Women Soldiers' Response to Treatment for PTSD

Psychiatric Times
By Peggy Peck
Reviewed by Zalman S. Agus, MD; Emeritus Professor at the University of Pennsylvania School of Medicine. Feb 28, 2007

WHITE RIVER JUNCTION, Vt., Feb. 28 -- For women soldiers being treated for post-traumatic stress disorder, symptoms improve when the therapy homes in on the original index event, no matter how long ago it occurred, researchers here found.

Compared with therapy that aimed at coping with PTSD symptoms in daily life, women whose therapy focused on the past traumatic events reduced symptoms by more than 70% (effect size, 0.27, P=0.03), investigators reported in the Feb. 28 issue of the Journal of the American Medical Association.

Moreover, the women who underwent "prolonged exposure" therapy were also about two-and-half times more likely to achieve total remission (15.2% versus 6.9%; odds ratio 2.43; 95% confidence interval, 1.10-5.37, P=0.01), said Paula P. Schnurr, Ph.D., of the National Center for PTSD at the VA Medical Center here, and colleagues.

The "maximum benefits of prolonged exposure are observed immediately after treatment and persist over time," she said.

But while the prolonged exposure therapy was more effective, it also had significantly higher dropout rate: 38% versus 21% (P=0.002).

The study randomized 277 women veterans and seven active duty women soldiers to either prolonged exposure or present-centered therapy. The mean age of women was 45 and roughly 31% were married.

The women were enrolled and treated from August 2002 through October 2005 at nine VA medical centers, two VA readjustment counseling centers, and one military hospital.
Both therapies were delivered according to standard protocols in 10 weekly 90-minutes sessions.

"Prolonged exposure included education about common reactions to trauma, breathing retraining; prolonged (repeated) recounting (imaginal exposure) of trauma memories during sessions; homework (listening to a recording of the recounting made during the therapy session and repeated in vivo exposure to safe situations the patient avoids because of trauma-related fear); and discussion of thoughts and feelings related to exposure exercises," they wrote.
By contrast, the present-centered therapy focused "on current life problems as manifestations of PTSD."

Sexual trauma was identified as the "worst" trauma exposure by 68.3% of the women, followed by physical assault (15.8%) and war zone exposure (5.6%). The index trauma usually occurred more than 22 years before the women were enrolled in the study.

The high rate of sexual trauma exposure tracked closely studies of PTSD in civilian women, but Dr. Schnurr pointed that 70% women in this study said their sexual trauma exposure was associated with military service.

The study was limited by the small number of active duty women included-the authors theorized that active duty soldiers might be reluctant to seek treatment because they were "worried about the stigmatizing effects of PTSD, a concern that has been expressed by soldiers serving in Iraq and Afghanistan."

Active duty soldiers, they explained, were likely to be younger than veterans and might have responded differently to the two treatments.

The study was also limited by a higher dropout rate in the prolonged exposure arm, and by the fact that the study was limited to women. But Dr. Schnurr said the findings could "with some caution" be extended to men because published studies suggested that cognitive behavioral therapy was an effective treatment for PTSD in men.

The study was funded by the VA Cooperative Studies Program and the Department of Defense. Dr. Schnurr and reported funding from the Department of Veterans Affairs. Some of her co-authors reported funding from the Department of Defense and three co-authors -- Matthew J. Friedman, M.D., Ph.D., Edna B. Foa, Ph.D., and Patricia A. Resick, Ph.D. -- published books on PTSD treatment for which they received income.

The Secret

On the The Oprah Show last week she had a panel of people talking about "The Secret". This movie, The Secret, and book was created by Australian Rhonda Byrne, and she says that if you follow its philosophy, you can create the life you want—whether that means getting out of debt, finding a more fulfilling job or even falling in love.

Rhonda defines The Secret as the law of attraction, which is the principle that "like attracts like." Rhonda calls it "the most powerful law in the universe," and says it is working all the time. "What we do is we attract into our lives the things we want, and that is based on what we're thinking and feeling," Rhonda says. The principle explains that we create our own circumstances by the choices we make in life. And the choices we make are fueled by our thoughts—which means our thoughts are the most powerful things we have here on earth.

See more about the show at the link above...

The Secret sounds like a new idea but it's a concept we have been using to assist people for a long time. The Secret has gained attention of the people and we would love to discuss it more with you. Contact us..

All Things Being Equal!

After a year of back-and-forth, a group of U.S. senators have reached a compromise on a bill offering "mental health parity" to health plan enrollees who have mental health coverage. While the details are still under discussion, generally speaking the bill would require health insurance plans with a mental health option to cover mental diseases the same way they do physical diseases, including reimbursement, co-payments, deductibles and limits on physician visits. The bill is being championed by Sen. Pete Domenici, who has worked on this issue since 1996, and co-written with Sens. Edward Kennedy (D-MA) and Mike Enzi (R-WY). Creating a workable consensus proposal took years, but everyone involved seems to think the measure can move ahead now. Though health plans argue that such parity would be too costly to sustain, President Bush has previously expressed a willingness so sign a parity bill, so the measure's prospects may be better than many previous versions.

Fierce HealthCare to see more...

NYU Child Study Center
The New York University Child Study Center has identified warning signs of depression in teenagers for parents and tips for helping teens who may be depressed, in light of a new report from the Centers for Disease Control and Prevention (CDC). The CDC study, published in the February 2007 issue of Pediatrics finds that suicide rates in children under 19 years of age increased between 2003 and 2004. Suicide was the only statistically significant increase in child death over this time. Overall, the suicide rate increased by 18.2 percent from 2003 to 2004, an increase largely driven by older teens.

"A teen's statement of a wish to kill him/herself must be taken seriously," said Lori Evans, Ph.D., Director of Psychology Training and the Project Coordinator of TASA (Treatment of Adolescent Suicide Attempters) at the NYU Child Study Center. "Before they actually commit or attempt suicide, teens often make direct statements about their intention to end their lives, or less direct statements about how they might as well be dead or that their friends and family would be better off without them."

"Discussing the problem does not encourage the teenager to go through with the plan," emphasizes Dr. Evans. "On the contrary, it will help him or her know that someone is willing to be a friend. It may save your adolescent's life."

Watch for symptoms of depression lasting longer than two weeks, which may include:
A change in eating and sleeping habits

A marked personality change, exhibiting angry actions or rebellious behavior or withdrawal from friends and regular activities

Involvement in drugs or alcohol or other risky behaviors such as reckless driving

An overreaction to a recent humiliating experience

Difficulty in concentrating and a decline in the quality of school work

Persistent boredom and/or lethargy

Unusual neglect of appearance

Complaints about physical symptoms such as headaches and fatigue

A pattern of giving away or throwing away possessions

Intolerance of praise or rewards

Preoccupation with death in writing songs or poems

An increase in comments such as "I can't take it anymore" or "nobody cares; I wish I was dead"

How to help
Take person's comments regarding self-hate, suicide, or death very seriously

Don't try to convince the person to not feel bad. Don't tell them to "snap out of it" or say "don't feel bad"

Keep in close contact with the person and their parent, teacher, or a good friend

Ask the child or teen what you could do that would be helpful to them

Don't promise to keep any information a secret

If symptoms persist or are dangerous and interfere with daily functioning, consult a mental health professional immediately
See Anxiety Insights for more...

Video Games May Increase Cognitive Functioning

Provided by: Sun Media
Written by: IAN GILLESPIE -- London Free Press Jan. 20, 2007

My brain is going bad. And probably yours is, too.

It's getting tougher to remember names. I go to the store and neglect to pick up the main item I need. I forget where I've put things (like, ah, the car).

I'm sure there are other symptoms, but I can't remember what they are.
Anyway, experts tell us memory problems are fairly common. They also say this is happening partly because our lives are so busy that our brains are being overloaded. (This doesn't explain why I can't remember where I put my glasses, when the only thing I've done all day is try to find my glasses.)

But now, there's hope.
Paradoxically, one of the solutions is something that, for years, we were told was bad for our brains: Video games.
That's right. Once regarded as devilish devices that would turn minds to mush, researchers now are saying video games may be good for us.

"There's been a lot of research recently, primarily on the standard shoot-'em-up action games, showing that those sorts of things can be beneficial," says Jody Culham, assistant professor of psychology at the University of Western Ontario. "Particularly with older people.
"There's some interesting stuff suggesting there might be some benefits to getting grandma playing the hot new games."

I'm not sure I can envision a gang of white-haired grandmothers, slumped in bean-bag chairs in a darkened basement, wasting gangsters in Scarface. But the general concept is gaining acceptance.

In his book Everything Bad is Good for You, for instance, technology expert Steven Johnson explored the benefits of an array of pop-culture offerings, including video games.
While early models like Pong and Pac Man were simple exercises in co-ordination and pattern recognition, Johnson argues today's games present a dizzying array of options and information. Indeed, he points out that one how-to-play guide for the game Grand Theft Auto III is more than 50,000 words long -- nearly the length of an average novel.

With their developing storylines, complex puzzles and multiple characters, Johnson argues, many modern video games are more than just instant-gratification machines. In fact, he says, these games actually delay gratification by forcing players to craft long-term strategies and figure out what to do. (Unlike board games of the past, you don't learn how to play a video game by reading a set of rules; you learn by playing it.)

Of course, many of these games are simply too fast and complicated for older players.
That's where Nintendo's Brain Age comes in. According to the promotional literature, this new software for the Nintendo DS hand-held system "acts like a treadmill for the mind."
Using a touch screen that allows players to write their answers with a special pen, Brain Age allows players to solve simple math problems, draw pictures, count moving objects and read examples of classic literature.

Culham says it's a variation on the old "use it or lose it" adage.

"There's lots of evidence that people who are in busy, stimulating work situations and have to do a lot of problem-solving fare much better in terms of (fending off) the development of Alzheimer's, senility and all sorts of cognitive problems," she says.

Oh boy! Finally -- a legitimate excuse to hide in the basement and waste hours and hours playing fancy video games with neat new software and . . . .
Hold it.

Culham says many of the benefits gained from video games can be found in plain old reality.
"I would suggest that people consider taking up tennis or playing strategy games like chess or backgammon with their friends," she says. "This way they get the intellectual benefits of a video game, but other benefits, too, such as cardiovascular exercise or social interaction and support."
Instead of shelling out cash for software, Culham says there are other ways -- just as effective but not as expensive -- to exercise your brain.

"Pull out the Sudoku from the newspaper, read some Jane Austen and play some games with your friends," she says. "That may do just as well -- or better."
Darn.