Brief Treatment of Co-Occurring Post-Traumatic Stress and Depressive Symptoms by Use of Accelerated Resolution Therapy®

Abstract

This uncontrolled prospective cohort study evaluated the use of accelerated resolution therapy (ART) for treatment of comorbid symptoms of post-traumatic stress disorder (PTSD) and major depressive disorder. Twenty-eight adult subjects, mean age of 41 years (79% female, 36% Hispanic), received a mean of 3.7 ± 1.1 ART treatment sessions (range 1–5). ART is a new exposure-based psychotherapy that makes use of eye movements. Subjects completed a range of self-report psychological measures before and after treatment with ART including the 17-item PCL-C checklist (symptoms of PTSD) and 20-item Center for Epidemiologic Studies Depression Scale (CES-D). For the PCL-C, the pre-ART mean (±standard deviation) was 62.5 (8.8) with mean reductions of −29.6 (12.5), −30.1 (13.1), and −31.4 (14.04) at post-ART, 2-month, and 4-month follow-up, respectively (p < 0.0001 for comparisons to pre-ART score). Compared to pre-ART status, this corresponded to standardized effect sizes of 2.37, 2.30, and 3.01, respectively. For the CES-D, the pre-ART mean was 35.1 (8.8) with mean reductions of −20.6 (11.0), −18.1 (11.5), and −15.6 (14.4) at post-ART, 2-month, and 4-month follow-up, respectively (p ≤ 0.0001 compared to Pre-ART score). This corresponded to standardized effect sizes of 1.88, 1.58, and 1.09, respectively. Strong correlations were observed at 2-month and 4-month follow-up for post-treatment changes in PTSD and depression symptom scores (r = 0.79, r = 0.76, respectively, p ≤ 0.0002). No serious treatment-related adverse effects were reported. In summary, ART appears to be a promising brief, safe, and effective treatment for adults with clinically significant comorbid symptoms of PTSD and depression. Future controlled and mechanistic studies with this emerging therapy are warranted, particularly given its short treatment duration, and in light of current heightened emphasis on health care cost constraints.

Describing the Mental Health Profile of First Responders: A Systematic Review

“…Depression commonly co-occurs with other disorders, such as PTSD, with a correlation between lifetime MDD and PTSD estimated at .50 (Kessler, Chiu, Demler, & Walters, 2005). Both MDD and PTSD are highly associated with suicidality, and when co-occurring, there are higher levels of symptom severity (Dobry & Sher, 2012; Kip et al, 2013). Prevalence rates of comorbidity vary between 21% and 95%, and are often predicted by severity of trauma exposure (Spinhoven, Penninx, van Hemert, de Rooij, & Elzinga, 2014).…”

Dysfunctional or hyperfunctional? The amygdala in posttraumatic stress disorder is the bull in the evolutionary China shop

“…What is abnormal in PTSD are intrusive, pathologically intense, trauma memories acting on a background of insufficient control from the prefrontal cortex and parasympathetic nervous system over a hyperactive amygdala and sympathetic nervous system (Hamner et al, ; Semple et al, ; Shin et al, ; Morris and Rao, ; Zoladz and Diamond, ). In theory, recovery of normative brain function may be accomplished in a person with PTSD in response to therapy that restores an appropriate level of prefrontal cortex control over amygdala hyperactivity (Levin et al, ; Osuch et al, ; Novakovic et al, ; King et al, ; Kip et al, ; Bormann et al, ; Marin et al, ). Successful therapy for PTSD, therefore, is analogous to calming the bull in the china shop and bringing it to an environment it perceives as safe, thereby allowing balance among brain structures and hormonal systems to be restored.…”

Accelerated Resolution Therapy for treatment of pain secondary to symptoms of combat-related posttraumatic stress disorder

“…This process of “watching” the scene (during both IE and IR) while performing eye movements was repeated multiple times, with the total sets of eye movements determined by the number required to complete the IE and IR components. Additional details on the ART protocol have been published (Kip, et al, 2012, 2014; Kip, Rosenzweig, et al, 2013; Kip, Sullivan, et al, 2013). …”