Comparative Efficacy of PTSD Treatments

This assignment reviews various studies on pharmacological interventions, cognitive behavioral therapy, and other treatment approaches for post-traumatic stress disorder (PTSD). The studies include a network meta-analysis of pharmacological treatments, a review of exposure therapy as a gold standard for PTSD treatment, and pilot studies on the efficacy of mindfulness-based exposure therapy and brief eclectic psychotherapy. The assignment also discusses adjustment disorder as proposed for ICD-11, its dimensionality, and symptom differentiation.

Running head: ABNORMAL PSYCHOLOGY
Abnormal psychology
Name of the student:
Name of the University:
Author’s note

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Introduction:
This paper provides an insight into clinical symptoms in patients suffering from post
traumatic stress disorder and adjustment disorder and main clinical differences in both the
condition. It also provides a detailed discussion on current research in the prevention and
treatment of PTSD. The paper also develops arguments related to the effectiveness and utility of
different interventions for PTSD.
Answer 1:
Post-traumatic stress disorder (PTSD) is a kind of emotional disorder occurring in an
individual after experiencing sudden trauma such as assault, natural disaster or sudden deaths of
loves one (Barlow & Durand, 2015). According DSM-5 criteria for mental illness, for people to
be diagnosed with PTSD, they must have a history of exposure to the traumatic event and
symptoms like changes in cognition and mood, nightmares or flashback of event, trauma related
thoughts and arousals like aggression, risky behavior and difficulty in sleeping (Friedman, 2014).
Adjustment disorder is also a trauma or stress related disorder associated with abnormal reaction
to life stressors in affected individuals. The main clinical symptoms of adjustment disorder
include depressed mood, agitation, anxiety, withdrawal and poor social or work performance
(Glaesmer et al., 2015). The main clinical difference between PTSD and adjustment disorder is
that PTSD is a more severe form of disorder with long lasting symptoms. However, adjustment
disorder is a disease of short duration. Hence, adjustment disorder can be regarded as a short
term condition, where people fail to cope with major life changes and the symptoms are
temporary, whereas PTSD is a long term and life threatening condition. The difference in

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severity of both disease is also understood from the fact that PTSD has been defined a specific
mental disorder as per DSM-V criteria, but no such criteria exist for adjustment disorder.
Answer 2:
PTSD is a several psychological disorder seen in people after a traumatic events leading
to symptoms of avoidance, emotional numbing and hyperarousal. There are various challenges
associated with treatment of PTSD in different individuals due to their individual life
circumstances and differences in occurrence of symptoms overtime (Abdelghaffar et al., 2016).
Hence, evaluating the current research on prevention and treatment of PTSD is essential to
determines interventions which are most effective in promoting recovery of PTSD patient.
The review of current research has given insight about different preventive and treatment
options to minimize disabling consequence in patients after traumatic events. Qi, Gevonden &
Shalev,(2016) informed about interventions like cognitive behavioral therapy (CBT) to treat
patient. The main purpose of CBT is to minimize symptoms by challenging patient’s beliefs
about trauma and provide sense of control to patient to safely deal with trauma-related
reminders. CBT is given to patient either individually or as group. However, the researcher
argued that moderately positive outcomes have been found in patient and effectiveness of the
intervention is found to be consistent in research studies. Rothbaume et al. (2012) showed that
efficacy of CBT as an early intervention for patient is dependent on the type of traumatic events
an individual has been exposed. Hence, according to this argument, studies investigating about
CBT in people with different types of trauma are needed to understand its benefits as an early
intervention for PTSD patient.

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Kar, (2011) was found to most suitable research that reviewed the effectiveness of CBT
for treating PTSD people with different types of trauma. In case of effectiveness of CBT for
PTSD patients exposed to terrorism and war related trauma, it was found that CBT acted as a
promising intervention for patients as the implementation of therapy improved social functioning
of patients and reduced symptoms of PTSD. CBT was also found as an effective intervention for
people with sexual assault and accident related trauma. However, there is limited evidence
regarding effectiveness in refugee patients. Hence, from this evidence, it can be confirmed that
CBT is an efficacious intervention to lower PTSD score in patients with different types of trauma
events. Acute stress disorder is regarded as a precursor of PTSD, however reduction in number
of patients meeting the criteria for PTSD after five session of CBT compared to those receiving
counseling also suggest the effectiveness of CBT as a preventive method for CBT (Nixon Sterk,
& Pearce, 2012).. To maximize the effectiveness of the intervention, there is a need to address
methodological challenges like culture issues in implementing interventions, training needs of
therapist and proper integration of CBT with internet (Kar, 2011). These considerations will
further enhance the value of CBT for at-risk individuals.
Exposure therapy is also one of the behavioral therapy to treat PTSD. It is also a based
theory based therapy where therapists encourage patients to re-experience the traumatic event
instead of avoiding it. Such kind of exposure is found to reduce trauma-induced psychological
disturbance in patient. For example, it is very common for patients experiencing traumatic events
to avoid talking about the trauma or visiting the place associated with trauma. However,
exposure therapy aims to reduce symptoms of fear and avoidance in patients. It is one of the
effective first line treatments for PTSD (Rauch et al., 2012). A study by King et al., (2016)
investigating about the impact of mindfulness-based exposure therapy (MBET) has revealed that

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mindfulness based training in exposure therapy minimizes the issue of early drop-out rate and
increases emotional regulation in patients with PTSD. The study was done in two participants
group- one receiving mindfulness based therapy and the other receiving group therapy. The
assessment of PTSD symptoms before and after the therapy showed increased activity in anterior
cingulated cortex, dorsal medial prefrontal cortex and left amygdale. This indicates that MBET
therapy is effective in changing the neural processing of socio-emotional threat related to the
traumatic event. Although the sample size was small, however the study gave good evidence
regarding the effectiveness of the therapy in symptoms reduction for PTSD patients.
CBT is a behavioral intervention to reduce adverse symptoms and improve functioning in
patients with PTSD. Apart from behavioral intervention, many pharmacological interventions is
also used for the prevention and treatment of PTSD. Hydrocortisone is one of the
pharmacological agents involved in treating patients with PTSD. The review of research on the
effectiveness of hydrocortisone has revealed that moderate quality of evidence for the efficacy of
the drug in treating PTSD development in adults. There are other drugs like propranolol,
morphine and benzodiapine for treating the disorder, however there is limited evidence to prove
their true impact on patient outcome (Amos, Stein & Ipser, 2014). Many drugs have been
reviewed for efficacy and acceptability among PTSD patient group. Although, robust evidence
for efficacy has not been found, however phenelzine has emerged as a good drug of choice and
more future trials needs to be done to use its for treating PTSD (Cipriani et al., 2017).
Current research also gave indication about eye movement desensitization and
reprocessing (EMDR) as an intervention for patients with PTSD. It is a kind of psychotherapy in
which utilizes eye movements to support clients in safely processing distressing memories and
beliefs. It is a validated and efficient treatment approach to address psychological and

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physiological symptoms in patient with adverse life experience (Shapiro, 2014). Nijdam et al.,
(2012) used randomized controlled trial method to compare the efficacy of eclectic
psychotherapy with EMDR for PTSD. The assessment of two patient group on outcome
measures related to anxiety, depression and clinical PTSD symptoms showed both interventions
to be effectiveness. However, the advantage of EMDR compared to other therapy was that good
response rate was achieved. This proves that EMDR can promote faster recovery of patients
suffering from PTSD.
Conclusion:
From the review of current research on PTSD, CBT is identified as good preventive
options for treatment of PTSD at the early stage of risk. In addition, exposure therapy and
EMDR have emerged as effective interventions both in terms of clinical outcome and response
received from patients with PTSD.

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