The role of perceived social support in crime victimization

Abstract 8 There has been extensive research into social support (SS) and trauma, but there remains a paucit

Predicting posttraumatic stress disorder after childbirth

Objective: around 50% of women report symptoms that indicate some aspect of their childbirth experience was 'traumatic', and at least 3.1% meet diagnosis for PTSD six months post partum. Here we aimed to conduct a prospective longitudinal study and examine predictors of birth-related trauma - predictors that included a range of pre-event factors - as a first step in the creation of a screening questionnaire. Method: of the 933 women who completed an assessment in their third trimester, 866 were followed-up at four to six week post partum. Two canonical discriminant function analyses were conducted to ascertain factors associated with experiencing birth as traumatic and, of the women who found the birth traumatic, which factors were associated with those who developed PTSD. Findings: a mix of 16 pre-birth predictor variables and event-specific predictor variables distinguished women who reported symptoms consistent with trauma from those who did not. Fourteen predictor variables distinguished women who went on to develop PTSD from those who did not. Conclusions: anxiety sensitivity to possible birthing problems, breached birthing expectations, and severity of any actual birth problem, predicted those who found the birth traumatic. Prior trauma was the single most important predictive factor of PTSD. Evaluating the utility of brief, cost-effective, and accurate screening for women at risk of developing birth-related PTSD is suggested

Low omega-6 vs. low omega-6 plus high omega-3 dietary intervention for Chronic Daily Headache: Protocol for a randomized clinical trial

<p>Abstract</p> <p>Background</p> <p>Targeted analgesic dietary interventions are a promising strategy for alleviating pain and improving quality of life in patients with persistent pain syndromes, such as chronic daily headache (CDH). High intakes of the omega-6 (n-6) polyunsaturated fatty acids (PUFAs), linoleic acid (LA) and arachidonic acid (AA) may promote physical pain by increasing the abundance, and subsequent metabolism, of LA and AA in immune and nervous system tissues. Here we describe methodology for an ongoing randomized clinical trial comparing the metabolic and clinical effects of a low n-6, average n-3 PUFA diet, to the effects of a low n-6 plus high n-3 PUFA diet, in patients with CDH. Our primary aim is to determine if: A) both diets reduce n-6 PUFAs in plasma and erythrocyte lipid pools, compared to baseline; and B) the low n-6 plus high n-3 diet produces a greater decline in n-6 PUFAs, compared to the low n-6 diet alone. Secondary clinical outcomes include headache-specific quality-of-life, and headache frequency and intensity.</p> <p>Methods</p> <p>Adults meeting the International Classification of Headache Disorders criteria for CDH are included. After a 6-week baseline phase, participants are randomized to a low n-6 diet, or a low n-6 plus high n-3 diet, for 12 weeks. Foods meeting nutrient intake targets are provided for 2 meals and 2 snacks per day. A research dietitian provides intensive dietary counseling at 2-week intervals. Web-based intervention materials complement dietitian advice. Blood and clinical outcome data are collected every 4 weeks.</p> <p>Results</p> <p>Subject recruitment and retention has been excellent; 35 of 40 randomized participants completed the 12-week intervention. Preliminary blinded analysis of composite data from the first 20 participants found significant reductions in erythrocyte n-6 LA, AA and %n-6 in HUFA, and increases in n-3 EPA, DHA and the omega-3 index, indicating adherence.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov <a href="http://www.clinicaltrials.gov/ct2/show/(NCT01157208)">(NCT01157208)</a></p

Power therapies and possible threats to the science of psychology and psychiatry

Advocates of new therapies frequently make bold claims regarding therapeutic effectiveness, particularly in response to disorders which have been traditionally treatment-refractory. This paper reviews a collection of new therapies collectively self-termed 'The Power Therapies', outlining their proposed procedures and the evidence for and against their use. These therapies are then put to the test for pseudoscientific practice. Therapies were included which self-describe themselves as 'Power Therapies'. Published work searches were conducted on each therapy using Medline and PsychInfo databases for randomized controlled trials assessing their efficacy, except for the case of Eye Movement Desensitization and Reprocessing (EMDR). Eye Movement Desensitization and Reprocessing has more randomized controlled studies conducted on its efficacy than any other treatment for trauma and thus, previous meta-analyses were evaluated. It is concluded that these new therapies have offered no new scientifically valid theories of action, show only non-specific efficacy, show no evidence that they offer substantive improvements to extant psychiatric care, yet display many characteristics consistent with pseudoscience

Clinical intervention, supportive counselling and therapeutic methods : a clarification and direction for restorative treatment

There is currently some confusion regarding the provision of therapeutic options as part of a restorative treatment approach to criminal victimisation. This article aims to clarify the issues surrounding psychological debriefing, early intervention, post traumatic stress disorder and recovered memory therapy as raised by Fattah (1999; 2000). In essence, the evidence to date suggests that while debriefing and repressed memory therapy may in fact be detrimental to the well-being of the victim, early intervention with Cognitive Behavioural Therapy for those with identifiable disorders who request help is very effective in relieving the suffering following victimisation. It is also suggested that while 'supportive counselling' for those with transient personal problems may be of use, this has not yet been demonstrated and is definitely not of use when treating mental disorders. There is no objective evidence to suggest that 'supportive counselling', active listening by quasi-professionals or 'tea and sympathy with Aunt Adie' are effective

The psychological effects of a lifestyle management course on war veterans and their spouses

This research assessed the effect on a war-veteran outpatient group in a week-long residential lifestyle-management course. This course also included the veterans' partners, and all participants were assessed at intake, post-intervention, and at three- and six-month follow-ups. In summary, it was found that while there was a statistically significant drop in PTSD symptomatology for the veterans, the clinical utility of this improvement was minimal, with an estimated effect size of d = 0.19 by six-month follow-up. However, the veterans displayed a significant decrease in measures of depression, anxiety, and stress by six-month follow-up, all with small-to-moderate effect sizes. Likewise, ratings of anger showed statistically significant improvement with a moderate effect size. While dyadic adjustment displayed a significant improvement to six-month follow-up, the derived effect size was small for the veterans. The spouses (all females in this study) displayed larger effect sizes on all measures, with the exception of ratings of anger, where a small effect was noted. Subjective quality-of-life indices displayed a significant change in the desired direction, although with a minimal effect for the veterans and a small effect size for the females. It was not feasible to have a control group during this naturalistic investigation and, therefore, caution is advised in over-generalizing from these data. However, these results warrant further controlled investigation into the inclusion of spouses in the treatment of veterans and the utility of lifestyle-management courses as a first step in the treatment of trauma related problems that have become chronic in nature within the veteran community

An approach to psychotherapy toleration : the Distress/Endorsement Validation Scale (DEVS) for clinical outcome studies

The issue of treatment tolerance within the field of psychotherapy is, at best, a nebulous construct and has been commonly evaluated via rates of subject attrition and homework compliance. This research presents the psychometric properties of a ten-item scale which endeavours to measure treatment distress and participant endorsement of therapy protocols used in clinical research. Two factors emerged and the subscales of Distress and Endorsement were derived. These subscales displayed good reliability with acceptable inter-item correlations within each subscale. The subscales were also able to differentiate the perspectives of male Vietnam veterans from their spouses on a lifestyle management course at the termination of intervention. However, this scale also displayed a cognitive behavioural trauma treatment protocol and eye movement desensitisation and reprocessing to be equivalent in treatment distress and participant endorsement in the treatment of post-traumatic stress disorder. Preliminary findings suggest that the relationship between these two subscales and outcome may, to some extent, be population specific. First evidence suggests that intervention distress ratings may be influenced by severity of presentation, whilst endorsement ratings are more influenced by symptomatic improvement over time. Suggestions for future research are presented and the full questionnaire is attached as an appendix

The roles of popularised distraction during exposure and researcher allegiance during outcome trials

This paper presents the argument that distraction techniques utilised during exposure frequently lead to a dissipation of therapeutic gains over time. Such dissolution particularly affects anxiety and depressive symptomatology and becomes more pronounced over time. It is argued that such a pattern is beginning to emerge in the case of Eye Movement Desensitisation and Reprocessing (EMDR). It is hypothesised that extinction of a fear response requires exposure to a functionally absorbing affective and sensory cue set. However, it is suggested that eye movements have an interference effect on this exposure with an initial reduction in anxiety common to exposure tasks coupled with avoidance strategies followed by a general deterioration in gains. It is further hypothesised that demand characteristics placed upon the treated research participant and experimenter expectancy and therapist allegiance may play prominent roles where similar studies obtain differing results