Cognitive-behavior therapy for disaster-exposed youth with posttraumatic stress: results from a multiple-baseline examination.
Behav Ther. 2011 Sep;42(3):349-63
Authors: Taylor LK, Weems CF
Youth traumatized by natural disasters report high levels of posttraumatic stress such as symptoms of posttraumatic stress disorder, other anxiety disorders, and depression. Research suggests that cognitive behavioral therapies are promising interventions for symptom reduction; however, few cognitive behavioral treatments have been systematically tested in youth hurricane survivors. The current study provides an examination of the efficacy of an intervention manual designed specifically for hurricane-exposed youth (i.e., the StArT manual) using a partially nonconcurrent multiple baseline design. Youth ages 8-13 (n = 6) who met diagnostic criteria for posttraumatic stress disorder were provided the individual StArT treatment in their school. Youth were assessed at pretreatment, weekly during treatment, and at posttreatment. Results provide initial evidence for the efficacy of the StArT manual and suggest the feasibility of conducting the StArT manual in a school setting. The importance of large-scale tests of effectiveness and implementation of cognitive behavioral treatments in the wake of disaster among youth are discussed.
PMID: 21658519 [PubMed - indexed for MEDLINE]stress disorder, free previews, depression research, initial evidence, promising interventions
Central functions of neuropeptide Y in mood and anxiety disorders.
Expert Opin Ther Targets. 2011 Nov;15(11):1317-31
Authors: Wu G, Feder A, Wegener G, Bailey C, Saxena S, Charney D, Mathé AA
Introduction: Neuropeptide Y (NPY) is a highly conserved neuropeptide belonging to the pancreatic polypeptide family. Its potential role in the etiology and pathophysiology of mood and anxiety disorders has been extensively studied. NPY also has effects on feeding behavior, ethanol intake, sleep regulation, tissue growth and remodeling. Findings from animal studies have delineated the physiological and behavioral effects mediated by specific NPY receptor subtypes, of which Y1 and Y2 are the best understood. Areas covered: Physiological roles and alterations of the NPYergic system in anxiety disorders, depression, posttraumatic stress disorder (PTSD), alcohol dependence and epilepsy. For each disorder, studies in animal models and human investigations are outlined and discussed, focusing on behavior, neurophysiology, genetics and potential for novel treatment targets. Expert opinion: The wide implications of NPY in psychiatric disorders such as depression and PTSD make the NPYergic system a promising target for the development of novel therapeutic interventions. These include intranasal NPY administration, currently under study, and the development of agonists and antagonists targeting NPY receptors. Therefore, we are proposing that via this mode of administration, NPY might exert CNS therapeutic actions without untoward systemic effects. Future work will show if this is a feasible approach.
PMID: 21995655 [PubMed - in process]pancreatic polypeptide, systemic effects, therapeutic interventions, therapeutic actions, anxiety disorders
Aust N Z J Psychiatry. 2011 Oct 13;
Authors: Reavley NJ, Jorm AF
Objective: The aim of the study was to carry out a national survey in order to assess recognition and beliefs about treatment for affective disorders, anxiety disorders and schizophrenia/psychosis. Method: In 2011, telephone interviews were carried out with 6019 Australians aged 15 or over. Participants were presented with a case vignette describing either depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder (PTSD). Questions were asked about what was wrong with the person, the likely helpfulness of a broad range of interventions and the likely outcomes for the person with and without appropriate treatment. Results: Rates of recognition of depression were relatively high, with almost 75% of respondents using the correct label. Rates of recognition for the schizophrenia vignettes and PTSD were similar, with around one third of respondents using the correct labels. Only 9.2% of respondents were able to correctly label social phobia. Respondents gave the highest helpfulness ratings to GPs, counsellors, antidepressants, antipsychotics (for schizophrenia) and lifestyle interventions such as physical activity, relaxation and getting out more. Respondents were generally optimistic about recovery following treatment, although relapse was seen as likely. Conclusions: While Australians’ beliefs about effective medications and interventions for mental disorders have moved closer to those of health professionals since surveys conducted in 1995 and 2003/4, there is still potential for mental health literacy gains in the areas of recognition and treatment beliefs for mental disorders. This is particularly the case for schizophrenia and anxiety disorders, which are less well recognized and, in the case of social phobia, generally perceived as having less need for professional help.
PMID: 21995330 [PubMed - as supplied by publisher]correct labels, lifestyle interventions, mental disorders, social phobia, affective disorders
The effect of repetitive transcranial magnetic stimulation on fear extinction in rats.
Neuroscience. 2011 Oct 1;
Authors: Baek K, Chae JH, Jeong J
Facilitating fear extinction is clinically important to improve the efficacy of current exposure therapies for the treatment of anxiety disorders, such as post-traumatic stress disorder (PTSD). The aim of this study was to determine if repeated transcranial magnetic stimulation (rTMS) facilitates fear extinction in rats, especially when paired with exposure to a conditioned stimulus (CS). Thirty-five rats were conditioned to a tone CS by pairing the tone with an electric foot shock as an aversive unconditioned stimulus (US). We assessed the effects of 10 Hz rTMS before fear extinction (experiment 1) and rTMS paired with CS during extinction (experiment 2) on the following day. Fear responses of the rats were estimated using the level of freezing upon tone stimulus and were compared between the rTMS and corresponding sham groups. The rats treated with rTMS before fear extinction showed no difference in freezing time when compared with the sham group. However, the rats treated with rTMS paired with CS during extinction showed significantly less freezing behavior than the sham group, and this enhancement of fear extinction remained after 24 h without further stimulation. This finding suggests that high-frequency rTMS paired with trauma-reminding stimuli enhances fear extinction and that rTMS in conjunction with exposure therapy is potentially useful for facilitating extinction memory in the treatment of PTSD.
PMID: 21989475 [PubMed - as supplied by publisher]freezing time, conditioned stimulus, traumatic stress disorder, ptsd books