The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Edna B. Foa - One of the best experts on this subject based on the ideXlab platform.
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Prolonged Exposure Therapy for PTSD - Intermediate Sessions: (From 4 to up to 14)
Prolonged Exposure Therapy for PTSD, 2019Co-Authors: Edna B. Foa, Barbara Olasov Rothbaum, Elizabeth A. Hembree, Sheila A. M. RauchAbstract:Beginning around Session 5 or 6, emotional processing of the trauma memories can be made more efficient by having the patient focus primarily or exclusively on the most currently distressing parts of the trauma, which the authors term the “hot spots.” The therapist helps the patient identify his hot spots and then select one to begin the Imaginal Exposure. This should be one of the most distressing parts, if not the most distressing part, of the trauma. Therapy continues with the focus on the patient’s hot spots during the Imaginal Exposure until each has been sufficiently processed, as reflected by diminished Subjective Units of Distress Scale (SUDS) levels and the patient’s behavior (e.g., body movement, facial expression). This may take several sessions, depending on the number of hot spots, the patient’s pace, and the amount of time spent listening to Exposure recordings as homework.
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Foundations of Prolonged Exposure
Prolonged Exposure Therapy for PTSD, 2019Co-Authors: Edna B. Foa, Barbara Olasov Rothbaum, Elizabeth A. Hembree, Sheila A. M. RauchAbstract:Foundations of prolonged Exposure (PE) include (1) education about common reactions to trauma, what maintains trauma-related symptoms, and how PE reduces posttraumatic stress disorder (PTSD) symptoms; (2) repeated in vivo confrontation with situations, people, or objects that the patient is avoiding because they are trauma-related and cause emotional distress such as anxiety, shame, or guilt; and (3) repeated, prolonged Imaginal Exposure to the trauma memories followed by processing the details of the event, the emotions, and the thoughts that the patient experienced during the trauma. The aim of in vivo and Imaginal Exposure is to enhance emotional processing of traumatic events by helping the patient face the trauma memories and reminders and process the emotions and thoughts, as well as the details of the trauma that emerge during revisiting experiences.
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Reclaiming Your Life from a Traumatic Experience - Intermediate Sessions: Session 4 to the End of Treatment
Reclaiming Your Life from a Traumatic Experience, 2019Co-Authors: Barbara Olasov Rothbaum, Edna B. Foa, Elizabeth A. Hembree, Sheila A. M. RauchAbstract:Up to this point, each time the patient has done an Imaginal Exposure, he or she has described the entire memory of what happened from the beginning to the end of the trauma. When the patient reaches the point in treatment of experiencing a decrease in anxiety and distress, at least with some of the relatively less disturbing parts of the memory, the patient and therapist will do the Imaginal Exposure a little differently. Beginning around Session 5 or 6, emotional processing of the trauma memories can be made more efficient by the patient focusing primarily or exclusively on the “hot spots,” which are the most currently distressing parts of the trauma.
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Enhancing Extinction Learning in Posttraumatic Stress Disorder With Brief Daily Imaginal Exposure and Methylene Blue: A Randomized Controlled Trial.
The Journal of clinical psychiatry, 2017Co-Authors: Lori A. Zoellner, Edna B. Foa, Frank J. Farach, Carmen P. Mclean, Michael Telch, Robert Gallop, Ellen J Bluett, Adam Cobb, F Gonzalez-limaAbstract:The memory-enhancing drug methylene blue (MB) administered after extinction training improves fear extinction retention in rats and humans with claustrophobia. Robust findings from animal research, in combination with established safety and data showing MB-enhanced extinction in humans, provide a foundation to extend this work to extinction-based therapies for posttraumatic stress disorder (PTSD) such as prolonged Exposure (PE). Patients with chronic PTSD (DSM-IV-TR; N = 42) were randomly assigned to Imaginal Exposure plus MB (IE + MB), Imaginal Exposure plus placebo (IE + PBO), or waitlist (WL/standard PE) from September 2011 to April 2013. Following 5 daily, 50-minute Imaginal Exposure sessions, 260 mg of MB or PBO was administered. Waitlist controls received PE following 1-month follow-up. Patients were assessed using the independent evaluator-rated PTSD Symptom Scale-Interview version (primary outcome), patient-rated PTSD, trauma-related psychopathology, and functioning through 3-month follow-up. Both IE + MB and IE + PBO showed strong clinical gains that did not differ from standard PE at 3-month follow-up. MB-augmented Exposure specifically enhanced independent evaluator-rated treatment response (number needed to treat = 7.5) and quality of life compared to placebo (effect size d = 0.58). Rate of change for IE + MB showed a delayed initial response followed by accelerated recovery, which differed from the linear pattern seen in IE + PBO. MB effects were facilitated by better working memory but not by changes in beliefs. The findings provide preliminary efficacy for a brief IE treatment for PTSD and point to the potential utility of MB for enhancing outcome. Brief interventions and better tailoring of MB augmentation strategies, adjusting for observed patterns, may have the potential to reduce dropout, accelerate change, and improve outcomes. ClinicalTrials.gov identifier: NCT01188694. © Copyright 2017 Physicians Postgraduate Press, Inc.
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Enhancing Extinction Learning in Posttraumatic Stress Disorder With Brief Daily Imaginal Exposure and Methylene Blue: A Randomized Controlled Trial.
The Journal of Clinical Psychiatry, 2017Co-Authors: Lori A. Zoellner, Edna B. Foa, Michael J. Telch, Frank J. Farach, Carmen P. Mclean, Robert Gallop, Ellen J Bluett, Adam R. Cobb, F Gonzalez-limaAbstract:Objective The memory-enhancing drug methylene blue (MB) administered after extinction training improves fear extinction retention in rats and humans with claustrophobia. Robust findings from animal research, in combination with established safety and data showing MB-enhanced extinction in humans, provide a foundation to extend this work to extinction-based therapies for posttraumatic stress disorder (PTSD) such as prolonged Exposure (PE). Methods Patients with chronic PTSD (DSM-IV-TR; N = 42) were randomly assigned to Imaginal Exposure plus MB (IE + MB), Imaginal Exposure plus placebo (IE + PBO), or waitlist (WL/standard PE) from September 2011 to April 2013. Following 5 daily, 50-minute Imaginal Exposure sessions, 260 mg of MB or PBO was administered. Waitlist controls received PE following 1-month follow-up. Patients were assessed using the independent evaluator-rated PTSD Symptom Scale-Interview version (primary outcome), patient-rated PTSD, trauma-related psychopathology, and functioning through 3-month follow-up. Results Both IE + MB and IE + PBO showed strong clinical gains that did not differ from standard PE at 3-month follow-up. MB-augmented Exposure specifically enhanced independent evaluator-rated treatment response (number needed to treat = 7.5) and quality of life compared to placebo (effect size d = 0.58). Rate of change for IE + MB showed a delayed initial response followed by accelerated recovery, which differed from the linear pattern seen in IE + PBO. MB effects were facilitated by better working memory but not by changes in beliefs. Conclusions The findings provide preliminary efficacy for a brief IE treatment for PTSD and point to the potential utility of MB for enhancing outcome. Brief interventions and better tailoring of MB augmentation strategies, adjusting for observed patterns, may have the potential to reduce dropout, accelerate change, and improve outcomes. Trial registration ClinicalTrials.gov identifier: NCT01188694.
Hunter G Hoffman - One of the best experts on this subject based on the ideXlab platform.
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prolonged Exposure and virtual reality enhanced Imaginal Exposure for ptsd following a terrorist bulldozer attack a case study
Cyberpsychology Behavior and Social Networking, 2010Co-Authors: Sara Freedman, Hunter G Hoffman, Patrice L. Weiss, Sara Avitzour, Azucena Garciapalacios, Naomi JosmanAbstract:Abstract In this case study, virtual reality was used to augment Imaginal Exposure in a protocol based on prolonged Exposure. A 29-year-old male patient developed posttraumatic stress disorder after surviving a deadly terrorist bulldozer attack on two civilian buses and several cars in Jerusalem; the traumas witnessed by the survivor included a decapitation. The crowded bus in which the patient was riding was pushed over onto its side by the terrorist, injuring, trapping, and terrifying the passengers and causing gasoline to leak. Guided by his therapist, the patient entered an immersive computer-generated virtual world to go “back” to the scene of the traumatic event to help him gain access to his memories of the event, process and reduce the intensity of the emotions (fear/anger) associated with his pathological memories, and change unhealthy thought patterns. Traumatic memories of childhood abuse and traumatic memories of the bulldozer terrorist attack were treated using Imaginal Exposure while the pat...
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Prolonged Exposure and Virtual Reality–Enhanced Imaginal Exposure for PTSD following a Terrorist Bulldozer Attack: A Case Study
Cyberpsychology behavior and social networking, 2010Co-Authors: Sara Freedman, Hunter G Hoffman, Azucena García-palacios, Patrice L. Weiss, Sara Avitzour, Naomi JosmanAbstract:Abstract In this case study, virtual reality was used to augment Imaginal Exposure in a protocol based on prolonged Exposure. A 29-year-old male patient developed posttraumatic stress disorder after surviving a deadly terrorist bulldozer attack on two civilian buses and several cars in Jerusalem; the traumas witnessed by the survivor included a decapitation. The crowded bus in which the patient was riding was pushed over onto its side by the terrorist, injuring, trapping, and terrifying the passengers and causing gasoline to leak. Guided by his therapist, the patient entered an immersive computer-generated virtual world to go “back” to the scene of the traumatic event to help him gain access to his memories of the event, process and reduce the intensity of the emotions (fear/anger) associated with his pathological memories, and change unhealthy thought patterns. Traumatic memories of childhood abuse and traumatic memories of the bulldozer terrorist attack were treated using Imaginal Exposure while the pat...
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virtual reality Exposure therapy for world trade center post traumatic stress disorder a case report
Cyberpsychology Behavior and Social Networking, 2002Co-Authors: Joann Difede, Hunter G HoffmanAbstract:Done properly by experienced therapists, re-Exposure to memories of traumatic events via Imaginal Exposure therapy can lead to a reduction of Post-traumatic Stress Disorder (PTSD) symptoms. Exposure helps the patient process and habituate to memories and strong emotions associated with the traumatic event: memories and emotions they have been carefully avoiding. But many patients are unwilling or unable to self-generate and re-experience painful emotional images. The present case study describes the treatment of a survivor of the World Trade Center (WTC) attack of 9-11-01 who had developed acute PTSD. After she failed to improve with traditional Imaginal Exposure therapy, we sought to increase emotional engagement and treatment success using virtual reality (VR) Exposure therapy. Over the course of six 1-h VR Exposure therapy sessions, we gradually and systematically exposed the PTSD patient to virtual planes flying over the World Trade Center, jets crashing into the World Trade Center with animated explo...
Naomi Josman - One of the best experts on this subject based on the ideXlab platform.
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prolonged Exposure and virtual reality enhanced Imaginal Exposure for ptsd following a terrorist bulldozer attack a case study
Cyberpsychology Behavior and Social Networking, 2010Co-Authors: Sara Freedman, Hunter G Hoffman, Patrice L. Weiss, Sara Avitzour, Azucena Garciapalacios, Naomi JosmanAbstract:Abstract In this case study, virtual reality was used to augment Imaginal Exposure in a protocol based on prolonged Exposure. A 29-year-old male patient developed posttraumatic stress disorder after surviving a deadly terrorist bulldozer attack on two civilian buses and several cars in Jerusalem; the traumas witnessed by the survivor included a decapitation. The crowded bus in which the patient was riding was pushed over onto its side by the terrorist, injuring, trapping, and terrifying the passengers and causing gasoline to leak. Guided by his therapist, the patient entered an immersive computer-generated virtual world to go “back” to the scene of the traumatic event to help him gain access to his memories of the event, process and reduce the intensity of the emotions (fear/anger) associated with his pathological memories, and change unhealthy thought patterns. Traumatic memories of childhood abuse and traumatic memories of the bulldozer terrorist attack were treated using Imaginal Exposure while the pat...
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Prolonged Exposure and Virtual Reality–Enhanced Imaginal Exposure for PTSD following a Terrorist Bulldozer Attack: A Case Study
Cyberpsychology behavior and social networking, 2010Co-Authors: Sara Freedman, Hunter G Hoffman, Azucena García-palacios, Patrice L. Weiss, Sara Avitzour, Naomi JosmanAbstract:Abstract In this case study, virtual reality was used to augment Imaginal Exposure in a protocol based on prolonged Exposure. A 29-year-old male patient developed posttraumatic stress disorder after surviving a deadly terrorist bulldozer attack on two civilian buses and several cars in Jerusalem; the traumas witnessed by the survivor included a decapitation. The crowded bus in which the patient was riding was pushed over onto its side by the terrorist, injuring, trapping, and terrifying the passengers and causing gasoline to leak. Guided by his therapist, the patient entered an immersive computer-generated virtual world to go “back” to the scene of the traumatic event to help him gain access to his memories of the event, process and reduce the intensity of the emotions (fear/anger) associated with his pathological memories, and change unhealthy thought patterns. Traumatic memories of childhood abuse and traumatic memories of the bulldozer terrorist attack were treated using Imaginal Exposure while the pat...
Barbara Olasov Rothbaum - One of the best experts on this subject based on the ideXlab platform.
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does virtual reality increase emotional engagement during Exposure for ptsd subjective distress during prolonged and virtual reality Exposure therapy
Journal of Anxiety Disorders, 2019Co-Authors: Greg M Reger, Aaron M Norr, Andrea C Katz, Benjamin Buck, Donald John Smolenski, Barbara Olasov RothbaumAbstract:Abstract Prolonged Exposure (PE) is a treatment for posttraumatic stress disorder (PTSD) based on emotional processing theory. According to this theory, emotional engagement during Imaginal Exposure is critical to clinical outcome. One rationale for virtual reality Exposure therapy (VRE) is the ability of trauma-relevant, multi-sensory stimuli to increase emotional engagement. This study compared the subjective distress of active duty soldiers (N = 108) during Exposure via PE or VRE. Soldiers with higher mean or peak distress during the first Imaginal Exposure had higher baseline PTSD symptom severity. There was no difference between groups on average or peak distress during Imaginal Exposure at the first or final Exposure session. There were no significant differences in between-session habituation observed between VRE and PE groups. However, each ten-point decrease in SUDS scores, either mean or peak, from the initiation of Imaginal Exposure to the end of treatment, was associated with a greater decrease in CAPS-W scores for both groups. There were no group differences in these trajectories or the magnitude of the association between distress/habituation, and PTSD symptoms. Future research on VRE should measure patient ratings of engagement during Exposure to better understand which patients are aided by this innovative approach to treatment.
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Reclaiming Your Life from a Traumatic Experience - Intermediate Sessions: Session 4 to the End of Treatment
Reclaiming Your Life from a Traumatic Experience, 2019Co-Authors: Barbara Olasov Rothbaum, Edna B. Foa, Elizabeth A. Hembree, Sheila A. M. RauchAbstract:Up to this point, each time the patient has done an Imaginal Exposure, he or she has described the entire memory of what happened from the beginning to the end of the trauma. When the patient reaches the point in treatment of experiencing a decrease in anxiety and distress, at least with some of the relatively less disturbing parts of the memory, the patient and therapist will do the Imaginal Exposure a little differently. Beginning around Session 5 or 6, emotional processing of the trauma memories can be made more efficient by the patient focusing primarily or exclusively on the “hot spots,” which are the most currently distressing parts of the trauma.
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Foundations of Prolonged Exposure
Prolonged Exposure Therapy for PTSD, 2019Co-Authors: Edna B. Foa, Barbara Olasov Rothbaum, Elizabeth A. Hembree, Sheila A. M. RauchAbstract:Foundations of prolonged Exposure (PE) include (1) education about common reactions to trauma, what maintains trauma-related symptoms, and how PE reduces posttraumatic stress disorder (PTSD) symptoms; (2) repeated in vivo confrontation with situations, people, or objects that the patient is avoiding because they are trauma-related and cause emotional distress such as anxiety, shame, or guilt; and (3) repeated, prolonged Imaginal Exposure to the trauma memories followed by processing the details of the event, the emotions, and the thoughts that the patient experienced during the trauma. The aim of in vivo and Imaginal Exposure is to enhance emotional processing of traumatic events by helping the patient face the trauma memories and reminders and process the emotions and thoughts, as well as the details of the trauma that emerge during revisiting experiences.
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Prolonged Exposure Therapy for PTSD - Intermediate Sessions: (From 4 to up to 14)
Prolonged Exposure Therapy for PTSD, 2019Co-Authors: Edna B. Foa, Barbara Olasov Rothbaum, Elizabeth A. Hembree, Sheila A. M. RauchAbstract:Beginning around Session 5 or 6, emotional processing of the trauma memories can be made more efficient by having the patient focus primarily or exclusively on the most currently distressing parts of the trauma, which the authors term the “hot spots.” The therapist helps the patient identify his hot spots and then select one to begin the Imaginal Exposure. This should be one of the most distressing parts, if not the most distressing part, of the trauma. Therapy continues with the focus on the patient’s hot spots during the Imaginal Exposure until each has been sufficiently processed, as reflected by diminished Subjective Units of Distress Scale (SUDS) levels and the patient’s behavior (e.g., body movement, facial expression). This may take several sessions, depending on the number of hot spots, the patient’s pace, and the amount of time spent listening to Exposure recordings as homework.
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Virtual Reality Exposure Therapy for PTSD
Oxford Medicine Online, 2016Co-Authors: Michael J. Roy, Albert Rizzo, Joann Difede, Barbara Olasov RothbaumAbstract:Expert treatment guidelines and consensus statements identified Imaginal Exposure therapy as a first-line treatment for posttraumatic stress disorder (PTSD) more than a decade ago. Subsequently, an Institute of Medicine report concluded that cognitive–behavioral therapy with Exposure therapy is the only therapy with sufficient evidence to recommend it for PTSD. Imaginal Exposure has been the most widely used Exposure approach. It requires patients to recall and narrate their traumatic experience repeatedly, in progressively greater detail, both to facilitate the therapeutic processing of related emotions and to decondition the learning cycle of the disorder via a habituation–extinction process. Prolonged Exposure, one of the best-evidenced forms of Exposure therapy, incorporates psychoeducation, controlled breathing techniques, in vivo Exposure, prolonged Imaginal Exposure to traumatic memories, and processing of traumatic material, typically for 9 to 12 therapy sessions of about 90 minutes each. However, avoidance of reminders of the trauma is a defining feature of PTSD, so it is not surprising that many patients are unwilling or unable to visualize effectively and recount traumatic events repeatedly. Some studies of Imaginal Exposure have reported 30% to 50% dropout rates before completion of treatment. Adding to the challenge, some patients have an aversion to “traditional” psychotherapy as well as to pharmacotherapy, and may find alternative approaches more appealing. Younger individuals in particular may be attracted to virtual reality-based therapies.
Sara Freedman - One of the best experts on this subject based on the ideXlab platform.
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prolonged Exposure and virtual reality enhanced Imaginal Exposure for ptsd following a terrorist bulldozer attack a case study
Cyberpsychology Behavior and Social Networking, 2010Co-Authors: Sara Freedman, Hunter G Hoffman, Patrice L. Weiss, Sara Avitzour, Azucena Garciapalacios, Naomi JosmanAbstract:Abstract In this case study, virtual reality was used to augment Imaginal Exposure in a protocol based on prolonged Exposure. A 29-year-old male patient developed posttraumatic stress disorder after surviving a deadly terrorist bulldozer attack on two civilian buses and several cars in Jerusalem; the traumas witnessed by the survivor included a decapitation. The crowded bus in which the patient was riding was pushed over onto its side by the terrorist, injuring, trapping, and terrifying the passengers and causing gasoline to leak. Guided by his therapist, the patient entered an immersive computer-generated virtual world to go “back” to the scene of the traumatic event to help him gain access to his memories of the event, process and reduce the intensity of the emotions (fear/anger) associated with his pathological memories, and change unhealthy thought patterns. Traumatic memories of childhood abuse and traumatic memories of the bulldozer terrorist attack were treated using Imaginal Exposure while the pat...
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Prolonged Exposure and Virtual Reality–Enhanced Imaginal Exposure for PTSD following a Terrorist Bulldozer Attack: A Case Study
Cyberpsychology behavior and social networking, 2010Co-Authors: Sara Freedman, Hunter G Hoffman, Azucena García-palacios, Patrice L. Weiss, Sara Avitzour, Naomi JosmanAbstract:Abstract In this case study, virtual reality was used to augment Imaginal Exposure in a protocol based on prolonged Exposure. A 29-year-old male patient developed posttraumatic stress disorder after surviving a deadly terrorist bulldozer attack on two civilian buses and several cars in Jerusalem; the traumas witnessed by the survivor included a decapitation. The crowded bus in which the patient was riding was pushed over onto its side by the terrorist, injuring, trapping, and terrifying the passengers and causing gasoline to leak. Guided by his therapist, the patient entered an immersive computer-generated virtual world to go “back” to the scene of the traumatic event to help him gain access to his memories of the event, process and reduce the intensity of the emotions (fear/anger) associated with his pathological memories, and change unhealthy thought patterns. Traumatic memories of childhood abuse and traumatic memories of the bulldozer terrorist attack were treated using Imaginal Exposure while the pat...
