Dealing with trauma memories eases posttraumatic stress: study
A new study from the United States has found that patients can decrease the risk of posttraumatic stress disorder (PTSD) or PTSD severity following a potentially traumatic event if they succeed in disrupting the rehearsal and strengthening of traumatic memories. This disruption is a process that experts call reconsolidation of memories. The finding is presented in the journal Biological Psychiatry.
The process is no easy feat. Researchers have found that altering memory reconsolidation is complex. Past attempts at 'trauma debriefing' ended up intensifying posttraumatic learning rather than easing it.
But in this latest study, researchers from Emory University in the United States investigated how behavioural intervention delivered to patients immediately after the traumatic event is instrumental in reducing posttraumatic stress reactions.
'PTSD is a major public health concern,' said co-author Professor Barbara Olasov Rothbaum from the Department of Psychiatry and Behavioral Sciences at Emory. 'In so many people, what happens immediately after a traumatic event can make things worse or better. Right now, there are no accepted interventions delivered in the immediate aftermath of trauma.'
The research team assessed patients who entered the local hospital's emergency room following a traumatic event, such as car accident, physical assault and rape. Immediate behavioural intervention was given to 50 % of the subjects, but not to the remaining ones. The researchers repeatedly assessed the patients for symptoms of depression and stress for three months.
They said the intervention focused on exposure therapy, where a survivor confronts anxiety about a traumatic event by recounting it. Three one-hour sessions helped the patients change their thoughts and feelings about what they were subjected to.
The patients described the trauma they just experienced and recorded the description. They were then instructed to listen to their recordings every day. According to the researchers, the therapists gave the patients the support they needed to look at obtrusive thoughts of guilt or responsibility, teaching them a brief breathing relaxation technique and self care.
Contrary to the patients who were assigned to the assessment-only condition, both at 4 and 12 weeks post-injury, the test group received interventions that are safe, that work and that effectively ease posttraumatic stress reactions.
'This study provides an elegant and clinically important test of the trauma reconsolidation hypothesis,' said Dr John Krystal, editor of Biological Psychiatry.
Commenting on the implications of the study, Professor Rothbaum said: 'If we know what to do, then we can train emergency workers to intervene with patients on a large scale. In addition to being implemented in the emergency room, it can help on the battlefield, in natural disasters, or after criminal assaults.
'More research is needed, but this prevention model could have significant public health implications. A long-standing hope of mental health research is to prevent the development of psychopathology in those at risk instead of being limited to symptom treatment after disease onset.'
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Data Source Provider: Biological Psychiatry; Emory University
Document Reference: Rothbaum, B.O., et al., 'Early Intervention May Prevent the Development of Posttraumatic Stress Disorder: A Randomized Pilot Civilian Study with Modified Prolonged Exposure', Biological Psychiatry, 2012.
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