Integrating Treatment For Alcohol Use Problems And Comorbid PTSD
Funder
National Health and Medical Research Council
Funding Amount
$658,073.00
Summary
Comorbid alcohol use problems and posttraumatic stress disorder (PTSD) are common mental health problems that cause disability and distress. Despite this, there are few randomized controlled trials of interventions. The proposed study is the first Australian randomised controlled trial in this field to address the question of whether treating PTSD and alcohol use problems is superior to treating alcohol use problems alone. The study compares the relative efficacy of a manual guided treatment for ....Comorbid alcohol use problems and posttraumatic stress disorder (PTSD) are common mental health problems that cause disability and distress. Despite this, there are few randomized controlled trials of interventions. The proposed study is the first Australian randomised controlled trial in this field to address the question of whether treating PTSD and alcohol use problems is superior to treating alcohol use problems alone. The study compares the relative efficacy of a manual guided treatment for alcohol use disorder alone with a simultaneous treatment for alcohol use and PTSD. This study improves on the methodological limitations described in the two existing studies reported in the published literature. Two-hundred and sixty four participants will be recruited from mutiple sites (media, GPs, specialist clinics) and treated in the community at two sites in Sydney. Participants will be eligible if they consume harmful levels of alcohol (NHMRC risky or high risk levels) and have a concurrent diagnosis of PTSD based on recognised diagnostic criteria. Treatment will consist of 16 sessions of manual guided individual psychological therapy that has been found to be very efficacious with each problem alone. The efficacy of treatment will be determined on the basis of reductions in harmful drinking (above NHMRC low risk levels) and in symptoms of PTSD. Participants will be followed up by an independent, blind, clinician three and six months after treatment completion. The findings of this study have the potential to provide valuable information regarding the treatment needs of people with these complex presentations to clinicians and policy developers alike.Read moreRead less
Acute Stress Disorder And Posttraumatic Stress Disorder In Injured Children
Funder
National Health and Medical Research Council
Funding Amount
$125,000.00
Summary
The aim of this project is to develop the means to identify acute reactions to trauma that will predict chronic posttraumatic stress disorder (PTSD) in children after a traumatic injury. This project will conduct the first prospective analysis of acute stress disorder and chronic traumatic stress symptoms in children, develop diagnostic guidelines to identify acutely traumatized children who are at risk of PTSD, and identify biological, cognitive, and familial factors that mediate PTSD developme ....The aim of this project is to develop the means to identify acute reactions to trauma that will predict chronic posttraumatic stress disorder (PTSD) in children after a traumatic injury. This project will conduct the first prospective analysis of acute stress disorder and chronic traumatic stress symptoms in children, develop diagnostic guidelines to identify acutely traumatized children who are at risk of PTSD, and identify biological, cognitive, and familial factors that mediate PTSD development following trauma. Two hundred children (aged 7 - 12 years) who are admitted to hospital following a traumatic injury will be assessed for acute disorder within one month of the accident. They will be also be assessed for heart rate, blood pressure, memory patterns, and family responses during the initial assesment. Parents will also be assessed for their trauma reactions. All participants will be re-assessed at 6-months posttrauma, and again at 18-months posttrauma. These findings will establish the means to identify acutely traumatized children who are at risk of PTSD and open up opportunities for early intervention and prevention of PTSD.Read moreRead less
Adult Consequences Of Childhood Exposure To Psychological Trauma
Funder
National Health and Medical Research Council
Funding Amount
$292,530.00
Summary
The importance of childhood experience to adult adjustment (DOES THIS MAKE SENSE) is an issue of general public health interest. In particular, in the area of personality development, there are a number of theories concerning the importance of childhood experience and developmental stresses on later personality, development, psychological functioning and physical health. More recently there has been debate on the accuracy with which adults areable to remember traumatic experiences in childhood. ....The importance of childhood experience to adult adjustment (DOES THIS MAKE SENSE) is an issue of general public health interest. In particular, in the area of personality development, there are a number of theories concerning the importance of childhood experience and developmental stresses on later personality, development, psychological functioning and physical health. More recently there has been debate on the accuracy with which adults areable to remember traumatic experiences in childhood. This study will follow a group of 808 primary school children who were exposed to the 1983 Ash Wednesday bushfires in SOuth Australia. They were involved in a study which examined them two months, eight months and twenty six months after the disaster. This rich descriptive set of information about these children and their families forms an objective data base against which their adult recall of the experience can be judged. The symptoms of these children were also documented at the time as was their disaster exposure. The impact of this one event, in the context of the other developmental influences will be examined as determinants of their adjustment in adult life. Finally, there has been an increasing interest in the way that previous traumatic exposure influences the nature of the hormonal response to stress. Using a test of functioning of the cortisol system, the stress response of this population will be compared with a control population who were also studied at the time of the original disaster.Read moreRead less
Cognitive Behaviour Therapy For Posttraumatic Stress Disorder In Police Officers
Funder
National Health and Medical Research Council
Funding Amount
$190,255.00
Summary
Posttraumatic stress disorder (PTSD) is a significant anxiety disorder that affects many serving police officers. Although cognitive behaviour therapy (CBT) is the treatment of choice to treat PTSD, it has never been validated in police offcers. This project represents the first controlled trial of applying CBT to reduce PTSD in police officers.
Enhancing Treatment Effectiveness In Acute Stress Disorder
Funder
National Health and Medical Research Council
Funding Amount
$235,330.00
Summary
Posttraumatic stress disorder (PTSD) is the most common psychiatric condition to develop after trauma. Early intervention of PTSD following a trauma is indicated because chronic PTSD can be resistant to treatment. Early intervention is possible because acute stress disorder immediately after a trauma identifies those people who will develop chronic PTSD. Although cognitive behaviour therapy of acute stress disorder can effectively prevent PTSD in many cases, many people do not benefit from this ....Posttraumatic stress disorder (PTSD) is the most common psychiatric condition to develop after trauma. Early intervention of PTSD following a trauma is indicated because chronic PTSD can be resistant to treatment. Early intervention is possible because acute stress disorder immediately after a trauma identifies those people who will develop chronic PTSD. Although cognitive behaviour therapy of acute stress disorder can effectively prevent PTSD in many cases, many people do not benefit from this treatment because this treatment involves exposure to distressing memories and emotions, and this contributes to many people dropping out of treatment. This project aims to extend the utility of early intervention following trauma by assessing approaches that can be used by most trauma survivors. The project compares early intervention with either exposure, cognitive therapy, combined exposure and cognitive therapy, or supportive counseling. All therapy will be conducted in the initial four weeks and will comprise 6 sessions. Assessments will be conducted posttreatment, six-months follow-up, and one-year follow-up. The outcomes of this project will have significant public health benefits because they will lead to increased treatment effectiveness for acutely traumatized people, and will markedly reduce the incidence of PTSD in the community.Read moreRead less
The Efficacy Of An Intervention For PTSD Among Illicit Drug Users
Funder
National Health and Medical Research Council
Funding Amount
$580,219.00
Summary
The high prevalence of PTSD among people with illicit drug use disorders (IDUD) has been clearly recognised in both the Australian and international literature. In Australia, 33% of those with opioid use disorders and 24% of those with amphetamine use disorders have comorbid PTSD. The prevalence among people with alcohol use disorders on the other hand, is comparably low (5%). Despite the high prevalence of PTSD among people with IDUD, research on treatment responses to this significant problem ....The high prevalence of PTSD among people with illicit drug use disorders (IDUD) has been clearly recognised in both the Australian and international literature. In Australia, 33% of those with opioid use disorders and 24% of those with amphetamine use disorders have comorbid PTSD. The prevalence among people with alcohol use disorders on the other hand, is comparably low (5%). Despite the high prevalence of PTSD among people with IDUD, research on treatment responses to this significant problem is sparse. Individuals with this comorbidity present a significant challenge to substance abuse treatment providers as they present with a poorer clinical profile, and have poorer treatment outcomes, including higher readmission rates. Consequently, they are a costly burden to the health care system. The costs of this comorbidity to individual sufferers and society may be reduced substantially by the implementation of an integrated treatment that addresses both disorders concurrently. There is however, little research to guide how best to treat comorbid IDUD and PTSD. Although a small number of interventions have been developed and trialled, none have been evaluated in an Australian setting. One intervention which has shown promise in the United States is Concurrent Treatment of PTSD and Substance Use Disorder (CTPSD). Preliminary research has shown that CTPSD can be used safely and is effective in the treatment of PTSD among individuals with cocaine dependence. Completers of the program have demonstrated significant reductions in all PTSD symptom clusters and cocaine use from baseline to end of treatment which were maintained at 6 month follow-up. Significant reductions in depressive symptoms were also observed. Despite these promising results, CTPSD is yet to undergo a randomised controlled trial. The proposed study is a randomised controlled trial of the efficacy of CTPSD in the Australian setting.Read moreRead less
Impact Of The Refugee Application Process On The Psychiatric Status Of Traumatized Asylum Seekers: A Prospective Study
Funder
National Health and Medical Research Council
Funding Amount
$147,859.00
Summary
Although the numbers of persons who identify themselves as fleeing from persecution (asylum seekers) residing in Western countries has increased substantially in the last decade, very little research has been undertaken on the psychiatric and physical health of this group. The only studies published in professional journals have been produced by members of the applicant team. The results indicate that approximately 50% have suffered gross human rights violations including torture, detention in c ....Although the numbers of persons who identify themselves as fleeing from persecution (asylum seekers) residing in Western countries has increased substantially in the last decade, very little research has been undertaken on the psychiatric and physical health of this group. The only studies published in professional journals have been produced by members of the applicant team. The results indicate that approximately 50% have suffered gross human rights violations including torture, detention in concentration camps and brainwashing, and 37% are affected by ongoing posttraumatic stress disorder (PTSD) - terrifying memories of past abuses, avoidance of experiences that trigger such memories, social withdrawal, and constant anxiety. The research has also shown that psychiatric symptoms may be worsened by the fears and insecurities associated with the asylum seeking process, but the exact impact of stresses such as rejection of their primary application at 2-3 months, could not be determined. We therefore aim to conduct the first study of its kind that traces the impact of such stresses on the mental health of asylum seekers. In addition, we will track asylum seekers' general health problems and the difficulties they may experience in accessing basic medical health services. This evidence will provide scientific confirmation of how stress can worsen PTSD; indicate that some asylum seekers may be in special need of support throughout the asylum assessment process; assist policy makers to re-assess the methods and processs of assessing asylum claims; and provide impetus to establishing better services for the medical and psychiatric problems faced by asylum seekers.Read moreRead less