Cognitive Trauma Therapy for Battered Women With PTSD (CTT-BW).

This article describes a second treatment-outcome study of cognitive trauma therapy for battered women with posttraumatic stress disorder (PTSD; CTT-BW). CTT-BW includes trauma history exploration: PTSD education; stress management; exposure to abuse and abuser reminders; self-monitoring of negative self-talk; cognitive therapy for guilt; and modules on self-advocacy, assertiveness, and how to identify perpetrators. One hundred twenty-five ethnically diverse women were randomly assigned to immediate or delayed CTT-BW. PTSD remitted in 87% of women who completed CTT-BW, with large reductions in depression and guilt and substantial increases in self-esteem. White and ethnic minority women benefited equally from CTT-BW. Similar treatment outcomes were obtained by male and female therapists and by therapists with different levels of education and training. Gains were maintained at 3- and 6-month follow-ups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Comparison of Narrative Exposure Therapy, Supportive Counseling, and Psychoeducation for Treating Posttraumatic Stress Disorder in an African Refugee Settlement.

Little is known about the usefulness of psychotherapeutic approaches for traumatized refugees who continue to live in dangerous conditions. Narrative exposure therapy (NET) is a short-term approach based on cognitive-behavioral therapy and testimony therapy. The efficacy of narrative exposure therapy was evaluated in a randomized controlled trial. Sudanese refugees living in a Ugandan refugee settlement (N = 43) who were diagnosed as suffering from posttraumatic stress disorder (PTSD) either received 4 sessions of NET, 4 sessions of supportive counseling (SC), or psychoeducation (PE) completed in 1 session. One year after treatment, only 29% of the NET participants but 79% of the SC group and 80% of the PE group still fulfilled PTSD criteria. These results indicate that NET is a promising approach for the treatment of PTSD for refugees living in unsafe conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The importance of the peritraumatic experience in defining traumatic stress.

In the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev., DSM–IV–TR; American Psychiatric Association, 2000), posttraumatic stress disorder (PTSD) Criterion A2 stipulates that an individual must experience intense fear, helplessness, or horror during an event that threatened the life or physical integrity of oneself or others to be eligible for the PTSD diagnosis. In considering this criterion, we describe its origins, review studies that have examined its predictive validity, and reflect on the intended purpose of the criterion and how it complements the mission of the DSM. We then assert that the predictive validity of Criterion A2 may not be an appropriate metric for evaluating its worth. We also note that the current Criterion A2 may not fully capture all the salient aspects of the traumatic stress response. To support this claim, we review empirical research showing that individuals adapt to extreme environmental events by responding in a complex and coordinated manner. This complex response set involves an individual's appraisal regarding the degree to which the event taxes his or her resources, as well as a range of other cognitions (e.g., dissociation), felt emotions (e.g., fear), physiological reactions (e.g., heart rate increase), and behaviors (e.g., tonic immobility). We provide evidence that these response components may be associated with the subsequent development of PTSD. We then describe the challenges associated with accurately assessing an individual's traumatic stress response. We conclude with a discussion of the need to consider the individual's immediate response when defining a traumatic stressor. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating traumatized OEF/OIF veterans: How does trauma treament affect the clinician?: Correction to Voss Horrell et al. (2011).

Reports an error in Treating traumatized OEF/OIF veterans: How does trauma treatment affect the clinician by Sarah C. Voss Horrell, Dana R. Holohan, Lea M. Didion and G. Todd Vance (Professional Psychology: Research and Practice, 2011[Feb], Vol 42[1], 79-86). The word “While” was erroneously inserted in the first sentence of the “Clinician Factors” section. The corrected sentence is provided in the erratum. (The following abstract of the original article appeared in record 2011-04544-011.) The authors of this article describe the rewards and challenges for clinicians treating veterans who have served in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). Issues of vicarious trauma, secondary traumatic stress, compassion fatigue, and burnout are defined and reviewed, as are compassion satisfaction and posttraumatic growth. Patient, clinician, and organizational characteristics that are likely to affect clinicians working with this clinical population are discussed. Patient factors that may increase strain on clinicians are discussed such as age, likelihood of redeployment, comorbid conditions, attendance issues, and elevated risk for suicide and aggression. Clinician factors, such as theoretical orientation, training, supervision, military affiliation, personal trauma history, spirituality, social support, and self-care, are also discussed as possible risk and protective factors for vicarious trauma and burnout. Organizational influences, such as caseload size and diversity, clinician control and autonomy, use of evidence-based practices, availability of resources, rural isolation, and the philosophy of the clinic, are further discussed. Recommendations for ameliorating risks are discussed relative to each area and include allowing clinicians to plan their own appointments so as to balance their caseload of OEF/OIF veterans, attending to self-care practices, and having a supportive team with thorough training in evidence-based practices. Future empirical research is needed on risk and resiliency factors for clinicians working with traumatized OEF/OIF veterans given that this population is likely to grow. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

APA's response to international and national disasters and crises: Addressing diverse needs. 2005 annual report of the APA Policy and Planning Board.

The 2005 Policy and Planning Board of the American Psychological Association (APA) was chaired by Sandra E. Tars, PhD. Other members of the Policy and Planning Board included G. Andrew H. Benjamin, JD, PhD; Mae Lee Billet-Ziskin, PhD; Connie Chan, PhD; Cynthia P. Deutsch, PhD; Lisa R. Grossman, JD, PhD; Janet R. Matthews, PhD; Morgan T. Sammons, PhD; Derald Wing Sue, PhD; Susan Krauss Whitbourne, PhD; and Gerald P. Koocher, PhD, the liaison for the Board of Directors. APA Bylaws Article XI.7 requires that the Policy and Planning Board report annually by publication to the membership and review the structure and function of the Association as a whole every fifth year. Given the tremendous psychological impact of disasters and crises, the Policy and Planning Board decided to focus this 2005 annual report on the history and evolution of APA's responses to such traumas, with an eye to future directions that might be taken as the need arises. This report reviews the phases of response to disaster and proposes parameters for APA's organizational response. It also highlights concerns posed by the racial and economic disparities laid bare in the aftermath of Hurricane Katrina and raises questions about the proper role of psychology in addressing the broader social context in both preparation for and the aftermath of disaster. Ultimately, it is our intent to identify points of both pride and challenge for APA members and governance leaders to consider. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Center for Victims of Torture-Guinea 2004-2005 International Mental Health Team: International Humanitarian Award.

Presents the citation for the Center for Victims of Torture--Guinea 2004-2005 International Mental Health Team, who received the International Humanitarian Award "for their outstanding commitment to the healing of torture victims and to educating the world community about torture and war trauma." A brief profile of the Center is presented, as well as the Center's award address, entitled Trauma Healing in Refugee Camps in Guinea: A Psychosocial Program for Liberian and Sierra Leonean Survivors of Torture and War (see record 2006-21079-047). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Epidemiology of Trauma and Posttraumatic Stress Disorder in Mexico.

Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Trauma, dissociation, and conflict: The space where neuroscience, cognitive science, and psychoanalysis overlap.

The authors describe their scientific and clinical interests in developing the panel Trauma, Dissociation, and Conflict: The Space Where Neuroscience, Cognitive Science, and Psychoanalysis Overlap, given at the 22nd Annual Spring Meeting of the Division of Psychoanalysis of the American Psychological Association. They cite the influence of the panelists, Philip M. Bromberg, Wilma Bucci, and Joseph LeDoux, on their own work. Specializing in the treatment of chronic pain, Anderson has developed a relational intersubjective technique informed by this interdisciplinary approach. Gold's work has focused on the distinction between dissociative processes and repression in traumatic memory. The relevance of trauma, dissociation, and conflict, heightened since September 11, 2001, could not have been anticipated in the planning of the panel. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Therapists' reactions to treatment of survivors of political torture.

Working with survivors of political torture and war trauma can trigger strong emotional responses in the therapist. As more survivors seek treatment, it is essential to identify and develop robust support systems for therapists who help their clients confront nearly unspeakable experiences. The emotional reactions of 6 psychotherapists who worked with traumatized survivors in a refugee treatment center were explored. The psychotherapists' reactions were compared with those of therapists who worked in different treatment settings with other presenting problems. The results of the study show that the strong level of responsibility therapists feel for their traumatized clients may hide an emotional strain and may lead to burnout. Suggestions are offered for supporting therapists in this difficult but important work. (PsycINFO Database Record (c) 2010 APA, all rights reserved)