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Improving treatments for complex PTSD and for survivors of child abuse (first post)

I've just come across a very interesting research study published in this month's American Journal of Psychiatry:  Cloitre, M., K. C. Stovall-McClough, et al. (2010). "Treatment for PTSD Related to Childhood Abuse: A Randomized Controlled Trial." Am J Psychiatry 167(8): 915-924.  The abstract reads:  "Objective: Posttraumatic stress disorder (PTSD) related to childhood abuse is associated with features of affect regulation and interpersonal disturbances that substantially contribute to impairment.

Recent research: CBT for a variety of conditions – back pain, PTSD, obsessions, bipolar disorder, schemas & social anxiety

Here are six recent papers on CBT treatment for a variety of disorders - for fuller details, abstracts and links, see further down this page.  Lamb et al explored the value of "Group cognitive behavioural treatment for low-back pain in primary care".  That their results were reported in the Lancet, highlights the importance of their findings.  The active treatment group received an additional assessment and then six 1.5 hour group therapy sessions (average group size, eight participants).  Therapy focused on "guided discovery, identifying and countering negative automatic thoughts, pacing, graded activity, relaxation, and other skills."   Outcomes demonstrated that "Over 1 year, the cognitive behavioural intervention had a sustained effect on troublesome subacute and chronic low-back pain at a low cost to the health-care provider."

Writing (& speaking) for resilience & wellbeing 3: personal growth

They taught me more about, in the midst of all this trauma and suffering and uncertainty - of remaining true to who you are,
and what love can be about in those moments. And there are three or four of those that really stand out very strongly,
whose lives were very different but who were kind of my teachers.
A therapist describing the impact on himself of working with clients struggling with AIDS

You can access a downloadable Word format version of this post by clicking here.

Writing (& speaking) for resilience & wellbeing 2: traumas & difficulties

Fear is the mind-killer ... I will face my fear. I will permit it to pass over me and through me. And when it has gone past I will turn the inner eye to see its path. Where the fear has gone there will be nothing. Only I will remain.  Bene Gesserit "Litany against Fear" from "Dune" by Frank Herbert

You can access a downloadable Word format version of this post by clicking here  .

Four aspects model & some associated evidence for relaxation, meditation & imagery

Relaxation, meditation, mindfulness, hypnosis, imagery and other associated methods form a complex, loosely interlinked field.  The "Four aspects of helpful inner focus" model, that I've put together to help me make more sense of this territory, looks like this: 

Four aspects model

For a downloadable copy of this diagram click here.  There is a fair amount of data supporting most of these methods.  To give some examples:

Recent research: six studies on the long-term effects of abuse & deprivation

Here are half a dozen studies on the long-term effects of various forms of abuse & deprivation.  Paras et al systematically reviewed the association between a history of sexual abuse and a lifetime diagnosis of a somatic disorder.  They found significant links with functional gastrointestinal disorders, nonspecific chronic pain, psychogenic seizures, and chronic pelvic pain.  When analysis was restricted to studies where sexual abuse was defined as rape, they also found an association with fibromyalgia.  Abstracts and links, for this research paper and the further papers described, can be found lower down this page.   

Exeter conference day 3: positive psychology, imagery symposium, compassion lecture, & closing remarks

Third and last day of the full conference.  In fact we finish at lunch time today.  Up, then an interesting conversation about bipolar disorder at breakfast.  It's fun how I can chat with almost any of the well over 1,000 conference participants and almost certainly we'll have a whole lot of helpful shared experiences and insights to explore.  Then off to an in-conference workshop on Positive psychology based interventions.  Sadly there's a notice on the seminar room door saying the workshop has been cancelled due to illness.  Oh dear, I hope the would-be presenter Ilona Boniwell (or any ill members of her family) get well soon.  What a pity.  It's been a feature of this year's BABCP conference that a number of research papers on positive psychology interventions have begun to emerge.  So, flipping through the conference programme, presentations that appear to overlap into this area include: Developing the role of psychological wellbeing practitioners; If it feels go

Recent research: six papers relevant to psychotherapy

Here are six studies relevant to improving psychotherapy outcomes.  Brewin et al report on using imagery-based interventions to help people with depressioin.  Lydiard et al highlight the importance of sleep-related disturbances as a treatment target in PTSD.  McCrady and colleagues show that working with couples rather than just individuals seems more effective when using behavioural therapy to help women with alcohol use disorders.  Geerts et al describe rather amazing research investigating "The role of parental bonding and nonverbal communication in the short-term treatment response was investigated in 104 depressed outpatients. At baseline patients completed the Parental Bonding Instrument. We registered the nonverbal involvement behaviour of patients and interviewers from video recordings of baseline clinical interviews and calculated the convergence between patient-interviewer behaviour over the interview ... As hypothesized, low maternal care and high paternal overprotection predicted a poor response to an 8-week treatment.  Maternal care was positively correlated with nonverbal convergence. Moreover, convergence moderated the relationship between maternal care and the response to treatment: Lack of convergence between patients and interviewers turned out to annul the positive effects of maternal care on the treatment response.

Recent research: a mixed bag of six papers on anxiety

Here are half a dozen papers with anxiety relevance.  The first couple are about the interaction between genetic vulnerability (or resilience) and childhood experience.  The Stevens et al paper is an update on the large body of research looking at psychological genetic vulnerability/resilience in macaque monkeys and how this interacts with parenting quality to lead, or not lead, to emotional and neurophysiological disturbances in adulthood.  The Battaglia paper particularises this gene/environment investigation by looking at the connections between early human childhood separation anxiety, loss of a parent, and panic disorder in adulthood.  

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