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“Chronic PTSD is tenacious and disabling. Short-term interventions without prior assessment or diagnosis have failed to prevent PTSD. Preventing post-traumatic stress disorder is a pressing public health need,” according to researchers from Hadassah University Hospital, Jerusalem in an article published in Archives of General Psychiatry, a JAMA journal.
In order to test best practices for post-traumatic stress disorder, researchers carried out an investigation comparing primary and delayed exposure-based, cognitive and pharmacological interventions. Participants were chosen from survivors of traumatic events who passed through the Hadassah Hospital in Jerusalem. A telephone interview 9 days after the event determined if they were candidates. They were asked to come in for assessment and if they met post traumatic stress disorder symptom criteria they were invited to join the study.
There were four groups: some received cognitive therapy (CT), a wait list control group that received prolonged exposure treatment after five months, a group taking selective serotonin reuptake inhibitors (SSRIs) and a prolonged exposure (PE) group. The PE treatment was characterized by breathing technique, psychoeducation, in vivo exposure to avoided situations, and prolonged imaginal exposure to traumatic memories. The cognitive treatment included altering schemas and identifying and challenging negative thoughts.
At the end of five months, PTSD had developed the least in the CT group at 18.2% and the PE group at 21.4%. The SSRI group had occurrences of 61.9% even more than the control group at 55.6%. Initially 58.2% of the waitlist group had PTS, but after their treatment began at a four month follow up the numbers had dropped to 22.9%.
“The results of our study show that there are significant and similar preventive effects of PE and CT. Our finding suggests that delaying the intervention does not increase the risk of chronic PTSD… Thus a delayed intervention is an acceptable option when early clinical interventions cannot be provided (eg during wars, disasters, or continuous hostilities).”
Source: Archives of General Psychiatry, MedicalNewsToday
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