Post Traumatic Stress Disorder and Psychological Therapies

Literature Review: The current review presents a recent review of the effectiveness of psychological therapies to treat sleep difficulties (such as insomnia and nightmares) in sufferers of posttraumatic stress disorder (PTSD). The review also aimed to investigate whether there are differences in the effectiveness of specific psychological therapies to treat sleep disturbances in PTSD, such as between the different types of psychological therapies such as cognitive behavioural therapy for insomnia (CBT-I) and imagery rehearsal therapy (IRT). Eleven studies were included in the review that met the inclusion and exclusion criteria. Results are presented in tables and a descriptive account is included. The review demonstrates that psychological therapies are effective for the treatment of insomnia and other sleep difficulties such as nightmares. However, firm conclusions cannot be drawn about the effectiveness of different types of psychological therapies as studies predominantly used CBT and only one non-CBT study was included in the review. Comparisons between the effectiveness of different CBT approaches is also not possible as there was a large range of diversity in the study characteristics and also there were only a small number of studies for each intervention, which therefore limits the generalisability of results in the current review. It may be that different CBT interventions such as CBT-I or EERT and IRT may be better suited to treat insomnia and nightmares respectively, but further research needs to be conducted into which of these approaches are beneficial for different PTSD specific sleep difficulties. Empirical Paper: Initial studies demonstrate that self-compassion reduces symptoms of PTSD in Armed Forces Veterans (AFV), however the use of self-compassion approaches in AFV is under-researched. The current study utilised self-report and psychophysiological measures to investigate whether a single self-compassion experimental induction reduced hyperarousal symptoms (PTSD Cluster E symptoms) and increased feelings of social connectedness in AFV. The study hypothesised that there would be a decrease in hyperarousal symptoms and an increase in social connectedness, which would be associated with PTSD severity. Fifty-three AFV who had been deployed to a combat zone took part in the study, of which n = 15 (28.3%) currently met criteria for PTSD and n = 4 (7.5%) met criteria for Subsyndromal PTSD on the PCL-5. Participants listened to a recording of a Loving Kindness Meditation for self-compassion (LKM-S) and psychophysiological recordings were taken throughout. Participants completed state measures of hyperarousal and social connectedness before and after the LKM-S. Findings partially demonstrated that self-compassion can be elicited in an AFV population. However, changes on the self-report measures were largely not supported by psychophysiological measures, apart from skin conductance levels (SCL). The longevity of the effects observed in the study were not measured and should be investigated in future studies. Although this study has demonstrated that self-compassion can be elicited within the AFV population, further research is needed including to test a longer self-compassion intervention