Citation

Post LM, Michopoulos V, Stevens JS, Reddy R, Maples JL, Morgan JR, Rothbaum AO, Jovanovic T, Ressler KJ, Rothbaum BO. Pract. Innov. (Wash. D. C.) 2017; 2(2): 55-65.

Affiliation

Emory University School of Medicine, Department of Psychiatry and Behavioral Sciences, Atlanta, Georgia.

Copyright

(Copyright © 2017, American Psychological Association)

DOI

10.1037/pri0000043

PMID

28993816

PMCID

PMC5630142

Abstract

Research suggests that exposure therapy provided in the hours immediately following trauma exposure may prevent PTSD development. This case report presents data on an at-risk for PTSD participant involved in a motor-vehicle crash that caused her severe distress. She received one session of exposure therapy in the emergency department (ED) as part of an ongoing randomized controlled study examining the optimal dose of exposure therapy in the immediate aftermath of trauma. PTSD and depression measures were collected at pre-treatment assessment and one- and three-month follow-up. Potential PTSD biomarkers were also examined. Psychophysiological reactions were measured using skin conductance data measured on an iPad during the exposure therapy session and the follow-up assessments. A fear-potentiated startle paradigm and an functional magnetic resonance imaging (fMRI) behavioral inhibition task were used at follow-up. The participant demonstrated subjective and psychophysiological extinction from pre- to post-imaginal exposure. At follow-up, she did not meet DSM-IV criteria for PTSD or demonstrate hyperarousal to trauma reminders and showed robust fear extinction and the ability to inhibit responses in an fMRI behavioral inhibition task. In line with previous early intervention for the prevention of PTSD studies, this case report supports the need for ongoing empirical research investigating the possibility that one session of exposure therapy in the ED may attenuate risk for PTSD. Furthermore, the current findings demonstrate psychophysiological extinction serving as a prognostic indicator of treatment response for PTSD early intervention to be an exciting avenue to explore in future systematic research.

Language: en

Keywords

PTSD; early intervention; exposure therapy; memory consolidation; psychobiology