Research gleanings


Topiramate was effective in improving reexperiencing and avoidance/numbing symptom clusters in patients with PTSD. This study supports the use of anticonvulsants for the improvement of symptoms of PTSD.

The new issue of CNS Neuroscience & Therapeutics includes an article: “A Double-Blind Randomized Controlled Trial To Study the Efficacy of Topiramate in a Civilian Sample of PTSD.”

The authors are Mary S. L. Yeh, Jair Jesus Mari, Mariana Caddrobi Pupo Costa, Sergio Baxter Andreoli, Rodrigo Affonseca Bressan, & Marcelo Feijó Mello.

Method: We conducted a 12-week double-blind, randomized, placebo-controlled study comparing topiramate to placebo. Men and women aged 18 – 62 years with diagnosis of PTSD according to DSM-IV were recruited … 35 patients were randomized to either group. The primary outcome measure was the CAPS total score changes.

Results: 82.35% of patients in the topiramate group exhibited improvements in PTSD symptoms. The efficacy analysis demonstrated that patients in the topiramate group exhibited significant improvements in reexperiencing symptoms: flashbacks, intrusive memories, and nightmares of the trauma (CAPS-B; P= 0.04) and in avoidance/numbing symptoms associated with the trauma, social isolation, and emotional numbing (CAPS-C; P= 0.0001). Furthermore, the experimental group demonstrated a significant difference in decrease in CAPS total score (topiramate 57.78; placebo 32.41; P= 0.0076). Mean topiramate dose was 102.94 mg/d. Topiramate was generally well tolerated.
——————–
Comment: this is important, as psychotherapy helps many, but not all people with PTSD, and is often not available for a variety of social and economic factors.

What predicts which women will develop PTSD after a potentially traumatic event?

Number of baseline PTSD reexperiencing symptoms, rape history, and history of childhood physical assault were all found to predict PTSD chronicity 2 years later.

Chronic cases were also more likely to experience subsequent exposure to potentially traumatic stressors not involving interpersonal violence.

Contrary to our prediction, binge drinking and poorer perceived health did not predict chronicity.

An analysis of mental health treatment seeking revealed no relationship between remission status and treatment seeking at baseline or any of the follow-up assessments, even when controlling for baseline PTSD symptom severity.

The absence of a relationship between subsequent treatment seeking and remission status suggests that, for many women, symptoms subsided without professional assistance.”

[Comment: That is, I would say, 1/2 got better using their own network and resources, not those of a professional; this probably does not mean that PTSD just evaporates.]

Psychological Trauma: Theory, Research, Practice, and Policy has scheduled an article for publication in a future issue: “Factors Associated With Chronicity in Posttraumatic Stress Disorder: A Prospective Analysis of a National Sample of Women.” The authors are Jesse R. Cougle, Heidi Resnick, and Dean G. Kilpatrick.

The University of California , San Diego, issued the following news release:

Acts of Kindness Spread Surprisingly Easily: Just a Few People Can Make
a Difference

For all those dismayed by scenes of looting in disaster-struck zones,
whether Haiti or Chile or elsewhere, take heart: Good acts — acts of
kindness, generosity and cooperation — spread just as easily as bad.
And it takes only a handful of individuals to really make a difference.

In a study published in the March 8 early online edition of the
Proceedings of the National Academy of Sciences, researchers from the
University of California, San Diego and Harvard provide the first
laboratory evidence that cooperative behavior is contagious and that it
spreads from person to person to person.

When people benefit from kindness they “pay it forward” by helping
others who were not originally involved, and this creates a cascade of
cooperation that influences dozens more in a social network.
(more…)

The new issue of *Archives of Internal Medicine* (Vol. 170, No. 4,
February 22) includes an article: “The Effect of Exercise Training on
Anxiety Symptoms Among Patients: A Systematic Review.”

The authors are Matthew P. Herring, MS, MEd, Patrick J. O’Connor, PhD, & Rodney K. Dishman, PhD.

Here’s how the article starts:

[begin excerpt]

Anxiety, an unpleasant mood characterized by thoughts of worry, is an
adaptive response to perceived threats that can develop into a
maladaptive anxiety disorder if it becomes severe and chronic.1

Anxiety symptoms and disorders are common among individuals with a
chronic illness,2-8  yet health care providers often fail to recognize
or treat anxiety and may consider it to be an unimportant response to a
chronic illness.9

Anxiety symptoms can have a negative impact on treatment outcomes in
part because anxious patients can be less likely to adhere to prescribed
medical treatments.10-11

Personal costs of anxiety among patients include reduced health-related
quality of life12 and increased disability, role impairment,13 and
health care visits.14
(more…)

The University of Rochester Medical Center issued the following news release:

Cognitive behavioral therapy for insomnia significantly improved sleep
for patients with chronic neck or back pain and also reduced the extent
to which pain interfered with their daily functioning, according to a
study by University of Rochester Medical Center researchers.

The study, published online by the journal Sleep Medicine, demonstrates
that a behavioral intervention can help patients who already are taking
medications for pain and might be reluctant or unable to take additional
drugs to treat sleep disturbance.

“This therapy made a major difference to these patients,” said Carla R.
Jungquist, F.N.P., Ph.D., of the Medical Center’s Sleep and
Neurophysiology Research Laboratory, who is the lead author of the Sleep
Medicine article.

(more…)

The journal *Child Development* issued the following news release:

Depression In Pregnancy Tied To Antisocial Behavior In Offspring During Teens

Children from urban areas whose mothers suffer from depression during
pregnancy are more likely than others to show antisocial behavior,
including violent behavior, later in life.

Furthermore, women who are aggressive and disruptive in their own teen
years are more likely to become depressed in pregnancy, so that the
moms’ history predicts their own children’s antisocial behavior. (more…)

The new issue of *Behaviour Research and Therapy* (vol. 48, #2, pp.
152-157) includes a study: “When self-help is no help: Traditional
cognitive skills training does not prevent depressive symptoms in people
who ruminate.”

The author is Gerald J. Haeffela.

Here’s the abstract:

[begin excerpt]

A randomized trial was conducted to test the efficacy of three self-
directed prevention intervention workbooks for depression.

Cognitively at-risk college freshmen were randomly assigned to one of
three conditions: traditional cognitive, non-traditional cognitive, and
academic skills.

Consistent with hypotheses, participants who were high in rumination and
experienced stress exhibited significantly greater levels of depressive
symptoms after completing the traditional cognitive skills workbook than
after completing the other two workbooks.

This pattern of results held post-intervention and 4 months later.

These findings indicate that rumination may hinder ones ability to
identify and dispute negative thoughts (at least without the help of a
trained professional).

The results underscore the importance of identifying individual
difference variables that moderate intervention efficacy.

They also raise concerns about the potential benefits of self-help
books, an industry that generates billions of dollars each year.

[end abstract]

Here’s the contact info from the author note: Gerald J. Haeffela,
Department of Psychology, University of Notre Dame, Haggar Hall, Notre
Dame, IN 46556, < g h a e f f e l @ n d . e d u >.

Courtesy of Ken Pope

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