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Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a three-year follow-up. Behav Res Ther (in press)

School of Psychology, University of New South Wales, NSW 2052, Sydney, Australia.
Behaviour Research and Therapy (Impact Factor: 3.85). 10/2006; 44(9):1331-5. DOI: 10.1016/j.brat.2005.04.007
Source: PubMed

ABSTRACT The long-term benefits of cognitive behaviour therapy (CBT) for trauma survivors with acute stress disorder were investigated by assessing patients 3 years after treatment. Civilian trauma survivors (n=87) were randomly allocated to six sessions of CBT, CBT combined with hypnosis, or supportive counselling (SC), 69 completed treatment, and 53 were assessed 2 years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician-Administered PTSD Scale. In terms of treatment completers, 2 CBT patients (10%), 4 CBT/hypnosis patients (22%), and 10 SC patients (63%) met PTSD criteria at 2-years follow-up. Intent-to-treat analyses indicated that 12 CBT patients (36%), 14 CBT/hypnosis patients (46%), and 16 SC patients (67%) met PTSD criteria at 2-year follow-up. Patients who received CBT and CBT/hypnosis reported less re-experiencing and less avoidance symptoms than patients who received SC. These findings point to the long-term benefits of early provision of CBT in the initial month after trauma.

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Available from: Reginald D.V. Nixon, Apr 16, 2015
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    • "Analyzing the PTSD diagnosis was based on k ¼ 3 studies (Bisson et al., 2004; Bryant, Moulds, & Nixon, 2003; Bryant et al., 2006). The total number of treated patients was n ¼ 255, including n ¼ 146 in the early TFCBT. "
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    ABSTRACT: Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27-0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.
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    • "(Bryant, Mastrodomenico, et al., 2008; Foa et al., 1995; Foa et al., 2006; Shalev et al., 2011 "
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    • "These qualities highlight the diagnosis of ASD as a way to identify individuals who may benefit from more immediate interventions as opposed to individuals whose symptoms may naturally remit with time. The treatment of ASD has shown promising evidence both in the remission of primary symptoms and in the prevention of PTSD (e.g., Bryant et al., 2006). Conclusions regarding the concept of ASD and the current status of the treatment outcome literature have broad implications for clinicians in practice, given the prevalence of trauma exposure and the likelihood of working with this client population. "
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    ABSTRACT: Acute stress disorder (ASD) was included as a diagnosis to the 4th edition of the Diagnostic and Statistical Manual (American Psychiatric Association, 1994) as a way of describing pathological reactions in the first month following a trauma. Since that time, ASD has been the focus of some controversy, particularly regarding the theoretical basis and practical utility of the disorder. Despite this controversy, ASD has demonstrated usefulness in identifying individuals experiencing a high level of distress in the acute aftermath of a trauma as well as those at risk for developing posttraumatic stress disorder (PTSD). This paper reviews the clinical application of ASD, the current controversy surrounding its conceptual basis, and then discusses the dilemmas regarding this diagnosis that might occur in clinical practice. A review of the randomized control trial treatment outcome literature for ASD is also included in an effort to assist clinicians selecting interventions for clients recently exposed to traumatic events. Throughout this paper, the relationship between research and applied clinical practice is highlighted.Highlights► ASD has clinical utility in describing pathological posttraumatic reactions. ► We review treatment outcome studies for ASD. ► CBT for ASD is effective and beneficial.
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