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There is limited evidence for effective interventions in the treatment of post-traumatic stress symptoms within individuals diagnosed with schizophrenia. Clinicians have concerns about using exposure treatments with this patient group. The current trial was designed to evaluate a 16-session cognitive restructuring programme, without direct exposure, for the treatment of post-traumatic stress symptoms specifically within individuals diagnosed with schizophrenia.
A multicentre randomized controlled single-blinded trial with assessments at 0 months, 6 months (post-treatment) and 12 months (follow-up) was conducted. A total of 61 participants diagnosed with schizophrenia and exhibiting post-traumatic stress symptoms were recruited. Those randomized to treatment were offered up to 16 sessions of cognitive–behaviour therapy (CBT, including psychoeducation, breathing training and cognitive restructuring) over a 6-month period, with the control group offered routine clinical services. The main outcome was blind rating of post-traumatic stress symptoms using the Clinician Administered PTSD Scale for Schizophrenia. Secondary outcomes were psychotic symptoms as measured by the Positive and Negative Symptom Scale and the Psychotic Symptom Rating Scale.
Both the treatment and control groups experienced a significant decrease in post-traumatic stress symptoms over time but there was no effect of the addition of CBT on either the primary or secondary outcomes.
The current trial did not demonstrate any effect in favour of CBT. Cognitive restructuring programmes may require further adaptation to promote emotional processing of traumatic memories within people diagnosed with a psychotic disorder.
A cognitive–behavioural therapy (CBT) programme designed for
post-traumatic stress disorder (PTSD) in people with severe mental
illness, including breathing retraining, education and cognitive
restructuring, was shown to be more effective than usual services.
To evaluate the incremental benefit of adding cognitive restructuring to
the breathing retraining and education components of the CBT programme
(trial registration: clinicaltrials.gov identifier: NCT00494650).
In all, 201 people with severe mental illness and PTSD were randomised to
12- to 16-session CBT or a 3-session brief treatment programme (breathing
retraining and education). The primary outcome was PTSD symptom severity.
Secondary outcomes were PTSD diagnosis, other symptoms, functioning and
quality of life.
There was greater improvement in PTSD symptoms and functioning in the CBT
group than in the brief treatment group, with both groups improving on
other outcomes and effects maintained 1-year post-treatment.
Cognitive restructuring has a significant impact beyond breathing
retraining and education in the CBT programme, reducing PTSD symptoms and
improving functioning in people with severe mental illness.
We have utilized an ultrahigh vacuum surface analysis system interfaced via a load-lock to a flexible diode dry etching apparatus to study vacuum transferred CF4/H2 reactive ion etched silicon surfaces by X-ray photoemission spectroscopy (XPS). From the observation and analysis of silicon-fluorine bonding underneath the fluorocarbon film and the dependence of the abundance of fluorosilyl species on the thickness of the fluorocarbon overlayer, the role of the fluorocarbon film in the slow-down of the Si etch rate has been elucidated: The role of the fluorocarbon film is to “protect” the Si surface from attack of fluorine, rather than prevent the escape of SiF4 etch product.
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