Current Treatment Options in Psychiatry最新文献

Purpose of review: Survivors of childhood maltreatment are at high risk for developing complex psychiatric disorders. Traditional treatments, including psychopharmacology, tend to be less efficacious for this population. This scoping review aimed to discuss existing empirical studies on the effects of mindfulness-based interventions for adult childhood trauma survivors, as well as the documented clinical challenges and adaptations for this population.

Recent findings: We reviewed 17 research articles that measured the effects of mindfulness-based interventions for adults with childhood maltreatment histories. These studies showed that mindfulness-based interventions can be beneficial for childhood maltreatment survivors to alleviate psychological symptoms including stress, anxiety, recurrent depression, substance use, and post-traumatic stress. Studies had a wide range of methodological quality and reported a broad range of effect sizes. The wide variety of outcome measures and control conditions made it difficult to compare across studies.

Summary: Mindfulness-based interventions can be beneficial for addressing psychopathology among adults with childhood maltreatment histories, although some adaptations can be necessary to address possible challenges this population are likely to encounter. More research is needed to specifically evaluate the clinical effects among childhood maltreatment survivors and to directly compare the effects among those with and without childhood maltreatment histories.

Purpose of review: Major Depressive Disorder is a global public health concern that is common in adolescents. Targeting this illness at the early stages of development is critical and could lead to better long-term outcomes because the adolescent brain is highly plastic and, hence, neural systems are likely to be more malleable to interventions. Although a variety of treatments are available, there are currently no guidelines to inform clinicians which intervention might be most suitable for a given youth. Here, we discuss current knowledge of prognostic and prescriptive markers of treatment outcome in adolescent depression, highlight two major limitations of the extant literature and suggest future directions for this important area of research.

Recent findings: Despite significant effort, none of the potential demographic (gender, age, race), environmental (parental depression, family functioning) and clinical (severity of depression, comorbid diagnoses, suicidality, hopelessness) predictors have been robustly replicated to warrant implementation in clinical care. Studies on biomarkers that truly reflect pathophysiology are scarce and difficult to draw conclusions from.

Summary: More efforts should be directed towards potential neurobiological predictors of treatment outcome. Moreover, rather than evaluating potential predictors in isolation, modern machine learning methods could also be used to build models that combine information across a large array of features and predict treatment outcome for individual patients. These strategies hold promise for advancing personalized healthcare in adolescent depression, which remains a high clinical priority.

Purpose: Few of the existing evidence-based interventions for child trauma exposure were specifically designed to address experiences and outcomes of complex developmental trauma. Stanford's cue-centered therapy (CCT) was designed to address this gap by offering a flexible, integrative, and insight-oriented treatment approach that is grounded in principles of neuroscience, developmental trauma, client empowerment, and allostasis. This article reviews the CCT rationale, treatment components, evidence base, and training approach.

Recent findings: Studies demonstrate promising outcomes indicating CCT effectiveness in reducing child and caregiver posttraumatic stress, and in improving child functioning. Further research, however, is needed to identify which clients are best-suited for CCT (versus other available child trauma treatments) and to identify which components of CCT are most critical for addressing complex developmental trauma.

Summary: CCT advances the field of child trauma treatment by offering an intervention approach focused on addressing complex developmental trauma. Positive treatment and training outcomes indicate utility of CCT for clients and clinicians. Innovations in research and training approaches are needed to further dissemination and implementation of CCT and other related child trauma interventions for complex developmental trauma.