Prolonged exposure, mindfulness and emotion regulation

Prolonged Exposure, Mindfulness, and Emotion Regulation for the Treatment of PTSD
Although several studies have demonstrated the efficacy of prolonged exposure (PE) for the treatment of posttraumatic stress disorder (PTSD), there are concerns regarding its clinical applications. The exacerbation of symptoms during exposure, poor adherence to treatment, and early treatment dropout are suggested to occur because of an unwillingness for some PTSD clients to confront feared trauma-relevant stimuli and experience anxious arousal during exposure. The application of mindfulness and emotion regulation skills during PE may be a useful substitute for clients’ attempts to escape, avoid, or control anxious arousal during treatment. Lauren A. Frye, C. Richard Spates. Clinical Case Studies 1534650112446850, first published on May 24, 2012 as doi:10.1177/1534650112446850

Psilocybin related PubMed articles published Jan to May 2012

 1. Psilocybin Biases Facial Recognition, Goal-Directed Behavior, and Mood State Toward Positive Relative to Negative Emotions Through Different Serotonergic Subreceptors. Kometer M, Schmidt A, Bachmann R, Studerus E, Seifritz E, Vollenweider FX. Biol Psychiatry. 2012 May 9. [Epub ahead of print] PMID: 22578254

2. High doses of dextromethorphan, an NMDA antagonist, produce effects similar to classic hallucinogens. Reissig CJ, Carter LP, Johnson MW, Mintzer MZ, Klinedinst MA, Griffiths RR.

Psychopharmacology (Berl). 2012 Apr 13. [Epub ahead of print] PMID: 22526529

3. Neuroimaging: a scanner, colourfully. Roiser JP, Rees G. Curr Biol. 2012 Apr 10;22(7):R231-3. PMID: 22497939

4. Prediction of psilocybin response in healthy volunteers. Studerus E, Gamma A, Kometer M, Vollenweider FX. PLoS One. 2012;7(2):e30800. Epub 2012 Feb 17. PMID: 22363492 Free PMC Article

5. Hallucinogen actions on human brain revealed. Lee HM, Roth BL. Proc Natl Acad Sci U S A. 2012 Feb 7;109(6):1820-1. Epub 2012 Jan 30. No abstract available.  PMID: 22308478

6. Neural correlates of the psychedelic state as determined by fMRI studies with psilocybin. Carhart-Harris RL, Erritzoe D, Williams T, Stone JM, Reed LJ, Colasanti A, Tyacke RJ, Leech R, Malizia AL, Murphy K, Hobden P, Evans J, Feilding A, Wise RG, Nutt DJ. Proc Natl Acad Sci U S A. 2012 Feb 7;109(6):2138-43. Epub 2012 Jan 23. PMID: 22308440

7. Implications for psychedelic-assisted psychotherapy: functional magnetic resonance imaging study with psilocybin. Carhart-Harris RL, Leech R, Williams TM, Erritzoe D, Abbasi N, Bargiotas T, Hobden P, Sharp DJ, Evans J, Feilding A, Wise RG, Nutt DJ. Br J Psychiatry. 2012 Mar;200(3):238-44. Epub 2012 Jan 26. PMID: 22282432

PubMed articles on PTSD and mindfulness (Limits: Humans and English, published past 12 months)

1. Web-based post-traumatic stress disorder education for military family members. Roy MJ, Taylor P, Runge W, Grigsby E, Woolley M, Torgeson T. Mil Med. 2012 Mar;177(3):284-90. PMID: 22479915

2. Attention bias toward threat is associated with exaggerated fear expression and impaired extinction in PTSD. Fani N, Tone EB, Phifer J, Norrholm SD, Bradley B, Ressler KJ, Kamkwalala A, Jovanovic T. Psychol Med. 2012 Mar;42(3):533-43. Epub 2011 Aug 22.

PMID: 21854700

3. Serious psychological distress and diabetes: a review of the literature. Egede LE, Dismuke CE. Curr Psychiatry Rep. 2012 Feb;14(1):15-22. Review. PMID: 22002804

4. Physical health conditions associated with posttraumatic stress disorder in U.S. older adults: results from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Pietrzak RH, Goldstein RB, Southwick SM, Grant BF. J Am Geriatr Soc. 2012 Feb;60(2):296-303. doi: 10.1111/j.1532-5415.2011.03788.x. Epub 2012 Jan 27. PMID: 22283516

5. Comparison of subjective cognitive complaints with neuropsychological tests in individuals with mild vs more severe traumatic brain injuries.  Jamora CW, Young A, Ruff RM.

Brain Inj. 2012;26(1):36-47. PMID: 22149443

6. The potential impact of recruitment method on sample characteristics and treatment outcomes in a psychosocial trial for women with co-occurring substance use disorder and PTSD. Winhusen T, Winstanley EL, Somoza E, Brigham G. Drug Alcohol Depend. 2012 Jan 1;120(1-3):225-8. Epub 2011 Jul 12. PMID: 21752556

7. The interactive effects of emotional clarity and cognitive reappraisal in Posttraumatic Stress Disorder. Boden MT, Bonn-Miller MO, Kashdan TB, Alvarez J, Gross JJ. J Anxiety Disord. 2012 Jan;26(1):233-8. Epub 2011 Nov 28. PMID: 22169054

8. The effects of dissociation on information processing for analogue trauma and neutral stimuli: a laboratory study. Olsen SA, Beck JG. J Anxiety Disord. 2012 Jan;26(1):225-32. Epub 2011 Nov 16. PMID: 22137464

9. Association of participation in a mindfulness program with measures of PTSD, depression and quality of life in a veteran sample. Kearney DJ, McDermott K, Malte C, Martinez M, Simpson TL. J Clin Psychol. 2012 Jan;68(1):101-16. doi: 10.1002/jclp.20853. Epub 2011 Nov 28. PMID: 22125187

10. Peritraumatic reactions and posttraumatic stress disorder symptoms after psychiatric admission.  Ladois-Do Pilar Rei A, Bui E, Bousquet B, Simon NM, Rieu J, Schmitt L, Billard J, Rodgers R, Birmes P. J Nerv Ment Dis. 2012 Jan;200(1):88-90. PMID: 22210368

11. Social cognition impairments in relation to general cognitive deficits, injury severity, and prefrontal lesions in traumatic brain injury patients.  Spikman JM, Timmerman ME, Milders MV, Veenstra WS, van der Naalt J. J Neurotrauma. 2012 Jan 1;29(1):101-11. Epub 2011 Nov 7.

PMID: 21933011

12. The cognitive neuroscience of true and false memories.  Johnson MK, Raye CL, Mitchell KJ, Ankudowich E. Nebr Symp Motiv. 2012;58:15-52. Review. PMID: 22303763

13. Work-related stress and posttraumatic stress in emergency medical services.  Donnelly E. Prehosp Emerg Care. 2012 Jan;16(1):76-85. PMID: 22128908

14. Perceptual processing advantages for trauma-related visual cues in post-traumatic stress disorder.  Kleim B, Ehring T, Ehlers A. Psychol Med. 2012 Jan;42(1):173-81. Epub 2011 Jun 21.

PMID: 21733208 Free PMC Article

Articles in PubMed involving Psilocybin AND (PTSD OR cancer)

1. Pilot study of psilocybin treatment for anxiety in patients with advanced-stage cancer. Grob CS, Danforth AL, Chopra GS, Hagerty M, McKay CR, Halberstadt AL, Greer GR. Arch Gen Psychiatry. 2011 Jan;68(1):71-8. Epub 2010 Sep 6. PMID: 20819978. Citations (from Google Scholar)

2. Return of a problem child. Stix G. Sci Am. 2009 Oct;301(4):18, 20. No abstract available.

PMID: 19780439. 

3. Psychedelic drugs: the ups and downs of ecstasy. Check E. Nature. 2004 May 13;429(6988):126-8. No abstract available.  PMID: 15141183.

4. A contribution to the electrogenesis of distant rhythms in EEG. Kolarík J, Pĕnicková V.

Act Nerv  Super (Praha). 1975 Mar;17(1):29-30. No abstract available. PMID: 1179966.

5. EEG changes after psilocybin in organic brain lesions. Kolarĩk J. Act Nerv Super (Praha). 1971;13(3):216-7. No abstract available.  PMID: 512214.

6. Post-traumatic neurosis--theme and variations. Fellner CH. IMS Ind Med Surg. 1968 May;37(5):347-50. No abstract available. PMID: 5239850.

New article on mindulness and PTSD from the Department of Neurology, Oregon Health & Science University

Mindful awareness and non-judging in relation to posttraumatic stress disorder symptoms.

Conclusion:  This study confirms in a clinical sample that mindful non-judging is associated with PTSD symptoms and could represent a meaningful focus for treatment.

Wahbeh H, Lu M, Oken B. Mindfulness (N Y). 2011 Dec 1;2(4):219-227. PMID: 22582091

Existential Medicine

Experiencing events that lead to PTSD or being diagnosed with a life threatening disease such as cancer often results in an existential crisis.  Mindfulness and psilocybin can both be considered" existential medicine" or "existential therapy".

New Study in Biological Psychiatry: psilocybin enhanced positive mood, increased goal-directed behavior toward positive.

Psilocybin Biases Facial Recognition, Goal-Directed Behavior, and Mood State Toward Positive Relative to Negative Emotions Through Different Serotonergic Subreceptors. 

RESULTS: Psilocybin enhanced positive mood and attenuated recognition of negative facial expression. Furthermore, psilocybin increased goal-directed behavior toward positive compared with negative cues, facilitated positive but inhibited negative sequential emotional effects, and valence-dependently attenuated the P300 component. Ketanserin alone had no effects but blocked the psilocybin-induced mood enhancement and decreased recognition of negative facial expression.

Kometer M, Schmidt A, Bachmann R, Studerus E, Seifritz E, Vollenweider FX. Biol Psychiatry. 2012 May 9. [Epub ahead of print] PMID: 22578254
Cited by (Google Scholar)

Newly indexed article in Pubmed from the International Society for Traumatic Stress Studies.

Treatment of complex PTSD: results of the ISTSS expert clinician survey on best practices.
This study provides a summary of the results of an expert opinion survey initiated by the International Society for Traumatic Stress Studies Complex Trauma Task Force regarding best practices for the treatment of complex posttraumatic stress disorder (PTSD). Ratings from a mail-in survey from 25 complex PTSD experts and 25 classic PTSD experts regarding the most appropriate treatment approaches and interventions for complex PTSD were examined for areas of consensus and disagreement. Experts agreed on several aspects of treatment, with 84% endorsing a phase-based or sequenced therapy as the most appropriate treatment approach with interventions tailored to specific symptom sets. First-line interventions matched to specific symptoms included emotion regulation strategies, narration of trauma memory, cognitive restructuring, anxiety and stress management, and interpersonal skills. Meditation and mindfulness interventions were frequently identified as an effective second-line approach for emotional, attentional, and behavioral (e.g., aggression) disturbances.