Posttraumatic stress disorder occurs when individuals experience intrusive effects of a troubling event that they have experienced for more than one month. PTSD is also proclaimed by a person's decided avoidance of any stimuli that might remind them of the aforementioned event, along with a marked move in feelings and behavior which is distressing to the people around them. Over time, a number of therapeutic techniques have been used to treat PTSD. Because of their effectiveness, exposure therapies and eye motion desensitization and reprocessing (EMDR) are two of the most widely used of these techniques. These have been utilized to treat soldiers as well as civilians who have experienced stress. However, the nuances of their application, in terms of their performance against specific demographics have yet to be driven. This newspaper will critically assess a number of different studies conducted using visibility techniques, EMDR, or both and determine their success in treating individuals with PTSD. Despite the fact that EMDR has its origins in exposure remedy, for the purposes of this study, EMDR and vulnerability therapies will be thought to be two distinctive healing techniques (CITE).
One of the biggest issues confronted by PTSD treatment research is a sizable variety of studies with subpar methodologies. For this reason, Foa and Meadows (1997) printed seven standards that needs to be within any research that handles treatment final results of PTSD. These are known as the "Gold Benchmarks" for treatment outcome studies. According to Foa and Meadows, every ideal PTSD research should have clearly identified symptoms; reliable and valid options; use of impartial evaluators; trained assessors; manualized, replicable, specific treatment programs; treatment adherence; and an neutral task to treatment.
Ready et al. (2012) provides an effective utilization of group-based exposure therapy which sets the precedent in favor of exposure techniques among experienced troops. Their decision to separate the members into three groups of ten means that every individual can develop personal associations with other customers of the group given the limited time of the procedure program. The small group size also allows the participants, who would typically avoid interpersonal situations, to not feel overwhelmed when asked to talk about their experiences. On the other hand, having less any gender diversity within the sample group reduces external validity and adds to the stereotype that only men who have been in combat suffer from PTSD. Given the comorbidity of PTSD and drug abuse (CITE), using drug abuse as exclusion criteria further decreases its exterior validity.
Allocating the first area of the program to developing support groups among participants is an efficient use of the small sample size. In addition, it assists with prolonging the cultural and emotional support that participants get during the program in order that they will continue to support one another after its conclusion. Using each individual's presentations as a form of exposure permits a highly personal coverage treatment while permitting them to recognize that others have confronted the same situations that they have. However, being that they are required to listen to it as home work, it can only just succeed with highly determined participants. Experiencing the long-term effectiveness of this type of exposure technique, Ready et al. (2012) suggested that the amount of times that members must pay attention to the presentations be increased from 10 to 20, which would theoretically raise the rate at which symptoms of PTSD would fade away. Overall, group structured exposure therapy (GBET) is been shown to be a powerful short-term and long-term treatment for PTSD.
Through research conducted in a Ugandan refugee camp, Neuner et al. (2008) demonstrated that, even with laypersons with reduced training in psychotherapy, exposure techniques such as narrative subjection therapy (NET) can be used to treat PTSD. Just nine research assistants, all laypersons, were hired to execute this study among an example size of 277 individuals. While these were given a 6 week crash course on healing techniques and communication skills, the utilization of unqualified personal to treat emotional disorders is unethical and could have negatively damaged the members being treated. Furthermore, it could have been easier to use research assistants who weren't from the camps that the analysis was being conducted on; this would have decreased hazards to the validity of the study such as demand characteristics and participant objectives. However, the main topic of PTSD wasn't alien to the laypersons since most of them had been diagnosed with it at one point or another, meaning that they could empathize with the participants via personal experience. Since follow-up assessments revealed that 70% of the participants who underwent NET can't be identified as having PTSD, this type of psychotherapy can be utilized in war-torn regions where professional help isn't readily available. But the validity of the ultimate results can be questioned due to the large numbers of participants who could not be located for the post-test and follow-up lessons, even though the study had adjusted for attrition during participant selection.
Another exposure strategy, known as imagery rescripting and exposure remedy (IRET), was used by Long et al. (2011) to take care of nightmares associated with PTSD. Like in these case of Ready et al. (2012), this program also experienced the issue of being all men. Furthermore, the temporal relevance of the study can be questioned because the participants were primarily veterans of the Vietnam Conflict and none of them of the participants possessed participated in productive combat because the early 1990s. While IRET possessed great success in reducing the regularity of nightmares and increasing the quality of sleep, it wasn't shown to have any effect on other symptoms associated with PTSD. The validity of these conclusions can be further questioned by the fact that the mean time for the individuals were 62. 1 years; and therefore their sleep disturbances may be the consequence of factors other than PTSD. Despite all of this, the self-employed and individualized vulnerability techniques found in this study, along with the comprehensive psychoeducation that preceded it, helps it be a highly effective tool to take care of nightmares associated with PTSD, even in individuals who have been experiencing it for decades.
Rothbaum, Astin, and Marstellar (2005) attemptedto compare the effectiveness of prolonged vulnerability therapy (PE) to EMDR with respect to the treatment of rape victims. One of the things that stood out from this study was the actual fact that every evaluation and evaluation that's needed is during the course of the study was conducted by unbiased, blind evaluators. Moreover the integrity of the specific therapies was measured by assessors who scored them highly. The sample size used was appropriate but a high dropout rate, combined with a few peculiar enhancements to the sample groups negatively influences the validity and trustworthiness of the analysis; three participants who would not have in any other case had the opportunity to pass the exclusion conditions were permitted to participate in the study. It also used the participant's subjective opinion on the most important occasions in their lives, which the treatments were centered on, which stands out because of the lengths they visited make the results of this study unbiased and objective. Furthermore, the remarkable success at which both PE and EMDR was able to treat the participants, raises questions on the trustworthiness of the treatment process; 95% of the PE group and 75% of the EMDR band of patients who have been experiencing PTSD for over ten years, were no longer diagnosable as PTSD patients after cure process that lasted a few weeks. Despite everything that, the efficacy of both coverage techniques and EMDR in treatment compared to no treatment cannot be questioned.
Ahmad, Larsson, and Sundlein-Wahlsten's (2006) review, which was conducted using participants between the age range of 6 to 16, exhibited that PTSD is widespread even among children. The randomized manipulated nature of the study combined with the independent assessments helps it be high in inside validity. Participants on the control group of this also exhibited improvements; they however, upgraded in non PTSD related symptoms. In addition, the inventory that was administered had been changed so that it could be comprehended and used easily with children. Furthermore, a far more extensive evaluation can be executed in the form of longitudinal studies or circumstance studies about the romance between PTSD in children and the history of mental illness in their family. Like many other programs which tested different treatments of PTSD, this research lacked a larger sample size, and used extensive exclusion criteria; this could have an impact on its generalizability. In addition to this, they didn't make independent assessments of their follow-up evaluations, impacting its claim of experiencing blind assessments.
Similar to Rothbaum, Astin, and Marstellar's (2005) review that used the victim's subjective view of their worst experience to be able to execute their PTSD examination, this study also decided to focus on a unitary event that the young members or their guardians considered significant. That is an effective approach to administering EMDR, since it is better in dealing with specific stories that are distressing to the participants. However, in a broader point of view, while an instance can be produced to the point that subjective views of individuals' most distressing occurrences are highly relevant to dealing with PTSD since it's the individuals themselves who are experiencing them, it will also be remarked that what a person considers to be the most important event in his/her life do not need to be the most important event in conditions of mental and emotional stress. Therefore, it should be best to carry out extensive criminal background checks before any type of decision is made regarding the need for any life happenings.
In a study shared by Taylor et al. (2003), a side by side comparison of prolonged exposure therapy and EMDR with respect to specific symptoms of PTSD was conducted to ascertain which technique was far better against all of them. Compared to most other studies conducted regarding PTSD, this research had a fairly large sample size (n=60) with the majority of them being Caucasian and women. As the study employed an impressive sample size, since the participants were mainly diagnosed with chronic and severe varieties of PTSD, the external validity of the results can be helped bring into question. However, since almost all of the participants of the analysis had persistent PTSD, it reduces the possibility that the changes which were observed in the pretests and posttests are strictly credited to temporal changes. The validity can be further questioned due to the difference in educational requirements of both therapists who administered these therapeutics techniques. However, impartial expert assessment of the interrater dependability produced high scores, disproving these doubts. Additionally, the treatments were given using standardized guides which increased the validity of the study by ensuring that all participants received near as similar treatments as you possibly can. This analysis is the first study to acquire achieved these "gold Standard" for PTSD results treatment research (CITE). This study's discovered reductions in PTSD symptoms for all those three subject teams were dependant on the authors consequently of the result of unintended exposure during leisure training and EMDR techniques. This contradicts with the fact that in EMDR, eye activity "enhances the retrieval of episodic recollection and increases cognitive overall flexibility" (CITE).
While coverage techniques and eyes movement desensitizing and reprocessing (EMDR) act like each other in many ways and are efficacious in their treatment of PTSD, their solutions, implementations, and goals are quite different from each other. EMDR snacks PTSD by asking the patients to subjectively choose the storage or experience that they think is leading to them the most distress and treating them so that they are desensitized to the particular experience. The main of these PTSD is determined to be their most distressing memory and by desensitizing them to that experience and the re-experiencing that follows it, they may be proven to have significant reduction in symptoms of PTSD. While some specialized vulnerability therapies employ similar solutions, others like the NET and GBET explores an individual's very existence or a particular period where they were susceptible to distressing experiences respectively. This method allows the therapist to play a role in determining the most significant event in an individual's life and changing the treatment process accordingly. In addition to that, since Taylor et al. (2003) revealed that prolonged vulnerability therapy was more effective than EMDR in minimizing the levels of re-experiencing and avoidance, the authors of the analysis concluded that it is the superior therapeutic approach. All in all, both coverage techniques and EMDR are incredibly proficient at what they are supposed to do; but subjection techniques are better at it. Therefore, a hypothesis can be produced from the aforementioned discussed studies which expresses that specialized visibility techniques are usually more efficacious in the treatment of PTSD than EMDR across interpersonal and temporal demographics.