| 1. |
- Mills, Katherine, et al.
(författare)
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A randomised controlled trial of integrated psychological therapy for traumatic stress and substance use among adolescents: Trial protocol
- 2020
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 10
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Post-traumatic stress disorder (PTSD) and substance use disorder frequently co-occur and tend to have their onset during adolescence. Although research has highlighted the importance of treating these disorders in an integrated fashion, there is a dearth of empirically validated integrated treatment options for adolescents with this comorbidity. This paper describes the study protocol for a randomised controlled trial (RCT) examining the efficacy of an integrated trauma-focused cognitive–behavioural treatment for traumatic stress and substance use among adolescents (Concurrent Treatment of PTSD and Substance Use Using Prolonged Exposure - Adolescent (COPE-A)), relative to a supportive counselling control condition (Person-Centred Therapy (PCT)). Methods and analysis: A two-arm, parallel, single-blind RCT with blinded follow-up at 4 and 12 months poststudy entry will be conducted in Sydney, Australia. Participants (n~100 adolescents aged 12–18 years) and their caregivers (caregiver participation is optional) will be allocated to undergo either COPE-A or PCT (allocation ratio 1:1) using minimisation. Both therapies will be delivered individually by project psychologists over a maximum of 16 sessions of 60–90 min duration and will include provision of up to four 30 min optional caregiver sessions. The primary outcome will be between-group differences in change in the severity of PTSD symptoms from baseline to 4-month follow-up, as measured by the Clinician-Administered PTSD Scale for Children and Adolescents for DSM-5. Ethics and dissemination: Ethical approval has been obtained from the human research ethics committees of the Sydney Children’s Hospital Network (HREC/17/SCHN/306) and the University of Sydney (HREC 2018/863). Findings will be published in peer-reviewed journals and presented at scientific conferences. Trial registration number: ACTRN12618000785202; Pre-reults.
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| 2. |
- Peach, Natalie, et al.
(författare)
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Clinical characteristics of adolescents and emerging adults presenting for integrated posttraumatic stress and substance use treatment
- 2024
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Ingår i: Advances in Dual Diagnosis. - 1757-0972.
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Tidskriftsartikel (refereegranskat)abstract
- Adolescence and emerging adulthood are key developmental stages with high risk for trauma exposure and the development of mental and substance use disorders (SUDs). The aim of this study was to compare the clinical profiles of adolescents (aged 12-17 years) and emerging adults (aged 18-25 years) presenting for treatment of posttraumatic stress disorder (PTSD) and SUD. Design/methodology/approach: Data was collected from the baseline assessment of individuals (n = 55) taking part in a randomized controlled trial (RCT) examining the efficacy of an integrated psychological therapy for co-occurring PTSD and SUDs (PTSD+SUD) in young people.Both age groups demonstrated complex and severe clinical profiles, including high frequency trauma exposure, and very poor mental health reflected on measures of PTSD, SUD, suicidality, and domains of social, emotional, behavioral and family functioning. There were few differences in clinical characteristics between the two groups. Similarity between the two groups suggests that the complex problems seen in emerging adults with PTSD+SUD are likely to have had their onset in adolescence or earlier, and to have been present for several years by the time individuals present for treatment. This is the first study to compare the demographic and clinical profiles of adolescents and emerging adults with PTSD+SUD. These findings yield important implications for practice and policy for this vulnerable group. Evidence-based prevention and early intervention approaches and access to care are critical. Alongside trauma-focused treatment, there is a critical need for integrated, trauma-informed approaches specifically tailored to young people with PTSD+SUD.
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| 3. |
- Poulton, Alex J., et al.
(författare)
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Phytoplankton carbon fixation, chlorophyll-biomass and diagnostic pigments in the Atlantic Ocean
- 2006
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Ingår i: Deep-sea research. Part II, Topical studies in oceanography. - : Elsevier BV. - 0967-0645 .- 1879-0100. ; 53:14-16, s. 1593-1610
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Tidskriftsartikel (refereegranskat)abstract
- We have made daily measurements of phytoplankton pigments, size-fractionated (< 2 and > 2-mu m) carbon fixation and chlorophyll-a concentration during four Atlantic Meridional Transect (AMT) cruises in 2003-04. Surface rates of carbon fixation ranged from < 0.2-mmol C m(-3) d(-1) in the subtropical gyres to 0.2-0.5-mmol C m(-3) d(-1) in the tropical equatorial Atlantic. Significant intercruise variability was restricted to the subtropical gyres, with higher chlorophyll-a concentrations and carbon fixation in the subsurface chlorophyll maximum during spring in either hemisphere. In surface waters, although picoplankton (<-mu m) represented the dominant fraction in terms of both carbon fixation (50-70%) and chlorophyll-alpha (80-90%), nanoplankton (> 2-mu m) contributions to total carbon fixation (30-50%) were higher than to total chlorophyll-alpha (10-20%). However, in the subsurface chlorophyll maximum picoplankton dominated both carbon fixation (70-90%) and chlorophyll-alpha (70-90%). Thus, in surface waters chlorophyll-normalised carbon fixation was 2-3 times higher for nanoplankton and differences in picoplankton and nanoplankton carbon to chlorophyll-alpha ratios may lead to either higher or similar growth rates. These low chlorophyll-normalised carbon fixation rates for picoplankton may also reflect losses of fixed carbon (cell leakage or respiration), decreases in photosynthetic efficiency, grazing losses during the incubations, or some combination of all these. Comparison of nitrate concentrations in the subsurface chlorophyll maximum with estimates of those required to support the observed rates of carbon fixation (assuming Redfield stoichiometry) indicate that primary production in the chlorophyll maximum may be light rather than nutrient limited.
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| 4. |
- Schollar-Root, Olivia, et al.
(författare)
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Integrated trauma-focused psychotherapy for traumatic stress and substance use: Two adolescent case studies
- 2022
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Ingår i: Clinical Case Studies. - : SAGE Publications. - 1534-6501 .- 1552-3802. ; 21:3, s. 192-208
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Tidskriftsartikel (refereegranskat)abstract
- Post-traumatic stress disorder (PTSD) and substance use disorder (SUD) occur frequently as comorbid diagnoses among adolescents. Historically, these conditions have been treated using a sequential model; however, emerging evidence suggests that an integrated treatment model may be most effective. This article presents two de-identified clinical case studies from an ongoing randomised controlled trial examining the efficacy of an integrated, exposure-based, cognitive-behavioral psychotherapy (CBT) for PTSD and SUD among adolescents (COPE-A), relative to a supportive counselling control condition (person-centred therapy). In both case studies, participants were randomised to receive the COPE-A integrated treatment, which incorporates prolonged exposure (PE) including imaginal and in vivo exposure as a core treatment component alongside CBT for PTSD and SUD. The clinical profile and treatment response of each participant is discussed. Promising results were found in both cases, with substantially reduced traumatic stress symptoms and decreased or stable levels of substance use by the end of treatment. Clinical implications of these early findings are discussed.
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