Can you prevent PTSD?

Lots of people experience a traumatic event at some point in their life: only a few, however, will go on to develop post-traumatic stress disorder (PTSD).

If we could work out who was likely to develop PTSD, we could perhaps do something to prevent it taking hold.

For a while, there was a fashion for giving people who’d experienced a traumatic event a “debriefing” with a counsellor, on the basis that if they could talk about it soon after it happened, they could get it out of their system.

This turned out to be counter-productive. Mental recovery from a trauma depends on being able to convert short-term memories into long-term ones. (PTSD sufferers experience a past trauma as if it had just happened, experiencing flashbacks and anxiety symptoms.) Talking about the event soon after it has happened, however, does the opposite: it keeps the memories fresh.

So the more common approach now is to wait: if someone is still suffering from PTSD symptoms three months after the trauma, then that is the time to start treatment. (This is in an ideal world – many PTSD sufferers never receive treatment, or receive it late.)

But a new study suggests that a technique used in trauma-focused cognitive behavioural therapy (CBT) with PTSD sufferers can also be used with victims of trauma before the PTSD has developed.

The technique is known as “updating”: traumatic memories are rewritten with factual information, bringing the meaning of trauma in line with what actually happened. In a traumatic labour, for example, a woman might feel frightened that she is going to die or that her baby is going to die: if all turns out well, then the “updating” can overwrite the fear in her memory with the memory of the positive outcome (assuming there was one).

In the study, participants watched film clips showing humans and animals in distress. The researchers found that if they told the participants what happened to the protagonists in the film, that reduced the frequency of intrusive memories (flashbacks) by half, compared to those who had to watch the films again, or to those who didn’t watch upsetting films.

Researchers also discovered that people who responded strongly to the films were much more likely to develop PTSD symptoms.

It’s not an entirely satisfactory of working out who will suffer from PTSD – there’s a big difference between watching a film of something terrible happening and watching a terrible thing happen in reality – but it’s a start.

The story quotes one of the co-authors, Dr Jennifer Wild, as saying that the updating approach is painless “and carries no harmful side effects”. The approach, she says, “appears to re-encode the traumatic memory with new information, making the memory less frightening and less likely to be triggered in the future.”

It’s encouraging to think that this technique may be able to stop PTSD symptoms developing though – as always with PTSD studies – much more work needs to be done.

To find out more about the research, you can read the abstract here.

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