBT or EMDR and trials with neurobiological measures as predictors of treatment response. Results: We included 23 publications reporting on 16 separate trials. TF-CBT was compared with a waitlist in most trials. TF-CBT was associated with a decrease in heart rate and blood pressure and changes in activity but not in volume of frontal brain structures and the amygdala. Neurobiological changes correlated with changes in symptom severity. EMDR was only tested against other active treatments in included trials. We did not find a difference in neurobiological treatment effects between EMDR and other treatments. Publications on neurobiological predictors of treatment response showed ambiguous results. Conclusion: TF-CBT was associated with a reduction of physiological reactivity. There is some preliminary evidence that TF-CBT influences brain regions involved in fear conditioning, extinction learning and possibly working memory and attention regulation; however, these effects could be nonspecific psychotherapeutic effects. Future trials should use paradigms aimed specifically at these brain regions and physiological reactivity. There are concerns regarding the risk of bias in some of the RCTs, indicating that methodologically more rigorous trials are required. Trials with neurobiological measures as predictors of treatment outcome render insufficient results to be useful in clinical practice.

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“…These limitations and an extensive literature for identifying triggering stimuli that affect physiologic responses make a strong case for the combined use of physiological and overt behavior measures. Stimulus-specific physiological and overt behavior responses have been recorded for a wide range of individuals, from athletic peak performance to numerous diagnoses including traumatic events [34,[42][43]. However, such an effort must be implemented with great consideration.…”

Section: Resultsmentioning

confidence: 99%

Absence of verbal recall or memory for symptom acquisition in fear and trauma exposure: A conceptual case for fear conditioning and learned nonuse in assessment and treatment

Ar¹

2012

JRRD

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Abstract-Absence of memory or verbal recall for symptom acquisition in fear and trauma exposure, as well as absence of successful coping behavior for life events, is associated with a number of diagnoses, including traumatic brain injury, posttraumatic stress disorder, pain, and anxiety. The difficulty with diagnosis and treatment planning based on the absence of recall, memory, and successful coping behavior is threefold: (1) these assessments do not distinguish between disruption of behavior and lack of capacity, (2) the absence of verbal recall and memory complicates cognitive-based treatment, and (3) a confounding issue is the same absent behavior can be observed at different times and contexts. While memory of the specific details of the initial traumatic event(s) may not be available to verbal report, the existence of time-and context-dependent relationships for the initial as well as subsequent experiences is arguable. The absence of memory or lack of verbal recall does not rule out measurable physiological bodily responses for the initial trauma(s), nor does it help to establish the effects of subsequent experiences for symptom expression. Also, the absence of memory must include the prospect of fear-based learning that does not require or involve the cortex. It is posited that the literatures of fear conditioning and learned nonuse provide complementary illustrations of how the time and context of the initial trauma(s) and subsequent experiences affect behavior, which is not dependent on the effected individual being able to provide a memory-based verbal report. The replicated clinical application demonstrates that, without scientific demonstration, neither neuroanatomy nor verbal report can be assumed sufficient to predict overt behavior or physiologic responses. For example, while commonly assumed to be predictively so, autonomic nervous system innervation is insufficient to define the unique stimulus-and context-dependent physiological responses of an individual. By recording simultaneous physiological responses to the controlled presentation of a context-dependent stimulus, the unique relationships of physiology and overt behaviors for the individual can be demonstrated. Using this process also allows more complex virtual reality or other in vivo stimulus assessments to be incorporated for the development of individually tailored assessments and therapeutic plans. Thus, with or without memory or verbal recall, the use of multiple time-and context-specific simultaneous physiological measures and overt behavior can guide clinical effort as well as serve to objectively assess the ongoing treatment and its outcome.Key words: anxiety, context learning, fear conditioning, learned nonuse, memory, pain, physiology, posttraumatic stress disorder, traumatic brain injury, verbal recall.Abbreviations: ANS = autonomic nervous system, CBT = cognitive behavioral therapy, CIMT = constraint-induced movement therapy, CR = conditioned response, PNS = parasympathetic nervous system, PTSD = posttraumatic stress disorder...

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Cardiovascular Correlates of Motor Vehicle Accident Related Posttraumatic Stress Disorder and its Successful Treatment

Cited by 34 publications

References 33 publications

Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury

Posttraumatic stress disorder and posttraumatic stress disorder-like symptoms and mild traumatic brain injury

Using Neurobiological Measures to Predict and Assess Treatment Outcome of Psychotherapy in Posttraumatic Stress Disorder: Systematic Review

Absence of verbal recall or memory for symptom acquisition in fear and trauma exposure: A conceptual case for fear conditioning and learned nonuse in assessment and treatment

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