Biomedical subjects

Rachel M Guthrie

Publications and source records attributed to Rachel M Guthrie.

7 recordsLinked to original sources

PubMed2005

The additive benefit of hypnosis and cognitive-behavioral therapy in treating acute stress disorder.

This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N=87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure, cognitive restructuring, and anxiety management. CBT-hypnosis comprised the CBT components with each imaginal exposure preceded by a hypnotic induction and suggestions to engage fully in the exposure. In terms of treatment completers (n=69), fewer participants in the CBT and CBT-hypnosis groups met criteria for posttraumatic stress disorder at posttreatment and 6-month follow-up than those in the SC group. CBT-hypnosis resulted in greater reduction in reexperiencing symptoms at posttreatment than CBT. These findings suggest that hypnosis may have use in facilitating the treatment effects of CBT for posttraumatic stress.

Adolescent↗

PubMed2005

Maladaptive appraisals as a risk factor for posttraumatic stress: a study of trainee firefighters.

This study tested the proposal that catastrophic appraisals are a risk factor for developing stress reactions after trauma. Trainee firefighters (N = 82) were assessed during training (and before trauma exposure), and 68 firefighters were subsequently reassessed 6 months after commencing firefighter duty (after trauma exposure). Initial assessment included the Clinician Administered PTSD Scale, the Traumatic Events Questionnaire, and the Posttraumatic Cognitions Inventory. The Clinician Administered PTSD Scale was again administered approximately 20 months after initial assessment and after trauma exposure. Posttraumatic stress at follow-up was predicted by pre*trauma catastrophic thinking (24% of variance). These findings accord with cognitive models predicting that a tendency to catastrophize about negative events is a risk factor for developing posttraumatic stress symptoms.

Adaptation, Psychological↗

PubMed2005

Auditory startle response in firefighters before and after trauma exposure.

OBJECTIVE: Although previous psychophysiological studies have revealed heightened muscular and autonomic responses in individuals with posttraumatic stress disorder (PTSD), these studies have not permitted inferences about whether the abnormal responses are a vulnerability factor or are acquired following trauma. The present study reports the first prospective psychophysiological investigation, to the authors' knowledge, of posttraumatic stress responses by prospectively evaluating the auditory startle response in firefighters before and after trauma exposure. METHOD: Orbicularis oculi (eye blink) electromyograms and skin conductance responses to 15 100-dB acoustic startle stimuli were assessed in 84 trainee firefighters before trauma exposure. After commencement of active duty, 35 firefighters were reassessed within 4 weeks of exposure to a traumatic event, and 36 firefighters were reassessed as a comparison group that was not exposed to trauma. RESULTS: In the trauma-exposed group, pretrauma physiological activity was predictive of posttrauma acoustic startle responses. Pretrauma skin conductance response to startle was also predictive of posttraumatic stress severity. CONCLUSIONS: These results provide initial support for elevated startle response being a vulnerability factor for posttraumatic stress responses.

Acoustic Stimulation↗

PubMed2003

Acute psychophysiological arousal and posttraumatic stress disorder: a two-year prospective study.

This study investigated the role of acute arousal in the development of posttraumatic stress disorder (PTSD). Hospitalized motor vehicle accident survivors (n = 146) were assessed for acute stress disorder (ASD) within 1 month of the trauma, 6 months later, and reassessed for PTSD 2 years posttrauma (n = 87). Heart rates (HR) were assessed on the day of hospital discharge. Participants who had PTSD 2 years posttrauma had higher HR at hospital discharge than those without PTSD. A diagnosis of ASD or a resting HR of 95 beats per minute had moderate sensitivity (74%) and specificity (91%) in predicting PTSD. These findings suggest that caution is required in using acute HR as a predictor of longer-term PTSD following trauma.

Accidents, Traffic↗

PubMed2003

Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder.

This study investigated the extent to which providing cognitive restructuring (CR) with prolonged imaginal exposure (IE) would lead to greater symptom reduction than providing IE alone for participants with posttraumatic stress disorder (PTSD). Fifty-eight civilian survivors of trauma with PTSD were randomly allocated to IE/CR, IE, or supportive counseling (SC). Treatment involved 8 individual weekly sessions with considerable homework. Independent assessments were conducted pretreatment, posttreatment, and at 6-month follow-up. IE/CR and IE resulted in reduced PTSD and depression compared with SC at posttreatment and follow-up. Further, IE/CR participants had greater reductions in PTSD and maladaptive cognitive styles than IE participants at follow-up. These findings suggest that providing CR in combination with IE may enhance treatment gains.

Adolescent↗

PubMed2003

Hypnotizability and posttraumatic stress disorder: a prospective study.

Although there is converging evidence that posttraumatic stress disorder (PTSD) is associated with higher levels of hypnotizability, there are no studies concerning the stability of hypnotizability levels following trauma. Acutely traumatized participants with acute stress disorder (N = 45) were administered the Stanford Hypnotic Clinical Scale (SHCS) within 4 weeks of their trauma. Participants were subsequently administered a brief cognitive-behavior therapy program. Six months after treatment, participants were re-assessed with the SHCS. Although SHCS scores were generally stable (r = .47), two thirds of participants responded differently across the 2 assessments. Increased SHCS scores at the second assessment were correlated with elevated PTSD avoidance scores. This finding suggests that elevated hypnotizability in PTSD populations may not be entirely stable and may be associated with specific PTSD responses.

Adolescent↗

PubMedDate not supplied

Extinction learning before trauma and subsequent posttraumatic stress.

OBJECTIVE: Fear conditioning theories propose that persistent stress reactions may occur as a result of impaired extinction learning, and a poor capacity for extinction learning may predispose some individuals to posttraumatic stress disorder development. This study indexed the extent to which deficits in extinction learning before trauma exposure are a risk factor for persistent posttraumatic stress after trauma exposure. METHODS: Eighty-four firefighters were assessed during cadet training (before trauma) and 70 were reassessed within 24 months of commencing active firefighting duties (after trauma). Measures of posttraumatic stress were used before and after trauma exposure. In addition, skin conductance and corrugator electromyogram (EMG) responses were obtained during fear conditioning and extinction paradigms before trauma exposure. RESULTS: Reduced extinction of an aversively conditioned corrugator EMG response pretrauma predicted 31% of the variance in posttraumatic stress severity. CONCLUSIONS: This result provides preliminary support for reduced extinction of a conditioned emotional response as a vulnerability factor for posttraumatic stress.

Adult↗