Chronic insomnia and recurrent nightmares are prominent features of posttraumatic stress disorder (PTSD). Evidence from adult research indicates that these sleep disturbances do not respond as well to cognitive-behavioral therapies for PTSD and are associated with poorer functional outcomes. This study examined the effect of prolonged exposure therapy for adolescents versus client-centered therapy on posttraumatic sleep disturbance, and the extent to which sleep symptoms impacted global functioning among adolescents with sexual abuse-related PTSD. Participants included 61 adolescent girls seeking treatment at a rape crisis center. The Child PTSD Symptom Scale-Interview (Foa, Johnson, Feeny, & Treadwell, 2001) was used to assess PTSD diagnosis and severity of symptoms, including insomnia and nightmares. The Children's Global Assessment Scale (Shaffer et al., 1983) was used to assess global functioning. There were significant main effects of time and treatment on insomnia symptoms. Additionally, there was a main effect of time on nightmares. Results also showed that insomnia and nightmares significantly predicted poorer global functioning posttreatment (R2 = .21). Despite significant improvements in posttraumatic sleep disturbance, there were still clinically significant insomnia symptoms after treatment, suggesting that additional interventions may be warranted to address residual sleep disturbance in PTSD.
Data analysis from a large family study of the familial aggregation of anxiety and substance use disorders aimed at investigating the role comorbid anxiety and depression in the association between sleep problems and migraine , showed that adults with migraine had significantly more lifetime sleep problems and more current sleep difficulties, including persistent nightmares of childhood onset than those without migraine, and that this association was independent from both lifetime and current anxiety and mood disorders. At variance, sleepwalking and sleep enuresis were not associated with migraine.
Pre-exposure prophylaxis (PrEP) is highly effective and an important prevention tool for African adolescent girls and young women (AGYW), but adherence and persistence are challenging. PrEP adherence support strategies for African AGYW were studied in an implementation study.
Abbreviations: AGYW, adolescent girls and young women; CES-D, Center for Epidemiologic Studies-Depression; CI, confidence interval; CONSORT, CONsolidated Standards of Reporting Trials; DBS, dried blood spots; HBV, hepatitis B virus; HPTN, HIV Prevention Trials Network; IQR, interquartile range; MSM, men who have sex with men; OR, odds ratio; PrEP, pre-exposure prophylaxis; SOC, standard of care; STI, sexually transmitted infection; TDF/FTC, tenofovir/emtricitabine; TFV-DP, tenofovir-diphosphate
But when Ellie hears that Rick has resurfaced, her nightmares return, and with them, small snippets of memory. No one has heard from Rick since before the incident, so why now? Ellie wants to move forward with her life, but first she must find the courage to look into her past, no matter what she finds there . . .
Best of all, though, is that Abby has been reunited with her sister Mallory. Separated as girls after their parents died in a double tragedy, Abby always dreamed that, one day, they would be together again.
The first girl raised her arms at the top of the diving board. We held our breath. She flipped off the board, spun like a starfish. She brought herself to an unnatural stop in the air just before hitting the skin of the pool. Then she let herself slip under without a splash. Bravo, we cheered.
We packed our suitcases, dressed our younger children warmly for the flight, said goodbye to our parents, who tried to cling to us as we rose into the air. Husbands and wives held hands in a circle around their struggling children, threading arms to lock in their incredible burdens. The children with their bodies of rocks weighed immensely. Everyone groaned while the children kicked and screamed and bit and sobbed, boys and girls fighting us and pushing at our arms. The sky was like a battle between angels.
Michael didn't think that he would be part of the investigation, but he is pulled in when Marie decides that he is the only one she will confess to. As Marie recounts her version of the story, it falls to Michael to find the truth: What really happened the night that the Carlsons were killed? And how did one girl wind up in the middle of all these bodies? 2b1af7f3a8