Interventions to Prevent Post-Traumatic Stress Disorder

Forneris, Catherine A; Gartlehner, Gerald; Brownley, Kimberly A; Gaynes, Bradley N.; Sonis, Jeffrey; Coker-Schwimmer, Emmanuel; Jonas, Daniel E; Greenblatt, Amy; Wilkins, Tania M; Woodell, Carol; Lohr, Kathleen N

doi:10.1016/j.amepre.2013.02.013

Cited by 116 publications

(85 citation statements)

References 28 publications

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“…For example, a commonly used, albeit controversial approach to prevent PTSD is so-called psychological debriefing, in which behavioral therapy is given soon after exposure to a traumatic event (57)(58)(59). Administration of noradrenergic pharmacological agents, such as propranolol, soon after trauma could enhance the effectiveness of debriefing or other early interventions by modulating prefrontal cortical activity as we have described here.…”

Section: Discussionmentioning

confidence: 99%

Noradrenergic blockade stabilizes prefrontal activity and enables fear extinction under stress

Fitzgerald

Giustino

Seemann

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

117

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Stress-induced impairments in extinction learning are believed to sustain posttraumatic stress disorder (PTSD). Noradrenergic signaling may contribute to extinction impairments by modulating medial prefrontal cortex (mPFC) circuits involved in fear regulation. Here we demonstrate that aversive fear conditioning rapidly and persistently alters spontaneous single-unit activity in the prelimbic and infralimbic subdivisions of the mPFC in behaving rats. These conditioning-induced changes in mPFC firing were mitigated by systemic administration of propranolol (10 mg/kg, i.p.), a β-noradrenergic receptor antagonist. Moreover, propranolol administration dampened the stress-induced impairment in extinction observed when extinction training is delivered shortly after fear conditioning. These findings suggest that β-adrenoceptors mediate stress-induced changes in mPFC spike firing that contribute to extinction impairments. Propranolol may be a helpful adjunct to behavioral therapy for PTSD, particularly in patients who have recently experienced trauma.fear | extinction | propranolol | prefrontal cortex | rat

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Section: Discussionmentioning

confidence: 99%

Noradrenergic blockade stabilizes prefrontal activity and enables fear extinction under stress

Fitzgerald

Giustino

Seemann

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

117

View full text Add to dashboard Cite

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“…Some studies corroborate this information and highlight sex as a risk factor for the development of the disorder, therefore, presenting a higher prevalence in women. 5,8,11,16,17 Another finding was that women showed a tendency for increased negative affectivity, more intrusive thoughts, avoidance behaviors and greater vigilance, when compared to men, increasing the risk of developing PTSD. 16 However, in the present study, the sex variable was not crossed due to the fact that the number of participants did not allow more predictor variables and due to the characteristics of the profession, which, according to Pimenta et al 18 (2013) and Fiocruz and Cofen 19 (2015) is related to historical issues, with nursing being predominantly exercised by women (84.6%), which may represent a bias.…”

Section: Discussionmentioning

confidence: 99%

“…Different levels of stress and distress due to exposure to PCBM have been identified in some studies, [3][4][5][6] which show that an event such as occupational exposure may cause suffering and anxiety, which, if not diagnosed, monitored and treated may become chronic and persistent, characterizing PTSD. 6,7 Post-Traumatic Stress Disorder was included in the 3 rd Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (APA) 5 (1980) and is characterized by the manifestation of symptoms that cause significant clinical suffering with physical, social and psychological aspects.…”

Section: -5mentioning

confidence: 99%

Symptoms of posttraumatic stress disorder after exposure to biological material

et al. 2017

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Objective: To track symptoms of posttraumatic stress disorder (PTSD) according to scores of the Impact of Event Scale-Revised (IES-R) in nursing staff exposed to accidents with biological material, from October 2014 to May 2016, in a philanthropic hospital in the state of Minas Gerais. Methods: Retrospective, descriptive study with a quantitative approach. Inferential analysis was performed using a 95% confidence interval, p ≤ 0.05. The data were collected considering all the ethical aspects described in resolution 466/2012. Results: The majority of workers were nursing technicians (52.5%), female (91.8%), with a mean age of 31.4 years (SD 7.5), the majority of exposures being percutaneous (60.7%). Of all individuals, 19.6% presented scores above 5.6, showing signs of PTSD. Individuals who had suffered accidents more than six months previously (p = 0.025) had significantly higher scores than those who had been exposure for less than three months. Conclusion: The study highlights the need for the use of validated instruments for the evaluation of fear, anxiety, stress, and other psychological reactions that characterize PTSD, as well as the provision of psychological care for workers exposed to biological material. Las exposiciones se produjeron por vía percutánea (60,7%). Del total de individuos, el 19,6% presentó escores por encima de 5,6 evidenciando señales para TEPT y aquellos que se habían accidentado hace más de seis meses tuvieron puntuaciones significativamente superiores (p = 0,025) a los que sufrieron exposición hace menos de tres Los meses. Conclusión: Se evidenció la necesidad del uso de instrumentos validados para la evaluación del miedo, ansiedad, estrés entre otras reacciones psicológicas que caracterizan el trastorno de estrés postraumático y de la oferta de atención psicológica para los trabajadores expuestos a material biológico. Palabras clave:

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“…In addition to these approaches, a number of other interventions have also been studied. The evidence for several psychosocial approaches to PTSD prevention, including single session and CBT-based interventions, has been examined in depth in several reviews (Agorastos et al, 2011;Bryant, 2007;Forneris et al, 2013;Kearns et al, 2012;Rose et al, 2002). For this reason, we will summarize evidence for each approach but will not describe each study separately.…”

Section: Psychosocial Approachesmentioning

confidence: 99%

Prevention of Trauma and Stressor-Related Disorders: A Review

Howlett

Stein

2015

Neuropsychopharmacol

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Posttraumatic stress disorder (PTSD) is a common, frequently chronic, and disabling condition which, along with acute stress disorder (ASD), is categorized as a trauma-and stressor-related disorder by the DSM-5. These disorders are unique in requiring exposure to a severe stressor, which implies that potential sufferers could be identified and helped before developing a disorder. Research on prevention strategies for stress-related disorders has taken a number of avenues, including intervention before and after trauma and the use of both psychosocial and somatic approaches. Despite advances in neurobiological understanding of response to trauma, clinical evidence for preventive interventions remains sparse. This review provides an overview of prevention approaches and summarizes the existing literature on prevention of ASD and PTSD, including clinical and preclinical studies. Given the potential benefits to trauma survivors and society, the development of effective preventive interventions should be given greater priority. Resources should be directed to adequately test promising interventions in clinical trials, and research should be conducted according to translational research principles in which preclinical research informs the design of clinical studies.

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Interventions to Prevent Post-Traumatic Stress Disorder

Cited by 116 publications

References 28 publications

Noradrenergic blockade stabilizes prefrontal activity and enables fear extinction under stress

Noradrenergic blockade stabilizes prefrontal activity and enables fear extinction under stress

Symptoms of posttraumatic stress disorder after exposure to biological material

Prevention of Trauma and Stressor-Related Disorders: A Review

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