The Traumatic Stress Clinic conducts a range of treatment studies that seek to determine the best ways to help people overcome their PTSD and associated problems after trauma. We focus on cognitive behaviour therapy because it has consistently been shown to be the most effective way to manage posttraumatic stress reactions. Our treatment studies are funded by the National Health & Medical Research Council, and although we compare different treatment strategies, every person is guaranteed of receiving the best available treatment for PTSD. The outcomes from our treatment studies are recognized around the world, and they have shaped the treatment polices of many agencies internationally. In recent years, we have made the following discoveries:
- Early intervention with exposure therapy provided within a month after trauma can effectively prevent PTSD from developing.
- Combining exposure therapy and cognitive therapy is the best way to help recover from chronic PTSD
- Cognitive behaviour therapy is a highly effective way of treating PTSD after mild traumatic brain injury
- Cognitive behaviour therapy is a highly effective way of treating PTSD in police officers
The Traumatic Stress Clinic is conducting a pioneering study of treating complicated grief – that is, people who are suffering intense distress after losing a loved one at least 6 months after the death. This program is also based on cognitive behaviour therapy and aims to (a) help patients process outstanding emotional issues relating to the loss, (b) correct unhelpful thoughts about themselves and their future, (c) re-engage with social networks and positive events, and (d) encourage more effective ways to manage memories of the loved one.
Brain Mechanisms of PTSD
The Traumatic Stress Clinic has a long tradition in understanding how the brain functions in people who are suffering the effects of PTSD and how this information can assist us to help people recover more effectively. We use a range of paradigms to address this issue, including MRI, EEG, and psychophysiology measures. These are state of the art brain and biological measures that allow us to identify the brain networks and biological processes that contribute to how people recover from trauma, and benefit from treatment. Some of the recent discoveries that we have made are:
- PTSD is associated with elevated amygdala responses to fear, especially when we process fearful stimuli preconsciously
- Different subtypes of PTSD are characterized by different neural patterns. For example, people with dissociative reactions have greater medial prefrontal activation that results in inhibition of fear
- Positive response to cognitive behaviour therapy is predicted by size of the rostral anterior cingulate, which is an important part of the brain that assists us to regulate emotion
- Successful therapy results in increased activation of the anterior cingulated, which demonstrates that cognitive behaviour therapy activates the part of the brain which is required to regulate our emotions
The Traumatic Stress Clinic collaborates closely with neuroscience researchers in the Brain Dynamics Centre, which is a multidisciplinary initiative committed to advancing our understanding of the neuroscience of a range of psychological conditions. For further details about our brain and neuroscience research activities, click here.
Memory and Trauma
The Traumatic Stress Clinic conducts considerable research into memory functions in PTSD and grief. Specifically, we are interested in how people remember and manage their traumatic memories. We use a range of paradigms that have established utility across many psychology studies to understand how trauma memories function. Some of our recent discoveries include:
- Trauma survivors often remember the trauma from another’s perspective and this is a way of avoiding emotional distress. Remembering trauma from another’s perspective can predict who will subsequently develop PTSD
- People with PTSD have difficulties remembering specific memories from their past, and there is a tendency to remember trauma-related memories. This pattern tends to interfere with people’s mood and the capacity to solve problems.
- People with complicated grief also have difficulties in retrieving specific personal memories, and their memories are dominated by memories of the loss. There is a strong association between recalling memories of the deceased and degree of complicated grief and being extremely attached to the lost loved one.
- People with PTSD tend to focus their memories on specific aspects of the traumatic experience, which often results in poorer memories of other aspects of the trauma. This tendency may explain why some aspects of traumatic experience are recalled more poorly than other aspects.
Aboriginal Mental Health
The Traumatic Stress Clinic is collaborating with indigenous colleagues on a major project funded by the NH&MRC that aims to empirically understand the relationship between violence, mental health, and substance abuse in indigenous Australians. This 5-year project is focused across a number of communities in western NSW, and is conducting ethnographic, epidemiological, and intervention programs to determine the optimal ways to assist Aborigines who are affected by violence and mental health.
The Traumatic Stress Clinic is developing novel ways to treat PTSD and grief via the web. This approach is needed because although we know that cognitive behaviour therapy is a highly effective strategy, we also know that most people with PTSD do not access clinicians who will provide this treatment. The internet provides a useful way to teach people strategies to overcome PTSD and grief. In an initial study, we collaborated with colleagues in the Pentagon to develop a web CBT program for army personnel who were attacked on September 11, 2001 – this study found that the web CBT program effectively assisted survivors to overcome their PTSD. We are developing new web programs to assist a range of trauma survivors, including survivors of disasters, emergency service personnel, and victims of traumatic injury.