Thursday, February 21, 2008

Behavioural activation for PTSD

Studies have found that, within the first year post-trauma 10-40% of individuals develop symptoms consistent with a diagnosis of post-traumatic stress disorder. Severely injured patients who require a standard inpatient admission are more likely to develop PTSD and benefit less from traditional cognitive-behavioural therapy (CBT) than patients who are less injured. Behavioural activation was originally developed as a treatment for depression and involves the identification and enactment of activities that are reinforcing for the individual and consistent with their long-term goals. In layman's terms this means getting people to do things which are beneficial, or part of everyday life, which they have been putting off doing because of their depression. In PTSD individuals avoid situations and experiences that may elicit trauma-related memories but such avoidance is believed to reinforce anxiety as people never confront and overcome their fears. Behavioural activation differs from exposure therapy as the emphasis is on confronting fears that prevent people from reaching their goals rather than on confronting them for their own sake. A small study of 8 PTSD patients in the U.S. compared behavioural activation with conventional treatment and found that it led to a greater improvement in symptom severity and physical functioning although not of patients' depression.

Wagner, Amy W. ... [et al] - Behavioural activation as an early intervention for posttraumatic stress disorder and depression among physically injured trauma survivors Cognitive and Behavioral Practice 2007, 14, 341-349

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