9 research outputs found
Trauma related rumination mediates the effect of naturally occurring depressive symptoms, but not momentary low mood on trauma intrusions
Comorbid depression is known to contribute to the maintenance of posttraumatic stress disorder (PTSD ) including distressing intrusive trauma memories. It is theorised that depression is a risk factor for persistent PTSD through preventing optimal habituation of distress provoked by trauma memories and reminders, but the underlying cognitive mechanisms responsible are uncertain. The present study investigated traumaârelated rumination as a possible mediator for the effect of depression on trauma intrusions. Participants received a low mood induction or control procedure. Following viewing an analogue trauma film, frequency of filmârelated intrusions and associated distress levels were measured and at 1âweek followâup. Between the two occasions, participants rated their levels of rumination about the film. Existing depression symptoms but not induced momentary sad mood predicted frequency of film intrusions and associated distress at 1âweek followâup. Some evidence was found that ruminative trauma processing mediated the relationship between baseline depressive symptoms and later intrusion frequency and associated distress. Future research is warranted to better understand the role of rumination in the depression-intrusion relationship, which may shed light on the clinical applicability of ruminationâtargeted intervention for PTSD and comorbid depression
Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders
IntroductionComorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18â35âyears) residential substance use treatment service.Methods and analysisA single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12âmonths using service and staff outcomes.Ethics and disseminationThe study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853
Trauma related rumination mediates the effect of naturally occurring depressive symptoms but not momentary low mood on the trauma intrusions
Comorbid depression is known to contribute to the maintenance of posttraumatic stress disorder (PTSD) including distressing
intrusive trauma memories. It is theorised that depression is a risk factor for persistent PTSD through preventing optimal habituation
of distress provoked by trauma memories and reminders, but the underlying cognitive mechanisms responsible are uncertain. The
present study investigated trauma-related rumination as a possible mediator for the effect of depression on trauma intrusions.
Participants received a low mood induction or control procedure. Following viewing an analogue trauma film, frequency of
film-related intrusions and associated distress levels were measured and at 1-week follow-up. Between the two occasions, participants
rated their levels of rumination about the film. Existing depression symptoms but not induced momentary sad mood predicted
frequency of film intrusions and associated distress at 1-week follow-up. Some evidence was found that ruminative trauma
processing mediated the relationship between baseline depressive symptoms and later intrusion frequency and associated distress.
Future research is warranted to better understand the role of rumination in the depressionâintrusion relationship, which may shed
light on the clinical applicability of rumination-targeted intervention for PTSD and comorbid depression
ExposureâBased Writing Therapies for Subthreshold and Clinical Posttraumatic Stress Disorder: A Systematic Review and MetaâAnalysis
We undertook a systematic review to assess the efficacy of exposure-based writing therapies (WTs) for trauma-exposed adults with subthreshold or clinical levels of posttraumatic stress disorder. Four databases (PsycINFO, Medline, Wiley Online, PILOTS) were searched
for randomized controlled trials (RCTs) of exposure-based WTs. A total of 13 RCTs that reported on results from 17 WT versus control
comparisons were included. The primary outcomes were posttraumatic stress symptom severity at posttreatment and/or clinical response.
An overall unclear or high risk of bias was identified in 84.6% of studies. In comparison to both waitlist k = 3, Hedgesâ g = â0.97, 95%
CI [-1.20, -0.73], and placebo writing conditions, k = 9, Hedgesâ g = â0.48, 95% CI [-0.87, -0.08], WTs were more beneficial to participants. There was no evidence of a difference between WTs that were longer in duration compared to other psychotherapy, k = 2; pooled
OR = 1.42; 95% CI [0.83, 2.43]. These findings indicate that exposure-based WTs are effective when compared to waitlist and placebo
writing control conditions. The evidence needs to be considered in the context of the modest number of studies conducted to date, the high
methodological heterogeneity between the studies, and the high or unclear risk of bias across many studies. Further research is needed to
increase the evidence base regarding the efficacy of WTs for posttraumatic stress. Future research should also measure the mediators and
predictors of outcomes to further develop protocols and understand which variants of WTs work for different populations or individuals
Data_Sheet_1_Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders.PDF
IntroductionComorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18â35âyears) residential substance use treatment service.Methods and analysisA single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12âmonths using service and staff outcomes.Ethics and disseminationThe study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853.</p
Table_1_Study protocol: implementing and evaluating a trauma-informed model of care in residential youth treatment for substance use disorders.doc
IntroductionComorbidity between Substance Use Disorders and trauma/post-traumatic stress disorder (PTSD) is common, particularly within residential treatment services. Comorbidity is associated with poorer treatment retention and treatment outcomes. Integrated treatment approaches are increasingly recommended but are still under examined in residential treatment services. This study will implement and evaluate a novel model of trauma-informed care (TIC) in a youth (18â35âyears) residential substance use treatment service.Methods and analysisA single-armed, phase 1 implementation trial will be conducted in one residential treatment service. The model, co-developed with staff, incorporates: (i) workforce development in TIC through staff training and clinical supervision; adaptions to the service (ii) policies, procedures, and physical settings and (iii) treatment program adaptions (in delivery style and content) to be more trauma-informed; (iv) client screening and feedback for trauma and PTSD at service entry; and (v) the provision of support, referral and/or trauma-focused therapy to those with PTSD. Service outcomes will include adherence to the TIC model and client treatment completion. Client substance use and mental health measures will be collected at service entry, and 1-, 3-, 6- and 12-months follow up. Staff outcomes, including workplace satisfaction, burnout, and fatigue, as well as perceptions and confidence in delivering TIC will be collected at baseline, and at 3-, 6-, 12- and 18-months following training in the model. The sustainability of the delivery of the TIC model of care will be evaluated for 12âmonths using service and staff outcomes.Ethics and disseminationThe study has received ethical approval by the University of Queensland (Approval number: 2020000949). The results will be disseminated through publication in a peer-reviewed scientific journal, presentations at scientific conferences, and distributed via a report and presentations to the partner organization.Clinical trial registration: ACTRN12621000492853.</p