Treatment of Acute Posttraumatic Stress Disorder with Brief Cognitive Behavioral Therapy: A Randomized Controlled Trial

Objective: The purpose of this study was to evaluate the efficacy of brief cognitive behavioral therapy for patients with acute posttraumatic stress disorder (PTSD) resulting for various types of psychological trauma. Method: The authors randomly assigned 143 patients with acute PTSD (irrespective of the time criterion), within 3 months after experiencing a traumatic incident, to either brief cognitive behavioral theraypy (N=79) or a waiting list comparison group (N=64). Cognitive behavioral therapy consisted of four weekly sessions containing education, relaxation exercises, imaginal exposure, in vivo exposure, and cognitive restructuring. Main outcomes measures was PTSD score measured by structured interview; secondary outcomes were anxiety and depressin measured by questionnaire. Assessments took palce before the intervention and 1 week and 4 months after the intervention. Results: Sympoms of PTSD, anxiety, and depression decreased in both groups over time. One week after the intervention, the cognitive behavioral therapy group had significantly fewer sumptoms of PTSD than the comparisson group, but this diference was smaller and no longer significant 4 months after the interventions. Similar results were founf of anxiety and depression scores. Subrgroup analuses showed that cognitive behavioral therapy led to significantly lower PTSD scores at 4 months in patients with baseline comorbid major depression and in patients who were included within the firs month after the traumatic incident both at 1 week and at 4 months. Conclusions: Brief early cognitive behavioral therapy accelerated recovery from symptoms of acute PTSD but did not influence long-term results. Brief early cognitive behavioral therapy showed enhanced efficacy in patients with baseline comorbid depression and patients who were included within 1 month after their traumatic experience. (AU)

The psychological sequelae to disasters

This article describes the psychological sequelae to disasters with reference to the 1983 Ash Wednesday bushfires in the Dandenong mountains of Victoria. Psychological reactions during and after the disaster were varied. The intervention of a mental health team is described(AU)