Determining what works in the treatment of PTSD

Wampold, Bruce E.; Imel, Zac E.; Laska, Kevin M.; Benish, Steven G.; Miller, Scott D.; Flückiger, Christoph; Re, A. C. Del; Baardseth, Timothy P.; Budge, Stephanie L.

doi:10.1016/j.cpr.2010.06.005

Cited by 109 publications

(88 citation statements)

References 70 publications

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“…Research further suggests that the effectiveness of psychotherapy often exceeds or is comparable with that of alternative psychopharmacological interventions (APA, 2012). There are still vigorous debates regarding the biopsychosocial mechanisms and processes responsible for behavior change (e.g., the role of common factors vs. specific treatment effects; Wampold et al, 2010). This is not unexpected, however, given that psychological outcomes are multifactorially determined and the process by which individuals change is likely to be complicated as well.…”

Section: More Clinical Perspective On Treatment Effectivenessmentioning

confidence: 99%

Leaving behind our preparadigmatic past: Professional psychology as a unified clinical science.

Melchert¹

2016

American Psychologist

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Acknowledgement:The behavioral and neurosciences have made remarkable progress in the past couple decades. Major advances have been made in understanding a wide range of phenomena, from epigenetics and neural plasticity to the nature of cognition, emotion, consciousness, moral reasoning, social behavior, and culture. Indeed, so much has been learned about human psychology recently that current explanations of many psychological mechanisms and processes are markedly different from those considered current just a generation ago.

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Section: More Clinical Perspective On Treatment Effectivenessmentioning

confidence: 99%

Leaving behind our preparadigmatic past: Professional psychology as a unified clinical science.

Melchert¹

2016

American Psychologist

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“…However, the classification of PTSD treatments according to the underlying etiological model has been a challenge in previous meta-analyses [14]. An inconsistent terminology and the use of treatment labels that are not clearly defined and thus not exclusive (see [22]) lead to considerable variation in the classification of PTSD treatments across individual meta-analyses. In order to reduce some complexity and despite the differences in the foci of the underlying etiological models (e.g.…”

Section: What Is Characteristic In Ptsd Treatments?mentioning

confidence: 99%

“…focusing on cognitions vs. focusing on behavioral aspects), several treatment packages have been summarized under the umbrella term of trauma-focused treatments [23]. But again, the definition of the term remained largely unclear and led to inconsistencies with respect to which treatments were to be considered trauma-focused [22]. In contrast, treatments that clearly do not address the trauma experience or even proscribe talking about the trauma have consistently been used as psychological placebo control conditions.…”

Section: What Is Characteristic In Ptsd Treatments?mentioning

confidence: 99%

Post-Traumatic Stress Disorder Outcome Research: Why Moderators Should not be Neglected

Gerger¹,

Gaab²

2016

A Multidimensional Approach to Post-Traumatic Stress Disorder - From Theory to Practice

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Several psychotherapeutic treatments have been developed over the years for treating the symptoms of post-traumatic stress disorder (PTSD). But it remains still unclear which components of the complex treatment packages are necessary and most beneficial for PTSD symptom improvement. In PTSD outcome research, the randomized controlled trial (RCT) design has been applied in order to address this issue. However, meta-analyses repeatedly reported considerable variation between results from individual RCTs (i.e. between-study heterogeneity). Attempts to explain such heterogeneity led to the identification of relevant moderators of treatment effects in PTSD RCTs. This study presents meta-analytic findings, which show that factors, which are not part of the treatment (such as the investigators' preferences for a particular treatment or the complexity of the patients' clinical problems), impact on outcome in PTSD RCTs. We show that considering extra-therapeutic moderators in meta-analyses on PTSD RCTs may impact the conclusions and recommendations that may be deduced. The summarized findings confirm the notion that no PTSD treatment consistently outperforms the others and strengthen the position that even non-trauma-focused treatments may be beneficial PTSD treatments.

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“…Despite the efficacy of these interventions, symptom persistence has been reported at rates of up to 50%, especially in of cases of diagnostic comorbidity (Baker, Neivergelt, & Risbrough, 2009;Nilamadhab, 2011;Norman, Tate, Anderson, & Brown, 2007;Wampold et al, 2010). In the landmark study of the long-term consequences of adverse childhood events (ACE), Felitti and Anda (2010) argued that in order to fully understand adult psychopathology we must move beyond the presenting symptom of the moment and attempt to understand patient issues within the full context of their lives.…”

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confidence: 99%

Effects of Developmental Abuse and Symptom Suppression among Traumatized Veterans

Whelan¹

2015

PSYCH

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While much of the research on military posttraumatic stress disorder (PTSD) focuses on warzone reactions, a burgeoning literature highlights complex relationships between childhood adversity and adult-onset PTSD. However, conceptual efforts to delineate the effects of childhood abuse on treatment trajectories for traumatized military veterans are lacking. This study compared trauma and psychological symptom profiles for developmentally abused and non-abused Canadian Forces (CF) veterans (N = 108) diagnosed with operational PTSD. Subscale scores from the Detailed Assessment of PTSD Scale (DAPS) and the Personality Assessment Inventory (PAI) were submitted to MANOVA. The analysis resulted in a composite variable reflecting' symptom suppression efforts' that separated abused veterans (n = 55) from non-abused veterans (n = 53). Post hoc analyses showed significant differences between the abused sub-groups (i.e., physical and sexual abuse [n = 15]; physical abuse only [n = 17]; sexual abuse only [n = 23]) and the non-abused group. Veterans with abuse histories had higher symptom suppression scores, reflecting higher levels of substance abuse, post-traumatic dissociation, interpersonal mistrust, as well as, lower depression and PTSD impairment scores. Implications for clinicians and an alternative intervention for treating traumatized military personnel with histories of developmental abuse are discussed.

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Determining what works in the treatment of PTSD

Cited by 109 publications

References 70 publications

Leaving behind our preparadigmatic past: Professional psychology as a unified clinical science.

Leaving behind our preparadigmatic past: Professional psychology as a unified clinical science.

Post-Traumatic Stress Disorder Outcome Research: Why Moderators Should not be Neglected

Effects of Developmental Abuse and Symptom Suppression among Traumatized Veterans

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