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In 2017, a National Academies of Sciences, Engineering, and Medicine (NASEM) report comprehensively evaluated the body of evidence regarding cannabis health effects through the year 2016. The objectives of this study are to identify and map the most recently (2016-2019) published literature across approved conditions for medical cannabis and to evaluate the quality of identified recent systematic reviews, published following the NASEM report. Following the literature search from 5 databases and consultation with experts, 11 conditions were identified for evidence compilation and evaluation: amyotrophic lateral sclerosis, autism, cancer, chronic noncancer pain, Crohn's disease, epilepsy, glaucoma, human immunodeficiency virus/AIDS, multiple sclerosis (MS), Parkinson's disease, and posttraumatic stress disorder. A total of 198 studies were included after screening for condition-specific relevance and after imposing the following exclusion criteria: preclinical focus, non-English language, abstracts only, editorials/commentary, case studies/series, and non-U.S. study setting. Data extracted from studies included: study design type, outcome definition, intervention definition, sample size, study setting, and reported effect size. Few completed randomized controlled trials (RCTs) were identified. Studies classified as systematic reviews were graded using the Assessing the Methodological Quality of Systematic Reviews-2 tool to evaluate the quality of evidence. Few high-quality systematic reviews were available for most conditions, with the exceptions of MS (9 of 9 graded moderate/high quality; evidence for 2/9 indicating cannabis improved outcomes; evidence for 7/9 indicating cannabis inconclusive), epilepsy (3 of 4 graded moderate/high quality; 3 indicating cannabis improved outcomes; 1 indicating cannabis inconclusive), and chronic noncancer pain (12 of 13 graded moderate/high quality; evidence for 7/13 indicating cannabis improved outcomes; evidence from 6/7 indicating cannabis inconclusive). Among RCTs, we identified few studies of substantial rigor and quality to contribute to the evidence base. However, there are some conditions for which significant evidence suggests that select dosage forms and routes of administration likely have favorable risk-benefit ratios (i.e., epilepsy and chronic noncancer pain). The body of evidence for medical cannabis requires more rigorous evaluation before consideration as a treatment option for many conditions, and evidence necessary to inform policy and treatment guidelines is currently insufficient for many conditions. Keywords: Medical marijuana, Cannabis, Cannabinoids, Cannabidiol, Marijuana efficacy, Commonly recommended conditions for marijuana treatment, Marijuana clinical outcomes, Author(s): Sebastian Jugl [a,b]; Aimalohi Okpeku [a,b]; Brianna Costales [a,b]; Earl J. Morris [a,b]; Golnoosh Alipour-Haris [a,b]; Juan M. Hincapie-Castillo [a,b]; Nichole E. Stetten [c]; Ruba Sajdeya [d]; Shailina Keshwani [...]

Outcomes after acute respiratory distress syndrome (ARDS) are similar to those of other survivors of critical illness and largely affect the nerve, muscle, and central nervous system but also include a constellation of varied physical devastations ranging from contractures and frozen joints to tooth loss and cosmesis. Compromised quality of life is related to a spectrum of impairment of physical, social, emotional, and neurocognitive function and to a much lesser extent discrete pulmonary disability. Intensive care unit-acquired weakness (ICUAW) is ubiquitous and includes contributions from both critical illness polyneuropathy and myopathy, and recovery from these lesions may be incomplete at 5 years after ICU discharge. Cognitive impairment in ARDS survivors ranges from 70 to 100 % at hospital discharge, 46 to 80 % at 1 year, and 20 % at 5 years, and mood disorders including depression and post-traumatic stress disorder (PTSD) are also sustained and prevalent. Robust multidisciplinary and longitudinal interventions that improve these outcomes are still uncertain and data in our literature are conflicting. Studies are needed in family members of ARDS survivors to better understand long-term outcomes of the post-ICU family syndrome and to evaluate how it affects patient recovery., Author(s): Margaret S. Herridge [sup.1], Marc Moss [sup.2], Catherine L. Hough [sup.3], Ramona O. Hopkins [sup.4] [sup.5] [sup.6] [sup.7], Todd W. Rice [sup.8], O. Joseph Bienvenu [sup.9], Elie Azoulay [sup.10] [...]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.brat.2009.06.003 Byline: Shireen L. Rizvi (a), Dawne S. Vogt (b)(c), Patricia A. Resick (b)(c) Abstract: This study examined cognitive and affective predictors of treatment dropout and treatment efficacy in Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE) for PTSD. Study participants were women with PTSD from a sexual assault who received at least one session of either treatment (n = 145) as part of a randomized clinical trial. Results revealed that younger age, lower intelligence, and less education were associated with higher treatment dropout, whereas higher depression and guilt at pretreatment were associated with greater improvement in PTSD symptomatology. Results by treatment condition indicated that women with higher anger at pretreatment were more likely to dropout of PE and that older women in PE and younger women in CPT had the best overall outcomes. These findings have implications for efforts to enhance treatment efficacy and retention in CBT treatment protocols. Author Affiliation: (a) New School for Social Research, 80 Fifth Ave, 7th Floor, New York, NY 10011, United States (b) Women's Health Sciences Division, National Center for PTSD, VA Boston Health Care System, United States (c) Division of Psychiatry, Department of Medicine, Boston University, United States Article History: Received 30 October 2008; Revised 8 May 2009; Accepted 10 June 2009

In this study, the authors examined the interrelations among family-of-origin maltreatment variables, posttraumatic stress disorder (PTSD) symptoms, social information processing deficits, and male-to-female psychological and physical intimate relationship abuse perpetration in adulthood among a community sample of 164 men and their partners. In bivariate analyses, higher family-of-origin childhood parental rejection was associated with the perpetration of psychological and physical abuse in adulthood, and childhood exposure to interparental violence was also associated with adult psychological abuse perpetration. Structural equation modeling analyses indicated that when childhood variables and other study variables were considered together, only childhood parental rejection was associated with the abuse perpetration outcomes, and these effects were indirect through PTSD symptoms and social information processing deficits. Results indicate a need for further investigation into the mechanisms accounting for the impact of early maltreatment on the development of abusive intimate relationship behavior. Keywords: child maltreatment, posttraumatic stress disorder, information processing, domestic abuse, relationship aggression

Post-traumatic stress disorder (PTSD) represents a frequent consequence of a variety of extreme psychological stressors. Lists of empirically supported treatments for PTSD usually include cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), but nonresponse and dropout rates in these treatments often are high. We review the treatment dropout and nonresponse rates in 55 studies of empirically supported treatments for PTSD, review the literature for predictors of dropout and nonresponse, discuss methodological inconsistencies in the literature that make comparisons across studies difficult, and outline future directions for research. Dropout rates ranged widely and may have depended, at least in part, on the nature of the study population. It was not uncommon to find nonresponse rates as high as 50%. Standard methods of reporting dropout and nonresponse rates are needed for reporting outcomes. We suggest guidelines for collecting data to help identify characteristics and predictors of dropouts and nonresponders.

Many studies report that comorbid borderline personality pathology is associated with poorer outcomes in the treatment of Axis I disorders. Given the high rates of comorbidity between borderline personality pathology and posttraumatic stress disorder (PTSD), it is essential to determine whether borderline symptomatology affects PTSD treatment outcome. This study examined the effects of borderline personality characteristics (BPC) on 131 female rape victims receiving cognitive-behavioral treatment for PTSD. Higher BPC scores were associated with greater pretreatment PTSD severity; however, individuals with higher levels of BPC were just as likely to complete treatment and also as likely to show significant treatment response on several outcome measures. There were no significant interactions between type of treatment and BPC on the outcome variables. Findings suggest that women with borderline pathology may be able to benefit significantly from cognitive-behavioral treatment for PTSD.

Background: Patients attending accident and emergency (A&E) may develop long-term psychological difficulties. Psychoeducation has been suggested to reduce the risk of post-injury disorders. Aims: We tested the efficacy of providing self-help information to a high-risk sample. Methods: A&E attenders were screened for acute stress disorder and randomised to two groups: patients (n = 116) receiving a self-help booklet and those who did not (n = 111). A sample of 'low' scorers was also included (n = 120); they did not receive a booklet. Psychological assessments were completed at baseline (within 1 month post-injury) and 3 and 6 months post-injury. Results: Post-traumatic stress disorder (PTSD), anxiety and depression decreased (p Conclusions: This trial failed to support the efficacy of providing self-help information, as a preventative strategy to ameliorate PTSD. Keywords: Trauma; Prevention; Self-help; Information; Acute stress disorder; Post-traumatic stress disorder

Objective: This study examined associations between alcohol use and PTSD symptoms among Red Cross workers who responded to the 9/11/2001 attacks. Method: Participants were 779 Red Cross paid and volunteer staff that responded during the first three months to the September 11, 2001, attacks against the United States. Women made up 64% of the sample. The American Red Cross provided a mailing list of all paid and volunteer staff (N=6055 with valid addresses) that participated in the disaster relief operations in response to the September 11, 2001, attacks. Participants were randomly assigned to receive one of four questionnaire packets. The present study is based on the fourth group, which received the alcohol questionnaires. Results: Overall, traumatic stress symptoms and alcohol use were low. Hyperarousal and intrusion symptoms on the Impact of Events Scale-Revised (mS-R) were associated with alcohol consumption, hazardous alcohol consumption, and change in alcohol consumption when controlling for age, gender, and worksite. Positive associations between Intrusion and Avoidance scores and hazardous consumption were stronger for younger participants. Individuals who reported increasing or decreasing alcohol use had higher IES-R scores than did those who maintained their normal rate of alcohol consumption, though effects were stronger for increasing alcohol use. Associations between alcohol variables and avoidance symptoms were minimal. Conclusions: The results suggest that there is a functional relation between posttraumatic stress symptoms and alcohol consumption. The study indicates that efforts to cope with traumatic stress symptoms may manifest in either increases or decreases in alcohol consumption. Keywords: Posttraumatic stress syndrome, disaster relief operations, alcohol use, INTRODUCTION Victims of disaster are at increased risk for a range of psychopathology including post-traumatic stress disorder (PTSD) and alcohol abuse and dependence [Diagnostic and Statistical Manual of Mental Disorders [...]

The article discusses the vital and important role that paraprofessionals can play in the use of narrative exposure therapy as a form of treatment for posttraumatic stress disorder (PTSD) in low-resource communities. However, several concerns exist regarding the use of paraprofessionals to treat peers with PTDS, which are highlighted.