Prolonged Exposure Therapy for PTSD in Sexually Abused Adolescents

Perrin, Sean

doi:10.1001/jama.2013.283944

Cited by 5 publications

(4 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One participant also spoke in detail about how she lowered the dose of her medication to engage in trauma‐focused therapy. Trauma‐focused therapies include in vivo exposure, which involves a gradual increase in physical or sensory contact with situations, locations and objects that trigger distressing symptoms, and/or imaginal exposure, whereby the individual voluntarily recalls traumatic events in vivid detail (Perrin, 2013). In line with the beliefs of particular participants in this study, the successful implementation of these techniques requires the individual to reach an optimal level of arousal (Kezelman & Stavropoulos, 2012).…”

Section: Discussionmentioning

confidence: 99%

The subjective effect of antipsychotic medication on trauma‐related thoughts, emotions, and physical symptoms: A qualitative study with people who have experienced childhood trauma and psychosis

2021

View full text Add to dashboard Cite

Objectives Among people with psychosis, those with a history of childhood trauma are likely to experience trauma‐related symptoms, such as trauma memory intrusions. Irrespective of whether these individuals continue to remember and re‐experience trauma, their treatment very often includes alleviating psychotic symptoms through the use of antipsychotic medication. Antipsychotics, while primarily used to treat psychotic symptoms, can influence non‐psychotic symptoms and alter how people think and feel. We thus aimed to explore how people with childhood trauma and psychosis experience the effects that antipsychotics have on their (1) thoughts, images, and memories, (2) emotions, and (3) physical responses, related to their childhood trauma. Design A qualitative phenomenological research design using semi‐structured interviews was implemented. Methods Data were analysed using interpretative phenomenological analysis. Results Nineteen participants were interviewed. Two super‐ordinate themes were conceptualized. Many participants spoke about the impact of antipsychotics on trauma‐related experiences (Theme 1). Some indicated that antipsychotics alleviated the intensity and frequency of trauma‐related thoughts, emotions, and physical symptoms. A few others reported that their trauma‐related flashbacks, thoughts, and physical symptoms intensified while taking antipsychotics. Participants spoke about the role of antipsychotics in confronting and processing trauma (Theme 2). A few participants reported that by suppressing trauma‐related thoughts and emotions antipsychotics prevented them from confronting their trauma. Conclusions The effects of antipsychotics can be subjectively experienced as beneficial or detrimental depending on how they influence trauma‐related thoughts, emotions, and physical responses. Intervention studies are needed to determine how people with childhood trauma and psychosis respond to antipsychotic drugs. Practitioner points Antipsychotics may alter the way in which people with childhood trauma and psychosis remember and re‐experience trauma. These alterations can be beneficial or detrimental, and thus play a role in whether people consider their medication helpful. By suppressing trauma‐related thoughts and emotions, antipsychotics can prevent people from confronting their trauma. This may be considered beneficial to some, but other people may need or want to confront their trauma to heal. The effectiveness of trauma‐focused psychological therapies may be influenced by the emotional, cognitive, and physiological effects of antipsychotic medications. The ability of antipsychotics to suppress people’s trauma memories may contribute to post‐traumatic avoidance. People with post‐traumatic stress symptoms and psychosis should be provided with psycho‐education about post‐traumatic avoidance and its role in the maintenance of post‐traumatic stress disorder.

show abstract

Section: Discussionmentioning

confidence: 99%

The subjective effect of antipsychotic medication on trauma‐related thoughts, emotions, and physical symptoms: A qualitative study with people who have experienced childhood trauma and psychosis

2021

View full text Add to dashboard Cite

show abstract

“…Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder resulting from direct or indirect stressors, threats or life-threatening events perceived to compromise personal physical or mental safety [1][2][3] . Symptoms include intense feelings of unprovoked fear, panic attacks, anxiety, intrusive fear memories during wakefulness or in nightmares, fear generalization and avoiding similar but neutral stimuli 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Closed-loop brain stimulation to reduce pathologic fear

Rodrigo

Pedraza

Barcsai

et al. 2022

Preprint

View full text Add to dashboard Cite

Maladaptive processing of trauma related memory engrams leads to dysregulated fear reactions. In post-traumatic stress disorder (PTSD), dysfunctional extinction learning prevents discretization of trauma-related memory engrams and leads to generalized fear responses. PTSD is postulated as a mnemonic-based disorder, but we lack markers or treatments targeting pathological fear memory processing. Hippocampal sharp wave-ripples (SWRs) and concurrent neocortical oscillations are scaffolds to consolidate contextual memory, but their role during fear processing remains poorly understood. We demonstrate that closed-loop SWRs triggered neuromodulation of the medial forebrain bundle (MFB) can enhance the consolidation of fear extinction. It modified fear memories that became resistant to induced recall (i.e., "renewal" and "reinstatement") and did not reemerge spontaneously as a PTSD-like phenotype. The effects are mediated by D2 receptor signaling induced synaptic remodeling in the basolateral amygdala. These results suggest that SWRs help consolidating fear extinction memories. Furthermore, enhancing the consolidation of extinction engrams by SWR-triggered induction of reward signals can alleviate pathologic fear reactions in a rodent model of PSTD. No adverse effects were seen, suggesting this potential therapy for PTSD and anxiety disorders.

show abstract

“…However, in some pathological scenarios, extinction learning is often impaired, leading to persistent and maladaptive fear responses 5 . For example, post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder resulting from direct or indirect exposure to stressful events, threats, or life-threatening events perceived to compromise personal physical or mental safety [6][7][8] . Symptoms include intense feelings of unprovoked fear, panic attacks, anxiety; intrusive fear memories during wakefulness or in nightmares, fear generalization, and avoiding similar but neutral stimuli 9,10 .…”

mentioning

confidence: 99%

Closed-loop brain stimulation augments fear extinction in male rats

et al. 2023

View full text Add to dashboard Cite

Dysregulated fear reactions can result from maladaptive processing of trauma-related memories. In post-traumatic stress disorder (PTSD) and other psychiatric disorders, dysfunctional extinction learning prevents discretization of trauma-related memory engrams and generalizes fear responses. Although PTSD may be viewed as a memory-based disorder, no approved treatments target pathological fear memory processing. Hippocampal sharp wave-ripples (SWRs) and concurrent neocortical oscillations are scaffolds to consolidate contextual memory, but their role during fear processing remains poorly understood. Here, we show that closed-loop, SWR triggered neuromodulation of the medial forebrain bundle (MFB) can enhance fear extinction consolidation in male rats. The modified fear memories became resistant to induced recall (i.e., ‘renewal’ and ‘reinstatement’) and did not reemerge spontaneously. These effects were mediated by D2 receptor signaling-induced synaptic remodeling in the basolateral amygdala. Our results demonstrate that SWR-triggered closed-loop stimulation of the MFB reward system enhances extinction of fearful memories and reducing fear expression across different contexts and preventing excessive and persistent fear responses. These findings highlight the potential of neuromodulation to augment extinction learning and provide a new avenue to develop treatments for anxiety disorders.

show abstract

Prolonged Exposure Therapy for PTSD in Sexually Abused Adolescents

Cited by 5 publications

References 8 publications

The subjective effect of antipsychotic medication on trauma‐related thoughts, emotions, and physical symptoms: A qualitative study with people who have experienced childhood trauma and psychosis

The subjective effect of antipsychotic medication on trauma‐related thoughts, emotions, and physical symptoms: A qualitative study with people who have experienced childhood trauma and psychosis

Closed-loop brain stimulation to reduce pathologic fear

Closed-loop brain stimulation augments fear extinction in male rats

Contact Info

Product

Resources

About