The North-Eastern part of Sri Lanka had already been affected by civil war when the 2004 tsunami wave hit the region, leading to high rates of posttraumatic stress disorder (PTSD) in children. In the acute aftermath of the tsunami, researchers tested the efficacy of two short-term interventions when applied by trained local counselors. A randomized treatment comparison was implemented in a refugee camp in a severely affected community. 31 children who presented with a preliminary diagnosis of PTSD were randomly assigned either to six sessions of Narrative Exposure Therapy for children (KIDNET) or six sessions of meditation-relaxation (MED-RELAX). KIDNET is a short-term treatment for PTSD based on a neurocognitive theory of traumatic memory. In KIDNET, the patient is requested to repeatedly talk about the worst traumatic event in detail while re-experiencing all emotions associated with the event. In the process, the majority of patients undergo habituation of the emotional response to the traumatic memory. In addition to the reconstruction of the traumatic memory, this habituation consequently leads to a remission of PTSD symptoms.

Outcome measures in this study included severity of PTSD symptoms, level of functioning and physical health. In both treatment conditions, PTSD symptoms and impairment in functioning were significantly reduced at one month post-test and remained stable over time. At 6 months follow-up, recovery rates were 81% for the children in the KIDNET group and 71% for those in the MED-RELAX group. There was no significant difference between the two therapy groups in any outcome measure. The authors conclude that this provides preliminary evidence for the effectiveness of Narrative Exposure Therapy as well as meditation-relaxation techniques when carried out by trained local counselors for the treatment of PTSD in children in the direct aftermath of mass disasters.

Catani C, M. Kohiladevy et al. (2009). Treating children traumatized by war and tsunami: a comparison between exposure therapy and meditation-relaxation in North-East Sri Lanka. BMC Psychiatry 9: 22.

Device-Guided Breathing Exercises Help Control Blood Pressure

In a randomized controlled trial carried out in four urban family practice clinics in Israel, device-guided breathing exercises helped lower blood pressure in Type II diabetic patients with hypertension. Baseline characteristics of the 66 patients who completed the study (33 intervention and 33 control) were: 62% men, age 62+/-8 years body mass index 29+/-5 kg/m2; systolic BP 148+/-11 mm Hg and diastolic BP 81+/-9 mm Hg. The intervention group used a device (RESPeRATE), which interactively guides the user towards slow and regular breathing by synchronizing respiration voluntarily to musical tones for 15 min daily for an 8-week period. The control group continued with their regular treatment. BP was measured in the clinic at baseline, after 4 weeks and at 8 weeks. Medication was unchanged for 4 weeks prior to and during the study period. The main outcome measure was the office BP change from baseline to the end of the 8-week period. BP was reduced in the treatment group (mean+/-s.e.) systolic -10.0+/-1.8 mm Hg and diastolic -3.6+/-1.3 mm Hg, but not in the controls +1.6+/-2.1 and -1.0+/-1.4 mm Hg. The subjects were highly compliant with the treatment, performing 75% of the requested exercise sessions. Greater BP reduction was observed with increased compliance with device usage. The authors conclude that self-treatment with device-guided breathing at home for 8 weeks by non-insulin-dependent diabetic patients was associated with a substantial reduction in office systolic BP.

Schein MH, Gavish B, Baevsky T et al. Treating hypertension in type II diabetic patients with device-guided breathing: a randomized controlled trial. J Hum Hypertens. May 2009;23(5):325-331.