The advent of widespread terrorism requires careful attention to preventing multiple cases of post-traumatic stress disorder (PTSD). Controlled studies suggest that early psychological interventions can prevent PTSD in selected groups of survivors. The effectiveness of early interventions in large groups of survivors is unknown. The effect of pharmacological prevention is equally unknown. The proposed work will test the hypothesis that cognitive behavioral therapy (CBT) and, independently, sertraline will effectively prevent PTSD when provided, within a month of a traumatic event, to highly distressed survivors, who are systematically identified in a large cohort of trauma-exposed individuals. It will also evaluate the extent to which a program to systematically prevent PTSD by early interventions is feasible, acceptable to survivors and effectively reduces morbidity. The proposed work consists of two embedded procedures: a comprehensive outreach and structured telephone evaluation of 4000 survivors, performed one week and seven months following a traumatic event, and an embedded randomized controlled trial of CBT, sertraline, and a wait list, offered within a month of a traumatic event to survivors with symptoms of acute stress disorder. Survivors in the wait list will receive CBT three months later. Repeated clinical assessments will probe treatment efficacy. Repeated telephone evaluations will assess treatment effectiveness. The study will generate vital knowledge about the feasibility and the effectiveness of secondary prevention of PTSD in large cohorts of survivors.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Planning Grant (R34)
Project #
3R34MH071651-02S1
Application #
7392527
Study Section
Interventions Research Review Committee (ITV)
Program Officer
Tuma, Farris K
Project Start
2005-04-01
Project End
2008-03-31
Budget Start
2006-04-01
Budget End
2008-03-31
Support Year
2
Fiscal Year
2007
Total Cost
$97,200
Indirect Cost
Name
Hadassah-Hebrew University Medical Center
Department
Type
DUNS #
600063937
City
Jerusalem
State
Country
Israel
Zip Code
91120
Qi, Wei; Gevonden, Martin; Shalev, Arieh (2017) Efficacy and Tolerability of High-Dose Escitalopram in Posttraumatic Stress Disorder. J Clin Psychopharmacol 37:89-93
Horesh, Danny; Qian, Meng; Freedman, Sara et al. (2017) Differential effect of exposure-based therapy and cognitive therapy on post-traumatic stress disorder symptom clusters: A randomized controlled trial. Psychol Psychother 90:235-243
Karstoft, Karen-Inge; Galatzer-Levy, Isaac R; Statnikov, Alexander et al. (2015) Bridging a translational gap: using machine learning to improve the prediction of PTSD. BMC Psychiatry 15:30
Galatzer-Levy, Isaac R; Karstoft, Karen-Inge; Statnikov, Alexander et al. (2014) Quantitative forecasting of PTSD from early trauma responses: a Machine Learning application. J Psychiatr Res 59:68-76
Shalev, Arieh Y; Ankri, Yael; Israeli-Shalev, Yossi et al. (2012) Prevention of posttraumatic stress disorder by early treatment: results from the Jerusalem Trauma Outreach And Prevention study. Arch Gen Psychiatry 69:166-76
Ankri, Yael L E; Bachar, Eytan; Shalev, Arieh Y (2010) Reactions to terror attacks in ultra-orthodox jews: the cost of maintaining strict identity. Psychiatry 73:190-7
Shalev, Arieh Y (2009) Posttraumatic stress disorder and stress-related disorders. Psychiatr Clin North Am 32:687-704
Shalev, Arieh Y; Segman, Ronen H (2008) Commentary: biological findings in PTSD -- too much or too little? Prog Brain Res 167:187-99
Einav, Sharon; Shalev, Arieh Y; Ofek, Hadas et al. (2008) Differences in psychological effects in hospital doctors with and without post-traumatic stress disorder. Br J Psychiatry 193:165-6
Peleg, Tamar; Shalev, Arieh Y (2006) Longitudinal studies of PTSD: overview of findings and methods. CNS Spectr 11:589-602