Benchmark- Literature Review Essay
Benchmark- Literature Review Essay
The clinical problem for my research is the use of cognitive behavioral therapy in combination with selective serotonin reuptake inhibitors in African American patients suffering from post-traumatic stress disorder. The results will be compared with those reported from a group of patients with post-traumatic disorder but using selective serotonin reuptake inhibitors alone. The period of study will be ten months. According to evidence, people from the African American ethnicity have a high risk of being affected by post-traumatic stress disorder when compared to those from other ethnicities. They are also highly vulnerable to poor course of the disease, which increases their risk of severe functional as well as psychosocial disabilities (Hall-Clark et al., 2016). Several factors contribute to the poor outcomes of post-traumatic stress disorder in this population. They include the stigmatization they undergo, cultural differences in emotional expression, high socioeconomic disparities among them, and the existence of pervasive incidences of crimes in their societies. The treatment of post-traumatic stress disorder has traditionally focused on the use of pharmacological interventions to manage its symptoms and prevent relapse. However, there is an increasing focus where the disease is treated with combined therapy involving non-pharmacological interventions and pharmacological interventions (Akbarian et al., 2015). An example is the focus of this paper where a comparison in the use of combined therapy (cognitive behavioral therapy and pharmacotherapy) and pharmacotherapy alone in treating post-traumatic stress disorder is made.
Methods
The articles used in this research were obtained from searching various databases. The databases included EMBASE, CINAHL, Cochrane, EBSCOhost, and MEDLINE. The articles were obtained using search terms that included post-traumatic stress disorder, cognitive behavioral therapy in post-traumatic stress disorder, cognitive behavioral therapy and selective serotonin reuptake inhibitors in post-traumatic stress disorder, post-traumatic stress disorder in African Americans, and selective serotonin reuptake inhibitors in post-traumatic stress disorder. A specific inclusion and exclusion criteria was used in determining the articles to be used in this research. Firstly, the articles must have been published within the last five years. The articles must have investigated the use of cognitive behavioral therapy and pharmacological interventions in post-traumatic stress disorder or pharmacological interventions alone. The study population was not specific. This was because limited evidence exists on the use of either combined therapy of pharmacotherapy or pharmacotherapy alone in treating post-traumatic stress disorder in African Americans. The selected articles were utilized to obtain insights into the efficacy of the intervention in the management of post-traumatic stress disorder in African American population.
Literature Synthesis, Part A
Five articles were selected for this review. One of them is the article by Akbarian et al. (2015), which investigated the effectiveness of using cognitive behavioral therapy in managing symptoms of post-traumatic stress disorder. Cognitive behavioral therapy was utilized alongside pharmacological interventions. The researchers used 40 study participants who were suffering from post-traumatic stress disorder. The participants were under psychopharmacological treatment and were assigned randomly to either treatment or control group. The participants in the intervention group were enrolled in ten session groups of cognitive behavioral therapy. The results of the study revealed that the symptoms of depression, post-traumatic stress disorder, and anxiety decreased with the administration of the intervention. Significant improvements were reported in patients who were assigned to the intervention group. The results also showed that the use of the intervention resulted in an improvement in symptoms of post-traumatic stress disorder and autobiographical memory (Akbarian et al., 2015). This study supports my area of research in that it shows the efficacy of incorporating cognitive behavioral therapy in the management of post-traumatic stress disorder. It shows that incorporating cognitive behavioral therapy to pharmacological interventions optimizes the outcomes of care.
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The study by Leiva-Bianchi et al. (2018) was also chosen for this review. The researchers explored the effectiveness of using cognitive behavioral therapy in managing symptoms of post-traumatic stress disorder among victims of Chilean earthquake. The researchers utilized a quasi-experimental study design where the study participants were divided into three groups. Cognitive behavioral therapy
was administered to the participants in the control group. The participants in the intervention group received complete treatment where they were enrolled for double sessions of cognitive behavioral therapy. The measurements of focus in the study included the level of symptoms of post-traumatic stress disorder before and after the administration of the treatment. The outcomes of this research revealed a significant decline in the symptoms of post-traumatic depression to a level below the dangerous levels was reported in the group that received complete treatment. Therefore, the authors recommended the use of cognitive behavioral therapy in conjunction with pharmacotherapy to optimize the health outcomes of patients with post-traumatic stress disorder (Leiva-Bianchi et al., 2018). This study supports my research focus by showing that the use of combined therapy is effective in promoting optimum health of patients with post-traumatic stress disorder.
The research by Adelufosi et al. (2017) was also selected for this analysis. The research aimed at exploring the effectiveness of cognitive behavioral therapy in managing symptoms of post-traumatic stress disorder in women and girls with the experience of female genital mutilation. The researchers performed a systematic review of studies conducted on the use of cognitive behavioral therapy in post-traumatic stress disorder. The outcomes revealed that while there is limited evidence on the efficacy of cognitive behavioral therapy in post-traumatic stress disorder, the existing evidence points towards its superiority in symptom management. Accordingly, the use of the therapy promotes suppression of symptoms of the disorder, thereby, minimizing functional and psychosocial disabilities in the affected (Adelufosi et al., 2017). This study will support my research by showing that the several studies that have been conducted to evaluate the effectiveness of cognitive behavioral therapy have shown it to be effective in the management of post-traumatic stress disorder.
The other study utilized in this analysis is the research by Keen, Hunter and Peters (2017). The study aimed at investigating the effect of integrated trauma focused cognitive behavioral therapy in the management of symptoms of post-traumatic stress disorder and psychotic symptoms. The researchers used nine participants who had symptoms of post-traumatic stress disorder and psychotic symptoms. They were then assessed before, during and after the study to determine the effectiveness of the intervention. The intervention was individualized based on the identified needs. It was administered in five sessions that aimed at guiding the participants understand effective emotional control, hence, reduction of the symptoms of post-traumatic stress disorder. The outcomes of the research showed that the intervention resulted in a significant decline in symptoms that included delusions, hallucinations, depression, and anxiety in the participants. There was also an overall improvement in the quality of life and wellbeing of the participants. This research supports my research by showing that the use of cognitive behavioral therapy with pharmacotherapy has enhanced benefits in patients with post-traumatic stress disorder.
The last study selected for this review is the research by Sarimin and Tololiu (2017). The research explored the effectiveness of using cognitive behavioral therapy when compared to cognitive behavioral therapy plus play in children with post-traumatic stress disorder. The researchers utilized quasi-experimental study design where the intervention was administered to the participants and assessed for outcomes used for comparative purposes. The assessment data was obtained before, during, and after the study to determine the effect of the intervention. The results revealed that there was a decline in the score of post-traumatic stress disorder in children both in the control and treatment group. However, the reduction was higher in children who were assigned to the cognitive behavioral therapy plus play, group. Therefore, it was concluded that while cognitive behavioral therapy might prove effective in managing post-traumatic stress disorder, additional interventions could enhance the outcomes of care further. Therefore, this research aligns with my research by showing the efficacy of cognitive behavioral therapy plus any other intervention that aims at improving the outcomes of care.
Literature Synthesis, Part B
The studies are similar in the sense that they all support the effectiveness of the combination therapy in the management of depression in African-Americans. The study by Akbarian et al. (2015) used human subjects to get its results, which is one of its strengths. However, the study used a sample of 40 patients, which impacts the applicability of the study. Hall-Clark, Sawyer, Golik, and Asnaani (2016) article’s results may be applicable due to the fact that they reviewed a large sample of articles. However, the weakness of the article is found in the fact that it did not use any human subject. Keen, Hunter and Peters (2017) adopted the usage of human subject in their study, which makes its applicable. However, the study only involved 9 participants, which negatively affects its applicability. Further, the participants were recruited from private clinics, which raises questions about the ethics of the process. The study by Leiva-Bianchi et al. (2018), was quasi-experimental in nature, which means that it was easier to formulate. The limitation of the study is that it involved only 29 participants which raises questions concerning its wider applicability. Further, the choice of the participants also raised controversies as it was thought that better settings would have been used. The study by Sarimin and Tololiu (2017) used human subjects, which made it strong. However, it was controversial in the sense that it used children whose provision of consent is not clearly defined. Moreover, the limitation of the study entails its use of a smaller population sample. Therefore, a majority of the studies used human participants making them applicable. However, there are certain weaknesses and limitations such as the number of participants which is evident in all the studies that used human subjects.
Areas of Further Study
Analysis of the above articles has shown that the use of cognitive behavioral therapy is effective in the management of post-traumatic stress disorder. The efficacy is enhanced in cases where there is the addition of another intervention to optimize the outcomes of care. Despite this evidence, there are weaknesses associated with the selected articles. Firstly, the samples used in the studies are not representative. The samples were small, making generalization of the findings inappropriate. The other weakness is the minimal focus on African Americans. Therefore, it leaves a huge gap in evidence on the effectiveness of the intervention. Nevertheless, the available evidence shows the possibility of enhanced outcomes with the use of cognitive behavioral therapy plus pharmacotherapy in the treatment of post-traumatic stress disorder.
Conclusion
African-Americans are highly predisposed to depression based on a number of factors. Literature reveals that the application of a combination therapy involving cognitive behavioral therapy and a serotonin reuptake inhibitor is effective in the management of the same. Several studies have supported the above intervention; however, the studies did not solely focus on African-Americans, which brings into question their applicability.