Shawn R Criswell1, Richard Sherman2, Stanley Krippner3. 1. Mental Health Therapist with the Department of Mental Health at Kaiser Permanente Northwest in Portland, OR (shawn.r.criswell@kp.org). 2. Chair of the Department of Psychophysiology at Saybrook University in Oakland, CA, and the Director of the Behavioral Medicine Research and Training Foundation in Port Angeles, WA (rsherman@saybrook.edu). 3. Instructor of Psychology in the College of Social Sciences with the Department of Humanistic and Clinical Psychology at Saybrook University in Oakland, CA (skrippner@saybrook.edu).
Abstract
OBJECTIVE: To test the effectiveness of a mental health therapy designed to reduce noncombat-related persistent posttraumatic stress disorder (PTSD) symptoms in 30 adult outpatients with a diagnosis of PTSD. The individual treatment offered modules to address PTSD nightmare distress, dissociation, general core skills, alterations in arousal and reactivity, avoidance, intrusion, and negative alternations in cognitions and mood. The therapeutic approach centered on cognitive behavioral therapy and heart rate variability biofeedback. METHODS: The study had 2 components: The quality improvement project that performed the treatment within a standard care environment, and a retrospective medical chart review process that analyzed the results. The Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual, Fifth Edition, was used to confirm the initial PTSD diagnosis and was the primary measure used to monitor change in the diagnosis following treatment. RESULTS: None of the patients who completed the PTSD treatment met criteria for a PTSD diagnosis in the posttreatment assessment. A 1-sample test of proportions, with a 95% confidence interval and a significance level of p < 0.05, showed p = 0.0008, and that the proportion of patients who would not have PTSD if the study was repeated would be 86.77% to 100.00%. The treatment dropout rate was 13% (4 patients). CONCLUSION: The study findings suggest that this intervention is an effective treatment for helping adult patients, including those with a history of childhood abuse, remit their PTSD diagnosis.
OBJECTIVE: To test the effectiveness of a mental health therapy designed to reduce noncombat-related persistent posttraumatic stress disorder (PTSD) symptoms in 30 adult outpatients with a diagnosis of PTSD. The individual treatment offered modules to address PTSD nightmare distress, dissociation, general core skills, alterations in arousal and reactivity, avoidance, intrusion, and negative alternations in cognitions and mood. The therapeutic approach centered on cognitive behavioral therapy and heart rate variability biofeedback. METHODS: The study had 2 components: The quality improvement project that performed the treatment within a standard care environment, and a retrospective medical chart review process that analyzed the results. The Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual, Fifth Edition, was used to confirm the initial PTSD diagnosis and was the primary measure used to monitor change in the diagnosis following treatment. RESULTS: None of the patients who completed the PTSD treatment met criteria for a PTSD diagnosis in the posttreatment assessment. A 1-sample test of proportions, with a 95% confidence interval and a significance level of p < 0.05, showed p = 0.0008, and that the proportion of patients who would not have PTSD if the study was repeated would be 86.77% to 100.00%. The treatment dropout rate was 13% (4 patients). CONCLUSION: The study findings suggest that this intervention is an effective treatment for helping adult patients, including those with a history of childhood abuse, remit their PTSD diagnosis.
Authors: Dean G Kilpatrick; Heidi S Resnick; Melissa E Milanak; Mark W Miller; Katherine M Keyes; Matthew J Friedman Journal: J Trauma Stress Date: 2013-10
Authors: Ethy Dorrepaal; Kathleen Thomaes; Adriaan W Hoogendoorn; Dick J Veltman; Nel Draijer; Anton J L M van Balkom Journal: Eur J Psychotraumatol Date: 2014-10-14