The ?Koach? project for treatment of combat-related PTSD: Rationale, aims, and methodology

Solomon, Zahava; Bleich, Avi; Shoham, Shlomo; Nardi, Chen; Kotler, Moshe

doi:10.1007/bf00976708

Cited by 17 publications

(14 citation statements)

References 14 publications

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“…Coupled with fearful perceptions of the environment and expectations of uncontrollable danger, their hope and desire to act positively can waver. One study has shown that when PTSD patients confront stressful interpersonal relations, they tend to adopt an emotion focused strategy, rather than a more effective problem focused strategy, to resolve the difficulty [ 46 , 47 ]. Rather than take action to remedy the situation, PTSD patients tend to withdraw into their feelings of distress and helplessness.…”

Section: Cognitive Theory Of Ptsdmentioning

confidence: 99%

Information Processing Bias in Post-traumatic Stress Disorder

Weber¹

2008

Open Neuroimag J

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This review considers theory and evidence for abnormal information processing in post-traumatic stress disorder (PTSD). Cognitive studies have indicated sensitivity in PTSD for traumatic information, more so than general emotional information. These findings were supported by neuroimaging studies that identify increased brain activity during traumatic cognition, especially in affective networks (including the amygdala, orbitofrontal and anterior cingulate cortex). In theory, it is proposed that traumatic cognition may interfere with neutral cognition and there is evidence of abnormal neutral stimulus processing in PTSD. Firstly, PTSD patients perform poorly on a variety of neuropsychology tasks that involve attention and memory for neutral information. The evidence from event-related potentials and functional neuroimaging also indicates abnormal results in PTSD during neutral stimulus processing. The research evidence generally provides support for theories of trauma sensitivity and abnormal neutral stimulus processing in PTSD. However, there is only tentative evidence that trauma cognition concurrently interferes with neutral cognition. There is even some evidence that traumatic or novelty arousal processes can increase the capacity for attentive processing, thereby enhancing cognition for neutral stimulus information. Research on this topic has not yet fully explored the mechanisms of interaction between traumatic and neutral content in the cognitive dynamics of PTSD.

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Section: Cognitive Theory Of Ptsdmentioning

confidence: 99%

Information Processing Bias in Post-traumatic Stress Disorder

Weber¹

2008

Open Neuroimag J

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“…Experiential avoidance is common in police officers with a traumatic history. Solomon (1992) found that separated police officers often constrict their scope of activity, social ties, and other civilian activities following traumatic exposures. It is interesting to note, Mr. Jones even appeared to be utilizing avoidance strategies while discussing the traumas during the first session.…”

Section: Case Conceptualizationmentioning

confidence: 99%

Application of Cognitive-Behavioral Treatment for Long-Standing Posttraumatic Stress Disorder in Law Enforcement Personnel

Cornelius

Kenyon-Jump

2007

Clinical Case Studies

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The development and maintenance of posttraumatic stress disorder (PTSD) can be understood as a function of learning and cognitive processes. This case report addresses treatment of PTSD with a 72-year-old former police officer who was experiencing intrusive thoughts, nightmares, experiential and affective avoidance, and hyperarousal resulting from witnessing a series of traumatic events during his time in law enforcement. Although the latency between events and treatment was more than 20 years, this patient was responsive to a cognitive-behavioral, exposure-based treatment. Several other factors, including the client's age and chronic pain, complicated this case. The aim of this study was to identify the conceptual framework for treatment, explore the course of therapy, and identify socially valid means of treatment and assessment in outpatient therapy. At the termination of treatment, this patient evidenced improvements in overall anxiety, depressive symptoms, and frequency and severity of PTSD symptoms. Recommendations for clinicians and treatment implications are also presented.

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“…74 Solomon and colleagues, in an article describing the Koach Project (a form of cognitive behavioral therapy provided by the Department of Israel Defense Forces Medical Corps for veterans with posttraumatic stress), expressed that by provoking the patients to concentrate too much on their psychological wounds from combat, the therapists distracted them -and everyone else -from the patients' "here-and-now" causal issues, all to the detriment of recovery and rehabilitation. 75 Perhaps, instead of concentrating and focusing on psychological "wounds," treatment should focus on problemsolving and the here-and-now problems of adjustment. 14 In treating patients with stress after traumatic events, it is important to note that recovery is variable and may depend on several factors, including the intensity of the provocative event, the person's response, and the community's reaction (for example, the reception of WWII veterans compared with that of Vietnam veterans).…”

Section: Treatment Approach To Patientsmentioning

confidence: 99%