@2024 Afarand., IRAN
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(2):67-72
ISSN: 2008-2630 Iranian Journal of War & Public Health 2015;7(2):67-72
Effectiveness of Cognitive-Behavior Therapy on Mental Health of PTSD Veterans under Pharmaceutical Treatment
ARTICLE INFO
Article Type
Original ResearchAuthors
Makvand Hosseini Sh. (* )Kasiri M. (1 )
Najafi M. (2 )
Shahi M. (2 )
(* ) Clinical Psychology Department, Psychology & Educational Sciences Faculty, Semnan University, Semnan, Iran
(1 ) Clinical Psychology Department, Human Sciences Faculty, Islamic Azad University, Semnan, Iran
(2 ) Clinical Psychology Department, Psychology & Educational Sciences Faculty, Semnan University, Semnan, Iran
Correspondence
Address: Faculty of Psychology & Educational Sciences, Semnan University, Darband, Mehdishahr, Semnan, IranPhone: +982333624250
Fax: +982333626888
shmakvand@yahoo.com
Article History
Received: January 15, 2015Accepted: April 6, 2015
ePublished: April 20, 2015
ABSTRACT
Aims
Post-traumatic stress disorder (PTSD) is a chronic anxiety disorder that characterized by behavioral and physiological changes. According to studies, cognitive behavioral therapy is one of the psychological treatments that have criteria of a good treatment. The aim of present research was to study the effectiveness of cognitive-behavior therapy on mental health of war soldiers with post-traumatic stress disorder under long-term pharmaceutical treatment.
Materials & Methods In this quasi-experimental study with pretest-posttest which was done in 2014, a sample of 20 war soldiers with post-traumatic stress disorder under pharmaceutical treatment were selected using available sampling method and randomly assigned to experimental and control groups. After providing informed consent, subjects of both groups completed the General Health Questionnaire before any experimental intervention. Then 8 sessions of group cognitive-behavior psychotherapy administered on subjects of experimental group, whereas no intervention received by control group subjects. Both groups were asked again to fill the General Health Questionnaire afterward. Data were analyzed by MANCOVA statistical analysis.
Findings significantly decreased scores were seen in subjects of experimental group compare with control group in 4 dimensions of mental health (p<0.05).
Conclusion Cognitive-behavior therapy is an efficient clinical intervention for improvement of residual symptoms of post-traumatic stress disorder veterans and may help improving their quality of life and mental health.
Materials & Methods In this quasi-experimental study with pretest-posttest which was done in 2014, a sample of 20 war soldiers with post-traumatic stress disorder under pharmaceutical treatment were selected using available sampling method and randomly assigned to experimental and control groups. After providing informed consent, subjects of both groups completed the General Health Questionnaire before any experimental intervention. Then 8 sessions of group cognitive-behavior psychotherapy administered on subjects of experimental group, whereas no intervention received by control group subjects. Both groups were asked again to fill the General Health Questionnaire afterward. Data were analyzed by MANCOVA statistical analysis.
Findings significantly decreased scores were seen in subjects of experimental group compare with control group in 4 dimensions of mental health (p<0.05).
Conclusion Cognitive-behavior therapy is an efficient clinical intervention for improvement of residual symptoms of post-traumatic stress disorder veterans and may help improving their quality of life and mental health.
CITATION LINKS
[1]Pizarro J, Silver RC, Prause J. Physical and mental health costs of traumatic war experiences among civil war veterans. Arch Gen Psychiatry. 2006;63(2):193-200.
[2]Mohaghegh-Motlagh J, Momtazi S, Musavinasab N, Arab A, Saburi E, Saburi A. Post-traumatic stress disorder in male chemical injured war veterans versus non-chemicals. Med J Mashhad Univ. 2013;56(6):361-8. [Persian]
[3]Hagenaars MA, Fisch T, Van Minnen A. The effect of trauma onset and frequency on PTSD-associated symptoms. J Affect Disord. 2011;132(1-2):192-9.
[4]Shafiee-Kamalabadi M, Bigdeli I, Alavi K, Kianersi F. Prevalence of post-traumatic stress disorder and comorbid personality disorders in the groups veterans in Tehran. J Clin Psychol. 2014;6(1):65-75. [Persian]
[5]Cesur R, Sabia JJ, Tekin E. The psychological costs of war: Military combat and mental health. J Health Econ. 2013;32(1):51-65.
[6]Nejad AG, Farahati H. Dissociative disorders and dissociative symptoms among veterans of the Iraq-Iran war suffering from chronic post-traumatic disorder. Neuroscience. 2007;12(4):318-21.
[7]Bruce SE, Buchholz KR, Brown WJ, Yan L, Durbin A, Sheline YI. Altered emotional interference processing in the amygdala and insula in woman with post-traumatic stress disorder. Neuroimage Clin. 2013;2:43-9.
[8]Tian F, Yennu A, Smith-Osborne A, Gonzalez-Lima F, North CS, Liu H. Prefrontal responses to digit spam memory phases in patients with post-traumatic stress disorder (PTSD): A functional near infrared spectroscopy study. Neuroimage Clin. 2014;4:808-19.
[9]American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Publishing; 2013.
[10]Vasile C. An analysis of psychological trauma interventions. Procedia Soc Behav Sci. 2014;127:781-5.
[11]Bakhshian F, Abolghasemi A, Narimani M. Thought control strategies in the patients with acute stress disorder and PTSD. Procedia Soc Behav Sci. 2013;84:929-33.
[12]Razik S, Ehring T, Emmelkamp PM. Psychological consequences of terrorist attacks: Prevalence and predictors of mental health problems in Pakistani emergency responders. Psychiatry Res. 2013;207(1-2):80-5.
[13]Kamari A, Najafi M, Rahimian Boogar I, Sohrabi F, Jafari N. The relation between family function and veterans’ general health. Iran J War Public Health. 2012;4(3):26-33. [Persian]
[14]Shansky RM. Sex differences in PTSD resilience and susceptibility: Challenges for animal models of fear learning. Neurobiol Stress. 2015;1:60-5.
[15]Azad-Marzabadi E, Moqtadaee K, Aria-Pooran S. The effectiveness of mindfulness training on psychological symptoms in veterans with post-traumatic stress disorder. J Behav Sci. 2013;7(1):67-74. [Persian]
[16]Najafi M, Mohammadyfar MA, Dabiri S, Erfani N, Kamari AA. The comparison of the quality of life of the war veterans’ families with/without post-traumatic stress disorder. Iran J War Public Health. 2011;3(3):27-35. [Persian]
[17]Forbes D, Creamer M, Phelps A, Bryant R, McFarlane A, Devilly GJ, et al. Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Aust N Z J Psychiatry. 2007;41(8):637-48.
[18]Aslani M, Hashemiyan K, LotfiKashani F, Mirzayi J. The effectiveness of cognitive behavior therapy on chronic post-traumatic stress disorder patients. App Psychol. 2007:1(3):6-17.
[19]Spence J, Titov N, Johnston L, Jones MP, Dear BF, Solley K. Internet-based trauma-focused cognitive behavioural therapy for PTSD with and without exposure components: a randomised controlled trial. J Affect Disord. 2014;162:73-80.
[20]Nagyova I, Krol B, Szilasiova A, Srewart R, Van Dijk J, Van den Heuvel W. General Health Questionnaire-28: Psychometric evaluation of the Slovak version. Studia Psychologica. 2000;42(4):351-61.
[21]Hajloo N, Sharifi AR, Vahedi S. Correlatives of individual identity in high school female students at Ardabil city. J Sch Psychol. 2012;1(2):21-38.
[22]Jennings SA. Randomized controlled trial of cognitive behavioral treatment for posttraumatic stress disorder in severe mental illness. J Consult Clin Psychol. 2008;76:259-71.
[23]Kar N. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: A review. Neuropsychiatr Dis Treat. 2011;7:167-81.
[24]Scheerigna MS, Salloum A, Arnberger RA, Weems CF, Amaya-Jackson L, Cohen JA. Feasibility and effectiveness of cognitive-behavioral therapy for posttraumatic stress disorder in preschool children: two case reports. J Trauma Stress. 2007;20(4):631-6.
[25]Ehlers A, Clark DM, Hackmann A, McManus F, Fennel M. Cognitive therapy for post-traumatic stress disorder: Development and evaluation. Behav Res Ther. 2005;43(4):413-43.
[26]Frueh BC, De Arellano MA, Turner SM. Systematic desensitization as an alternative exposure strategy for PTSD. Am J Psychiatry. 1997;154(2):287-8.
[27]Marks I, Lovell K, Noshirvani H, Livanou M, Thrasher S. Treatment of PTSD by exposure and cognitive restructuring. Arch Gen Psychiatry. 1998;55(4):325-37.
[28]Resick PA, Schnicke MK. Cognitive processing therapy for sexual assault victims. J Consult Clin Psychol. 1992;60(5):748-56.
[29]Mueser KT, Rosenberg SD, Xie H, Jankowski MK, Bolton EE, Lu W, et al. A randomized controlled trial of cognitive-behavioral treatment for post-traumatic stress disorder in severe mental illness. J Consult Clin Psychol. 2008;76(2):259-71.
[30]Ahmadizadeh MJ, Ahmadi Kh, Eskandari H, Falsafinejad MR, Borjali A, Anisi J, et al. Improvement in quality of life after exposure therapy, problem solving and combined therapy in chronic war-related post-traumatic stress disorder: Exposure therapy, problem solving and combined therapy in war-related PTSD. Procedia Soc Behav Sci. 2010;5:262-6.
[31]Nikmorad A, Soltaninejhad A, Anessi G, Panahi H, Kafrashi S, Barati H, et al. Comparing the effectiveness of eye movement desensitization reprocessing and cognitive-behavioral therapy on reducing post-traumatic stress disorder in war veterans. J Police Med. 2014;2(4):239-48. [Persian]
[32]Somers J, Querée M. Cognitive behavioral therapy core information document [Internet]. Victoria: Mental Health and Addictions Branch, Ministry of Health, Government of British Columbia; 2007. Available from: http://www.health.gov.bc.ca/library/publications/year/2007/MHA_CognitiveBehaviouralTherapy.pdf.
[33]Friedman MJ. Posttraumatic stress disorder among military returnees from Afghanistan and Iraq. Am J Psychiatry. 2006;163(4):586-93.
[34]Kar N. Psychosocial issues following a natural disaster in a developing country: A qualitative longitudinal observational study. Int J Disaster Med. 2006;4:169-76.
[35]Kar N. Suicidality following a natural disaster. Am J Disaster Med. 2010;5(6):361-8.
[36]Abdullah S, Salleh A, Mahmud Z, Ahmad J, Abdul Ghani S. Cognitive distortion, depression and self-esteem among adolescents rape victims. World Appl Sci J. 2011;14:67-73.
[37]Smith P, Yule W, Perrin S, Tranah T, Dalgleish T, Clark DM. Cognitive-behavioral therapy for PTSD in children and adolescents: A preliminary randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2007;46(8):1051-61.
[2]Mohaghegh-Motlagh J, Momtazi S, Musavinasab N, Arab A, Saburi E, Saburi A. Post-traumatic stress disorder in male chemical injured war veterans versus non-chemicals. Med J Mashhad Univ. 2013;56(6):361-8. [Persian]
[3]Hagenaars MA, Fisch T, Van Minnen A. The effect of trauma onset and frequency on PTSD-associated symptoms. J Affect Disord. 2011;132(1-2):192-9.
[4]Shafiee-Kamalabadi M, Bigdeli I, Alavi K, Kianersi F. Prevalence of post-traumatic stress disorder and comorbid personality disorders in the groups veterans in Tehran. J Clin Psychol. 2014;6(1):65-75. [Persian]
[5]Cesur R, Sabia JJ, Tekin E. The psychological costs of war: Military combat and mental health. J Health Econ. 2013;32(1):51-65.
[6]Nejad AG, Farahati H. Dissociative disorders and dissociative symptoms among veterans of the Iraq-Iran war suffering from chronic post-traumatic disorder. Neuroscience. 2007;12(4):318-21.
[7]Bruce SE, Buchholz KR, Brown WJ, Yan L, Durbin A, Sheline YI. Altered emotional interference processing in the amygdala and insula in woman with post-traumatic stress disorder. Neuroimage Clin. 2013;2:43-9.
[8]Tian F, Yennu A, Smith-Osborne A, Gonzalez-Lima F, North CS, Liu H. Prefrontal responses to digit spam memory phases in patients with post-traumatic stress disorder (PTSD): A functional near infrared spectroscopy study. Neuroimage Clin. 2014;4:808-19.
[9]American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Publishing; 2013.
[10]Vasile C. An analysis of psychological trauma interventions. Procedia Soc Behav Sci. 2014;127:781-5.
[11]Bakhshian F, Abolghasemi A, Narimani M. Thought control strategies in the patients with acute stress disorder and PTSD. Procedia Soc Behav Sci. 2013;84:929-33.
[12]Razik S, Ehring T, Emmelkamp PM. Psychological consequences of terrorist attacks: Prevalence and predictors of mental health problems in Pakistani emergency responders. Psychiatry Res. 2013;207(1-2):80-5.
[13]Kamari A, Najafi M, Rahimian Boogar I, Sohrabi F, Jafari N. The relation between family function and veterans’ general health. Iran J War Public Health. 2012;4(3):26-33. [Persian]
[14]Shansky RM. Sex differences in PTSD resilience and susceptibility: Challenges for animal models of fear learning. Neurobiol Stress. 2015;1:60-5.
[15]Azad-Marzabadi E, Moqtadaee K, Aria-Pooran S. The effectiveness of mindfulness training on psychological symptoms in veterans with post-traumatic stress disorder. J Behav Sci. 2013;7(1):67-74. [Persian]
[16]Najafi M, Mohammadyfar MA, Dabiri S, Erfani N, Kamari AA. The comparison of the quality of life of the war veterans’ families with/without post-traumatic stress disorder. Iran J War Public Health. 2011;3(3):27-35. [Persian]
[17]Forbes D, Creamer M, Phelps A, Bryant R, McFarlane A, Devilly GJ, et al. Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder. Aust N Z J Psychiatry. 2007;41(8):637-48.
[18]Aslani M, Hashemiyan K, LotfiKashani F, Mirzayi J. The effectiveness of cognitive behavior therapy on chronic post-traumatic stress disorder patients. App Psychol. 2007:1(3):6-17.
[19]Spence J, Titov N, Johnston L, Jones MP, Dear BF, Solley K. Internet-based trauma-focused cognitive behavioural therapy for PTSD with and without exposure components: a randomised controlled trial. J Affect Disord. 2014;162:73-80.
[20]Nagyova I, Krol B, Szilasiova A, Srewart R, Van Dijk J, Van den Heuvel W. General Health Questionnaire-28: Psychometric evaluation of the Slovak version. Studia Psychologica. 2000;42(4):351-61.
[21]Hajloo N, Sharifi AR, Vahedi S. Correlatives of individual identity in high school female students at Ardabil city. J Sch Psychol. 2012;1(2):21-38.
[22]Jennings SA. Randomized controlled trial of cognitive behavioral treatment for posttraumatic stress disorder in severe mental illness. J Consult Clin Psychol. 2008;76:259-71.
[23]Kar N. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: A review. Neuropsychiatr Dis Treat. 2011;7:167-81.
[24]Scheerigna MS, Salloum A, Arnberger RA, Weems CF, Amaya-Jackson L, Cohen JA. Feasibility and effectiveness of cognitive-behavioral therapy for posttraumatic stress disorder in preschool children: two case reports. J Trauma Stress. 2007;20(4):631-6.
[25]Ehlers A, Clark DM, Hackmann A, McManus F, Fennel M. Cognitive therapy for post-traumatic stress disorder: Development and evaluation. Behav Res Ther. 2005;43(4):413-43.
[26]Frueh BC, De Arellano MA, Turner SM. Systematic desensitization as an alternative exposure strategy for PTSD. Am J Psychiatry. 1997;154(2):287-8.
[27]Marks I, Lovell K, Noshirvani H, Livanou M, Thrasher S. Treatment of PTSD by exposure and cognitive restructuring. Arch Gen Psychiatry. 1998;55(4):325-37.
[28]Resick PA, Schnicke MK. Cognitive processing therapy for sexual assault victims. J Consult Clin Psychol. 1992;60(5):748-56.
[29]Mueser KT, Rosenberg SD, Xie H, Jankowski MK, Bolton EE, Lu W, et al. A randomized controlled trial of cognitive-behavioral treatment for post-traumatic stress disorder in severe mental illness. J Consult Clin Psychol. 2008;76(2):259-71.
[30]Ahmadizadeh MJ, Ahmadi Kh, Eskandari H, Falsafinejad MR, Borjali A, Anisi J, et al. Improvement in quality of life after exposure therapy, problem solving and combined therapy in chronic war-related post-traumatic stress disorder: Exposure therapy, problem solving and combined therapy in war-related PTSD. Procedia Soc Behav Sci. 2010;5:262-6.
[31]Nikmorad A, Soltaninejhad A, Anessi G, Panahi H, Kafrashi S, Barati H, et al. Comparing the effectiveness of eye movement desensitization reprocessing and cognitive-behavioral therapy on reducing post-traumatic stress disorder in war veterans. J Police Med. 2014;2(4):239-48. [Persian]
[32]Somers J, Querée M. Cognitive behavioral therapy core information document [Internet]. Victoria: Mental Health and Addictions Branch, Ministry of Health, Government of British Columbia; 2007. Available from: http://www.health.gov.bc.ca/library/publications/year/2007/MHA_CognitiveBehaviouralTherapy.pdf.
[33]Friedman MJ. Posttraumatic stress disorder among military returnees from Afghanistan and Iraq. Am J Psychiatry. 2006;163(4):586-93.
[34]Kar N. Psychosocial issues following a natural disaster in a developing country: A qualitative longitudinal observational study. Int J Disaster Med. 2006;4:169-76.
[35]Kar N. Suicidality following a natural disaster. Am J Disaster Med. 2010;5(6):361-8.
[36]Abdullah S, Salleh A, Mahmud Z, Ahmad J, Abdul Ghani S. Cognitive distortion, depression and self-esteem among adolescents rape victims. World Appl Sci J. 2011;14:67-73.
[37]Smith P, Yule W, Perrin S, Tranah T, Dalgleish T, Clark DM. Cognitive-behavioral therapy for PTSD in children and adolescents: A preliminary randomized controlled trial. J Am Acad Child Adolesc Psychiatry. 2007;46(8):1051-61.