Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges.

Post-traumatic stress disorder: a state-of-the-art review of evidence and challenges. World Psychiatry. 2019 Oct;18(3):259-269 Authors: Bryant RA Abstract Post-traumatic stress disorder (PTSD) is arguably the most common psychiatric disorder to arise after exposure to a traumatic event. Since its formal introduction in the DSM-III in 1980, knowledge has grown significantly regarding its causes, maintaining mechanisms and treatments. Despite this increased understanding, however, the actual definition of the disorder remains controversial. The DSM-5 and ICD-11 define the disorder differently, reflecting disagreements in the field about whether the construct of PTSD should encompass a broad array of psychological manifestations that arise after trauma or should be focused more specifically on trauma memory phenomena. This controversy over clarifying the phenotype of PTSD has limited the capacity to identify biomarkers and specific mechanisms of traumatic stress. This review provides an up-to-date outline of the current definitions of PTSD, its known prevalence and risk factors, the main models to explain the disorder, and evidence-supported treatments. A major conclusion is that, although trauma-focused cognitive behavior therapy is the best-validated treatment for PTSD, it has stagnated over recent decades, and only two-thirds of PTSD patients respond adequately to this intervention. Moreover, most people with PTSD do not access evidence-based treatm...
Source: World Psychiatry - Category: Psychiatry Authors: Tags: World Psychiatry Source Type: research

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Purpose of review Childhood maltreatment is associated with all types of eating disorders. We provide a systematic review of the recent literature on comorbid posttraumatic stress disorder (PTSD) in patients with eating disorders, and focus on prevalence, relationship with symptom severity, operating mechanisms and treatment. Recent findings The prevalence of comorbid PTSD in patients with eating disorders ranges from 9 to 24%, with research suggesting that comorbid PTSD is associated with more severe eating disorder symptoms. Maladaptive emotional regulation strategies may mediate the relationship between PTSD and ea...
Source: Current Opinion in Psychiatry - Category: Psychiatry Tags: EATING DISORDERS: Edited by Hans W. Hoek and Anna Keski-Rahkonen Source Type: research
Abstract Although impressive progress has been made toward developing empirically-supported psychological treatments, the reality remains that a significant proportion of people with mental health problems do not receive these treatments. Finding ways to reduce this treatment gap is crucial. Since app-supported smartphone interventions are touted as a possible solution, access to up-to-date guidance around the evidence base and clinical utility of these interventions is needed. We conducted a meta-analysis of 66 randomized controlled trials of app-supported smartphone interventions for mental health problems....
Source: World Psychiatry - Category: Psychiatry Authors: Tags: World Psychiatry Source Type: research
AbstractFarnsworth (2019) proposed that posttraumatic stress disorder (PTSD) and moral injury (MI) can be differentiated usingDSM ‐5 PTSD's Criteria D. It was suggested that PTSD cognitions are descriptions about what the world is like whose accuracy can be targeted by cognitive therapies, whereas MI cognitions are prescriptions about what the world should be like, which cannot be assessed for truth or falsehood and so are unsuitable for cognitive therapies. We believe that this appeal to the is/ought distinction distorts the therapeutic challenge, and misconceptualizes moral thinking as manifested only in thin terms suc...
Source: Journal of Traumatic Stress - Category: Psychiatry & Psychology Authors: Tags: Commentary Source Type: research
AbstractWe respond to the commentary by Frankfurt and Coady (this issue) regarding the descriptive –prescriptive framework for partially distinguishing between posttraumatic stress disorder (PTSD) and moral injury (Farnsworth, 2019). In their commentary, Frankfurt&Coady raise concerns about the application of R. M. Hare's (2014) philosophical approach of prescriptivism to military ‐related moral injury (MI) and the potential philosophical and ethical implications that may follow. In this response, we clarify that Farnsworth's descriptive–prescriptive framework is not tied to or aligned with Hare's prescri...
Source: Journal of Traumatic Stress - Category: Psychiatry & Psychology Authors: Tags: Commentary Source Type: research
AbstractFarnsworth (2019) proposed that posttraumatic stress disorder (PTSD) and moral injury (MI) can be differentiated usingDSM ‐5 PTSD's Criteria D. It was suggested that PTSD cognitions are descriptions about what the world is like whose accuracy can be targeted by cognitive therapies, whereas MI cognitions are prescriptions about what the world should be like, which cannot be assessed for truth or falsehood and so are unsuitable for cognitive therapies. We believe that this appeal to the is/ought distinction distorts the therapeutic challenge, and misconceptualizes moral thinking as manifested only in thin terms suc...
Source: Journal of Traumatic Stress - Category: Psychiatry & Psychology Authors: Tags: Commentary Source Type: research
CONCLUSION: There is limited evidence from randomised controlled trials which supports claims that computer- or Internet-delivered cognitive-behavioural therapy for anxiety disorders is not inferior to in-person delivery. Randomised controlled trials properly designed to test non-inferiority are needed before conclusions about the relative benefits of in-person and Internet- and computer-delivered cognitive-behavioural therapy can be made. PROSPERO: CRD420180961655-6. PMID: 31339342 [PubMed - as supplied by publisher]
Source: The Australian and New Zealand Journal of Psychiatry - Category: Psychiatry Authors: Tags: Aust N Z J Psychiatry Source Type: research
The American Psychological Association (APA) developed a clinical practice guideline (CPG) to provide recommendations on psychological and pharmacological treatments for posttraumatic stress disorder (PTSD) in adults. This paper is a summary of the CPG, including the development process. Members of the guideline development panel (GDP) used a comprehensive systematic review conducted by the Research Triangle Institute-University of North Carolina Evidence-based Practice Center (RTI-UNC EPC) as its primary evidence base (Jonas et al., 2013). The GDP consisted of health professionals from psychology, psychiatry, social work,...
Source: American Psychologist - Category: Psychiatry & Psychology Source Type: research
AbstractWe respond to the commentary by Frankfurt and Coady (this issue) regarding the descriptive –prescriptive framework for partially distinguishing between posttraumatic stress disorder (PTSD) and moral injury (Farnsworth, 2019). In their commentary, Frankfurt&Coady raise concerns about the application of R. M. Hare's (2014) philosophical approach of prescriptivism to military ‐related moral injury (MI) and the potential philosophical and ethical implications that may follow. In this response, we clarify that Farnsworth's descriptive–prescriptive framework is not tied to or aligned with Hare's prescri...
Source: Journal of Traumatic Stress - Category: Psychiatry & Psychology Authors: Tags: Special Article Source Type: research
AbstractPurpose of ReviewThis paper reviews recent research on the depression in young people following exposure to catastrophic stresses such as disasters, terrorism and political violence.Recent FindingsDepression is one of the commonest outcomes following mass trauma, for all ages including children and adolescents. Recent articles continue to report high prevalence of depression which often continues for years. It is often comorbid with other psychiatric disorders, especially PTSD. Post-traumatic depression in children and adolescence affects purpose of life, impairs scholastic achievements, increases suicidality and h...
Source: Current Psychiatry Reports - Category: Psychiatry Source Type: research
Conditions:   PTSD;   Anxiety Disorders;   Depression;   Stress Disorders, Posttraumatic Intervention:   Behavioral: Cognitive Behavioural Therapy with Mindfulness Course Sponsor:   University of Manitoba Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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