Week 6 Reading

Question 1

Cloitre 2014 - distinguishing PTSD and BPD

Answer 1

• Debate whether complex PTSD is distinct from borderline personality disorder when BPD is comorbid with PTSD
  
  • four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD.
  • Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness.
  • Construct validity of Complex PTSD as distinguishable from BPD

Question 2

Liberzon 2016 - neurobiology of PTSD

Answer 2

• redefining psychiatric illness as symptomatic expression of cellular/molecular dysfunctions in specific brain circuits.
  
  • many features of PTSD remain unexplained and a parsimonious model that more fully accounts for symptoms and the core neurobiology remains elusive.
  • Contextual processing is a key modulatory function of hippocampal-prefrontal-thalamic circuitry, allowing organisms to disambiguate cues and derive situation-specific meaning from the world.
    ○ dysregulation within this context-processing circuit is at the core of PTSD pathophysiology, accounting for much of its phenomenology and most of its biological findings.

Question 3

Landin-Romero 2018 - eye movement therapy

Answer 3

• reasonable empirical support for the working memory hypothesis and for the physiological changes associated with successful EMDR therapy.
  
  • more sophisticated structural and functional neuroimaging studies using high resolution structural and temporal techniques are starting to provide preliminary evidence into the neuronal correlates before, during and after EMDR therapy.
  • the research into the mechanisms underlying EMDR therapy is still in its infancy.
  • Studies in well-defined clinical and non-clinical populations, larger sample sizes and tighter methodological control are further needed in order to establish firm conclusions.

Question 4

Cooper 2017 - prolonged exposure therapy

Answer 4

• Prolonged exposure (PE) as a treatment for PTSD, but the precise mechanism(s) by which PE promotes symptom change are not well established.
  
  • mechanisms research conducted in clinical treatment settings is complex, and findings may be difficult to interpret without appropriate context.
  • six putative mechanisms identified by emotional processing theory and contemporary models of fear extinction
  • variables with strong evidence (belief change and between-session habituation)
  • intermediate evidence (inhibitory learning and emotional engagement)
  • minimal support (narrative organization and within-session habituation).