Sudden Gains in Two Trauma-Focused Treatments for Post-traumatic Stress Disorder

 

PTSD, or post-traumatic stress disorder, is a mental health condition that can develop in response to a traumatic event such as a natural disaster, a car accident, or a violent assault. It is characterized by symptoms such as flashbacks, in which the person experiences vivid and distressing memories of the trauma as if it were happening again; nightmares, in which the person experiences vivid and distressing dreams related to the trauma; avoidance of reminders of the trauma, such as certain places, people, or activities; and intense feelings of fear and anxiety.

Other symptoms of PTSD can include irritability and angry outbursts, difficulty concentrating, difficulty sleeping, and hyper vigilance, or an increased state of alertness. People with PTSD may also experience physical symptoms such as a racing heart, sweating, or trembling. These symptoms can interfere with the person's daily life and relationships and can lead to other mental health conditions such as depression or substance abuse.

PTSD is a treatable condition, and there are several effective treatments available. These can include cognitive-behavioral therapy, which helps the person to change the way they think and react to the traumatic event; exposure therapy, in which the person gradually confronts their fears and memories of the trauma; and medication, such as antidepressants or anti-anxiety medications, which can help to reduce the symptoms of PTSD.

 

         In the article “Sudden Gains in Two-Trauma Focused Treatments for Post-Traumatic Stress Disorder” the current study examined the role of cognitive change and emotional expression in cognitive processing therapy (CPT) and written exposure therapy (WET), two types of therapy for post-traumatic stress disorder (PTSD). The study found that the percentage of participants who experienced sudden gains and the magnitude of the sudden gains did not differ between the two treatments. The study also found that experiencing a sudden gain predicted better PTSD treatment outcomes in both therapies and that self-reported cognitive change preceded sudden gains in one study of cognitive therapy for PTSD. The study used the CHANGE coding system to examine negative beliefs about the self and others in the first narratives of WET and CPT as predictors of sudden gains in the trial. The study included 126 treatment-seeking adults diagnosed with PTSD who were randomized to either WET or CPT. Participants were required to meet the diagnostic criteria for PTSD and to be stable on any psychiatric medication for at least four weeks. Potential participants were excluded if they were at high risk for suicide, were actively psychotic or manic, had severe cognitive impairment, met criteria for severe substance abuse, or were engaged in PTSD-focused psychotherapy. Sudden gains were identified using ratings on the PTSD.

The results of the study showed that the percentage of participants who experienced sudden gains and the magnitude of the sudden gains did not differ between the two treatments. In addition, experiencing a sudden gain predicted better PTSD treatment outcomes in both therapies. The study also found that self-reported cognitive change preceded sudden gains in one study of cognitive therapy for PTSD. The CHANGE coding system was used to examine negative beliefs about the self and others in the first narratives of WET and CPT as predictors of sudden gains in the trial. The study also investigated whether more expression of negative emotions in the narratives was associated with experiencing a sudden gain.

In conclusion, the study found that the percentage of participants who experienced sudden gains and the magnitude of the sudden gains did not differ between the two treatments and that experiencing a sudden gain predicted better PTSD treatment outcomes in both therapies. The study also found that self-reported cognitive change preceded sudden gains in one study of cognitive therapy for PTSD. The CHANGE coding system was used to examine negative beliefs about the self and others in the first narratives of WET and CPT as predictors of sudden gains in the trial.

         In the article called “Reactivating hippocampal-mediated memories during reconsolidation to disrupt fear” by Stephanie L. Grella et al discusses a study that explored the use of memory reactivation and reconsolidation as a potential therapeutic mechanism for reducing conditioned fear in individuals with anxiety disorders such as PTSD. The researchers used a mouse model to show that reactivating memories associated with a positive experience during memory recall can disrupt the consolidation of negative memories, leading to a reduction in conditioned fear. These findings suggest that targeting the dorsal dentate gyrus could be a potential therapeutic approach for reducing fear in individuals with anxiety disorders such as PTSD.

         In both articles, PTSD is used as a condition that can be treated using cognitive-behavioral therapy, exposure therapy, and medication. In the first article, "Sudden Gains in Two-Trauma Focused Treatments for Post-Traumatic Stress Disorder," PTSD is used as the primary focus of the study, which examines the role of cognitive change and emotional expression in cognitive processing therapy (CPT) and written exposure therapy (WET), two treatments for PTSD. The study aims to investigate whether sudden gains in therapy are predictive of better treatment outcomes and whether negative beliefs and emotional expression are associated with sudden gains in treatment. In the second article, "Reactivating hippocampal-mediated memories during reconsolidation to disrupt fear," PTSD is used as an example of an anxiety disorder that can be treated using memory reactivation and reconsolidation. The study shows that reactivating memories associated with a positive experience during memory recall can disrupt the consolidation of negative memories, leading to a reduction in conditioned fear. This finding suggests that targeting the dorsal dentate gyrus could be a potential therapeutic approach for reducing fear in individuals with anxiety disorders such as PTSD.

 

 

 

                                                 References

Grella, Stephanie L., et al. “Reactivating Hippocampal-Mediated Memories during Reconsolidation to Disrupt Fear.” Nature News, Nature Publishing Group, 12 Sept. 2022, https://www.nature.com/articles/s41467-022-32246-8.  

Author links open overlay panelDenise M.SloanPersonEnvelopeJohannaThompson-HollandsAdele M.HayesDaniel J.LeeElizabethAlpertBrian P.Marx, et al. “Sudden Gains in Two Trauma-Focused Treatments for Posttraumatic Stress Disorder.” Behavior Therapy, Elsevier, 30 Aug. 2021, https://reader.elsevier.com/reader/sd/pii/S0005789421001076?token=7B1045AF07C4FB6204D1D7309771835DBE0BF4D02903E54A58A6821D33A9BE988B2C4D8E08B647DD002B412ED3C57609&originRegion=us-east-1&originCreation=20221215005237.