Biomedical subjects

Reginald D V Nixon

Publications and source records attributed to Reginald D V Nixon.

18 recordsLinked to original sources

PubMed2005

Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up.

The long-term benefits of cognitive behaviour therapy (CBT) for trauma survivors with acute stress disorder were investigated by assessing patients 3 years after treatment. Civilian trauma survivors (n=87) were randomly allocated to six sessions of CBT, CBT combined with hypnosis, or supportive counselling (SC), 69 completed treatment, and 53 were assessed 2 years post-treatment for post-traumatic stress disorder (PTSD) with the Clinician-Administered PTSD Scale. In terms of treatment completers, 2 CBT patients (10%), 4 CBT/hypnosis patients (22%), and 10 SC patients (63%) met PTSD criteria at 2-years follow-up. Intent-to-treat analyses indicated that 12 CBT patients (36%), 14 CBT/hypnosis patients (46%), and 16 SC patients (67%) met PTSD criteria at 2-year follow-up. Patients who received CBT and CBT/hypnosis reported less re-experiencing and less avoidance symptoms than patients who received SC. These findings point to the long-term benefits of early provision of CBT in the initial month after trauma.

Adolescent↗

PubMed2005

The effect of arousal on memory for emotionally-relevant information: a study of skydivers.

The aim of the present study was to test memory for information under conditions of extreme arousal in an analogue design to mimic hyperarousal during trauma exposure. Prior to their skydive, 70 novice skydivers were administered measures of fear, heart rate, and anxiety sensitivity. Half the participants learnt a list of words that varied in both relevance to their skydive and valence (irrelevant/relevant, negative/neutral) on the plane (skydivers), and remaining participants learnt an identical list of words on the ground (delayed controls). Following the skydive, participants completed free recall and recognition tasks; heart rate, dissociation, and subjective arousal were also measured. Consistent with an attentional narrowing hypothesis, skydivers recalled comparable a comparable number of relevant words as delayed controls, but significantly less irrelevant words. In terms of recognition performance, skydivers displayed better recognition of relevant words but poorer recognition of irrelevant words than delayed controls. Valence of words did not alter the pattern of results. The implications of the findings are discussed in the context of understanding memory processes under conditions of high threat.

Adult↗

PubMed2005

In vivo flooding for anxiety disorders: proposing its utility in the treatment posttraumatic stress disorder.

Exposure techniques have now been used in the treatment of anxiety disorders for several decades. Although such techniques are a dominant feature of current therapies for disorders such as posttraumatic stress disorder and acute stress disorder, examination of their relative merits has been less studied. The purpose of this review is to suggest the usefulness of in vivo flooding in the treatment of posttraumatic stress. We discuss the relevant exposure literature by briefly examining the efficacy of these techniques in the treatment of anxiety. The theoretical and methodological limitations of investigations to date of exposure methods that have been used in posttraumatic stress treatment studies are then reviewed. We highlight the fact that in vivo flooding, an exposure technique that has been used to treat some anxiety-based disorders, has received scant clinical and research attention as a treatment for posttraumatic stress. A case is made for further study of in vivo flooding in the treatment of posttraumatic stress.

Anxiety Disorders↗

PubMed2005

Physiological arousal and dissociation in acute trauma victims during trauma narratives.

The aim of the present study was to examine whether the finding of suppressed physiological activity in dissociative rape-trauma victims (Griffin, Resick, & Mechanic, 1997) was replicable in a nonsexual assault trauma group. A sample of 17 high-dissociating (HD) participants and 18 low-dissociating (LD) participants who had experienced a motor vehicle accident or physical assault described their trauma while skin conductance, heart rate activity, and self-reported mood were recorded. HD individuals demonstrated a trend for elevated heart rate during the experiment compared with LD participants, but both groups displayed comparable skin-conductance levels. Curve estimation analysis indicated that the two groups had a similar pattern of physiological responding during the trauma narratives. These findings challenge the notion that dissociative reactions are associated with reduced psychophysiological arousal after trauma.

Accidents, Traffic↗

PubMed2005

Resolution of trauma-related guilt following treatment of PTSD in female rape victims: a result of cognitive processing therapy targeting comorbid depression?

BACKGROUND AND METHODS: Although Resick et al. [Resick, P.A., Nishith, P., Weaver, T.L., Astin, M.C., Feuer, C.A., 2002. A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. J. Consult. Clin. Psychol. 70, 867-879.] reported comparable results for treating rape-related posttraumatic stress disorder (PTSD) using either cognitive-processing therapy (CPT) or prolonged exposure (PE), there was some suggestion that CPT resulted in better outcomes than PE for certain aspects of trauma-related guilt. The present study revisited these findings to examine whether this effect was a function of improvement in a subset of participants with both PTSD and major depressive disorder (MDD). RESULTS: Results indicated that CPT was just as effective in treating "pure" PTSD and PTSD with comorbid MDD in terms of guilt. Clinical significance testing underscored that CPT was more effective in reducing certain trauma-related guilt cognitions than PE. LIMITATIONS: Findings cannot be generalized to men, and only one measure of guilt was used. CONCLUSIONS: The observed superiority of CPT over PE for treating certain guilt cognitions was not due to participant comorbidity. Further research is recommended to untangle the relationship between guilt, depression and differential response to treatment in PTSD following sexual assault trauma.

Adult↗

PubMed2005

Induced arousal and reexperiencing in acute stress disorder.

This study investigated the relationship of hyperarousal and intrusive symptoms in acute stress disorder (ASD). Civilian trauma survivors with ASD (n = 18) and without ASD (n = 14) completed a hyperventilation provocation test (HVPT) and then completed the Physical Reactions Scale. All participants provided a narrative describing their hyperventilation experience that was audiotaped and independently coded. Individuals with ASD reported greater numbers of intrusive memories and reported greater distress than non-ASD participants. More ASD than non-ASD participants experienced a flashback-type reaction during the hyperventilation. Intrusive symptoms were significantly correlated with elevated arousal following the HVPT. The findings provide evidence that reexperiencing is directly associated with elevated states of arousal.

Accidents, Traffic↗

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

September 11 attacks: prior interpersonal trauma, dysfunctional cognitions, and trauma response in a midwestern university sample.

Undergraduate college students (N = 133) were assessed for posttrauma and depressive symptomatology, posttrauma cognitions, and previous traumatic experiences 1 month after the September 11 attacks in the United States. Negative beliefs regarding oneself and the world mediated the relationship between prior interpersonal trauma and acute trauma symptoms. Acute depression acted as a mediator between prior interpersonal trauma and negative cognitions of oneself and self-blame cognitions. The results suggest that even in a nonclinical, nontreatment seeking college sample, prior traumatic events can play an important role in an individual's short-term adjustment following indirect exposure to a significant trauma. The differential relationship of negative beliefs on acute trauma symptoms and depression is discussed.

Adolescent↗

PubMed2004

An exploration of comorbid depression among female victims of intimate partner violence with posttraumatic stress disorder.

BACKGROUND AND METHODS: Factors contributing to posttraumatic stress disorder (PTSD) and comorbid major depression (MDD) were investigated among female victims of intimate partner violence (IPV). RESULTS: High levels of PTSD (75% of the sample) and MDD (54% of the sample) were observed. Individuals with both PTSD and MDD reported significantly greater levels of PTSD and depression symptoms than individuals with either PTSD alone or without major psychopathology. Individuals with comorbid PTSD and MDD had more maladaptive depressogenic cognitive styles than individuals without PTSD. The three groups were comparable in terms of pre-abuse mental health, childhood trauma history, and relationship violence variables and injuries. Maladaptive schemas did not contribute to the identification of comorbidity caseness, whereas PTSD severity and prior trauma did. Psychological aggression by an abuser and PTSD severity accounted for 52% of the variance in depressive symptoms. LIMITATIONS: Cross-sectional design and lack of trauma-specific cognitive measures. CONCLUSIONS: The findings confirm that comorbid PTSD and MDD is common among IPV victims. The mechanisms that contribute to comorbid depression, however, are unclear, and prospective studies are necessary to delineate the roles that psychological abuse, PTSD severity and prior trauma experiences may have in the development of depression following IPV.

Adult↗

PubMed2004

Panic following trauma: the etiology of acute posttraumatic arousal.

Two studies examined the contributing factors for panic symptoms following trauma. In Study 1, survivors of sexual and nonsexual assaults (N=105) were assessed at 2 weeks postcrime. Prior trauma, psychiatric history, crime characteristics, and peritraumatic dissociation were assessed. Posttraumatic panic was modestly predicted by childhood sexual abuse (CSA) experiences, a history of Anxiety and Depression, and peritraumatic dissociation. Childhood physical abuse (CPA), Adult Victimization, crime variables, and a prior history of Substance Use disorders and posttraumatic stress disorder (PTSD) were not implicated. In Study 2, the role of peritraumatic panic in predicting later arousal was also examined in a similar sample who were assessed within 6 weeks of their trauma (N=93). Presence of significant arousal during trauma predicted frequency of posttrauma panic attacks, but not its severity. In contrast to Study 1, prior history of PTSD, perception of life threat, and the index trauma being a sexual assault all predicted posttrauma panic, whereas prior trauma exposure and depression did not. These findings are discussed in terms of cognitive and arousal factors that may influence posttrauma panic.

Acute Disease↗

PubMed2004

Parent-child interaction therapy: one- and two-year follow-up of standard and abbreviated treatments for oppositional preschoolers.

The long-term effect of two parent training programs for conduct problem preschoolers is reported. Families of 54 behaviorally disturbed preschool-aged children were randomly assigned to 1 of 3 treatment conditions: standard Parent-Child Interaction Therapy (STD), an abbreviated form of PCIT (ABB), and a no-treatment waitlist control group (WL). Of the families who completed treatment (STD and ABB), data were collected on 97% and 94% of families at 1- and 2-year follow-up, respectively. Follow-up assessment of parent report and independent observations indicated that treatment gains were largely maintained for both treatment conditions with little difference between the two treatments. The findings suggest that an abbreviated form of PCIT has long-term benefits for families with young children displaying early conduct problems.

Adult↗

PubMed2004

The accumulative effect of trauma exposure on short-term and delayed verbal memory in a treatment-seeking sample of female rape victims.

The accumulative effect of prior high-magnitude trauma exposure on memory was examined in 73 rape victims, 92% of whom had current posttraumatic stress disorder (PTSD). Participants were administered the Logical Memory component of the Wechsler Memory Scale, the Quick Test to obtain an estimate of intelligence, and were assessed for prior traumatic experiences. Prior exposure to high-magnitude stressors (e.g., child rape, being kidnapped) was significantly correlated with poorer performance on the memory tasks. Regression analyses controlling for estimated IQ and psychopathology severity demonstrated that magnitude of prior trauma exposure predicted performance on the memory task, suggesting that in the current sample, deficits in verbal memory may be related (in part) to the degree of accumulative stress experienced over the lifetime.

Adult↗

PubMed2003

Peritraumatic and persistent panic attacks in acute stress disorder.

This study examined the prevalence of peritraumatic and persistent panic symptoms following trauma. Survivors of civilian trauma (n=30) with either acute stress disorder (ASD) or no acute stress disorder (non-ASD) were administered the Panic Module of the Structured Clinical Interview for DSM-IV (SCID). Participants also completed the Impact of Event Scale, Acute Stress Disorder Scale, Beck Depression Inventory, Beck Anxiety Inventory, and the Anxiety Sensitivity Index. Panic attacks were experienced by 77% of participants during their trauma, and 47% reported recurrent panic attacks post-trauma. ASD participants demonstrated more panic symptoms during and after their trauma than non-ASD participants. Posttraumatic panic was most strongly associated with anxiety sensitivity. These findings are discussed in terms of cognitive factors that may mediate posttrauma panic and treatment implications for managing posttraumatic anxiety. There is increasing evidence that panic attacks play a role in psychopathological response to trauma. A significant proportion of people with panic disorder report a history of trauma (). Moreover, two-thirds of trauma survivors report panic attacks within the previous 2 weeks (). There is also evidence that people with posttraumatic stress disorder (PTSD) display elevated levels of anxiety sensitivity (). Recent attention has focused on acute panic reactions because of proposals that panic during trauma may condition trauma-related cues to subsequent panic (). There is evidence that panic attacks occur in 53-90% of trauma survivors during the traumatic experience (). Further, people with acute stress disorder (ASD) are more likely to report peritraumatic panic attacks than non-ASD individuals. ASD is a useful framework in which to investigate the role of panic in posttraumatic stress because ASD describes acute responses to trauma that are strongly predictive of chronic PTSD (). This study investigated the relationship between peritraumatic panic and ongoing panic attacks following trauma. Specifically, we indexed panic attacks during trauma and subsequent to trauma in trauma survivors with and without ASD. We also indexed the extent to which distorted interpretations about somatic sensations may be associated with panic attacks following trauma. We considered that the strong evidence that maladaptive appraisals of somatic sensations mediate panic () is directly relevant to posttraumatic panic. We hypothesized that ASD participants would report more peritraumatic and persistent panic than non-ASD participants, and that this panic would be associated with dysfunctional interpretations about somatic stimuli.

Accidents, Traffic↗

PubMed2003

Parent-child interaction therapy: a comparison of standard and abbreviated treatments for oppositional defiant preschoolers.

Families of 54 behaviorally disturbed preschool-aged children (3 to 5 years) were randomly assigned to 1 of 3 treatment conditions: standard parent-child interaction therapy (PCIT; STD); modified PCIT that used didactic videotapes, telephone consultations, and face-to-face sessions to abbreviate treatment; and a no-treatment waitlist control group (WL). Twenty-one nondisturbed preschoolers were recruited as a social validation comparison condition. Posttreatment assessment indicated significant differences in parent-reported externalizing behavior in children, and parental stress and discipline practices from both treatment groups on most measures compared with the WL group. Clinical significance testing suggested a superior effect for the STD immediately after intervention, but by 6-month follow-up, the two groups were comparable. The findings indicate that abbreviated PCIT may be of benefit for families with young conduct problem children.

Adult↗

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↗

PubMed2003

Treating acute stress disorder following mild traumatic brain injury.

OBJECTIVE: Acute stress disorder permits early identification of trauma survivors who are at risk of developing chronic posttraumatic stress disorder (PTSD). This study aimed to prevent PTSD in people who developed acute stress disorder after a mild brain injury by early provision of cognitive behavior therapy. METHOD: Twenty-four civilian trauma survivors with acute stress disorder were given five individually administered sessions of either cognitive behavior therapy or supportive counseling within 2 weeks of their trauma. RESULTS: Fewer patients receiving cognitive behavior therapy than supportive counseling met criteria for PTSD at a posttreatment evaluation (8% versus 58%, respectively). There were also fewer cases of PTSD at a 6-month follow-up evaluation among those receiving cognitive behavior therapy (17%) than among those receiving supportive counseling (58%). Patients in the cognitive behavior therapy condition displayed less reexperiencing and avoidance symptoms at the follow-up evaluation than patients receiving supportive counseling. CONCLUSIONS: These findings suggest that PTSD following mild brain injury can be effectively prevented with early provision of cognitive behavior therapy.

Adult↗

PubMed2002

Treatment of behavior problems in preschoolers: a review of parent training programs.

The literature for parent training interventions with conduct-problem preschool-aged children is reviewed. Although previous reviews have identified the preschool years as a critical point for intervention [J. Clin. Psychol. 21 (1992) 306; School Psychol. Rev. 22 (1993) 437], there still remains a paucity of well-designed outcome studies that have focused exclusively on preschoolers. Interventions that utilize parents as active sources of change remain predominant. The review reveals the need for further research to improve accessibility and delivery of interventions. Treatments that have undergone modification in their delivery format (e.g., use of telephone and videotape) were also identified and critically evaluated. Results of the review indicate that many studies are still accompanied by methodological limitations. Although promising interventions exist for young conduct-problem children, it is recommended that treatment effectiveness for preschoolers be evaluated more rigorously.

Behavior Therapy↗