Clinician's Trauma Update - Online: August 2013

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Clinician's Trauma Update - Online (6 issues/year)

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Editor
Paula P. Schnurr, PhD

Senior Associate Editor
Barbara A. Hermann, PhD


U.S. Department of Veterans Affairs

CLINICIAN'S TRAUMA UPDATE-Online
Issue 7(4), August 2013

For COMPLETE summaries, see this month's CTU-Online PDF
on our website:

http://www.ptsd.va.gov/professional/newsletters/ctu-online/ctu_V7N4.pdf

This issue of CTU-Online contains 10 summaries:

 

Special Notices

 

Special journal issue on violence and human rights: The August 7 issue of JAMA Psychiatry covers research and clinical aspects of topics related to violence and human rights, including suicide in military personnel, mass casualty events, refugee health, and gun violence. Read the issue…JAMA, 310(5).

 

RAND report supports the “D” in PTSD: A new report by the RAND Corporation concludes that the “D” in PTSD matters, contrary to the position taken by some senior military leaders. Read the report… http://www.rand.org/pubs/occasional_papers/OP389 

  

Evidence review on intimate partner violence: The VA Evidence-based Synthesis Program recently released a report on the prevalence of intimate partner violence (IPV) among Veterans and active duty personnel, as well as intervention approaches. This ESP Report is available for VA staff only on the VA intranet…http://vaww.hsrd.research.va.gov/publications/esp/partner_violence.cfm

 

Treatment

 

Patient outcomes from VA’s Prolonged Exposure training

In 2007, VA launched a national training initiative in Prolonged Exposure. Led by the National Center for PTSD, the program evaluation of this effort builds on PE’s existing evidence base, providing real-world data on the treatment’s effectiveness. Read more...

 

Positive initial findings for prazosin in active duty soldiers 

The VA/DoD Practice Guideline for PTSD recommends prazosin as an adjunct treatment targeting nightmares, noting insufficient evidence for its use as a stand-alone PTSD treatment. A small randomized controlled trial of prazosin for sleep and PTSD in active duty soldiers helps to fill the gap. Read more...

 

Combined treatment for comorbid PTSD and alcohol dependence

A study of treatment for comorbid PTSD and alcohol dependence examined the separate and combined effects of two established treatments: naltrexone, which is effective for treating alcohol problems, and Prolonged Exposure, which is effective for treating PTSD. The investigators, who were based at the University of Pennsylvania and Philadelphia VA Medical Center, expected that combined treatment would be more effective than either treatment alone, but that is not what they found. Read more...

 

Online intervention for problem drinking works for PTSD too

VetChange is a web-based cognitive-behavioral intervention targeting recently returned Veterans with problem drinking. A team led by the National Center for PTSD and Boston University report that, based on their randomized controlled trial, VetChange improves not only drinking but also PTSD symptoms. Read more...

 

What accounts for differential prescribing for women Veterans with PTSD?

Women are the fastest growing segment of the Veteran population. Recently, researchers from the National Center for PTSD and Iowa VAMC examined whether VA providers are more likely to prescribe psychotropic medications for women than for men with PTSD. Read more...

 

Role of patient characteristics in predicting type of PTSD treatment referral

Providers and patients may consider many factors when choosing a PTSD treatment. Investigators at the Houston VA Medical Center examined how patient demographic and clinical characteristics do, and do not, influence the kind of PTSD treatment for which a patient is referred. Read more...

 

Why patients choose sertraline or Prolonged Exposure

Understanding what drives PTSD treatment preferences may improve treatment initiation and engagement. Researchers from the University of Washington and Case Western Reserve University report on a qualitative study in a treatment-seeking sample, finding that the reasons for choosing psychotherapy versus medication differ substantially. Read more...

 

Meta-analysis demonstrates greater efficacy of psychotherapy than medication for PTSD

The VA/DoD Practice Guideline for PTSD recommends cognitive-behavioral therapy, EMDR, and serotonin reuptake inhibitors (SSRIs and SNRIs) as primary treatments for PTSD. A recent meta-analysis by investigators at the White River Junction VA Medical Center and National Center for PTSD reinforces the Guideline’s recommendations but suggests that all of these treatments are not equal. Read more...

 

Assessment

 

Validating a screen for intimate partner violence among women Veterans

Identifying Veterans at risk for intimate partner violence, or IPV, may improve their safety and mitigate negative mental and physical health effects. As part of VA’s initiative to develop national guidelines for IPV care, researchers from the National Center for PTSD evaluated the usefulness of an existing screening tool among women Veterans enrolled in VA; results are promising. Read more...

 

Comorbidity

Unexpected findings on combat deployment as a risk factor for suicide

A rise in suicide rates among active duty Servicemembers since 2005 has drawn attention to the potential role of combat deployment as a risk factor. However, results of a new study suggest that other risk factors may account for the increase. Read more...

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CTU-Online, the Clinician's Trauma Update, is an electronic newsletter produced by the Department of Veterans Affairs, National Center for PTSD. CTU-Online provides summaries of clinically relevant publications in the trauma field with links to published abstracts or full text articles when available. Please send any feedback to barbara.hermann@va.gov.

CTU-Online

ISSUE 7(4) August 2013

 

www.ptsd.va.gov