Reliving trauma can help prevent PTSD: study

People who undergo a type of psychotherapy in which they relive a traumatic event are less likely to get post-traumatic stress disorder than those getting another common form of therapy, researchers said on Monday.

The Australian study, which involved people who had experienced a vehicle crash or a nonsexual assault, was the latest to show the value of using so-called prolonged exposure therapy for PTSD, a sometimes debilitating anxiety disorder.

The growing number of U.S. troops returning from Iraq and Afghanistan with PTSD has focused attention on the condition, adding urgency to efforts to learn how best to deal with it.

Richard Bryant of the University of New South Wales in Sydney and colleagues studied 90 people with acute stress disorder, a condition that may appear shortly after a traumatic event and can lead to PTSD if it persists.

They were divided into three groups—one getting five weekly 90-minute sessions of prolonged exposure therapy, another getting the same amount of a type of therapy called cognitive restructuring and a third getting neither therapy.

In prolonged exposure therapy, a therapist helps a person vividly relive the trauma in a controlled environment, imaging it in detail and facing objects involved in the event. The idea is to expose people to the very thing that causes them distress to help them learn to better cope with it.

In cognitive restructuring, a therapist helps a person to try to alter negative thinking patterns related to a trauma.

REDUCES ANXIETY

Shortly after the therapy, 33 percent of the prolonged exposure group developed PTSD, compared to 63 percent of the cognitive restructuring therapy group and 77 percent of the untreated patients. The untreated patients were offered therapy at that point.

Six months after therapy, 37 percent of the exposure therapy group had PTSD, compared to 63 percent of the cognitive therapy patients, the researchers said.

“The current findings suggest that direct activation of trauma memories is particularly useful for prevention of PTSD symptoms in patients with (acute stress disorder),” they wrote in the journal Archives of General Psychiatry.

PTSD often begins about three months after an event such as wartime combat or injury, rape, assault, a car or plane crash or other traumas. But sometimes PTSD appears years later.

Persistently reliving a trauma is one of the common symptoms of PTSD. Others may include irritability, outbursts of anger, sleep difficulties, trouble concentrating, extreme vigilance and an exaggerated startle response.

Bryant’s group said that “there is evidence that many mental health care providers do not use exposure therapy for trauma survivors because it causes distress.”

Prolonged exposure therapy may work well because it reduces the anxiety from the trauma and gives a person better control over the psychological repercussions of the event, the researchers said.

Other studies also have backed prolonged exposure therapy. For example, a study published in the Journal of the American Medical Association last year showed this type of therapy helped female U.S. military veterans with PTSD.

By Will Dunham
WASHINGTON (Reuters)

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