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What I have changed my mind about and why.

Rachel Yehuda1,2, David Spiegel3, Steven Southwick4,5

  • 1James J. Peters Veterans Affairs, New York, NY, USA.

European Journal of Psychotraumatology
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Experts reflect on evolving trauma treatment, noting limitations of fear-based models and the need for broader therapeutic principles beyond specific post-traumatic stress disorder (PTSD) guidelines.

Keywords:
PTSDalternative treatmentsevidenced based treatmentsfear extinctionmindfulnessneurobiologynovel approachespharmacotherapyrandomized clinical trialsresilience

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Area of Science:

  • Psychiatry and Behavioral Sciences
  • Trauma Studies
  • Clinical Psychology

Background:

  • The paper summarizes a panel discussion at the ISTSS 2015 annual meeting.
  • The discussion focused on evolving perspectives in trauma research and treatment.
  • Key experts shared insights on changes in their professional thinking over time.

Purpose of the Study:

  • To synthesize expert opinions on paradigm shifts in understanding and treating trauma.
  • To highlight limitations of current fear-based models for post-traumatic stress disorder (PTSD).
  • To explore emerging therapeutic approaches and principles in trauma care.

Main Methods:

  • Summary of a panel discussion featuring five clinician-scholars.
  • Qualitative synthesis of expert viewpoints and ensuing discussion.
  • Review of major themes and conceptual shifts presented by the panelists.

Main Results:

  • Identified limitations in the prevailing fear-based model of PTSD.
  • Acknowledged that some trauma effects may not be fully reparable despite treatment advances.
  • Discussed the potential for overly specific evidence-based treatment guidelines to obscure general therapeutic principles.

Conclusions:

  • Treatment for trauma may benefit from viewing it as enhancing brain plasticity in social cue processing.
  • Novel and integrative therapies, including holistic care, exercise, logotherapy, mindfulness, and medications like ketamine, show promise.
  • A shift towards more general principles and integrative approaches may be necessary for advancing trauma treatment.