Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders

Addiction ◽  
2013 ◽  
Vol 108 (8) ◽  
pp. 1397-1410 ◽  
Author(s):  
Claudia Sannibale ◽  
Maree Teesson ◽  
Mark Creamer ◽  
Thiagarajan Sitharthan ◽  
Richard A. Bryant ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Controlled Trial ◽  
Alcohol Use Disorders ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Randomized Controlled ◽  
Cognitive Behaviour ◽  
Post Traumatic

Augmenting cognitive behaviour therapy for post-traumatic stress disorder with emotion tolerance training: a randomized controlled trial

2013 ◽  
Vol 43 (10) ◽  
pp. 2153-2160 ◽  
Author(s):  
R. A. Bryant ◽  
J. Mastrodomenico ◽  
S. Hopwood ◽  
L. Kenny ◽  
C. Cahill ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Controlled Trial ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Randomized Controlled ◽  
Cognitive Behaviour ◽  
Post Traumatic

BackgroundMany patients do not adhere to or benefit from cognitive behaviour therapy (CBT) for post-traumatic stress disorder (PTSD). This randomized controlled trial evaluates the extent to which preparing patients with emotion regulation skills prior to CBT enhances treatment outcome.MethodA total of 70 adult civilian patients with PTSD were randomized to 12 sessions of either supportive counselling followed by CBT (Support/CBT) or emotion regulation training followed by CBT (Skills/CBT).ResultsSkills/CBT resulted in fewer treatment drop-outs, less PTSD and anxiety, and fewer negative appraisals at 6 months follow-up than Support/CBT. Between-condition effect size was moderate for PTSD severity (0.43, 95% confidence interval −0.04 to 0.90). More Skills/CBT (31%) patients achieved high end-state functioning at follow-up than patients in Support/CBT (12%) [χ2(n = 70) = 3.67, p < 0.05].ConclusionsThis evidence suggests that response to CBT may be enhanced in PTSD patients by preparing them with emotion regulation skills. High attrition of participants during the study limits conclusions from this study.

Amygdala and ventral anterior cingulate activation predicts treatment response to cognitive behaviour therapy for post-traumatic stress disorder

2007 ◽  
Vol 38 (4) ◽  
pp. 555-561 ◽  
Author(s):  
R. A. Bryant ◽  
K. Felmingham ◽  
A. Kemp ◽  
P. Das ◽  
G. Hughes ◽  
...  
Keyword(s):  
Treatment Response ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Cognitive Behaviour Therapy ◽  
Stress Disorder ◽  
Anterior Cingulate ◽  
Post Traumatic Stress ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Post Traumatic

BackgroundAlthough cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), approximately half of patients do not respond to CBT. No studies have investigated the capacity for neural responses during fear processing to predict treatment response in PTSD.MethodFunctional magnetic resonance imaging (fMRI) responses of the brain were examined in individuals with PTSD (n=14). fMRI was examined in response to fearful and neutral facial expressions presented rapidly in a backwards masking paradigm adapted for a 1.5 T scanner. Patients then received eight sessions of CBT that comprised education, imaginal and in vivo exposure, and cognitive therapy. Treatment response was assessed 6 months after therapy completion.ResultsSeven patients were treatment responders (defined as a reduction of 50% of pretreatment scores) and seven were non-responders. Poor improvement after treatment was associated with greater bilateral amygdala and ventral anterior cingulate activation in response to masked fearful faces.ConclusionsExcessive fear responses in response to fear-eliciting stimuli may be a key factor in limiting responses to CBT for PTSD. This excessive amygdala response to fear may reflect difficulty in managing anxiety reactions elicited during CBT, and this factor may limit optimal response to therapy.

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