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  1. PTSD: National Center for PTSD

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  2. PTSD: National Center for PTSD

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  3. PTSD: National Center for PTSD

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  4. PTSD: National Center for PTSD

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  5. Higher FKBP5, COMT, CHRNA5, and CRHR1 allele burdens are associated with PTSD and interact with trauma exposure: implications for neuropsychiatric research and treatment

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    Boscarino JA

    2012-03-01

    Full Text Available Joseph A Boscarino1,2, Porat M Erlich1,3, Stuart N Hoffman4, Xiaopeng Zhang51Center for Health Research, Geisinger Clinic, Danville, PA, 2Department of Psychiatry, 3Department of Medicine, Temple University School of Medicine, Philadelphia, PA, 4Department of Neurology, 5Department of Anesthesiology, Geisinger Clinic, Danville, PA, USAObjective: The study aim was to assess the cumulative burden of polymorphisms located within four genetic loci previously associated with posttraumatic stress disorder (PTSD among outpatients at risk for PTSD.Methods: Diagnostic interviews were completed and DNA samples collected among 412 pain patients to determine if FKBP5 (rs9470080, COMT (rs4680, CHRNA5 (rs16969968, and CRHR1 (rs110402 single nucleotide polymorphisms were cumulatively associated with increased risk for PTSD.Results: In bivariate analyses, it was found that a count of specific PTSD risk alleles located within FKBP5, COMT, CHRNA5, and CRHR1 genetic loci (allele range = 0–6, mean count = 2.92, standard deviation = 1.36 was associated with lifetime (t [409] = 3.430, P = 0.001 and early onset PTSD (t [409] = 4.239, P = 0.000028. In logistic regression, controlling for demographic factors, personality traits, and trauma exposures, this risk allele count remained associated with both lifetime (odds ratio = 1.49, P = 0.00158 and early onset PTSD (odds ratio = 2.36, P = 0.000093. Interaction effects were also detected, whereby individuals with higher risk allele counts and higher trauma exposures had an increased risk of lifetime PTSD (allele count × high trauma, P = 0.026 and early onset PTSD (allele count × high trauma, P = 0.016 in these logistic regressions. Those with no or few risk alleles appeared resilient to PTSD, regardless of exposure history.Conclusion: A cumulative risk allele count involving four single nucleotide polymorphisms located within the FKBP5, COMT, CHRNA5, and CRHR1 genes are associated with PTSD. Level of trauma exposure

  6. PTSD: National Center for PTSD

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  7. PTSD: National Center for PTSD

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  8. PTSD: National Center for PTSD

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  9. PTSD: National Center for PTSD

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  10. PTSD: National Center for PTSD

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  11. PTSD: National Center for PTSD

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  12. PTSD: National Center for PTSD

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  13. PTSD: National Center for PTSD

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  14. PTSD: National Center for PTSD

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  17. PTSD: National Center for PTSD

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  18. PTSD: National Center for PTSD

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  19. PTSD: National Center for PTSD

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  20. PTSD: National Center for PTSD

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  1. PTSD: National Center for PTSD

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  2. PTSD: National Center for PTSD

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  3. PTSD: National Center for PTSD

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  4. PTSD: National Center for PTSD

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  5. PTSD: National Center for PTSD

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  7. PTSD: National Center for PTSD

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  8. PTSD: National Center for PTSD

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  9. PTSD: National Center for PTSD

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  10. PTSD: National Center for PTSD

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  11. PTSD: National Center for PTSD

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  12. PTSD: National Center for PTSD

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  13. PTSD: National Center for PTSD

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  14. PTSD: National Center for PTSD

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  15. PTSD: National Center for PTSD

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  16. PTSD: National Center for PTSD

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  18. PTSD: National Center for PTSD

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  20. PTSD: National Center for PTSD

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  1. PTSD: National Center for PTSD

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  2. PTSD: National Center for PTSD

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  3. PTSD: National Center for PTSD

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  4. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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  7. PTSD: National Center for PTSD

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  8. PTSD: National Center for PTSD

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    Full Text Available ... The following short animated videos use hand-drawn images to help you learn about PTSD and effective treatments. What is PTSD? Treatment: Know Your Options "Evidence-based" Treatment Cognitive Processing Therapy Prolonged Exposure Watch our whiteboard video for ...

  9. PTSD: National Center for PTSD

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  10. PTSD: National Center for PTSD

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  11. PTSD: National Center for PTSD

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  12. PTSD: National Center for PTSD

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  13. PTSD: National Center for PTSD

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  14. PTSD: National Center for PTSD

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  15. PTSD: National Center for PTSD

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  18. PTSD: National Center for PTSD

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  19. PTSD: National Center for PTSD

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  20. PTSD: National Center for PTSD

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  1. PTSD: National Center for PTSD

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  2. PTSD: National Center for PTSD

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  3. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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  7. PTSD: National Center for PTSD

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  8. PTSD: National Center for PTSD

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  9. PTSD: National Center for PTSD

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  10. PTSD: National Center for PTSD

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  11. PTSD: National Center for PTSD

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  12. PTSD: National Center for PTSD

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  13. PTSD: National Center for PTSD

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  14. PTSD: National Center for PTSD

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  15. PTSD: National Center for PTSD

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  16. PTSD: National Center for PTSD

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  17. PTSD: National Center for PTSD

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  18. PTSD: National Center for PTSD

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  19. PTSD: National Center for PTSD

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  1. PTSD: National Center for PTSD

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  2. PTSD: National Center for PTSD

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    Full Text Available ... please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to ... Exposure for PTSD" (22.7 MB) Close Video Help Problems viewing videos in pop up windows? See ...

  3. PTSD: National Center for PTSD

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    Full Text Available ... Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it ... Professionals Professional Section Home PTSD Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & ...

  4. PTSD: National Center for PTSD

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  5. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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    Full Text Available ... menus on this page please perform the following steps. 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option (Health, Benefits, ... Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens ...

  7. Higher anterior knee laxity influences the landing biomechanics displayed by pubescent girls.

    Science.gov (United States)

    Wild, Catherine Y; Munro, Bridget J; Steele, Julie R

    2017-01-01

    Despite an increase in anterior knee laxity (AKL) during the adolescent growth spurt in girls, it is unknown whether landing biomechanics are affected by this change. This study investigated whether pubescent girls with higher AKL displayed differences in their lower limb strength or landing biomechanics when performing a horizontal leap movement compared to girls with lower AKL. Forty-six pubescent girls (10-13 years) were tested at the time of their peak height velocity (PHV). Passive AKL was quantified and used to classify participants into higher (HAKL; peak displacement > 4 mm) and lower (LAKL; peak displacement biomechanics, which are suggested to assist the functional stability of their knees during this dynamic task. Further research is warranted, however, to confirm or refute this notion.

  8. Trauma and PTSD rates in an irish psychiatric population

    Science.gov (United States)

    Wilson, Fiona E; Hennessy, Eilis; Dooley, Barbara; Kelly, Brendan D; Ryan, Dermot A

    2013-01-01

    Although Western mental health services are increasingly finding themselves concerned with assisting traumatized individuals migrating from other countries, trauma and posttraumatic stress disorder (PTSD) are under-detected and undiagnosed in psychiatric populations. This study examined and compared rates of traumatic experiences, frequency of traumatic events, trauma symptomatology levels, rates of torture, rates of PTSD and chart documentation of trauma and PTSD between (a) Irish and migrant service-users and (b) forced migrant and voluntary migrant service-users in Dublin, Ireland. Data were gathered from 178 psychiatric outpatients attending using a sociodemographic questionnaire, the Harvard Trauma Questionnaire-Revised Cambodian Version and the SCID-I/P. A substantial number of service-users had experienced at least one lifetime trauma (71.3%), and a high percentage of both the Irish (47.4%) and migrant groups (70.3%) of service-users had experienced two or more events. Overall, analyses comparing rates between Irish, forced migrant and voluntary migrant service-users found that forced migrants displayed more traumatic life events, posttraumatic symptoms, and higher levels of PTSD than their voluntary migrant and Irish counterparts, with over 50% experiencing torture prior to arrival in Ireland. The lifetime rate of PTSD in the overall sample was 15.7% but only 53.57% of cases were documented in patient charts. The results of this study are informative about the nature and extent of the problem of trauma and PTSD among migrant mental health service users as well as highlighting the under-detected levels of trauma among native-born service users.

  9. Need for liquid-crystal display monitors having the capability of rendering higher than 8 bits in display-bit depth.

    Science.gov (United States)

    Hiwasa, Takeshi; Morishita, Junji; Hatanaka, Shiro; Ohki, Masafumi; Toyofuku, Fukai; Higashida, Yoshiharu

    2009-01-01

    Our purpose in this study was to examine the potential usefulness of liquid-crystal display (LCD) monitors having the capability of rendering higher than 8 bits in display-bit depth. An LCD monitor having the capability of rendering 8, 10, and 12 bits was used. It was calibrated to the grayscale standard display function with a maximum luminance of 450 cd/m(2) and a minimum of 0.75 cd/m(2). For examining the grayscale resolution reported by ten observers, various simple test patterns having two different combinations of luminance in 8, 10, and 12 bits were randomly displayed on the LCD monitor. These patterns were placed on different uniform background luminance levels, such as 0, 50, and 100%, for maximum luminance. All observers participating in this study distinguished a smaller difference in luminance than one gray level in 8 bits irrespective of background luminance levels. As a result of the adaptation processes of the human visual system, observers distinguished a smaller difference in luminance as the luminance level of the test pattern was closer to the background. The smallest difference in luminance that observers distinguished was four gray levels in 12 bits, i.e., one gray level in 10 bits. Considering the results obtained by use of simple test patterns, medical images should ideally be displayed on LCD monitors having 10 bits or greater so that low-contrast objects with small differences in luminance can be detected and for providing a smooth gradation of grayscale.

  10. PTSD Treatment Options

    Science.gov (United States)

    ... Elements of Cognitive Behavioral Therapies Cognitive behavioral therapies (CBTs) for PTSD involve a relatively structured, short-term treatment that ... time does it take? A usual course of CBT for PTSD lasts about eight to 20 sessions but can ...

  11. PTSD: Symptoms, Diagnosis, Treatment

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    ... Bar Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table of Contents ... version of this page please turn Javascript on. Symptoms As with mild traumatic brain injury (TBI), PTSD ...

  12. Spontaneous Remission From PTSD Depends on the Number of Traumatic Event Types Experienced

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    Kolassa, Iris; Ertl, Verena; Eckart, Cindy; Kolassa, Stephan; Onyut, Lamaro Patience; Elbert, Thomas

    2010-01-01

    As exposure to different types of traumatic stressors increases, the prevalence of PTSD increases. However, little is known about the effects of cumulative exposure to traumatic stress on the maintenance and remission from PTSD. In 2006/2007, we investigated 444 refugees from the 1994 Rwandan genocide, assessing exposure to traumatic events, current and lifetime PTSD, and PTSD symptom severity. Higher trauma exposure was associated with higher prevalence of current and lifetime PTSD, with low...

  13. Differentiated Rewards as an Enticement to Display and Develop More Professionalism in Higher Professional Education

    NARCIS (Netherlands)

    Jol Stoffers; Erik Canisius

    2015-01-01

    This research investigates to what extent lecturers at universities of applied sciences do regard differentiated rewards(intended to develop and/or display professionalism)to be fair, and to what extent, and in which form, do these stimulate their willingness to (further) professionalise and/or

  14. Sleep disturbance in pediatric PTSD: current findings and future directions.

    Science.gov (United States)

    Kovachy, Ben; O'Hara, Ruth; Hawkins, Nate; Gershon, Anda; Primeau, Michelle M; Madej, Jessica; Carrion, Victor

    2013-05-15

    Many studies have provided strong evidence of a fundamental and complex role for sleep disturbances in adult posttraumatic stress disorder (PTSD). Investigations of adult PTSD using subjective and objective measures document sleep architecture abnormalities and high prevalence of sleep disordered breathing, periodic limb movement disorder, nightmares, and insomnia. PTSD treatment methods do appear to significantly improve sleep disturbance, and also studies suggest that treatments for sleep disorders often result in improvements in PTSD symptoms. Further, the most recent evidence suggests sleep abnormalities may precede the development of PTSD. Given the importance of sleep disorders to the onset, course, and treatment of adult PTSD, examination of sleep disturbances far earlier in the life course is imperative. Here we review the literature on what we know about sleep disturbances and disorders in pediatric PTSD. Our review indicates that the extant, empirical data examining sleep disturbance and disorders in pediatric PTSD is limited. Yet, this literature suggests there are significantly higher reports of sleep disturbances and nightmares in children and adolescents exposed to trauma and/or diagnosed with PTSD than in non-trauma-exposed samples. Sleep questionnaires are predominantly employed to assess sleep disorders in pediatric PTSD, with few studies utilizing objective measures. Given the important, complex relationship being uncovered between adult PTSD and sleep, this review calls for further research of sleep in children with PTSD using more specific subjective measures and also objective measures, such as polysomnography and eventually treatment trial studies.

  15. PTSD og kjønnsforskjeller- en litteraturstudie

    OpenAIRE

    Muneer, Saba

    2008-01-01

    BACKGROUND: PTSD is a trauma related anxiety disorder that can develop after exposure to one or more frightening events that threatened or caused severe physical harm. Reexperience trough flashbacks and/or nightmares are common. Persistent avoidance of the stimuli which is associated with trauma and increased physiological arousal are other important aspects of PTSD. Lifetime prevalence of PTSD is one percent. Men have a greater exposure to traumatic situations but women have higher rates ...

  16. Examining PTSD Treatment Choice Among Individuals with Subthreshold PTSD

    OpenAIRE

    Bergman, Hannah E.; Kline, Alexander C.; Feeny, Norah C.; Zoellner, Lori A.

    2015-01-01

    Subthreshold posttraumatic stress disorder (PTSD) is associated with impairment and has a prevalence rate comparable to full PTSD. Yet, little is known regarding treatment preferences among individuals with subthreshold PTSD, even though they seek trauma-related treatment at a similar rate to those with full PTSD. This study explored subthreshold diagnostic PTSD diagnostic category and treatment preference in undergraduate (N = 439) and trauma-exposed community (N = 203) samples. Participants...

  17. Heart rate variability (HRV) and posttraumatic stress disorder (PTSD): a pilot study.

    Science.gov (United States)

    Tan, Gabriel; Dao, Tam K; Farmer, Lorie; Sutherland, Roy John; Gevirtz, Richard

    2011-03-01

    Exposure to combat experiences is associated with increased risk of developing Post Traumatic Stress Disorder. Prolonged exposure therapy and cognitive processing therapy have garnered a significant amount of empirical support for PTSD treatment; however, they are not universally effective with some patients continuing to struggle with residual PTSD symptoms. Heart rate variability (HRV) is a measure of the autonomic nervous system functioning and reflects an individual's ability to adaptively cope with stress. A pilot study was undertaken to determine if veterans with PTSD (as measured by the Clinician-Administered PTSD Scale and the PTSD Checklist) would show significantly different HRV prior to an intervention at baseline compared to controls; specifically, to determine whether the HRV among veterans with PTSD is more depressed than that among veterans without PTSD. The study also aimed at assessing the feasibility, acceptability, and potential efficacy of providing HRV biofeedback as a treatment for PTSD. The findings suggest that implementing an HRV biofeedback as a treatment for PTSD is effective, feasible, and acceptable for veterans. Veterans with combat-related PTSD displayed significantly depressed HRV as compared to subjects without PTSD. When the veterans with PTSD were randomly assigned to receive either HRV biofeedback plus treatment as usual (TAU) or just TAU, the results indicated that HRV biofeedback significantly increased the HRV while reducing symptoms of PTSD. However, the TAU had no significant effect on either HRV or symptom reduction. A larger randomized control trial to validate these findings appears warranted.

  18. Proximal relationships between PTSD and drinking behavior

    Directory of Open Access Journals (Sweden)

    Debra Kaysen

    2014-12-01

    Full Text Available Co-morbid PTSD and alcohol use disorders are both common and debilitating. However, many of these studies rely on cross-sectional studies that obscure more complex relationships between PTSD and drinking. Event-level studies allow for examination of proximal relationships between PTSD and drinking. Among women (n=136 with past sexual victimization, n=40 no past trauma history, a two-part mixed hurdle model was used to examine daily PTSD and drinking. On days women experienced more intrusive and behavioral avoidance symptoms, they were more likely to drink. For a 2 SD increase in symptoms, there was a 5% increased likelihood of drinking, and for a 2 SD increase in dysphoric symptoms or negative affect, women drank approximately half drink less. Daily-level coping self-efficacy moderated the association between distress and drinking (IRR=0.91, p<0.01. Women who reported less coping drank more as their distress increased on a certain day whereas women who reported more coping drank about the same regardless of distress. Overall, findings suggest that specific PTSD symptoms are associated with higher alcohol use and that these relationships are moderated by daily coping self-efficacy. Implications of these findings for informing models of PTSD/AUD comorbidity, as well as clinical implications will be discussed.

  19. PTSD among a treatment sample of repeat DUI offenders.

    Science.gov (United States)

    Peller, Allyson J; Najavits, Lisa M; Nelson, Sarah E; LaBrie, Richard A; Shaffer, Howard J

    2010-08-01

    Recent studies indicate that posttraumatic stress disorder (PTSD) is one of the most common psychiatric comorbidities among driving-under-the-influence (DUI) offenders in treatment. Investigation of DUI offenders' PTSD and clinical characteristics could have important implications for prevention and treatment. This prospective study examined the demographic and clinical characteristics of repeat DUI offenders with PTSD symptoms at baseline and 1-year follow-up. Seven hundred twenty-nine DUI offenders admitted to a 2-week inpatient program participated in the study. Participants with PTSD evidenced more severe psychiatric comorbidity and reported a higher DUI recidivism rate at 1-year than those without PTSD. This study suggests a need to address PTSD among DUI offenders, as well as to further develop methodologies for accurately reporting DUI recidivism.

  20. PTSD Treatment Options

    Science.gov (United States)

    ... Force photo by Staff Sgt. Timothy Chacon Posttraumatic stress disorder (PTSD) is a mental health condition that can significantly affect a person’s thoughts, feelings, behaviors and relationships. The ...

  1. Association between theta power in 6-month old infants at rest and maternal PTSD severity: A pilot study.

    Science.gov (United States)

    Sanjuan, Pilar M; Poremba, Carly; Flynn, Lucinda R; Savich, Renate; Annett, Robert D; Stephen, Julia

    2016-09-06

    Compared to infants born to mothers without PTSD, infants born to mothers with active PTSD develop poorer behavioral reactivity and emotional regulation. However, the association between perinatal maternal PTSD and infant neural activation remains largely unknown. This pilot study (N=14) examined the association between perinatal PTSD severity and infant frontal neural activity, as measured by MEG theta power during rest. Results indicated that resting left anterior temporal/frontal theta power was correlated with perinatal PTSD severity (p=0.004). These findings suggest delayed cortical maturation in infants whose mothers had higher perinatal PTSD severity and generate questions regarding perinatal PTSD severity and infant neurophysiological consequences.

  2. Biomarkers for PTSD

    Science.gov (United States)

    2013-07-01

    anxiety disorders. Ressler hopes that by understanding how fear works in the mammalian brain in the laboratory, it will improve understanding of and...provide translational treatments and possibly prevention for fear-based disorders, such as PTSD, phobic disorders and panic disorder. Dr. Ressler...PROVE (Project for Return and Opportunity in Veterans Education) Queens Vet Center Rutgers Anxiety Disorders Clinic Veteran PTSD Support Group

  3. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD.

    Science.gov (United States)

    Armour, Cherie; Karstoft, Karen-Inge; Richardson, J Don

    2014-08-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD. The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group. In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.

  4. Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

    OpenAIRE

    Freedman, Sara A.; Gilad, Moran; Ankri, Yael; Roziner, Ilan; Shalev, Arieh Y

    2015-01-01

    Background: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD), but the association’s underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD.Objective: This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS) in a large cohort of recent trauma survivors. It also explores the ef...

  5. Sources of the increasing number of Vietnam era veterans with a diagnosis of PTSD using VHA services.

    Science.gov (United States)

    Hermes, Eric D A; Hoff, Rani; Rosenheck, Robert A

    2014-06-01

    Correlates of the sharp increase in Vietnam era veterans diagnosed as having posttraumatic stress disorder (PTSD) in the Veterans Health Administration (VHA) were examined. Analyses compared receipt of a PTSD diagnosis and service-connected disability compensation in 2004-2006 and 2007-2009. Among Vietnam era veterans, the percentage with a PTSD diagnosis in 2007-2009 was 22.2% higher than the percentage with PTSD in 2004-2006; the percentage without PTSD was 6.2% higher than in 2004-2006. Of those with PTSD in 2007-2009, 22.6% were previous VHA service users newly diagnosed ("conversions"); only 12.8% were entirely new to VHA ("recents"). Rates of disability compensation among recents and conversions were almost two and three times higher, respectively, than among those without PTSD. The increase in Vietnam era veterans with PTSD is associated with more frequent "conversion" to PTSD among previous VHA users and receipt of disability compensation.

  6. Undifferentiated bronchial fibroblasts derived from asthmatic patients display higher elastic modulus than their non-asthmatic counterparts.

    Directory of Open Access Journals (Sweden)

    Michal Sarna

    Full Text Available During asthma development, differentiation of epithelial cells and fibroblasts towards the contractile phenotype is associated with bronchial wall remodeling and airway constriction. Pathological fibroblast-to-myofibroblast transition (FMT can be triggered by local inflammation of bronchial walls. Recently, we have demonstrated that human bronchial fibroblasts (HBFs derived from asthmatic patients display some inherent features which facilitate their FMT in vitro. In spite of intensive research efforts, these properties remain unknown. Importantly, the role of undifferentiated HBFs in the asthmatic process was systematically omitted. Specifically, biomechanical properties of undifferentiated HBFs have not been considered in either FMT or airway remodeling in vivo. Here, we combine atomic force spectroscopy with fluorescence microscopy to compare mechanical properties and actin cytoskeleton architecture of HBFs derived from asthmatic patients and non-asthmatic donors. Our results demonstrate that asthmatic HBFs form thick and aligned 'ventral' stress fibers accompanied by enlarged focal adhesions. The differences in cytoskeleton architecture between asthmatic and non-asthmatic cells correlate with higher elastic modulus of asthmatic HBFs and their increased predilection to TGF-β-induced FMT. Due to the obvious links between cytoskeleton architecture and mechanical equilibrium, our observations indicate that HBFs derived from asthmatic bronchi can develop considerably higher static tension than non-asthmatic HBFs. This previously unexplored property of asthmatic HBFs may be potentially important for their myofibroblastic differentiation and bronchial wall remodeling during asthma development.

  7. Undifferentiated bronchial fibroblasts derived from asthmatic patients display higher elastic modulus than their non-asthmatic counterparts.

    Science.gov (United States)

    Sarna, Michal; Wojcik, Katarzyna A; Hermanowicz, Pawel; Wnuk, Dawid; Burda, Kvetoslava; Sanak, Marek; Czyż, Jarosław; Michalik, Marta

    2015-01-01

    During asthma development, differentiation of epithelial cells and fibroblasts towards the contractile phenotype is associated with bronchial wall remodeling and airway constriction. Pathological fibroblast-to-myofibroblast transition (FMT) can be triggered by local inflammation of bronchial walls. Recently, we have demonstrated that human bronchial fibroblasts (HBFs) derived from asthmatic patients display some inherent features which facilitate their FMT in vitro. In spite of intensive research efforts, these properties remain unknown. Importantly, the role of undifferentiated HBFs in the asthmatic process was systematically omitted. Specifically, biomechanical properties of undifferentiated HBFs have not been considered in either FMT or airway remodeling in vivo. Here, we combine atomic force spectroscopy with fluorescence microscopy to compare mechanical properties and actin cytoskeleton architecture of HBFs derived from asthmatic patients and non-asthmatic donors. Our results demonstrate that asthmatic HBFs form thick and aligned 'ventral' stress fibers accompanied by enlarged focal adhesions. The differences in cytoskeleton architecture between asthmatic and non-asthmatic cells correlate with higher elastic modulus of asthmatic HBFs and their increased predilection to TGF-β-induced FMT. Due to the obvious links between cytoskeleton architecture and mechanical equilibrium, our observations indicate that HBFs derived from asthmatic bronchi can develop considerably higher static tension than non-asthmatic HBFs. This previously unexplored property of asthmatic HBFs may be potentially important for their myofibroblastic differentiation and bronchial wall remodeling during asthma development.

  8. Ophiobolin A, a sesterterpenoid fungal phytotoxin, displays higher in vitro growth-inhibitory effects in mammalian than in plant cells and displays in vivo antitumor activity.

    Science.gov (United States)

    Bury, Marina; Novo-Uzal, Esther; Andolfi, Anna; Cimini, Sara; Wauthoz, Nathalie; Heffeter, Petra; Lallemand, Benjamin; Avolio, Fabiana; Delporte, Cédric; Cimmino, Alessio; Dubois, Jacques; Van Antwerpen, Pierre; Zonno, Maria Chiara; Vurro, Maurizio; Poumay, Yves; Berger, Walter; Evidente, Antonio; De Gara, Laura; Kiss, Robert; Locato, Vittoria

    2013-08-01

    Ophiobolin A, a sesterterpenoid produced by plant pathogenic fungi, was purified from the culture extract of Drechslera gigantea and tested for its growth-inhibitory activity in both plant and mammalian cells. Ophiobolin A induced cell death in Nicotiana tabacum L. cv. Bright Yellow 2 (TBY-2) cells at concentrations ≥10 µM, with the TBY-2 cells showing typical features of apoptosis-like cell death. At a concentration of 5 µM, ophiobolin A did not affect plant cell viability but prevented cell proliferation. When tested on eight cancer cell lines, concentrations <1 µM of ophiobolin A inhibited growth by 50% after 3 days of culture irrespective of their multidrug resistance (MDR) phenotypes and their resistance levels to pro-apoptotic stimuli. It is, thus, unlikely that ophiobolin A exerts these in vitro growth-inhibitory effects in cancer cells by activating pro-apoptotic processes. Highly proliferative human keratinocytes appeared more sensitive to the growth-inhibitory effects of ophiobolin A than slowly proliferating ones. Ophiobolin A also displayed significant antitumor activity at the level of mouse survival when assayed at 10 mg/kg in the B16F10 mouse melanoma model with lung pseudometastases. Ophiobolin A could, thus, represent a novel scaffold to combat cancer types that display various levels of resistance to pro-apoptotic stimuli and/or various MDR phenotypes.

  9. Differential predictors of DSM-5 PTSD and ICD-11 complex PTSD among African American women.

    Science.gov (United States)

    Powers, Abigail; Fani, Negar; Carter, Sierra; Cross, Dorthie; Cloitre, Marylene; Bradley, Bekh

    2017-01-01

    Background: Complex posttraumatic stress disorder (CPTSD) is proposed for inclusion in the ICD-11 as a diagnosis distinct from posttraumatic stress disorder (PTSD), reflecting deficits in affective, self-concept, and relational domains. There remains significant controversy over whether CPTSD provides useful diagnostic information beyond PTSD and other comorbid conditions, such as depression or substance use disorders. Objective: The present study examined differences in psychiatric presentation for three groups: traumatized controls, DSM-5 PTSD subjects, and ICD-11 CPTSD subjects. Method: The sample included 190 African American women recruited from an urban public hospital where rates of trauma exposure are high. PTSD was measured using Clinician Administered PTSD Scale for DSM-5 and CPTSD was measured using clinician administered ICD-Trauma Interview. Psychiatric diagnoses and emotion dysregulation were also assessed. In a subset of women (n = 60), emotion recognition was measured using the Penn Emotion Recognition Task. Results: There were significant differences across groups on current and lifetime major depression (p PTSD and depression symptoms and, as expected, more severe emotion dysregulation and dissociation, compared to DSM-5 PTSD and traumatized control groups. Individuals with CPTSD also had higher levels of emotion recognition to faces on a computer-based behavioural assessment, which may be related to heightened vigilance toward emotional cues from others. CPTSD women had better facial emotion recognition on a computer-based assessment, which may suggest heightened vigilance toward emotional cues. Conclusions: Our results suggest clear, clinically-relevant differences between PTSD and CPTSD, and highlight the need for further research on this topic with other traumatized populations, particularly studies that combine clinical and neurobiological data.

  10. The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims?

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Lauterbach, Dean; Elhai, Jon D

    2014-05-01

    The DSM-5 currently includes a dissociative-PTSD subtype within its nomenclature. Several studies have confirmed the dissociative-PTSD subtype in both American Veteran and American civilian samples. Studies have begun to assess specific factors which differentiate between dissociative vs. non-dissociative PTSD. The current study takes a novel approach to investigating the presence of a dissociative-PTSD subtype in its use of European victims of sexual assault and rape (N=351). Utilizing Latent Profile Analyses, we hypothesized that a discrete group of individuals would represent a dissociative-PTSD subtype. We additionally hypothesized that levels of depression, anger, hostility, and sleeping difficulties would differentiate dissociative-PTSD from a similarly severe form of PTSD in the absence of dissociation. Results concluded that there were four discrete groups termed baseline, moderate PTSD, high PTSD, and dissociative-PTSD. The dissociative-PTSD group encompassed 13.1% of the sample and evidenced significantly higher mean scores on measures of depression, anxiety, hostility, and sleeping difficulties. Implications are discussed in relation to both treatment planning and the newly published DSM-5. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD

    DEFF Research Database (Denmark)

    Armour, C.; Karstoft, K. I.; Richardson, J. D.

    2014-01-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative......-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants...... were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity...

  12. Bullying and PTSD Symptoms

    Science.gov (United States)

    Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

    2012-01-01

    PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

  13. Universal Numeric Segmented Display

    CERN Document Server

    Azad, Md Abul kalam; Kamruzzaman, S M

    2010-01-01

    Segmentation display plays a vital role to display numerals. But in today's world matrix display is also used in displaying numerals. Because numerals has lots of curve edges which is better supported by matrix display. But as matrix display is costly and complex to implement and also needs more memory, segment display is generally used to display numerals. But as there is yet no proposed compact display architecture to display multiple language numerals at a time, this paper proposes uniform display architecture to display multiple language digits and general mathematical expressions with higher accuracy and simplicity by using a 18-segment display, which is an improvement over the 16 segment display.

  14. Differences in Cortisol Response to Trauma Activation in Individuals with and without Comorbid PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Sharon Dekel

    2017-05-01

    Full Text Available Background: Although depression symptoms are often experienced by individuals who develop posttraumatic stress disorder (PTSD following trauma exposure, little is know about the biological correlates associated with PTSD and depression co-morbidity vs. those associated with PTSD symptoms alone.Methods: Here we examined salivary cortisol responses to trauma activation in a sample of 60 survivors of the World Trade Center attacks on September 11, 2001. Participants recalled the escape from the attacks 7 months post 9/11. Salivary cortisol levels were measured before and after their recollection of the trauma. PTSD, depression, and somatic symptoms were also assessed. From the behavioral assessment scales, the participants were grouped into three conditions: those with comorbid PTSD and depressive symptoms, PTSD alone symptoms, or no-pathology.Results: Baseline and cortisol response levels differed between the comorbid, PTSD alone, and no-pathology groups. Individuals endorsing co-morbid symptoms had higher PTSD and somatic symptom severity and their cortisol response decreased following their trauma reminder while a trend of an elevated response to the trauma was found in the PTSD alone group. Our findings show distinct psychological and biological correlates related to the endorsement of PTSD with and without depression comorbidity.Conclusions: The findings suggest that comorbidity symptoms manifestation entails a separate trauma induced condition from PTSD. Future research on biological correlates of comorbid PTSD and depression is warranted.

  15. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

    Directory of Open Access Journals (Sweden)

    Sadeghi-Bazargani H

    2011-07-01

    Full Text Available Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran.Methods: This prospective study examined adult patients aged 16–65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD.Results: Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01. Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned.Conclusion: PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury. Keywords: post-traumatic stress disorder, burn injury, predictors, Iran

  16. Relationship between PTSD symptomatology and nicotine dependence severity in crime victims.

    Science.gov (United States)

    Baschnagel, Joseph S; Coffey, Scott F; Schumacher, Julie A; Drobes, David J; Saladin, Michael E

    2008-11-01

    Smoking rates are higher and cessation rates are lower among individuals with posttraumatic stress disorder (PTSD) compared to the general population, thus understanding the relationship between PTSD and nicotine dependence is important. In a sample of 213 participants with a crime-related trauma (109 with PTSD), the relationship between PTSD status, smoking status (smoker vs. non-smoker), substance abuse diagnosis (SUD), PTSD symptoms, and sex was assessed. SUD diagnosis was significantly related to smoking status, but PTSD symptomatology and sex were not. Among smokers (n=117), increased nicotine dependence severity was associated with being male and with increased level of PTSD avoidance symptoms. Correlations indicated that PTSD avoidance and hyperarousal symptom clusters and total PTSD symptom scores were significantly related to nicotine dependence severity in males, while PTSD symptomatology in general did not correlate with dependence severity for females. The results suggest that level of PTSD symptomatology, particularly avoidance symptoms, may be important targets for smoking cessation treatment among male smokers who have experienced a traumatic event.

  17. PTSD and Problems with Alcohol Use

    Science.gov (United States)

    ... Enter ZIP code here PTSD and Problems with Alcohol Use Public This section is for Veterans, General Public, Family, & Friends PTSD and Problems with Alcohol Use PTSD and alcohol use problems are often ...

  18. Anger intensification with combat-related PTSD and depression comorbidity.

    Science.gov (United States)

    Gonzalez, Oscar I; Novaco, Raymond W; Reger, Mark A; Gahm, Gregory A

    2016-01-01

    Anger is becoming more widely recognized for its involvement in the psychological adjustment problems of current war veterans. Recent research with combat veterans has found anger to be related to psychological distress, psychosocial functioning, and harm risk variables. Using behavioral health data for 2,077 treatment-seeking soldiers who had been deployed to Iraq and Afghanistan, this study examined whether anger disposition was intensified for those who met screen-threshold criteria for posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Anger was assessed with a 7-item screening measure previously validated with the study population. The study tested the hypothesis that anger would be highest when "PTSD & MDD" were conjoined, compared with "PTSD only," "MDD only," and "no PTSD, no MDD." PTSD and depression were assessed with well-established screening instruments. A self-rated "wanting to harm others" variable was also incorporated. Age, gender, race, military component, military grade, and military unit social support served as covariates. Hierarchical multiple regression was used to test the hypothesis, which was confirmed. Anger was intensified in the PTSD & MDD condition, in which it was significantly higher than in the other 3 conditions. Convergent support was obtained for "wanting to harm others" as an exploratory index. Given the high prevalence and co-occurrence of PTSD and MDD among veterans, the results have research and clinical practice relevance for systematic inclusion of anger assessment postdeployment from risk-assessment and screening standpoints. (c) 2016 APA, all rights reserved).

  19. Role and treatment of early maladaptive schemas in Vietnam Veterans with PTSD.

    Science.gov (United States)

    Cockram, David M; Drummond, Peter D; Lee, Christopher W

    2010-01-01

    The role of early maladaptive schemas in understanding and treating post-traumatic stress disorder (PTSD) was investigated. The first study examined the role of perceived adverse parenting and early maladaptive schemas in the development of PTSD in Australian and New Zealand Vietnam war veterans (n = 220). Veterans diagnosed with PTSD scored higher on the Young Schema Questionnaire (L3) and had higher scores on the Measure of Parental Style than veterans not diagnosed with PTSD. The results suggest that early maladaptive schemas have an important role in the development or maintenance of PTSD in Vietnam veterans. The second study measured at baseline, termination and 3 months the early maladaptive schemas, PTSD, anxiety and depression of war veterans (n = 54) participating in a PTSD group treatment programme that included schema-focused therapy. Scores on the PTSD Checklist, the Hospital Anxiety and Depression Scale, and 17 schemas decreased significantly after treatment. Change scores for the schema treatment were compared with change scores of war veterans (n = 127) who had completed a manualized cognitive-behavioural therapy programme without schema-focused therapy. Pre-treatment measures were similar in both groups. Nevertheless, PTSD and anxiety improved more significantly for the schema-focused therapy group. Together, these findings support the feasibility of schema-focused therapy to assist veterans with PTSD.

  20. An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2013-12-01

    Full Text Available Background : The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11 that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD, also define a new diagnosis termed “complex posttraumatic stress disorder” (CPTSD. Objective : We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision] PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. Methods : To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C and the Brief Symptom Inventory (BSI scales, to a sample of adult survivors (N=229 of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA. Results : More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8% than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD. The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively. Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. Conclusion : CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects.

  1. Predicting PTSD following bank robbery

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

    exposed to robbery (N = 371, response rate = 73 %, dropout rate = 18 %). The results of a hierarchical regression analysis showed that 51 % of the variance in PTSD severity could be explained with only peritraumatic dissociation, acute stress disorder (ASD) severity, and negative cognitions about self......Each year, numerous bank robberies take place worldwide. Even so, only few studies have investigated the psychological sequelae of bank robbery and little is known about the risk factors associated with the development of posttraumatic stress disorder (PTSD) following this potentially traumatic...... event. Knowledge about risk factors related to PTSD may allow for preventive measures to be taken against the development of PTSD and reduce the large cost associated with the disorder. We investigated multiple predictors of PTSD severity in a highly representative Danish cohort study of bank employees...

  2. Predicting PTSD following bank robbery

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

    Each year, numerous bank robberies take place worldwide. Even so, only few studies have investigated the psychological sequelae of bank robbery and little is known about the risk factors associated with the development of posttraumatic stress disorder (PTSD) following this potentially traumatic...... event. Knowledge about risk factors related to PTSD may allow for preventive measures to be taken against the development of PTSD and reduce the large cost associated with the disorder. We investigated multiple predictors of PTSD severity in a highly representative Danish cohort study of bank employees...... exposed to robbery (N = 371, response rate = 73 %, dropout rate = 18 %). The results of a hierarchical regression analysis showed that 51 % of the variance in PTSD severity could be explained with only peritraumatic dissociation, acute stress disorder (ASD) severity, and negative cognitions about self...

  3. Resilient but addicted: The impact of resilience on the relationship between smoking withdrawal and PTSD.

    Science.gov (United States)

    Asnaani, Anu; Alpert, Elizabeth; McLean, Carmen P; Foa, Edna B

    2015-06-01

    Nicotine use is common among people with posttraumatic stress disorder (PTSD). Resilience, which is reflected in one's ability to cope with stress, has been shown to be associated with lower cigarette smoking and posttraumatic stress symptoms, but relationships among these three variables have not been examined. This study investigates the relationships of resilience and nicotine withdrawal with each other and in relation to PTSD symptoms. Participants were 118 cigarette smokers with PTSD seeking treatment for PTSD and nicotine use. Data were randomly cross-sectionally sampled from three time points: week 0, week 12, and week 27 of the study. Hierarchical multiple regression analyses revealed main effects of both resilience and nicotine withdrawal symptoms on PTSD severity, controlling for the sampled time point, negative affect, and expired carbon monoxide concentration. Consistent with prior research, PTSD severity was higher among individuals who were less resilient and for those who had greater nicotine withdrawal. There was an interaction between resilience and nicotine withdrawal on self-reported PTSD severity, such that greater resilience was associated with lower PTSD severity only among participants with low nicotine withdrawal symptoms. Among individuals with high nicotine withdrawal, PTSD severity was high, regardless of resilience level. These results suggest that resilience is a protective factor for PTSD severity for those with low levels of nicotine withdrawal, but at high levels of nicotine withdrawal, the protective function of resilience is mitigated.

  4. Relationships between a Dissociative Subtype of PTSD and Clinical Characteristics in Patients with Substance Use Disorders.

    Science.gov (United States)

    Mergler, Michaela; Driessen, Martin; Lüdecke, Christel; Ohlmeier, Martin; Chodzinski, Claudia; Weirich, Steffen; Schläfke, Detlef; Wedekind, Dirk; Havemann-Reinecke, Ursula; Renner, Walter; Schäfer, Ingo

    2017-01-01

    The increasing support for a dissociative subtype of post-traumatic stress disorder (PTSD-D) has led to its inclusion in DSM-5. We examined relationships between PTSD-D and relevant variables in patients with substance use disorders (SUD). The sample comprised N = 459 patients with SUD. The International Diagnostic Checklist and the Posttraumatic Diagnostic Scale were used to diagnose PTSD. In addition, participants completed the Childhood Trauma Questionnaire and the Dissociative Experiences Scale. The course of SUD was assessed by means of the European Addiction Severity Index. One-fourth of participants fulfilled a diagnosis of PTSD (25.3%). Patients with PTSD-D (N = 32, 27.6% of all patients with PTSD) reported significantly more current depressive symptoms, more current suicidal thoughts, more lifetime anxiety/tension, and more suicide attempts. The PTSD-D group also showed a significantly higher need for treatment due to drug problems, higher current use of opiates/analgesics, and a higher number of lifetime drug overdoses. In a regression model, symptoms of depression in the last month and lifetime suicide attempts significantly predicted PTSD-D. These findings suggest that PTSD-D is related to additional psychopathology and to a more severe course of substance-related problems in patients with SUD, indicating that this group also has additional treatment needs.

  5. [Assessment of complex PTSD - internal and external validity of a diagnostic interview].

    Science.gov (United States)

    Boroske-Leiner, Katja; Hofmann, Arne; Sack, Martin

    2008-05-01

    The diagnostic construct of complex posttraumatic stress disorder (complex PTSD) describes the consequences of early onset and long-term persisting psychological traumatizations. The interview for complex PTSD (I-kPTBS) - is the German adaptation of the structured interview for disorders of extreme stress (SIDES). The present study reports first data regarding the internal validity of the I-kPTBS as well as on the external validity of the diagnosis of complex PTSD. The I-kPTBS was applied in 72 consecutive patients of a specialized outpatient clinic. 31 patients fulfilled the criteria of the diagnosis complex PTSD. 25 suffered from a PTSD but did not fulfil the diagnostic criteria of complex PTSD. Both groups where compared regarding their symptoms, resources and reports of childhood events. Internal consistence of the I-kPTBS regarding the sample was good to excellent (alpha = 0.88). As expected, patients with the diagnosis of complex PTSD showed more severe dissociative, depressive and general anxiety symptoms than patients with PTSD alone. Patients fulfilling the criteria of complex PTSD reported a lower age at their first traumatic event, more multiple traumatizations and more often a dissociative disorder as comorbid diagnosis. Patients with complex PTSD show a higher traumaload in childhood and a lower level of compensatory resources. The interview for complex PTSD (I-kPTBS) describes a consistent diagnostic construct. The results demonstrate that the diagnosis of complex PTSD selects a specific group of patients with early childhood trauma and high symptom level. Specific criteria can differentiate this patient group well from patients that suffer from PTSD alone.

  6. Mental health professionals’ attitudes toward patients with PTSD and depression

    Directory of Open Access Journals (Sweden)

    Thomas Maier

    2015-10-01

    Full Text Available Background: To date, mental health professionals’ attitudes toward posttraumatic stress disorder (PTSD, compared to other psychiatric disorders such as schizophrenia or depression, have rarely been studied. Objective: We assessed mental health professionals’ attitudes toward patients with PTSD compared to patients suffering from depression. Method: Case vignettes of a patient with either PTSD or depression were presented to two samples of mental health professionals: attendees of a conference on posttraumatic stress (N=226 or of a lecture for psychiatry residents (N=112. Participants subsequently completed a questionnaire that assessed their attitude reactions to the presented case. Results: Participants showed similarly positive attitudes toward depression and PTSD. PTSD elicited a more favorable attitude with regard to prosocial reactions, estimated dependency, attributed responsibility, and interest in the case, particularly in mental health professionals specializing in psychotraumatology. Across diagnoses, higher age and longer professional experience were associated with more positive attitudes toward patients. Conclusions: Mental health professionals’ positive attitudes toward patients with depression and PTSD correlate with their specific knowledge about the disorder, their level of professional training, and their years of professional experience. Limitations: The instruments used, although based on established theoretical concepts in attitude research, were not validated in their present versions.

  7. Differences in PTSD Symptomatology Among Latinos with Childhood and Adult Trauma: The Moderating Effect of Acculturation

    Science.gov (United States)

    DiGangi, Julia A.; Goddard, Andrea J.; Miller, Steven A.; Leon, Gabriela; Jason, Leonard A.

    2016-01-01

    The development of PTSD has been shown to be dependent on a variety of factors, including ethnicity, whether the trauma was experienced as a child or adult, and acculturation. Using 104 Latinos who had completed treatment for substance abuse disorder(s), this study compared PTSD symptomatology for individuals reporting their worst traumatic event (WTE) in childhood versus adulthood. The moderating effect of acculturation was also examined. Although many studies have reported on the pernicious effects of childhood trauma, very few have provided direct comparisons of child and adult trauma in terms of PTSD symptoms. Results indicated that those reporting their WTE in childhood had greater PTSD symptomatology than those reporting in adulthood. Acculturation moderated the relationship between timing of the trauma and PTSD symptoms. Specifically, those who reported their WTE in childhood and had the lower levels of acculturation reported the higher number of PTSD symptoms. Implications and future directions are discussed. PMID:27227166

  8. Management of trauma and PTSD

    African Journals Online (AJOL)

    Lecturer, Department of Psychiatry and Mental Health, University of Cape Town and Consultant Psychiatrist, ... PTSD.[2,3] In the primary healthcare setting .... psychiatric history were more uniform .... trials support the use of selective serotonin.

  9. Relationship between burnout and PTSD symptoms in firefighters: the moderating effects of a sense of calling to firefighting.

    Science.gov (United States)

    Jo, Insung; Lee, Songhee; Sung, Gyhye; Kim, Minkyoung; Lee, Sanghyuk; Park, Jooeon; Lee, Kangsoo

    2017-10-03

    Firefighting has been reported to lead to burnout and posttraumatic stress disorder (PTSD). However, burnout and PTSD symptoms may vary depending on personal characteristics, such as having a sense of calling. This study examined the role of calling in the association between burnout and PTSD symptoms. We hypothesized that burnout would be associated with more severe PTSD symptoms and calling would buffer the relationship between burnout and PTSD symptoms. The Korean version of the Maslach Burnout Inventory-General Survey, Sense of Calling Subscale of the Professionalism Scale, and the Impact of Event Scale-Revised-Korean version were used to measure burnout, calling, and PTSD symptoms. Data from 109 of 127 firefighters from Gyeonggi-do, South Korea were analyzed using hierarchical linear regression. Burnout was a significant predictor of PTSD symptoms. Furthermore, the interaction term between burnout and calling accounted for a significant variance in PTSD symptoms. Higher burnout was associated with severe PTSD symptoms, but this relationship differed by the level of calling. The increase in PTSD symptoms due to increased burnout in the high calling group was relatively higher than in the low and average calling groups. Calling, though perceived as a positive variable, can be hazardous to exhausted people. A sense of calling as part of one's job identity should not be encouraged until personal circumstances and characteristics, such burnout symptoms, are evaluated. Identifying context and variables associated with PTSD for interventions with firefighters and persons in other dangerous occupations should aid in their recovery from trauma exposure.

  10. Sentiment analysis for PTSD signals

    CERN Document Server

    Kagan, Vadim; Sapounas, Demetrios

    2013-01-01

    This book describes a computational framework for real-time detection of psychological signals related to Post-Traumatic Stress Disorder (PTSD) in online text-based posts, including blogs and web forums. Further, it explores how emerging computational techniques such as sentiment mining can be used in real-time to identify posts that contain PTSD-related signals, flag those posts, and bring them to the attention of psychologists, thus providing an automated flag and referral capability.

  11. The New York PTSD Risk Score for Assessment of Psychological Trauma: Male and Female Versions

    Science.gov (United States)

    Boscarino, Joseph A.; Kirchner, H. Lester; Hoffman, Stuart N.; Sartorius, Jennifer; Adams, Richard E.; Figley, Charles R.

    2012-01-01

    We previously developed a new posttraumatic stress disorder (PTSD) screening instrument – the New York PTSD Risk Score (NYPRS). Since research suggests different PTSD risk factors and outcomes for men and women, in the current study we assessed the suitability of male and female versions of this screening instrument among 3,298 adults exposed to traumatic events. Using diagnostic test methods, including receiver operating curve (ROC) and bootstrap techniques, we examined different prediction domains, including core PTSD symptoms, trauma exposures, sleep disturbances, depression symptoms, and other measures to assess PTSD prediction models for men and women. While the original NYPRS worked well in predicting PTSD, significant interaction was detected by gender, suggesting that separate models are warranted for men and women. Model comparisons suggested that while the overall results appeared robust, prediction results differed by gender. For example, for women, core PTSD symptoms contributed more to the prediction score than for men. For men, depression symptoms, sleep disturbance, and trauma exposure contributed more to the prediction score. Men also had higher cut-off scores for PTSD compared to women. There were other gender-specific differences as well. The NYPRS is a screener that appears to be effective in predicting PTSD status among at-risk populations. However, consistent with other medical research, this instrument appears to require male and female versions to be the most effective. PMID:22648009

  12. Neural Markers and Rehabilitation of Executive Functioning in Veterans with TBI and PTSD

    Science.gov (United States)

    2016-10-01

    multiple domains of living and reduce emotional dysregulation and disinhibition associated with the co-occurring disorders . 15 Specific...Posttraumatic Stress Disorder (PTSD). TBI and PTSD are both characterized by deficits in multiple cognitive domains, including attention, executive function...provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently

  13. α-Helix peptides designed from EBV-gH protein display higher antigenicity and induction of monocyte apoptosis than the native peptide.

    Science.gov (United States)

    Urquiza, Mauricio; Melo-Cardenas, Johanna; Guevara, Tatiana; Echeverria, Ignacia; Rodriguez, Isabel C; Vanegas, Magnolia; Amzel, Mario; Patarroyo, Manuel E

    2010-11-01

    We tested the hypothesis that stabilizing α-helix of Epstein-Barr virus gH-derived peptide 11438 used for binding human cells will increase its biological activity. Non-stable α-helix of peptide 11438 was unfolded in an entropy-driven process, despite the opposing effect of the enthalpy factor. Adding and/or changing amino acids in peptide 11438 allowed the designing of peptides 33207, 33208 and 33210; peptides 33208 and 33210 displayed higher helical content due to a decreased unfolding entropy change as was determined by AGADIR, molecular dynamics and circular dichroism analysis. Peptides 33207, 33208 and 33210 inhibited EBV invasion of peripheral blood mononuclear cells and displayed epitopes more similar to native protein than peptide 11438; these peptides could be useful for detecting antibodies induced by native gH protein since they displayed high reactivity with anti-EBV antibodies. Anti-peptide 33207 antibodies showed higher reactivity with EBV than anti-peptide 11438 antibodies being useful for inducing antibodies against EBV. Anti-peptide 33210 antibodies inhibit EBV invasion of epithelial cells better than anti-peptide 11438 antibodies. Peptide 33210 bound to normal T lymphocytes and Raji cells stronger than peptide 11438 and also induced apoptosis of monocytes and Raji cells but not of normal T cells in a similar way to EBV-gH. Peptide 33210 inhibited the monocytes' development toward dendritic cells better than EBV and peptide 11438. In conclusion, stabilizing the α-helix in peptides 33208 and 33210 designed from peptide 11438 increased the antigenicity and the ability of the antibodies induced by peptides of inhibiting EBV invasion of host cells.

  14. Beyond Exposure for Posttraumatic Stress Disorder (PTSD) Symptoms: Broad-Spectrum PTSD Treatment Strategies

    Science.gov (United States)

    Lombardo, Thomas W.; Gray, Matt J.

    2005-01-01

    Although cases of posttraumatic stress disorder (PTSD) with comorbid disorders are common, the first generation of PTSD treatment approaches, including exposure and cognitive-behavioral therapy, generally ignore symptoms beyond those specific to PTSD. Optimum PTSD treatment outcome requires more comprehensive strategies, and the development and…

  15. PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents.

    Science.gov (United States)

    Hafstad, G S; Thoresen, S; Wentzel-Larsen, T; Maercker, A; Dyb, G

    2017-05-01

    The conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two separate waves. Young survivors of the 2011 Norway attacks (n = 325) and their parents (n = 451) were interviewed at 4-6 months (wave 1) and 15-18 months (wave 2) after the shooting. PTSD was assessed with the UCLA PTSD Reaction Index for DSM-IV adapted for DSM-5, and a subset was used as diagnostic criteria for ICD-11. In survivors, PTSD prevalence did not differ significantly at any time point, but in parents, the DSM-5 algorithm produced significantly higher prevalence rates than the ICD-11 criteria. The overlap was fair for survivors, but amongst parents a large proportion of individuals met the criteria for only one of the diagnostic systems. No systematic differences were found between ICD-11 and DSM-5 in predictive validity. The proposed ICD-11 criteria and the DSM-5 criteria performed equally well when identifying individuals in distress. Nevertheless, the overlap between those meeting the PTSD diagnosis for both ICD-11 and DSM-5 was disturbingly low, with the ICD-11 criteria identifying fewer people than the DSM-5. This represents a major challenge in identifying individuals suffering from PTSD worldwide, possibly resulting in overtreatment or unmet needs for trauma-specific treatment, depending on the area of the world in which patients are being diagnosed.

  16. The psychobiology and psychopharmacology of PTSD.

    Science.gov (United States)

    Van Der Kolk, Bessel A.

    2001-01-01

    This paper reviews the currently available knowledge about the psychobiology and psychopharmacology of post-traumatic stress disorder (PTSD). It also reviews the various studies that have elucidated changes in brain function and structure in PTSD populations, including position emission tomography (PET), single photon emission computed tomography (SPECT), and event-related potential (ERP) studies. It then reviews the literature on catecholamine and hypothalamic-pituitary-adrenal (HPA) axis abnormalities in PTSD, and finally reviews the literature available on the psychopharmacology of PTSD. It discusses how the pathophysiology of PTSD determines the nature of psychopharmacological interventions. Psychopharmacological interventions in PTSD are largely limited to good studies on the effects of the selective serotonin reuptake inhibitors (SSRIs). In order to effectively intervene in PTSD, studies of other psychopharmacological agents are necessary, specifically of agents which affect limbic activation, decreased frontal lobe functioning, altered HPA activity, and other biological features of PTSD. Copyright 2001 John Wiley & Sons, Ltd.

  17. Proximal relationships between PTSD and drinking behavior

    OpenAIRE

    2014-01-01

    Co-morbid PTSD and alcohol use disorders are both common and debilitating. However, many of these studies rely on cross-sectional studies that obscure more complex relationships between PTSD and drinking. Event-level studies allow for examination of proximal relationships between PTSD and drinking. Among women (n=136 with past sexual victimization, n=40 no past trauma history), a two-part mixed hurdle model was used to examine daily PTSD and drinking. On days women experienced more intrusive ...

  18. Considering PTSD for DSM-5.

    Science.gov (United States)

    Friedman, Matthew J; Resick, Patricia A; Bryant, Richard A; Brewin, Chris R

    2011-09-01

    This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish "traumatic" from "non-traumatic" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD. © 2010 Wiley-Liss, Inc.

  19. Differences in relationship conflict, attachment, and depression in treatment-seeking veterans with hazardous substance use, PTSD, or PTSD and hazardous substance use.

    Science.gov (United States)

    Owens, Gina P; Held, Philip; Blackburn, Laura; Auerbach, John S; Clark, Allison A; Herrera, Catherine J; Cook, Jerome; Stuart, Gregory L

    2014-05-01

    Veterans (N = 133) who were seeking treatment in either the Posttraumatic Stress Program or Substance Use Disorders Program at a Veterans Affairs Medical Center (VAMC) and, based on self-report of symptoms, met clinical norms for posttraumatic stress disorder (PTSD) or hazardous substance use (HSU) completed a survey related to relationship conflict behaviors, attachment styles, and depression severity. Participants were grouped into one of three categories on the basis of clinical norm criteria: PTSD only, HSU only, and PTSD + HSU. Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, Center for Epidemiologic Studies-Depression scale, Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test, and Psychological Aggression and Physical Violence subscales of the Conflict Tactics Scale. Most participants were male and Caucasian. Significant differences were found between groups on depression, avoidant attachment, psychological aggression perpetration and victimization, and physical violence perpetration and victimization. Post hoc analyses revealed that the PTSD + HSU group had significantly higher levels of depression, avoidant attachment, and psychological aggression than the HSU only group. The PTSD + HSU group had significantly higher levels of physical violence than did the PTSD only group, but both groups had similar mean scores on all other variables. Potential treatment implications are discussed.

  20. Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

    Directory of Open Access Journals (Sweden)

    Sara A. Freedman

    2015-12-01

    Full Text Available Background: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD, but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD. Objective: This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT on the association between the two. Method: Consecutive emergency department trauma admissions with qualifying PTSD symptoms (n=501 were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms. Results: The cross-lagged effect of SRS on PTSD was statistically significant (β=−0.12, p=0.01 among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (β=−0.02, p=0.67. Both relationships were non-significant among survivors who received CBT. Discussion: SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention.

  1. Neuropsychological functions and visual contrast sensitivity in schizophrenia: the potential impact of comorbid posttraumatic stress disorder (PTSD

    Directory of Open Access Journals (Sweden)

    Ibolya eHalasz

    2013-03-01

    Full Text Available Previous studies have revealed a high prevalence of posttraumatic stress disorder (PTSD in patients with other severe mental disorders, including schizophrenia. However, the neuropsychological and psychophysical correlates of comorbid PTSD are less exactly defined. The purpose of the present study was to assess immediate and delayed memory, attention, visuospatial skills, language, and basic visual information processing in patients with schizophrenia with or without PTSD. We recruited 125 patients with schizophrenia and 70 healthy controls matched for visual acuity, age, gender, education, and socioeconomic status. Twenty-one of patients with schizophrenia exhibited comorbid PTSD. We administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS and visual contrast sensitivity tasks for low spatial/high temporal frequency (0.3 cycle/degree and 18 Hz and high spatial/low temporal frequency (10 cycles/degree and 1Hz sinusoidal gratings. All patients were clinically stable and received antipsychotic medications. Results revealed that relative to healthy controls, patients with schizophrenia exhibited significant and generalized neuropsychological dysfunctions and reduced visual contrast sensitivity, which was more pronounced at low spatial/high temporal frequency. When we compared schizophrenia patients with and without PTSD, we found that patients with comorbid PTSD displayed lower scores for RBANS attention, immediate and delayed memory, and visuospatial scores. Schizophrenia patients with or without PTSD displayed similar visual contrast sensitivity. In conclusion, comorbid PTSD in schizophrenia may be associated with worse neuropsychological functions, whereas it does not affect basic visual information processing.

  2. [Suicidality among veterans suffering from chronic PTSD treated at Center for Crisis Intervention, Zagreb University Hospital Center].

    Science.gov (United States)

    Marcinko, Darko; Begić, Drazen; Malnar, Zivko; Dordević, Veljko; Popović-Knapić, Vesna; Brataljenovic, Tomo; Martinac, Marko; Karlović, Dalibor; Prgomet, Drago

    2006-09-01

    Recent literature suggests that posttraumatic stress disorder (PTSD) patients are at an increased risk of suicidal behavior. The purpose of our study was to assess the impact of psychiatric comorbidity on suicidality (as assessed by SUAS) and relationship to combat exposure (as assessed by CES) in 277 veterans suffering from chronic PTSD. The diagnosis of PTSD and psychiatric comorbidity was confirmed according to DSM-IV criteria. Patients with PTSD and comorbidity had significantly higher scores (psuicidality and combat exposure than the groups without psychiatric comorbidity. These findings suggest that persons with PTSD and psychiatric comorbidity are at a higher risk of suicidal behavior. Therefore, on assessing suicide risk in PTSD patients attention should be paid to comorbidity factors, in order to reduce the risk of fatal complications.

  3. Reduced amygdala and ventral striatal activity to happy faces in PTSD is associated with emotional numbing.

    Directory of Open Access Journals (Sweden)

    Kim L Felmingham

    Full Text Available There has been a growing recognition of the importance of reward processing in PTSD, yet little is known of the underlying neural networks. This study tested the predictions that (1 individuals with PTSD would display reduced responses to happy facial expressions in ventral striatal reward networks, and (2 that this reduction would be associated with emotional numbing symptoms. 23 treatment-seeking patients with Posttraumatic Stress Disorder were recruited from the treatment clinic at the Centre for Traumatic Stress Studies, Westmead Hospital, and 20 trauma-exposed controls were recruited from a community sample. We examined functional magnetic resonance imaging responses during the presentation of happy and neutral facial expressions in a passive viewing task. PTSD participants rated happy facial expression as less intense than trauma-exposed controls. Relative to controls, PTSD participants revealed lower activation to happy (-neutral faces in ventral striatum and and a trend for reduced activation in left amygdala. A significant negative correlation was found between emotional numbing symptoms in PTSD and right ventral striatal regions after controlling for depression, anxiety and PTSD severity. This study provides initial evidence that individuals with PTSD have lower reactivity to happy facial expressions, and that lower activation in ventral striatal-limbic reward networks may be associated with symptoms of emotional numbing.

  4. PTSD symptom severity and psychiatric comorbidity in recent motor vehicle accident victims: a latent class analysis.

    Science.gov (United States)

    Hruska, Bryce; Irish, Leah A; Pacella, Maria L; Sledjeski, Eve M; Delahanty, Douglas L

    2014-10-01

    We conducted a latent class analysis (LCA) on 249 recent motor vehicle accident (MVA) victims to examine subgroups that differed in posttraumatic stress disorder (PTSD) symptom severity, current major depressive disorder and alcohol/other drug use disorders (MDD/AoDs), gender, and interpersonal trauma history 6-weeks post-MVA. A 4-class model best fit the data with a resilient class displaying asymptomatic PTSD symptom levels/low levels of comorbid disorders; a mild psychopathology class displaying mild PTSD symptom severity and current MDD; a moderate psychopathology class displaying severe PTSD symptom severity and current MDD/AoDs; and a severe psychopathology class displaying extreme PTSD symptom severity and current MDD. Classes also differed with respect to gender composition and history of interpersonal trauma experience. These findings may aid in the development of targeted interventions for recent MVA victims through the identification of subgroups distinguished by different patterns of psychiatric problems experienced 6-weeks post-MVA. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Spirituality factors in the prediction of outcomes of PTSD treatment for U.S. military veterans.

    Science.gov (United States)

    Currier, Joseph M; Holland, Jason M; Drescher, Kent D

    2015-02-01

    Spirituality is a multifaceted construct that might affect veterans' recovery from posttraumatic stress disorder (PTSD) in adaptive and maladaptive ways. Using a cross-lagged panel design, this study examined longitudinal associations between spirituality and PTSD symptom severity among 532 U.S. veterans in a residential treatment program for combat-related PTSD. Results indicated that spirituality factors at the start of treatment were uniquely predictive of PTSD symptom severity at discharge, when accounting for combat exposure and both synchronous and autoregressive associations between the study variables, βs = .10 to .16. Specifically, veterans who scored higher on adaptive dimensions of spirituality (daily spiritual experiences, forgiveness, spiritual practices, positive religious coping, and organizational religiousness) at intake fared significantly better in this program. In addition, possible spiritual struggles (operationalized as negative religious coping) at baseline were predictive of poorer PTSD outcomes, β = .11. In contrast to these results, PTSD symptomatology at baseline did not predict any of the spirituality variables at posttreatment. In keeping with a spiritually integrative approach to treating combat-related PTSD, these results suggest that understanding the possible spiritual context of veterans' trauma-related concerns might add prognostic value and equip clinicians to alleviate PTSD symptomatology among those veterans who possess spiritual resources or are somehow struggling in this domain.

  6. Dorsal Anterior Cingulate Thickness Is Related to Alexithymia in Childhood Trauma-Related PTSD.

    Directory of Open Access Journals (Sweden)

    Lauren A Demers

    Full Text Available Alexithymia, or "no words for feelings", is highly prevalent in samples with childhood maltreatment and posttraumatic stress disorder (PTSD. The dorsal anterior cingulate cortex (dACC has been identified as a key region involved in alexithymia, early life trauma, and PTSD. Functional alterations in the dACC also have been associated with alexithymia in PTSD. This study examined whether dACC morphology is a neural correlate of alexithymia in child maltreatment-related PTSD. Sixteen adults with PTSD and a history of childhood sexual abuse, physical abuse, or exposure to domestic violence, and 24 healthy controls (HC completed the Toronto Alexithymia Scale 20 (TAS-20 and underwent magnetic resonance imaging. Cortical thickness of the dACC was measured using FreeSurfer, and values were correlated with TAS-20 scores, controlling for sex and age, in both groups. Average TAS-20 score was significantly higher in the PTSD than the HC group. TAS-20 scores were significantly positively associated with dACC thickness only in the PTSD group. This association was strongest in the left hemisphere and for TAS-20 subscales that assess difficulty identifying and describing feelings. We found that increasing dACC gray matter thickness is a neural correlate of greater alexithymia in the context of PTSD with childhood maltreatment. While findings are correlational, they motivate further inquiry into the relationships between childhood adversity, emotional awareness and expression, and dACC morphologic development in trauma-related psychopathology.

  7. The GIP receptor displays higher basal activity than the GLP-1 receptor but does not recruit GRK2 or arrestin3 effectively.

    Directory of Open Access Journals (Sweden)

    Suleiman Al-Sabah

    Full Text Available Glucagon-like peptide-1 (GLP-1 and glucose-dependent insulinotropic polypeptide (GIP are important regulators of insulin secretion, and their functional loss is an early characteristic of type 2 diabetes mellitus (T2DM. Pharmacological levels of GLP-1, but not GIP, can overcome this loss. GLP-1 and GIP exert their insulinotropic effects through their respective receptors expressed on pancreatic β-cells. Both the GLP-1 receptor (GLP-1R and the GIP receptor (GIPR are members of the secretin family of G protein-coupled receptors (GPCRs and couple positively to adenylate cyclase. We compared the signalling properties of these two receptors to gain further insight into why GLP-1, but not GIP, remains insulinotropic in T2DM patients.GLP-1R and GIPR were transiently expressed in HEK-293 cells, and basal and ligand-induced cAMP production were investigated using a cAMP-responsive luciferase reporter gene assay. Arrestin3 (Arr3 recruitment to the two receptors was investigated using enzyme fragment complementation, confocal microscopy and fluorescence resonance energy transfer (FRET.GIPR displayed significantly higher (P<0.05 ligand-independent activity than GLP-1R. Arr3 displayed a robust translocation to agonist-stimulated GLP-1R but not to GIPR. These observations were confirmed in FRET experiments, in which GLP-1 stimulated the recruitment of both GPCR kinase 2 (GRK2 and Arr3 to GLP-1R. These interactions were not reversed upon agonist washout. In contrast, GIP did not stimulate recruitment of either GRK2 or Arr3 to its receptor. Interestingly, arrestin remained at the plasma membrane even after prolonged (30 min stimulation with GLP-1. Although the GLP-1R/arrestin interaction could not be reversed by agonist washout, GLP-1R and arrestin did not co-internalise, suggesting that GLP-1R is a class A receptor with regard to arrestin binding.GIPR displays higher basal activity than GLP-1R but does not effectively recruit GRK2 or Arr3.

  8. Breath-hold gadolinium-enhanced three-dimensional MR thoracic aortography. Higher spatial resolution imaging with phased-array coil and three-dimensional surface display

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Tadashi; Hata, Ryoichiro; Tamura, Akihisa; Kohata, Minako; Miyasaka, Kenji; Kajima, Toshio; Fukuoka, Haruhito; Ito, Katsuhide [Hiroshima Univ. (Japan). School of Medicine

    2000-09-01

    The aim of this study was to examine signal intensities of data sets from MR thoracic aortography and to evaluate three-dimensional surface display (3DSD) for postprocessing. Twenty-five patients were imaged with gadolinium-enhanced 3D fast gradient echo sequence. The intensity at the aortic arch was significantly higher than that at the mediastinal fat (p<0.0001). The signal-to-noise ratio was lower at the aortic arch than at the ascending and descending aorta, whereas the contrast-to-noise ratio was fairly high at the aortic arch. Although in one case (4%) the intensity at the arch was smaller than that at the mediastinal fat, 3DSD was successfully performed in all cases. Superiority of 3DSD over maximum intensity projection was obtained in 67% of the cases. 3DSD was evaluated to be superior to maximum intensity projection in all cases of thoracic aortic aneurysm and coarctation of aorta. Higher resolution MR thoracic aortography could be successfully performed with phased-array coil and 3DSD. (author)

  9. Trauma exposure and PTSD among older adolescents in foster care.

    Science.gov (United States)

    Salazar, Amy M; Keller, Thomas E; Gowen, L Kris; Courtney, Mark E

    2013-04-01

    Youth in foster care represent a highly traumatized population. However, trauma research on this population has focused primarily on maltreatment rather than the full spectrum of trauma experiences identified within the DSM-IV. The current study aims to fill this gap by reporting the prevalence of exposure to specific types of traumatic events for a large sample of youth with foster care experience. The study also reports the likelihood of lifetime PTSD diagnoses associated with each specific type of trauma. Data are from a longitudinal panel study of 732 adolescents aged 17 and 18 who were in foster care. Lifetime trauma exposure and PTSD diagnosis were assessed using the Composite International Diagnostic Interview. Statistical comparisons were made using logistic regressions. The majority of respondents had experienced at least one trauma in their lifetime. While overall trauma prevalence did not differ by gender, males were more likely to experience interpersonal violence and environmental trauma, while females were more likely to experience sexual trauma. Caucasian participants reported higher rates of trauma exposure than African-American participants did. The types of trauma associated with the highest probability of a lifetime PTSD diagnosis were rape, being tortured or a victim of terrorists, and molestation. Youth in foster care are a highly traumatized population and meet diagnostic criteria for PTSD at higher rates than general youth populations. The ongoing impact of trauma may be particularly problematic for these young people given their abrupt transition to independence.

  10. Cortisol, heart rate, and blood pressure as early markers of PTSD risk: A systematic review and meta-analysis.

    Science.gov (United States)

    Morris, Matthew C; Hellman, Natalie; Abelson, James L; Rao, Uma

    2016-11-01

    Individuals with posttraumatic stress disorder (PTSD) typically exhibit altered hypothalamic-pituitary-adrenal (HPA) function and sympathetic nervous system (SNS) activity. The goals of this study were to determine whether HPA and SNS alterations in the immediate aftermath of trauma predict subsequent PTSD symptom development and whether inconsistencies observed between studies can be explained by key demographic and methodological factors. This work informs secondary prevention of PTSD by identifying subgroups of trauma survivors at risk for PTSD. This meta-analysis (26 studies, N=5186 individuals) revealed that higher heart rate measured soon after trauma exposure was associated with higher PTSD symptoms subsequently (r=0.13). Neither cortisol (r=-0.07) nor blood pressure (diastolic: r=-0.01; systolic: r=0.02) were associated with PTSD symptoms which may be influenced by methodological limitations. Associations between risk markers (heart rate, cortisol, systolic blood pressure) and PTSD symptoms were in the positive direction for younger samples and negative direction for older samples. These findings extend developmental traumatology models of PTSD by revealing an age-related shift in the presentation of early risk markers. More work will be needed to identify risk markers and pathways to PTSD while addressing methodological limitations in order to shape and target preventive interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. PTSD contributes to teen and young adult cannabis use disorders.

    Science.gov (United States)

    Cornelius, Jack R; Kirisci, Levent; Reynolds, Maureen; Clark, Duncan B; Hayes, Jeanine; Tarter, Ralph

    2010-02-01

    Previous studies involving adults suggest that Post Traumatic Stress Disorder (PTSD) increases the prevalence of cannabis use disorders (CUD) (cannabis dependence and cannabis abuse). However, little work with PTSD and CUD has been conducted involving adolescents, despite the fact that CUD typically have their onset during adolescence. This study addresses the effect of PTSD on CUD among teenagers transitioning to young adulthood. The subjects in this ongoing study were the offspring of adult men with a lifetime history of a substance use disorder (SUD) (SUD+probands, N=343) vs those with no lifetime history of a SUD (SUD-probands, N=350). The participants were initially recruited when the index sons of these fathers were 10-12 years of age, and subsequent assessments were conducted at age 12-14, 16, 19, 22, and 25. Other variables examined were an index of behavioral undercontrol associated with future risk for developing SUD, known as the Transmissible Liability Index, or TLI, and affiliation with deviant peers. Multivariate logistic regression and path analyses were conducted. Of these 693 subjects, 31 subjects were diagnosed with PTSD, and 161 were diagnosed with a CUD. The CUD subjects included 136 male participants and 25 female participants, including 103 (64%) Caucasian participants and 58 (36%) participants of other races. Logistic regression demonstrated that the development of a CUD was associated with deviance of peers (Wald=63.4, p=0.000), the TLI (Wald=28.8, p=0.000), African American race (Wald=14.2, p=0.000), PTSD (Wald=12.7, p=0.000), male gender (Wald=12.0, p=0.001), household SES (Wald=9.2, p=0.002), and being an offspring of a SUD+proband (Wald=6.9, p=0.009). Path analyses demonstrated that PTSD is directly associated with the presence of a CUD and with peer deviance, that higher peer deviance is associated with the presence of a CUD, and that PTSD mediated the association between peer deviance and CUD. These findings suggest that PTSD

  12. New DSM-5 PTSD guilt and shame symptoms among Italian earthquake survivors: Impact on maladaptive behaviors.

    Science.gov (United States)

    Carmassi, Claudia; Bertelloni, Carlo Antonio; Gesi, Camilla; Conversano, Ciro; Stratta, Paolo; Massimetti, Gabriele; Rossi, Alessandro; Dell'Osso, Liliana

    2017-05-01

    Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic symptoms among Italian survivors to a massive earthquake and their possible correlation with PTSD and maladaptive behaviors. 869 residents of the town of L'Aquila exposed to the earthquake of April 6th, 2009 were investigated by the Trauma and Loss Spectrum-Self Report (TALS-SR) with particular attention to guilt and shame feelings. DSM-5 symptomatological PTSD was reported by 41.7% of survivors, further 11.6% endorsed at least one guilt/shame symptoms, with significantly higher rates of endorsement were in PTSD respect to No-PTSD subjects, and in the subgroup with at least one maladaptive behavior respect to those with none. There was a significant main effects of PTSD and at least one guilt/shame symptom on TALS-SR symptomatological domains. Mean TALS-SR Maladaptive coping domain score appeared significantly higher in the subgroup with at least one guilt/shame symptom. Further study are needed to investigate guilt and shame feelings in survivors to a natural disaster. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  13. Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2014-09-01

    Full Text Available Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD is distinct from Borderline Personality Disorder (BPD when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.

  14. Essential Oil from Berries of Lebanese Juniperus excelsa M. Bieb Displays Similar Antibacterial Activity to Chlorhexidine but Higher Cytocompatibility with Human Oral Primary Cells

    Directory of Open Access Journals (Sweden)

    Barbara Azzimonti

    2015-05-01

    Full Text Available Chlorhexidine (CHX, one of the most effective drugs administered for periodontal treatment, presents collateral effects including toxicity when used for prolonged periods; here, we have evaluated the bactericidal potency and the cytocompatibility of Juniperus excelsa M. Bieb essential oil (EO in comparison with 0.05% CHX. The EO was extracted from berries by hydrodistillation and components identified by gas chromatography and mass spectrometry. Bacterial inhibition halo analysis, quantitative cell viability 2,3-bis(2-methoxy-4-nitro-5-sulphophenyl-5-[(phenyl amino carbonyl]-2H-tetrazolium hydroxide assay (XTT, and colony forming unit (CFU count were evaluated against the two biofilm formers Aggregatibacter actinomycetemcomitans and Streptococcus mutans. Finally, cytocompatibility was assessed with human primary gingival fibroblasts (HGF and mucosal keratinocytes (HK. The resulting EO was mainly composed of monoterpene hydrocarbons and oxygenated monoterpenes. An inhibition halo test demonstrated that both bacteria were sensitive to the EO; XTT analysis and CFU counts confirmed that 10-fold-diluted EO determined a statistically significant (p < 0.05 reduction in bacteria count and viability towards both biofilm and planktonic forms in a comparable manner to those obtained with CHX. Moreover, EO displayed higher cytocompatibility than CHX (p < 0.05. In conclusion, EO exhibited bactericidal activity similar to CHX, but a superior cytocompatibility, making it a promising antiseptic alternative to CHX.

  15. Essential Oil from Berries of Lebanese Juniperus excelsa M. Bieb Displays Similar Antibacterial Activity to Chlorhexidine but Higher Cytocompatibility with Human Oral Primary Cells.

    Science.gov (United States)

    Azzimonti, Barbara; Cochis, Andrea; Beyrouthy, Marc El; Iriti, Marcello; Uberti, Francesca; Sorrentino, Rita; Landini, Manuela Miriam; Rimondini, Lia; Varoni, Elena Maria

    2015-05-21

    Chlorhexidine (CHX), one of the most effective drugs administered for periodontal treatment, presents collateral effects including toxicity when used for prolonged periods; here, we have evaluated the bactericidal potency and the cytocompatibility of Juniperus excelsa M. Bieb essential oil (EO) in comparison with 0.05% CHX. The EO was extracted from berries by hydrodistillation and components identified by gas chromatography and mass spectrometry. Bacterial inhibition halo analysis, quantitative cell viability 2,3-bis(2-methoxy-4-nitro-5-sulphophenyl)-5-[(phenyl amino) carbonyl]-2H-tetrazolium hydroxide assay (XTT), and colony forming unit (CFU) count were evaluated against the two biofilm formers Aggregatibacter actinomycetemcomitans and Streptococcus mutans. Finally, cytocompatibility was assessed with human primary gingival fibroblasts (HGF) and mucosal keratinocytes (HK). The resulting EO was mainly composed of monoterpene hydrocarbons and oxygenated monoterpenes. An inhibition halo test demonstrated that both bacteria were sensitive to the EO; XTT analysis and CFU counts confirmed that 10-fold-diluted EO determined a statistically significant (p < 0.05) reduction in bacteria count and viability towards both biofilm and planktonic forms in a comparable manner to those obtained with CHX. Moreover, EO displayed higher cytocompatibility than CHX (p < 0.05). In conclusion, EO exhibited bactericidal activity similar to CHX, but a superior cytocompatibility, making it a promising antiseptic alternative to CHX.

  16. Deployment, PTSD Symptoms, and Co-morbid Mental Health Conditions in the Active Force and Reserve Components

    Science.gov (United States)

    2010-10-01

    servists face, including uncertainty associated with workload, environments, and timelines,2 exacerbate mental well-being issues. For exam - ple...4 drug abuse as well as a high intake of nicotine and caffeine among veterans with PTSD. Veterans with PTSD showed a higher prevalence of alcohol

  17. Common paths to ASD and PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

    Numerous studies have investigated the prediction of acute and long term posttraumatic symptoms following traumatic exposure. As a result several factors have been shown to be predictive of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) respectively. Furthermore, research...... suggests a strong relationship between ASD severity and subsequent PTSD severity. However, little is known in relation to whether there are common pathways to the development of ASD and PTSD. Peritraumatic responses to trauma are found to be associated with both the development of ASD and PTSD. Although...... of peritraumatic factors such as symptoms of tonic immobility, panic, and dissociation on the development of ASD (N = 458) and PTSD (n = 378) symptoms in a national study of Danish bank robbery victims. The estimated ASD rate was 11.1 % (n = 41) and the estimated PTSD rate was 6.2 % (n = 23). The results...

  18. PTSD in Primary Care: A Physician’s Guide to Dealing with War-Induced PTSD

    Science.gov (United States)

    2012-01-01

    with mild TBI and ASD could be effectively treated with a brief CBT protocol designed to prevent development of PTSD . Impaired family functioning...7 PTSD in Primary Care: A Physician’s Guide to Dealing with War-Induced PTSD Jeffrey S. Yarvis1 and Grace D. Landers2 1Department of Psychiatry...stress disorder ( PTSD ), as defined in DSM IV-TR, is the most common and conspicuous psychiatric problem associated with the stress experienced by

  19. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  20. Cumulative traumas and risk thresholds: 12-month PTSD in the World Mental Health (WMH) surveys.

    Science.gov (United States)

    Karam, Elie G; Friedman, Matthew J; Hill, Eric D; Kessler, Ronald C; McLaughlin, Katie A; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C; Bromet, Evelyn J; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E; Haro, Josep Maria; He, Yanling; Karam, Aimee N; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A Oakley; Posada-Villa, José A; Shalev, Arieh Y; Stein, Dan J; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C

    2014-02-01

    Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n = 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyperarousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more "complex" clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. © 2013 Wiley Periodicals, Inc.

  1. Proximal relationships between PTSD symptoms and drinking among female college students: results from a daily monitoring study.

    Science.gov (United States)

    Kaysen, Debra; Atkins, David C; Simpson, Tracy L; Stappenbeck, Cynthia A; Blayney, Jessica A; Lee, Christine M; Larimer, Mary E

    2014-03-01

    Self-medication has been theorized to explain comorbidity between posttraumatic stress disorder (PTSD) and drinking, whereupon problem drinking develops in order to modulate negative affect and ameliorate PTSD symptoms. Daily monitoring methodologies may help refine our understanding of proximal relations between PTSD, affect, and alcohol use. One hundred thirty-six female college drinkers with a past history of sexual victimization and 38 female college drinkers with no past trauma history completed electronic monitoring of PTSD symptoms, affect, alcohol use, and alcohol cravings, daily for 4 weeks. A two-part mixed hurdle model was used to examine likelihood of drinking and amount of alcohol consumed on drinking days. We found significant relationships between daily PTSD symptoms, affect, and drinking. On days women experienced more intrusive and behavioral avoidance symptoms of PTSD, they experienced stronger urges to drink and were more likely to drink on that day. On days in which women experienced more negative affect than their average, they experienced stronger urges to drink, whereas on days in which women experienced more of the dysphoric symptoms associated with PTSD than their average, they drank less. On days with higher positive affect, women reported stronger urges to drink and were more likely to drink. Results suggest the need to examine both aspects of affect and specific PTSD symptoms as they may differentially predict drinking behavior. Differences in the ways in which PTSD symptoms and affect influence drinking suggest that interventions more specifically address the function of drinking behaviors in reducing alcohol use among college women.

  2. Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders

    Directory of Open Access Journals (Sweden)

    Lesia M. Ruglass

    2017-02-01

    Full Text Available Background: Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD and substance use disorders (SUDs in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed.

  3. Impact of Cannabis Use on Treatment Outcomes among Adults Receiving Cognitive-Behavioral Treatment for PTSD and Substance Use Disorders

    Science.gov (United States)

    Ruglass, Lesia M.; Shevorykin, Alina; Radoncic, Vanja; Smith, Kathryn M. Z.; Smith, Philip H.; Galatzer-Levy, Isaac R.; Papini, Santiago; Hien, Denise A.

    2017-01-01

    Background: Research has demonstrated a strong link between trauma, posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) in general and cannabis use disorders in particular. Yet, few studies have examined the impact of cannabis use on treatment outcomes for individuals with co-occurring PTSD and SUDs. Methods: Participants were 136 individuals who received cognitive-behavioral therapies for co-occurring PTSD and SUD. Multivariate regressions were utilized to examine the associations between baseline cannabis use and end-of-treatment outcomes. Multilevel linear growth models were fit to the data to examine the cross-lagged associations between weekly cannabis use and weekly PTSD symptom severity and primary substance use during treatment. Results: There were no significant positive nor negative associations between baseline cannabis use and end-of-treatment PTSD symptom severity and days of primary substance use. Cross-lagged models revealed that as cannabis use increased, subsequent primary substance use decreased and vice versa. Moreover, results revealed a crossover lagged effect, whereby higher cannabis use was associated with greater PTSD symptom severity early in treatment, but lower weekly PTSD symptom severity later in treatment. Conclusion: Cannabis use was not associated with adverse outcomes in end-of-treatment PTSD and primary substance use, suggesting independent pathways of change. The theoretical and clinical implications of the reciprocal associations between weekly cannabis use and subsequent PTSD and primary substance use symptoms during treatment are discussed. PMID:28178207

  4. Altered lipid peroxidation markers are related to post-traumatic stress disorder (PTSD) and not trauma itself in earthquake survivors.

    Science.gov (United States)

    Atli, Abdullah; Bulut, Mahmut; Bez, Yasin; Kaplan, İbrahim; Özdemir, Pınar Güzel; Uysal, Cem; Selçuk, Hilal; Sir, Aytekin

    2016-06-01

    The traumatic life events, including earthquakes, war, and interpersonal conflicts, cause a cascade of psychological and biological changes known as post-traumatic stress disorder (PTSD). Malondialdehyde (MDA) is a reliable marker of lipid peroxidation, and paraoxonase is a known antioxidant enzyme. The aims of this study were to investigate the relationship between earthquake trauma, PTSD effects on oxidative stress and the levels of serum paraoxonase 1 (PON1) enzyme activity, and levels of serum MDA. The study was carried out on three groups called: the PTSD group, the traumatized with earthquake exercise group, and healthy control group, which contained 32, 31, and 38 individuals, respectively. Serum MDA levels and PON1 enzyme activities from all participants were measured, and the results were compared across all groups. There were no significant differences between the PTSD patients and non-PTSD earthquake survivors in terms of the study variables. The mean PON1 enzyme activity from PTSD patients was significantly lower, while the mean MDA level was significantly higher than that of the healthy control group (p earthquake survivors who did not develop PTSD showed higher MDA levels and lower PON1 activity when compared to healthy controls. However, the differences between these groups did not reach a statistically significant level. Increased MDA level and decreased PON1 activity measured in PTSD patients after earthquake and may suggest increased oxidative stress in these patients. The nonsignificant trends that are observed in lipid peroxidation markers of earthquake survivors may indicate higher impact of PTSD development on these markers than trauma itself. For example, PTSD diagnosis seems to add to the effect of trauma on serum MDA levels and PON1 enzyme activity. Thus, serum MDA levels and PON1 enzyme activity may serve as biochemical markers of PTSD diagnosis.

  5. Traumatic events, PTSD, and psychiatric comorbidity in forensic patients – assessed by questionnaires and diagnostic interview

    Directory of Open Access Journals (Sweden)

    Elbert Thomas

    2006-04-01

    Full Text Available Abstract Background Relationships between posttraumatic stress disorder (PTSD, comorbid illness and experiences of traumatic stressors have been reported for large and different groups. The present study investigated this relationship specifically for patients with psychiatric disorders admitted to a forensic ward because of criminal behavior. Methods In sixteen German and fifteen Sudanese forensic patients the prevalence of PTSD and comorbid symptoms of anxiety and depression were assessed and related to traumatic experiences, emotional distress, and stressful life events over four developmental periods. Results In the total sample, subjects had experienced an average of five traumatic events, the first one occurring early in childhood, and 39% met criteria of current, 55% of lifetime PTSD, the diagnosis being more likely in patients with a greater number of reported traumatic experiences. Neglect and emotional abuse in childhood were associated with current PTSD diagnosis. As reported for other populations, comorbid symptoms were frequent with 60% of the sample displaying comorbid anxiety symptoms and 64% comorbid depression. PTSD and comorbidity did not differ between cultures. Conclusion Results suggest that forensic patients experience multiple traumatic events, usually beginning early in development, so that the assessment of PTSD and comorbid anxiety and depression is recommended for the clinical evaluation. Further studies have to substantiate, whether traumatic stress during developmental stages interact with other factors leading to routes of forensic psychopathology.

  6. Review of group treatment for PTSD

    Directory of Open Access Journals (Sweden)

    Denise M. Sloan, PhD

    2012-06-01

    Full Text Available The purpose of this article is to provide a brief review of group treatment for posttraumatic stress disorder (PTSD. This review includes a description of group-based treatments for PTSD and the available data on the efficacy of group treatment for PTSD. The literature review indicates that group treatment for PTSD is efficacious compared with no treatment. However, specific types of group treatment are not efficacious when compared with a nonspecific group treatment, such as psychoeducation or supportive counseling. Recommendations for practice and research are made in light of the available literature.

  7. Increased cortisol concentrations in hair of severely traumatized Ugandan individuals with PTSD.

    Science.gov (United States)

    Steudte, Susann; Kolassa, Iris-Tatjana; Stalder, Tobias; Pfeiffer, Anett; Kirschbaum, Clemens; Elbert, Thomas

    2011-09-01

    Previous research has mostly suggested general hypocortisolism in posttraumatic stress disorder (PTSD). However, PTSD is a complex disorder and opposite neuroendocrinological changes have also been reported. Amongst other things, heterogeneous results might be related to differences in sample characteristics as well as methodological factors associated with the assessment of cortisol. The current study used the novel method of hair cortisol analysis to examine cumulative long-term cortisol secretion in a severely traumatized PTSD sample. Hair samples of 10 traumatized individuals with PTSD and 17 traumatized controls without PTSD from a civil war area of Northern Uganda were analyzed. Results revealed that hair samples of PTSD participants contained higher cortisol levels than those of traumatized controls (pPTSD in severely traumatized individuals who continue to live under stressful conditions might be associated with general hypercortisolism. Future research examining participants after traumatic events at different follow-up periods is needed to determine the specific influence of time interval since traumatization. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Is ideology a risk factor for PTSD symptom severity among Israeli political evacuees?

    Science.gov (United States)

    Oren, Lior; Possick, Chaya

    2010-08-01

    To study the role of ideology in situations of extreme stress, a research questionnaire, measuring posttraumatic stress disorder (PTSD), settlement ideology (the importance of Jewish settlement in Gaza), and type of evacuation was administered to 326 Jewish residents who were evacuated from Gaza settlements by the Israeli government. Forty percent of the participants met the criteria of probable PTSD. Forcibly evicted individuals reported higher levels of settlement ideology and higher levels of PTSD symptom severity compared to voluntarily evacuated individuals. Contrary to previous studies, ideology was found to be positively associated with PTSD symptom severity. The results are explained by the conservation of resources and terror management theories. Theoretical and practical implications are discussed.

  9. Accounting for sex differences in PTSD: A multi-variable mediation model

    DEFF Research Database (Denmark)

    Christiansen, Dorte M.; Hansen, Maj

    2015-01-01

    ABSTRACT Background: Approximately twice as many females as males are diagnosed with posttraumatic stress disorder (PTSD). However, little is known about why females report more PTSD symptoms than males. Prior studies have generally focused on few potential mediators at a time and have often used...... specifically to test a multiple mediator model. Results: Females reported more PTSD symptoms than males and higher levels of neuroticism, depression, physical anxiety sensitivity, peritraumatic fear, horror, and helplessness (the A2 criterion), tonic immobility, panic, dissociation, negative posttraumatic...... that females report more PTSD symptoms because they experience higher levels of associated risk factors. The results are relevant to other trauma populations and to other trauma- related psychiatric disorders more prevalent in females, such as depression and anxiety. Keywords: Posttraumatic stress disorder...

  10. Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2013-05-01

    Full Text Available Background: The WHO International Classification of Diseases, 11th version (ICD-11, has proposed two related diagnoses, posttraumatic stress disorder (PTSD and complex PTSD within the spectrum of trauma and stress-related disorders. Objective: To use latent profile analysis (LPA to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile. Method: An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse to single-incident events (e.g., exposure to 9/11 attacks. Results: The LPA revealed three classes of individuals: (1 a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2 a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3 a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity. Conclusion: Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  11. Factor structure of PTSD, and relation with gender in trauma survivors from India

    Directory of Open Access Journals (Sweden)

    Ruby Charak

    2014-11-01

    Full Text Available Background: The factor structure of posttraumatic stress disorder (PTSD has been extensively studied in Western countries. Some studies have assessed its factor structure in Asia (China, Sri Lanka, and Malaysia, but few have directly assessed the factor structure of PTSD in an Indian adult sample. Furthermore, in a largely patriarchal society in India with strong gender roles, it becomes imperative to assess the association between the factors of PTSD and gender. Objective: The purpose of the present study was to assess the factor structure of PTSD in an Indian sample of trauma survivors based on prevailing models of PTSD defined in the DSM-IV-TR (APA, 2000, and to assess the relation between PTSD factors and gender. Method: The sample comprised of 313 participants (55.9% female from Jammu and Kashmir, India, who had experienced a natural disaster (N=200 or displacement due to cross-border firing (N=113. Results: Three existing PTSD models—two four-factor models (Emotional Numbing and Dysphoria, and a five-factor model (Dysphoric Arousal—were tested using Confirmatory Factor Analysis with addition of gender as a covariate. The three competing models had similar fit indices although the Dysphoric Arousal model fit significantly better than Emotional Numbing and Dysphoria models. Gender differences were found across the factors of Re-experiencing and Anxious arousal. Conclusions: Findings indicate that the Dysphoric Arousal model of PTSD was the best model; albeit the fit indices of all models were fairly similar. Compared to males, females scored higher on factors of Re-experiencing and Anxious arousal. Gender differences found across two factors of PTSD are discussed in light of the social milieu in India.

  12. Risk factors for chronic post-traumatic stress disorder (PTSD) in SARS survivors.

    Science.gov (United States)

    Mak, Ivan Wing Chit; Chu, Chung Ming; Pan, Pey Chyou; Yiu, Michael Gar Chung; Ho, Suzanne C; Chan, Veronica Lee

    2010-01-01

    Post-traumatic stress disorder (PTSD) is one of the most prevalent long-term psychiatric diagnoses among survivors of severe acute respiratory syndrome (SARS). The objective of this study was to identify the predictors of chronic PTSD in SARS survivors. PTSD at 30 months after the SARS outbreak was assessed by the Structured Clinical Interview for the DSM-IV. Survivors' demographic data, medical information and psychosocial variables were collected for risk factor analysis. Multivariate logistic regression analysis showed that female gender as well as the presence of chronic medical illnesses diagnosed before the onset of SARS and avascular necrosis were independent predictors of PTSD at 30 months post-SARS. Associated factors included higher-chance external locus of control, higher functional disability and higher average pain intensity. The study of PTSD at 30 months post-SARS showed that the predictive value of acute medical variables may fade out. Our findings do not support some prior hypotheses that the use of high dose corticosteroids is protective against the development of PTSD. On the contrary, the adversity both before and after the SARS outbreak may be more important in hindering recovery from PTSD. The risk factor analysis can not only improve the detection of hidden psychiatric complications but also provide insight for the possible model of care delivery for the SARS survivors. With the complex interaction of the biopsychosocial challenges of SARS, an integrated multidisciplinary clinic setting may be a superior approach in the long-term management of complicated PTSD cases. Copyright © 2010 Elsevier Inc. All rights reserved.

  13. Pharmacotherapy treatment of PTSD and comorbid disorders.

    Science.gov (United States)

    Kozarić-Kovacić, Dragica

    2009-09-01

    Comorbity is very high in posttraumatic stress disorder (PTSD) patients. PTSD is very often complicated with depressive disorder, substance abuse, other anxiety disorders, personality disorders, psychotic features, etc. There have been few pharmacotherapy studies in this complicated field. In the past few years the literature on pharmacotherapy treatment for PTSD and comorbidity has arisen. From empirical evidence (level A) exist three sertraline studies in PTSD comorbid with: 1) anxiety, 2) depression, and 3) anxiety and depression, and one risperidone study in PTSD comorbid with psychotic symptoms. From empirical evidence (level B) exist two disulfiram, naltrexone, and their combination studies in patients with PTSD comorbid with alcohol dependence and one paroxetine or bupropion versus cognitive behavioral therapy (CBT) versus community mental health referral study in PTSD women outpatients with major depressive disorder. The results from our label trials in the Croatian war veterans with chronic PTSD comorbid with psychotic features treated with novel antipsychotics (olanzapine, risperidone, or quetiapine) are promising. In the future more rigorously designed, comparative studies are needed to determine the usefulness, efficacy, tolerability, and safety of particular psychopharmaceutical drugs in the treatment of this therapeutically and functionally challenging disorder, especially the trials from level A.

  14. Recovery from PTSD following Hurricane Katrina.

    Science.gov (United States)

    McLaughlin, Katie A; Berglund, Patricia; Gruber, Michael J; Kessler, Ronald C; Sampson, Nancy A; Zaslavsky, Alan M

    2011-06-01

    We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina. A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview. An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD. The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina. © 2011 Wiley-Liss, Inc.

  15. Validation of post-traumatic stress disorder (PTSD) and complex PTSD using the International Trauma Questionnaire.

    Science.gov (United States)

    Hyland, P; Shevlin, M; Brewin, C R; Cloitre, M; Downes, A J; Jumbe, S; Karatzias, T; Bisson, J I; Roberts, N P

    2017-09-01

    The 11th version of the International Classification of Diseases (ICD-11) has proposed two related trauma diagnoses: Post-traumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Using a newly developed, disorder-specific measure of PTSD and CPTSD called the International Trauma Questionnaire (ITQ) the current study will (i) assess the factorial validity of ICD-11 PTSD and CPTSD; (ii) provide the first test of the discriminant validity of these constructs; and (iii) provide the first comparison of ICD-11, and Diagnostic and Statistical Manual, Fifth Edition (DSM-5), PTSD diagnostic rates using disorder-specific measures. ICD-11 and DSM-5 PTSD-specific measures were completed by a British clinical sample of trauma-exposed patients (N = 171). The structure and validity of ICD-11 PTSD and CPTSD were assessed by means of factor analysis and assessing relationships with criterion variables. Diagnostic rates under ICD-11 were significantly lower than those under DSM-5. A two-factor second-order model reflecting the distinction between PTSD and CPTSD best represented the data from the ITQ; and the PTSD and CPTSD factors differentially predicted multiple psychological variables. The factorial and discriminant validity of ICD-11 PTSD and CPTSD was supported, and ICD-11 produces fewer diagnostic cases than DSM-5. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. [War trauma and PTSD among German war survivors. A comparison of former soldiers and women of World War II].

    Science.gov (United States)

    Nandi, C; Weierstall, R; Huth, S; Knecht, J; Elbert, T

    2014-03-01

    Stressful war experiences can cause posttraumatic stress disorder (PTSD) in survivors. To what extent were the soldiers and young women of World War II affected by PTSD symptoms over the course of their lives? Do these men and women differ in the traumatic experiences and PTSD symptom severity? To investigate these questions 52 male and 20 female Germans aged 81-95 years were recruited through newspaper advertisements and notices and interviewed regarding war experiences and PTSD symptoms. Of the men 2% and 7% met the criteria for current and lifetime PTSD diagnoses, respectively, as compared to 10% and 30% of the women, respectively. Using multiple linear regression a dose-response relationship between the number of trauma types experienced and PTSD symptom severity could be demonstrated. The slope of the regression curve was steeper for women than for men. When controlling for the number of different traumatic experiences women reported a significantly higher severity of PTSD symptoms than men. It is presumed that this difference in severity of symptoms can be attributed to qualitative differences in the type of traumatic stress factors during the war. The present study provides evidence that even today people continue to be affected by PTSD symptoms due to events which occurred during World War II; therefore, during patient contact with this age group the war experiences specific to each individual need to be considered as potential moderators of symptoms.

  17. Shame, Dissociation, and Complex PTSD Symptoms in Traumatized Psychiatric and Control Groups: Direct and Indirect Associations With Relationship Distress.

    Science.gov (United States)

    Dorahy, Martin J; Corry, Mary; Black, Rebecca; Matheson, Laura; Coles, Holly; Curran, David; Seager, Lenaire; Middleton, Warwick; Dyer, Kevin F W

    2017-04-01

    Elevated shame and dissociation are common in dissociative identity disorder (DID) and chronic posttraumatic stress disorder (PTSD) and are part of the constellation of symptoms defined as complex PTSD. Previous work examined the relationship between shame, dissociation, and complex PTSD and whether they are associated with intimate relationship anxiety, relationship depression, and fear of relationships. This study investigated these variables in traumatized clinical samples and a nonclinical community group. Participants were drawn from the DID (n = 20), conflict-related chronic PTSD (n = 65), and nonclinical (n = 125) populations and completed questionnaires assessing the variables of interest. A model examining the direct impact of shame and dissociation on relationship functioning, and their indirect effect via complex PTSD symptoms, was tested through path analysis. The DID sample reported significantly higher dissociation, shame, complex PTSD symptom severity, relationship anxiety, relationship depression, and fear of relationships than the other two samples. Support was found for the proposed model, with shame directly affecting relationship anxiety and fear of relationships, and pathological dissociation directly affecting relationship anxiety and relationship depression. The indirect effect of shame and dissociation via complex PTSD symptom severity was evident on all relationship variables. Shame and pathological dissociation are important for not only the effect they have on the development of other complex PTSD symptoms, but also their direct and indirect effects on distress associated with relationships. © 2016 Wiley Periodicals, Inc.

  18. Etiopathogenic perspectives on chronic psycho traumatic and chronic psychotic symptoms: the hypothesis of a hyperdopaminergic endophenotype of PTSD.

    Science.gov (United States)

    Auxemery, Yann

    2012-11-01

    Post traumatic stress disorder (PTSD) is a complex and heterogeneous disorder, which specific symptoms are re-experiencing, increased arousal and avoidance of stimuli associated with the trauma. PTSD has much comorbidity like depression, substance abuse, somatic complaints, repeated dissociative phenomena and transitory or chronic psychotic reactions. PTSD can manifest itself in different clinical forms: some patients present higher symptoms in one domain as compared to another, probably because of abnormalities in different neurobiological systems. Hyposerotonergic and hypernoradrenergic PTSD endophenotypes have been previously identified and the purpose of this paper is to focus on the hypothesis of a hyperdopaminergic endophenotype. The current review discusses several entities: PTSD with psychotic features with or without depression, the comorbide use of psychoactive substances that increase psychotic symptoms and traumatic brain injuries as agents of psycho traumatic and psychotic features. For all of these nosographic entities, the dopaminergic neuromodulation may play a central role. The hypothesis of a hyperdopaminergic endophenotype of PTSD opens up new research and therapeutic perspectives. Although antipsychotics are frequently used for people with PTSD further studies are needed to develop a consensus on the guidelines for treating the psychotic forms of PTSD. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. PTSD

    African Journals Online (AJOL)

    Abuse. Loss. Pain. In South Africa, trauma has been described as a regular occurrence and ... as a condition of memory impairment3 that manifests only in psycho-genetically ... of both trauma and its long term sequelae. A brief overview of the ...

  20. Predictors of PTSD symptoms in caregivers of pediatric burn survivors

    Directory of Open Access Journals (Sweden)

    Lucía Del Carmen Quezada Berumen

    2015-11-01

    Full Text Available Facing a severe injury in the children is one of the most devastating experiences that parents may face. The aim of this study was to explore the role of resilience showed by fathers and mothers of children with burns, the TBSA burned, age at the time of the burn and time since the burn in PTSD symptoms in caregivers. It was a cross-sectional study where fathers, mothers and guardians of 51 burn patients were evaluated. Results showed that the higher strength and confidence in caregivers, less severity in PTSD symptoms. The post-burn reactions of parents and guardians can affect the responses and welfare of their children. Therefore, a better understanding of factors related to the adaptation in caregivers, better attention by health services.

  1. PTSD in Depressed Mothers in Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Chard, Kathleen M.; Stevens, Jack; Van Ginkel, Judith B.

    2013-01-01

    Recent research has suggested that mothers participating in home visitation programs have a high incidence of mental health problems, particularly depression. Posttraumatic stress disorder (PTSD) is a common comorbidity with depression, yet its prevalence among home visiting populations and implications for parenting and maternal functioning have not been examined. This study contrasted depressed mothers with (n = 35) and without PTSD (n = 55) who were enrolled in a home visitation program. Results indicated that depressed mothers with comorbid PTSD were more likely to have experienced childhood sexual abuse, had greater severity of depressive symptoms, increased social isolation, and lower overall functioning than their counterparts without PTSD. Among PTSD mothers, greater severity of PTSD symptoms, in particular avoidance and emotional numbness, were associated with increased maternal psychopathology and parenting deficits even after controlling for depression severity. These findings add to the literature documenting the negative impacts of PTSD on maternal functioning and parenting. Implications for screening and treatment in the context of home visitation are discussed. PMID:24307928

  2. Dissociation, shame, complex PTSD, child maltreatment and intimate relationship self-concept in dissociative disorder, chronic PTSD and mixed psychiatric groups.

    Science.gov (United States)

    Dorahy, Martin J; Middleton, Warwick; Seager, Lenaire; McGurrin, Patrick; Williams, Mary; Chambers, Ron

    2015-02-01

    Whilst a growing body of research has examined dissociation and other psychiatric symptoms in severe dissociative disorders (DDs), there has been no systematic examination of shame and sense of self in relationships in DDs. Chronic child abuse often associated with severe DDs, like dissociative identity disorder, is likely to heighten shame and relationship concerns. This study investigated complex posttraumatic stress disorder (PTSD), borderline and Schneiderian symptoms, dissociation, shame, child abuse, and various markers of self in relationships (e.g., relationship esteem, relationship depression, fear of relationships). Participants were assessed via clinical interview with psychometrically sound questionnaires. They fell into three diagnostic groups, dissociative disorder (n=39; primarily dissociative identity disorder), chronic PTSD (Chr-PTSD; n=13) or mixed psychiatric presentations (MP; n=21; primarily mood and anxiety disorders). All participants had a history of child abuse and/or neglect, and the groups did not differ on age and gender. The DD group was higher on nearly all measured variables than the MP group, and had more severe dissociative, borderline and Schneiderian symptoms than the Chr-PTSD sample. Shame and complex PTSD symptoms fell marginally short of predicting reductions in relationship esteem, pathological dissociative symptoms predicted increased relationship depression, and complex PTSD symptoms predicted fear of relationships. The representativeness of the samples was unknown. Severe psychiatric symptoms differentiate DDs from chronic PTSD, while dissociation and shame have a meaningful impact on specific markers of relationship functioning in psychiatric patients with a history of child abuse and neglect. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. Prevalence rate of post-traumatic stress disorders (PTSD and other psychological disorders among Saudi firefighters

    Directory of Open Access Journals (Sweden)

    Mohammed Alghamd

    2013-08-01

    Full Text Available Background: Firefighters have a high probability of being exposed to a variety of traumatic events. Potentially traumatic events can occur during a single rescue such as: providing aid to seriously injured or helpless victims. Moreover, firefighters who are injured in the line of duty may have to retire as a consequence of their injury. The psychological cost of this exposure may increase the risk of long-term problems, such as post-traumatic stress disorder (PTSD symptoms, depression, and anxiety. Objective: The purpose of this study was to investigate the prevalence of PTSD symptoms, depression, anxiety, and assess related variables such as coping strategies and social support among Saudi firefighters. Method: Two hundred firefighters completed the Fire-fighter Trauma History Screen (FTHS to measure the number of traumatic events, Screen for Post-traumatic Stress Symptoms (SPTSS scale to assess the prevalence of PTSD symptoms, Hospital Anxiety and Depression Scales (HADS to assess depression and anxiety, Brief Cope (BC scale to measure coping strategies used, and Social Support scale was used to evaluate the firefighter's support received. Results: The results showed that 84% (169/200 of firefighters were exposed to at least one traumatic event. The result presented that 57% (96/169 of exposure firefighters fully met the DSM-IV criteria for PTSD with high levels of depression and anxiety; 39% (66/169 partially met the PTSD criteria. However, only 4% participants have not met the PTSD criteria. The results also revealed that adaptive coping strategies and higher perceived social support was associated with lower levels of PTSD. Conclusion: The high prevalence rate of PTSD related to the type and severity of the traumatic events and years of experience in the job. Accordingly, many firefighters were severely affected by their experiences, and we should be developing methods to help them.

  4. Analysis of prevalence of PTSD and its influencing factors among college students after the Wenchuan earthquake

    Directory of Open Access Journals (Sweden)

    Fu Yan

    2013-01-01

    Full Text Available Abstract Background This study explored the prevalence and severity of post-traumatic stress disorder (PTSD in college students who lived in earthquake center one year after the Wenchuan earthquake on May 12, 2008, the factors affecting the prevalence of PTSD was also investigated. Methods 2987 students studying at the senior normal school in Tibetan autonomous region which was one of the most devastated regions were selected for this study. The PTSD Checklist-Civilian Version (PCL-C was used as a screening instrument. Results A total of 420 cases (14.1% were diagnosed with PTSD, among which mild, moderate, severe and extreme symptoms were reported in 122, 185, 106 and 7 cases, respectively. The PTSD prevalence in college students lived in the severely affected area was significantly higher than that in the less severe area (P  Conclusions At one year after the earthquake, the PTSD rate in college students in the severely affected area was high. The social support, psychological help and rehabilitation project should be strengthened to improve their ability to cope with the trauma.

  5. Trauma exposure, PTSD, and HIV sexual risk behaviors among labor migrants from Tajikistan.

    Science.gov (United States)

    Weine, Stevan; Bahromov, Mahbat; Loue, Sana; Owens, Linda

    2012-08-01

    Little is known about the role of trauma and PTSD symptoms in the context of migration-associated HIV risk behaviors. A survey of Tajik married male seasonal labor migrants in Moscow was completed by 200 workers from 4 bazaars and 200 workers from 18 construction sites as part of a mixed method (quantitative and qualitative) study. The mean PC-PTSD score was 1.2 with one-quarter of migrants scoring at or above the cutoff of 3 indicating likely PTSD diagnosis. PC-PTSD score was directly correlated with both direct and indirect trauma exposure, but PC-PTSD score did not predict either HIV sexual risk behaviors or HIV protective behaviors. HIV sexual risk behavior was associated with higher indirect trauma exposure. PC-PTSD score was associated with some indicators of increased caution (e.g., more talking with partners about HIV and condoms; more use of condom when drinking). Qualitative findings were used to illustrate the differences between direct and indirect traumas in terms of HIV sexual risk. The study findings call for future efforts to address labor migrant's mental health needs and to integrate trauma dimensions into HIV prevention.

  6. Common paths to ASD and PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

    Numerous studies have investigated the prediction of acute and long term posttraumatic symptoms following traumatic exposure. As a result several factors have been shown to be predictive of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) respectively. Furthermore, research...... of peritraumatic factors such as symptoms of tonic immobility, panic, and dissociation on the development of ASD (N = 458) and PTSD (n = 378) symptoms in a national study of Danish bank robbery victims. The estimated ASD rate was 11.1 % (n = 41) and the estimated PTSD rate was 6.2 % (n = 23). The results...

  7. Projection displays

    Science.gov (United States)

    Chiu, George L.; Yang, Kei H.

    1998-08-01

    Projection display in today's market is dominated by cathode ray tubes (CRTs). Further progress in this mature CRT projector technology will be slow and evolutionary. Liquid crystal based projection displays have gained rapid acceptance in the business market. New technologies are being developed on several fronts: (1) active matrix built from polysilicon or single crystal silicon; (2) electro- optic materials using ferroelectric liquid crystal, polymer dispersed liquid crystals or other liquid crystal modes, (3) micromechanical-based transducers such as digital micromirror devices, and grating light valves, (4) high resolution displays to SXGA and beyond, and (5) high brightness. This article reviews the projection displays from a transducer technology perspective along with a discussion of markets and trends.

  8. PTSD in older bereaved people

    DEFF Research Database (Denmark)

    O'Connor, Maja

    2010-01-01

    bereaved elderly people compared to married controls and to investigate whether the loss of a spouse in old age, in contrast with earlier assumptions, could lead to PTSD. Two hundred and ninety six Danish elderly bereaved people (mean age 73 years, 113 males) were chosen from national registers and were...... subsequently assessed two months post-bereavement. They were compared with a control group of 276 married elderly people. The prevalence of PTSD and depression were measured through a self-report questionnaire. Results showed that 16% of the bereaved and 4% of the control group had a PTSD diagnosis (ES=.35......; Cohen's d=.74). It was also concluded that 37% of the bereaved and 22% of the control group had mild to severe depression (ES=.19; Cohen's d=.37). The results suggested that late life spousal bereavement, in some cases, does result in PTSD, and that the disorder is as common in elderly bereaved people...

  9. PTSD and Problems with Alcohol Use

    Science.gov (United States)

    ... drinking on your PTSD symptoms. As noted above, alcohol can affect sleep, anger and irritability, anxiety, depression, and work or relationship problems. Treatment should include education, therapy, and support ...

  10. Post-Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    ... relevant brain structures, biological or genetic traits, and psychosocial factors. Some examples include: In 2009, NIH-funded ... the optimal time to begin exposure therapy after trauma exposure to prevent the development of PTSD. This ...

  11. JAVA Stereo Display Toolkit

    Science.gov (United States)

    Edmonds, Karina

    2008-01-01

    This toolkit provides a common interface for displaying graphical user interface (GUI) components in stereo using either specialized stereo display hardware (e.g., liquid crystal shutter or polarized glasses) or anaglyph display (red/blue glasses) on standard workstation displays. An application using this toolkit will work without modification in either environment, allowing stereo software to reach a wider audience without sacrificing high-quality display on dedicated hardware. The toolkit is written in Java for use with the Swing GUI Toolkit and has cross-platform compatibility. It hooks into the graphics system, allowing any standard Swing component to be displayed in stereo. It uses the OpenGL graphics library to control the stereo hardware and to perform the rendering. It also supports anaglyph and special stereo hardware using the same API (application-program interface), and has the ability to simulate color stereo in anaglyph mode by combining the red band of the left image with the green/blue bands of the right image. This is a low-level toolkit that accomplishes simply the display of components (including the JadeDisplay image display component). It does not include higher-level functions such as disparity adjustment, 3D cursor, or overlays all of which can be built using this toolkit.

  12. PTSD and trauma in Austria's elderly: influence of wartime experiences, postwar zone of occupation, and life time traumatization on today's mental health status—an interdisciplinary approach

    Directory of Open Access Journals (Sweden)

    Tobias M. Glück

    2012-07-01

    Full Text Available Background: While in recent years epidemiological studies on World War (WW II-related traumatization and prevalence of posttraumatic stress disorder (PTSD in elderly persons have been conducted for various European countries, for Austria, these numbers are unknown. Objective: The focus of this epidemiologic study was to picture the current mental health status and prevalence of PTSD and lifetime traumatic events in Austria's elderly with respect to WWII and subsequent occupation. Method: In an interdisciplinary approach of psychologists and historians, 316 elderly Austrians (born before 1946 were interviewed for symptoms of PTSD and lifetime traumatization (Traumatic Life Events Questionnaire, PTSD Checklist-Civilian Version, current mental health (Brief Symptom Inventory, wartime-related trauma, and traumatic experiences with occupational forces. These factors were also compared regarding the zone of occupation (Allied vs. Soviet. Data were collected between March and September 2010. Results: 97.5% of the sample reported at least one lifetime trauma. War-related traumata were reported by 92.7% and non-war-related traumata by 82.3%; 40.2% experienced traumatic events with occupational forces. PTSD was present in 1.9% of the sample and up to 13.9% taking subthreshold PTSD into account. Both, the presence of symptoms indicative of PTSD and subthreshold PTSD implied weaker current mental health (regarding General Distress: odds ratios up to 25.51; 95% CI = 9.82 to 66.27. Independent of PTSD diagnosis persons from the Soviet occupied zone showed higher levels of Interpersonal Sensitivity, Global Distress, and Phobic Anxiety. Prevalence of PTSD was independent of gender. Conclusions: Our results corroborate findings from other European countries that PTSD is a common disorder in the elderly due to WWII experience and that PTSD and trauma affect mental health even across long periods of time. Postwar distressing conditions also pose a further risk

  13. Predicting Child Ptsd: The Relationship between Acute Stress Disorder and PTSD in Injured Children

    Science.gov (United States)

    Kassam-Adams, Nancy; Winston, Flaura Koplin

    2004-01-01

    Objective: To examine the prevalence of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in injured children and to evaluate the utility of ASD as a predictor of PTSD. Method: Children hospitalized for injuries sustained in a traffic crash were enrolled in a prospective study. ASD was assessed in 243 children within 1 month…

  14. The impact of treatment condition and the lagged effects of PTSD symptom severity and alcohol use on changes in alcohol craving.

    Science.gov (United States)

    Kaczkurkin, Antonia N; Asnaani, Anu; Alpert, Elizabeth; Foa, Edna B

    2016-04-01

    Given the high rates of comorbidity between posttraumatic stress disorder (PTSD) and substance use disorder (SUD), we investigated an integrated treatment for these disorders. Individuals with comorbid PTSD and alcohol dependence were randomized to receive naltrexone or placebo, with or without prolonged exposure (PE). All participants also received BRENDA (supportive counseling). The naltrexone plus PE group showed a greater decline in alcohol craving symptoms than those in the placebo with no PE group. The PE plus placebo and the naltrexone without PE groups did not differ significantly from the placebo with no PE group in terms of alcohol craving. No treatment group differences were found for percentage of drinking days. Alcohol craving was moderated by PTSD severity, with those with higher PTSD symptoms showing faster decreases in alcohol craving. Both PTSD and alcohol use had a lagged effect on alcohol craving, with changes in PTSD symptoms and percentage of days drinking being associated with subsequent changes in craving. These results support the relationship between greater PTSD symptoms leading to greater alcohol craving and suggest that reducing PTSD symptoms may be beneficial to reducing craving in those with co-occurring PTSD/SUD.

  15. Associations Between Specific Negative Emotions and DSM-5 PTSD Among a National Sample of Interpersonal Trauma Survivors.

    Science.gov (United States)

    Badour, Christal L; Resnick, Heidi S; Kilpatrick, Dean G

    2015-06-18

    The diagnosis of posttraumatic stress disorder (PTSD) has undergone several significant changes corresponding with the recent implementation of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Many of these changes reflect a growing recognition that PTSD is characterized by a wide range of negative affective experiences that were underrepresented in prior conceptualizations of the disorder. The present study examined the prevalence and correlates of a new Criterion D symptom (D4-Negative Affect), which is aimed at assessing subjective problems with persistent negative emotion states (e.g., fear, anger, shame, guilt, horror) among a sample of 1,522 U.S. adults with a history of interpersonal trauma recruited from a national online panel. The prevalence of D4-Negative Affect was very high among individuals with assault-related PTSD (AR-PTSD) and in particular, was significantly higher than among PTSD negative individuals. Moreover, specific problems with anger, shame, and fear were significantly and uniquely associated with AR-PTSD. Important differences also emerged as a function of gender and interpersonal trauma history. These findings provide initial empirical support for the expanded emphasis on assessing a wide range of negative affective experiences that may be associated with PTSD in DSM-5.

  16. Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE): A Pilot Study in Alcohol-dependent Women.

    Science.gov (United States)

    Persson, Anna; Back, Sudie E; Killeen, Therese K; Brady, Kathleen T; Schwandt, Melanie L; Heilig, Markus; Magnusson, Åsa

    Posttraumatic stress disorder (PTSD) and substance use disorders are highly comorbid. Effective treatments are largely lacking. This pilot study evaluated the safety and feasibility of a novel intervention, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), in preparation for a randomized controlled trial. Twenty-two treatment-seeking women with current DSM-IV-TR PTSD and alcohol dependence (AD) were recruited. Participants received COPE. Safety and feasibility were evaluated, as were efficacy-related outcomes: PTSD and depression symptom severity, alcohol use, craving, and dependence severity. No adverse events occurred. COPE was implemented in routine clinical practice. Among the assessed women, 95.8% were eligible to participate. Treatment attendance and completion were higher than in previous studies. Post treatment, all efficacy-related outcomes, including PTSD and depression symptom severity, alcohol use, craving, and dependence severity, were significantly reduced. COPE was safe and feasible to use. Concerns that trauma-focused, exposure-based therapy might promote relapse in this population appear unwarranted. Our findings provide initial evidence suggestive of COPE efficacy for comorbid PTSD and AD in women. These results provide a strong rationale for investigating the efficacy of COPE for comorbid PTSD and AD in women in a randomized controlled trial.

  17. Associations Between Specific Negative Emotions and DSM-5 PTSD Among a National Sample of Interpersonal Trauma Survivors

    Science.gov (United States)

    Badour, Christal L.; Resnick, Heidi S.; Kilpatrick, Dean G.

    2015-01-01

    The diagnosis of posttraumatic stress disorder (PTSD) has undergone several significant changes corresponding with the recent implementation of the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Many of these changes reflect a growing recognition that PTSD is characterized by a wide range of negative affective experiences that were underrepresented in prior conceptualizations of the disorder. The present study examined the prevalence and correlates of a new Criterion D symptom (D4-Negative Affect), which is aimed at assessing subjective problems with persistent negative emotion states (e.g., fear, anger, shame, guilt, horror) among a sample of 1,522 U.S. adults with a history of interpersonal trauma recruited from a national online panel. The prevalence of D4-Negative Affect was very high among individuals with assault-related PTSD (AR-PTSD) and in particular, was significantly higher than among PTSD negative individuals. Moreover, specific problems with anger, shame, and fear were significantly and uniquely associated with AR-PTSD. Important differences also emerged as a function of gender and interpersonal trauma history. These findings provide initial empirical support for the expanded emphasis on assessing a wide range of negative affective experiences that may be associated with PTSD in DSM-5. PMID:26088902

  18. Should subjects be forewarned of the possible psychological consequences of filling out a PTSD questionnaire?

    Science.gov (United States)

    Berghout, Caspar; van Ginkel, Joost; Groeneweg, Nikolaj; Israëls, Han; Kas, Arnoud; Lesniewski, Ulrike; van Stempvoort, Jeannette

    2002-04-01

    In 1993 Albach investigated the long-term consequences of sexual abuse on psychological health. A group of abused women a a control group of nonabused women were asked to fill in a questionnaire assessing posttraumatic stress disorder (PTSD). For ethical reasons, the abused women were warned that filling in the questionnaire might be emotionally stressful. The control group did not receive this warning. The abused women scored higher on the questionnaire than the nonabused women. The warning they received may have influenced their reports. Our experiment investigated this. 101 psychology students were divided into two groups, one who received a warning and a control group who did not. The hypothesis was that people who had been previously warned would score higher on a PTSD questionaire than people who had not. There were, however, no significant differences in mean PTSD scores and no known initial differences between groups.

  19. Personality and neuroimaging measures differentiate PTSD from mTBI in veterans.

    Science.gov (United States)

    Davenport, Nicholas D; Lim, Kelvin O; Sponheim, Scott R

    2015-09-01

    Mild traumatic brain injury (mTBI) is common among recent veterans and often is associated with chronic post-concussive symptoms (PCS). Elevated PCS may also be a consequence of post-traumatic stress disorder (PTSD) which shares symptoms with PCS. Identification of personality, biological, and psychopathology factors that contribute to the relationship between mTBI and PCS could help isolate the sources of chronic post concussive syndrome in veterans. Clinician rated diagnoses (PTSD, Major Depression, Alcohol Dependence), personality characteristics (Multidimensional Personality Questionnaire [MPQ] subscales), white matter brain imaging measures (Mean Diffusivity, Generalized Fractional Anisotropy), and diagnoses of mTBI were collected from 125 American military veterans of Iraq or Afghanistan. Linear and logistic regression models were tested to determine contributions to PCS and whether there were similar contributors to PTSD and mTBI. PCS score was associated with personality characteristics of high Stress Reaction and Traditionalism and low Control as well as mTBI. A diagnosis of PTSD was associated with low Social Closeness, PCS, Alcohol Dependence, and abnormal white matter mean diffusivity. Diagnosis of mTBI was associated with fewer white matter mean diffusivity abnormalities, PCS, and number of deployments. As commonly observed clinically, both PTSD and mTBI were associated with higher rates of PCS, though the contribution of PTSD appears to be secondary to personality traits, particularly Stress Reaction. Furthermore, the observation of factors that are uniquely associated with Blast mTBI (number of deployments) or with PTSD (Lifetime Alcohol Dependence and low Social Closeness), as well as a factor (region of abnormal MD) that had opposite effects on the likelihood of each diagnosis, indicates that the complex relationships between personality, psychopathology, and nature of mTBI need to be considered when interpreting chronic post-concussive symptoms.

  20. Complex PTSD, affect dysregulation, and borderline personality disorder.

    Science.gov (United States)

    Ford, Julian D; Courtois, Christine A

    2014-01-01

    Complex PTSD (cPTSD) was formulated to include, in addition to the core PTSD symptoms, dysregulation in three psychobiological areas: (1) emotion processing, (2) self-organization (including bodily integrity), and (3) relational security. The overlap of diagnostic criteria for cPTSD and borderline personality disorder (BPD) raises questions about the scientific integrity and clinical utility of the cPTSD construct/diagnosis, as well as opportunities to achieve an increasingly nuanced understanding of the role of psychological trauma in BPD. We review clinical and scientific findings regarding comorbidity, clinical phenomenology and neurobiology of BPD, PTSD, and cPTSD, and the role of traumatic victimization (in general and specific to primary caregivers), dissociation, and affect dysregulation. Findings suggest that BPD may involve heterogeneity related to psychological trauma that includes, but extends beyond, comorbidity with PTSD and potentially involves childhood victimization-related dissociation and affect dysregulation consistent with cPTSD. Although BPD and cPTSD overlap substantially, it is unwarranted to conceptualize cPTSD either as a replacement for BPD, or simply as a sub-type of BPD. We conclude with implications for clinical practice and scientific research based on a better differentiated view of cPTSD, BPD and PTSD.

  1. The Impact of PTSD on Functioning in Patients Seeking Treatment for Chronic Pain and Validation of the Posttraumatic Diagnostic Scale.

    Science.gov (United States)

    Åkerblom, Sophia; Perrin, Sean; Rivano Fischer, Marcelo; McCracken, Lance M

    2017-04-01

    The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status. Participants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital. The translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events with 28.9% fulfilling criteria for a current PTSD diagnosis. The patients with PTSD also reported significantly higher levels of pain interference, kinesiophobia, anxiety, and depression and significantly lower levels of life control, compared to patients exposed to trauma and not fulfilling criteria for PTSD and patients with no history of traumatic exposure. Consistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for PTSD according to a standardized self-report measure. The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted. Self-report measures like the PDS appear to be valid for use in chronic pain samples and offer a relative low-cost method for screening for PTSD.

  2. How the exposure to trauma has hindered physicians' capacity to heal: prevalence of PTSD among healthcare workers

    Directory of Open Access Journals (Sweden)

    Damian Jacob Sendler

    Full Text Available Background and Objectives: Post-traumatic stress disorder (PTSD is a condition affecting individuals exposed to trauma in the past. This article evaluates the prevalence of PTSD in practicing physicians and how it influences work performance. Methods: A review of the literature, followed by data extraction and meta-analysis were performed. Articles were searched for in PubMed, Web of Science, and Medline using keywords: ("physician" AND "ptsd", as well as Meshterms ("stress disorders, post-traumatic" AND "physicians". Since 1980, 1363 unique hits published in English were identified and filtered by pre-specified inclusion criteria to yield a sample of 110 full-text articles examining the prevalence of PTSD among healthcare workers. Among these, 9 articles represented an accurate examination of the prevalence of PTSD among physicians only. Information was extracted on the demographic, as well as PTSD prevalence data, from these studies for final comparison. Results Across all studies (n = 9 we examined, the prevalence of PTSD among physicians of both genders (n = 1616 was 14.8%, and the range was between 4.4% to 28%. This estimation is higher than the general prevalence of PTSD in the adult population of 3-4%, yet lower than prevalence found among people traumatized by war or torture, a range of 20-45%. Since only 50% of the studies examined here stratified PTSD prevalence among physicians by gender, we could not accurately conclude gender differences. Conclusions Our findings prompt a need for further investigation into the development of support programs for healthcare providers, aimed at reducing the traumatic stress experienced by physicians at work.

  3. Near isohydric grapevine cultivar displays higher photosynthetic efficiency and photorespiration rates under drought stress as compared with near anisohydric grapevine cultivar.

    Science.gov (United States)

    Hochberg, Uri; Degu, Asfaw; Fait, Aaron; Rachmilevitch, Shimon

    2013-04-01

    Drought stress is known to limit photosynthesis rates and to inflict photo-oxidative damage in grapevines. Grapevines, which are considered drought-tolerant plants, are characterized by diverse hydraulic and photosynthetic behaviors, depending on the cultivar. This research compared the photosynthesis and the photorespiration of Cabernet Sauvignon (Cs) (isohydric) and Shiraz (anisohydric) in an attempt to acquire a wider perspective on the iso/anisohydric phenomenon and its implications. Shiraz and Cs were subjected to terminal drought in the greenhouse. Soil water content (θ), leaf water potential (Ψl ) and stomata conductance (gs ) were measured to determine the cultivars' hydraulic behavior. Gas exchange and fluorometry measurements were taken at 21 and 2% O2 to acquire photosynthesis and photorespiration characteristics. Cs was found to behave in a near isohydric manner whereas Shiraz behaved in a near anisohydric manner. Compared to Shiraz, the reduced stomata conductance values of Cs were accompanied by higher water use efficiency and photorespiration rates, as well as photosystem II photochemical potential (Fv /Fm ). As compared with Shiraz, Cs compensated for lower stomata conductance by higher photosynthesis and photorespiration. These two processes contributed to higher electron flow rates that might have a role in photoinhibition avoidance, which was observed in the stability of Fv /Fm under drought stress.

  4. Development and Clinical Results from the Virtual Iraq Exposure Therapy Application for PTSD

    Science.gov (United States)

    2009-06-01

    Authorized licensed use limited to: University of Southern California. Downloaded on October 5, 2009 at 16:03 from IEEE Xplore . Restrictions apply. Report...03 from IEEE Xplore . Restrictions apply. [8]. In this study, 16 male veterans with PTSD were exposed to two head-mounted display-delivered virtual...16:03 from IEEE Xplore . Restrictions apply. Users can navigate in both scenarios via the use of a standard game pad controller, although we have

  5. PTSD as a criminal defense: a review of case law.

    Science.gov (United States)

    Berger, Omri; McNiel, Dale E; Binder, Renée L

    2012-01-01

    Posttraumatic stress disorder (PTSD) has been offered as a basis for criminal defenses, including insanity, unconsciousness, self-defense, diminished capacity, and sentencing mitigation. Examination of case law (e.g., appellate decisions) involving PTSD reveals that when offered as a criminal defense, PTSD has received mixed treatment in the judicial system. Courts have often recognized testimony about PTSD as scientifically reliable. In addition, PTSD has been recognized by appellate courts in U.S. jurisdictions as a valid basis for insanity, unconsciousness, and self-defense. However, the courts have not always found the presentation of PTSD testimony to be relevant, admissible, or compelling in such cases, particularly when expert testimony failed to show how PTSD met the standard for the given defense. In cases that did not meet the standard for one of the complete defenses, PTSD has been presented as a partial defense or mitigating circumstance, again with mixed success.

  6. Post Traumatic Stress Disorder (PTSD): NIH Research to Results

    Science.gov (United States)

    ... virtual reality" (VR) exposure therapy. The VR therapy combines traditional therapy and exposure via VR technology that ... families. Read More "Post Traumatic Stress Disorder (PTSD)" Articles PTSD: A Growing Epidemic / Symptoms, Diagnosis, Treatment / NIH ...

  7. Can the dissociative PTSD subtype be identified across two distinct trauma samples meeting caseness for PTSD?

    Science.gov (United States)

    Hansen, Maj; Műllerová, Jana; Elklit, Ask; Armour, Cherie

    2016-08-01

    For over a century, the occurrence of dissociative symptoms in connection to traumatic exposure has been acknowledged in the scientific literature. Recently, the importance of dissociation has also been recognized in the long-term traumatic response within the DSM-5 nomenclature. Several studies have confirmed the existence of the dissociative posttraumatic stress disorder (PTSD) subtype. However, there is a lack of studies investigating latent profiles of PTSD solely in victims with PTSD. This study investigates the possible presence of PTSD subtypes using latent class analysis (LCA) across two distinct trauma samples meeting caseness for DSM-5 PTSD based on self-reports (N = 787). Moreover, we assessed if a number of risk factors resulted in an increased probability of membership in a dissociative compared with a non-dissociative PTSD class. The results of LCA revealed a two-class solution with two highly symptomatic classes: a dissociative class and a non-dissociative class across both samples. Increased emotion-focused coping increased the probability of individuals being grouped into the dissociative class across both samples. Social support reduced the probability of individuals being grouped into the dissociative class but only in the victims of motor vehicle accidents (MVAs) suffering from whiplash. The results are discussed in light of their clinical implications and suggest that the dissociative subtype can be identified in victims of incest and victims of MVA suffering from whiplash meeting caseness for DSM-5 PTSD.

  8. Is there a biological difference between trauma-related depression and PTSD? DST says 'NO'.

    Science.gov (United States)

    Savic, Danka; Knezevic, Goran; Damjanovic, Svetozar; Spiric, Zeljko; Matic, Gordana

    2012-09-01

    The use of the low-dose dexamethasone suppression test (DST) as a potentially discriminative marker between post-traumatic stress disorder (PTSD) and depression is still under discussion. In order to compare the influence of these psychopathologies on the DST results, we examined suppression in war-traumatized subjects with one or both of these disorders, as well as in healthy controls. Based on our previous findings, we hypothesized that subjects with any disorder would exhibit higher dexamethasone suppression than healthy controls due to traumatic experiences. This study was a part of a broader project in which simultaneous psychological and biological investigations were carried out in hospital conditions on 399 male participants: 57 with PTSD, 28 with depression, 76 with PTSD+depression, and 238 healthy controls. Cortisol was measured in blood samples taken at 0900 h before and after administering 0.5mg of dexamethasone (at 2300 h). Group means ± standard deviation of cortisol suppression were: 79.4±18.5 in the PTSD group, 80.8±11.6 in the depression group, 77.5±24.6 in the group with PTSD+depression, and 66.8±34.6 in healthy controls. The first three groups suppressed significantly more than the fourth. When the number of traumas was introduced as a covariate, the differences disappeared. The hypothesis was confirmed: in respect to DST, the examined trauma-related psychopathologies showed the same pattern: hypersuppression, due to multiple traumatic experiences.

  9. The psychobiology of PTSD: coping with trauma.

    Science.gov (United States)

    Olff, Miranda; Langeland, Willie; Gersons, Berthold P R

    2005-11-01

    Posttraumatic stress disorder (PTSD) is one of the few psychiatric conditions where a specific psychosocial stressor is explicitly tied to etiology. Although a majority of people experience a traumatic event in their life, most of them will not develop PTSD or other mental health problems such as depressive or anxiety disorders. Emotional and neurobiological responses to psychosocial stressors show striking individual variation. In this paper cognitive appraisal and coping factors are explored as potential sources of individual differences in the neuroendocrinological stress response, and subsequently in mental health outcome. Continued study of the psychobiology of trauma and PTSD will enhance our understanding of adaptation to psychosocial stressors and support efforts to treat associated psychological and biological sequelae.

  10. Cognitive-behavioral conjoint therapy for PTSD improves various PTSD symptoms and trauma-related cognitions: Results from a randomized controlled trial.

    Science.gov (United States)

    Macdonald, Alexandra; Pukay-Martin, Nicole D; Wagner, Anne C; Fredman, Steffany J; Monson, Candice M

    2016-02-01

    Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD.

  11. Posttraumatic Stress Disorder (PTSD) and Disorders of Extreme Stress (DESNOS) symptoms following prostitution and childhood abuse.

    Science.gov (United States)

    Choi, Hyunjung; Klein, Carolin; Shin, Min-Sup; Lee, Hoon-Jin

    2009-08-01

    With the participation of 46 prostituted women in Korea, this study investigates the relationship between prostitution experiences, a history of childhood sexual abuse (CSA), and symptoms of posttraumatic stress disorder (PTSD) and disorders of extreme stress not otherwise specified (DESNOS). Prostituted women showed higher levels of PTSD and DESNOS symptoms compared to a control group. Women who had experienced both CSA by a significant other and prostitution showed the highest levels of traumatic stress. However, posttraumatic reexperiencing and avoidance and identity, relational, and affect regulation problems were significant for prostitution experiences even when the effects of CSA were controlled.

  12. Examining potential contraindications for prolonged exposure therapy for PTSD

    NARCIS (Netherlands)

    Minnen, A. van; Harned, M.S.; Zöllner, L.; Mills, K.

    2012-01-01

    Although prolonged exposure (PE) has received the most empirical support of any treatment for posttraumatic stress disorder (PTSD), clinicians are often hesitant to use PE due to beliefs that it is contraindicated for many patients with PTSD. This is especially true for PTSD patients with comorbid p

  13. Taxometric Investigation of PTSD: Data from Two Nationally Representative Samples

    Science.gov (United States)

    Broman-Fulks, Joshua J.; Ruggiero, Kenneth J.; Green, Bradley A.; Kilpatrick, Dean G.; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.

    2006-01-01

    Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build…

  14. Taxometric Investigation of PTSD: Data from Two Nationally Representative Samples

    Science.gov (United States)

    Broman-Fulks, Joshua J.; Ruggiero, Kenneth J.; Green, Bradley A.; Kilpatrick, Dean G.; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.

    2006-01-01

    Current psychiatric nosology depicts posttraumatic stress disorder (PTSD) as a discrete diagnostic category. However, only one study has examined the latent structure of PTSD, and this study suggested that PTSD may be more accurately conceptualized as an extreme reaction to traumatic life events rather than a discrete clinical syndrome. To build…

  15. The impact of endorsing Spitzer's proposed criteria for PTSD in the forthcoming DSM-V on male and female Veterans.

    Science.gov (United States)

    Miller, Lyndsey N; Chard, Kathleen M; Schumm, Jeremiah A; O'Brien, Carol

    2011-06-01

    This study explored differences between Spitzer's proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer's proposed criteria. Veterans who met both DSM-IV and Spitzer's proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed criteria. These findings have important implications regarding proposed changes to the diagnostic classification criteria for PTSD in the forthcoming DSM-V.

  16. Sleep Paralysis Among Egyptian College Students: Association With Anxiety Symptoms (PTSD, Trait Anxiety, Pathological Worry).

    Science.gov (United States)

    Jalal, Baland; Hinton, Devon E

    2015-11-01

    Among Egyptian college students in Cairo (n = 100), this study examined the relationship between sleep paralysis (SP) and anxiety symptoms, viz., posttraumatic stress disorder (PTSD), trait anxiety, and pathological worry. SP rates were high; 43% of participants reported at least one lifetime episode of SP, and 24% of those who reported at least one lifetime episode had experienced four or more episodes during the previous year. Fourteen percent of men had experienced SP as compared to 86% of women. As hypothesized, relative to non-SP experiencers, participants who had SP reported higher symptoms of PTSD, trait anxiety, and pathological worry. Also, as hypothesized, the experiencing of hypnogogic/hypnopompic hallucinations during SP, even after controlling for negative affect, was highly correlated with symptoms of PTSD and trait anxiety. The study also investigated possible mechanisms by examining the relationship of hallucinations to anxiety variables.

  17. Role of neuroinflammation and sex hormones in war-related PTSD.

    Science.gov (United States)

    Mendoza, Cristhian; Barreto, George E; Ávila-Rodriguez, Marco; Echeverria, Valentina

    2016-10-15

    The susceptibility to develop posttraumatic stress disorder (PTSD) is greatly influenced by both innate and environmental risk factors. One of these factors is gender, with women showing higher incidence of trauma-related mental health disorders than their male counterparts. The evidence so far links these differences in susceptibility or resilience to trauma to the neuroprotective actions of sex hormones in reducing neuroinflammation after severe stress exposure. In this review, we discuss the impact of war-related trauma on the incidence of PTSD in civilian and military populations as well as differences associated to gender in the incidence and recovery from PTSD. In addition, the mutually influencing role of inflammation, genetic, and sex hormones in modulating the consequences derived from exposure to traumatic events are discussed in light of current evidence.

  18. Childhood abuse and the experience of pain in adulthood: the mediating effects of PTSD and emotion dysregulation on pain levels and pain-related functional impairment.

    Science.gov (United States)

    Powers, Abigail; Fani, Negar; Pallos, Andrew; Stevens, Jennifer; Ressler, Kerry J; Bradley, Bekh

    2014-01-01

    Previous findings suggest a relationship between childhood abuse and pain-related conditions. It is yet to be determined whether adult posttraumatic stress disorder (PTSD) symptoms may mediate the association between the experience of childhood abuse and reported pain in adulthood. We sought to determine if emotion dysregulation may also play a role in mediating PTSD and pain levels. We examined subjects (N = 814) recruited from the primary care clinics of an urban public hospital as part of an National Institute of Mental Health-funded study of trauma-related risk and resilience. We evaluated childhood abuse with the Childhood Trauma Questionnaire, PTSD symptoms with the PTSD Symptom Severity scale, and emotional dysregulation with the Emotion Dysregulation Scale. Pain and functional limitations of pain were assessed through self-report. We found that both childhood abuse and current PTSD symptoms predicted higher levels of reported pain. Childhood abuse, PTSD symptoms, and emotion dysregulation all predicted higher levels of functional impairment related to pain. Using the Sobel method and bootstrapping techniques and controlling for current level of negative affect, we found that PTSD fully mediated the effect of childhood abuse on pain level and pain-related limitations; emotion dysregulation partially mediated the effect of PTSD symptoms in predicting higher levels of pain-related limitations. Although causality cannot be determined in the present study, these findings suggest that PTSD may serve as the pathway between exposure to childhood abuse and the development of pain-related conditions in adulthood, and that emotion dysregulation is a significant factor in understanding how PTSD relates to specific pain-related functional impairment. © 2013 Published by Academy of Psychosomatic Medicine on behalf of Academy of Psychosomatic Medicine.

  19. Diacylglycerol Kinases Are Widespread in Higher Plants and Display Inducible Gene Expression in Response to Beneficial Elements, Metal, and Metalloid Ions

    Science.gov (United States)

    Escobar-Sepúlveda, Hugo F.; Trejo-Téllez, Libia I.; Pérez-Rodríguez, Paulino; Hidalgo-Contreras, Juan V.; Gómez-Merino, Fernando C.

    2017-01-01

    Diacylglycerol kinases (DGKs) are pivotal signaling enzymes that phosphorylate diacylglycerol (DAG) to yield phosphatidic acid (PA). The biosynthesis of PA from phospholipase D (PLD) and the coupled phospholipase C (PLC)/DGK route is a crucial signaling process in eukaryotic cells. Next to PLD, the PLC/DGK pathway is the second most important generator of PA in response to biotic and abiotic stresses. In eukaryotic cells, DGK, DAG, and PA are implicated in vital processes such as growth, development, and responses to environmental cues. A plethora of DGK isoforms have been identified so far, making this a rather large family of enzymes in plants. Herein we performed a comprehensive phylogenetic analysis of DGK isoforms in model and crop plants in order to gain insight into the evolution of higher plant DGKs. Furthermore, we explored the expression profiling data available in public data bases concerning the regulation of plant DGK genes in response to beneficial elements and other metal and metalloid ions, including silver (Ag), aluminum (Al), arsenic (As), cadmium (Cd), chromium (Cr), mercury (Hg), and sodium (Na). In all plant genomes explored, we were able to find DGK representatives, though in different numbers. The phylogenetic analysis revealed that these enzymes fall into three major clusters, whose distribution depends on the composition of structural domains. The catalytic domain conserves the consensus sequence GXGXXG/A where ATP binds. The expression profiling data demonstrated that DGK genes are rapidly but transiently regulated in response to certain concentrations and time exposures of beneficial elements and other ions in different plant tissues analyzed, suggesting that DGKs may mediate signals triggered by these elements. Though this evidence is conclusive, further signaling cascades that such elements may stimulate during hormesis, involving the phosphoinositide signaling pathway and DGK genes and enzymes, remain to be elucidated.

  20. Treating Iraq and Afghanistan War Veterans with PTSD Who Are at High Risk for Suicide

    Science.gov (United States)

    Jakupcak, Matthew; Varra, Edward M.

    2011-01-01

    Iraq and Afghanistan War veterans diagnosed with psychiatric disorders commit suicide at a higher rate than the general population (Kang & Bullman, 2008). Posttraumatic stress disorder (PTSD) has been identified as a risk factor for suicide in veterans (Bullman & Kang, 1994) and is the most common mental disorder among Iraq and Afghanistan…

  1. Decreased uncinate fasciculus tract integrity in male and female patients with PTSD: a diffusion tensor imaging study

    Science.gov (United States)

    Koch, Saskia B.J.; van Zuiden, Mirjam; Nawijn, Laura; Frijling, Jessie L.; Veltman, Dick J.; Olff, Miranda

    2017-01-01

    Background Posttraumatic stress disorder (PTSD) is a disabling psychiatric disorder that has been associated with lower white matter integrity of tracts connecting the prefrontal cortex with limbic regions. However, previous diffusion tensor imaging (DTI) findings have been inconsistent, showing high variability in the exact location and direction of effects. Methods We performed probabilistic tractography of the bilateral uncinate fasciculus, cingulum and superior longitudinal fasciculus (both temporal and parietal projections) in male and female police officers with and without PTSD. Results We included 38 (21 men) police officers with and 39 (20 men) without PTSD in our analyses. Compared with trauma-exposed controls, patients with PTSD showed significantly higher mean diffusivity of the right uncinate fasciculus, the major white matter tract connecting the amygdala to the prefrontal cortex (p = 0.012). No other significant between-group or group × sex differences were observed. Mean diffusivity of the right uncinate fasciculus was positively associated with anxiety symptoms (r = 0.410, p = 0.013) in patients with PTSD as well as with amygdala activity (r = 0.247, p = 0.038) and ventromedial prefrontal cortex (vmPFC) activity (r = 0.283, p = 0.016) in all participants in response to happy and neutral faces. Limitations Our specific sample of trauma-exposed police officers limits the generalizability of our findings to other PTSD patient groups (e.g., civilian trauma). Conclusion Patients with PTSD showed diminished structural connectivity between the amygdala and vmPFC, which was correlated with higher anxiety symptoms and increased functional activity of these brain regions. Our findings provide additional evidence for the prevailing neurocircuitry model of PTSD, postulating that ineffective communication between the amygdala and vmPFC underlies decreased top–down control over fear responses. PMID:28452713

  2. Support mechanisms and vulnerabilities in relation to PTSD in veterans of the Gulf War, Iraq War, and Afghanistan deployments: a systematic review.

    Science.gov (United States)

    Wright, Breanna K; Kelsall, Helen L; Sim, Malcolm R; Clarke, David M; Creamer, Mark C

    2013-06-01

    Pretrauma factors of psychiatric history and neuroticism have been important in highlighting vulnerability to posttraumatic stress disorder (PTSD), whereas posttrauma support mechanisms have been associated with positive health and well-being outcomes, particularly in veterans. The relationship between these factors and PTSD has not been the subject of a systematic review in veterans. An online search was conducted, supplemented by reference list and author searches. Two investigators systematically and independently examined eligible studies. From an initial search result of 2,864, 17 met inclusion criteria. A meta-analysis of unit cohesion involving 6 studies found that low unit cohesion was associated with PTSD, standardised mean difference of -1.62, 95% confidence interval (CI) [-2.80, -0.45]. A meta-analysis of social support involving 7 studies found that low social support was associated with PTSD, standardised mean difference of - 12.40, 95% CI [-3.42, -1.38]. Three of 5 studies found a significant relationship between low-family support and PTSD; insufficient data precluded a meta-analysis. Regarding pretrauma vulnerability, 2 studies on psychiatric history and 1 on neuroticism found positive relationships with PTSD. Posttrauma factors of low support were associated with higher reporting of PTSD. Cross-sectional methodology may be inadequate to capture complex relationships between support and PTSD; more longitudinal research is required. Copyright © 2013 International Society for Traumatic Stress Studies.

  3. Ecological study of sleep disruption in PTSD: a pilot study.

    Science.gov (United States)

    Germain, Anne; Hall, Martica; Katherine Shear, M; Nofzinger, Eric A; Buysse, Daniel J

    2006-07-01

    Laboratory-based sleep studies have yielded inconsistent results regarding the presence and nature of objective sleep anomalies in posttraumatic stress disorder (PTSD). This pilot study aimed at assessing sleep in adult crime victims with PTSD by using in-home polysomnography. Compared to healthy archival subjects, PTSD subjects showed longer sleep latency, reduced total sleep time, and increased duration of nocturnal awakening. Quantitative electroencephalography (EEG) measures of delta and beta activity also differed in PTSD and healthy subjects. These preliminary findings suggest that ambulatory methods can capture objective signs of sleep disruption, and corroborate subjective complaints of disrupted sleep in PTSD.

  4. Simple versus complex PTSD: a cluster analytic investigation.

    Science.gov (United States)

    Taylor, Steven; Asmundson, Gordon J G; Carleton, R Nicholas

    2006-01-01

    A cluster analytic investigation was conducted on measures of PTSD associated features (e.g., personality pathology, dissociative tendencies) to investigate whether empirically-defined clusters correspond to Herman's [1992, Complex PTSD: a syndrome in survivors of prolonged and repeated trauma. Journal of Traumatic Stress, 5, 377-391; 1997, Trauma and recovery (Rev. ed.). New York: Basic Books] distinction between simple and complex PTSD. Results from a sample of 60 PTSD patients were broadly consistent with this distinction, although some inconsistencies were observed. Treatment outcome generally did not differ between the two clusters. Implications for classifying and treating PTSD are discussed.

  5. The STRONG STAR Multidisciplinary PTSD Research Consortium

    Science.gov (United States)

    2014-11-01

    little is known about its role as a potential risk factor for PTSD (Davis and Sandman , 2012; Talge et al., 2007). Animal studies suggest that PNS programs...Baum, A., 1986. Chronic stress and posttraumatic stress disorders. J. Consult. Clin. Psychol. 54, 303—308. Davis, E.P., Sandman , C.A., 2012. Prenatal

  6. PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology.

    Science.gov (United States)

    Contractor, Ateka A; Weiss, Nicole H; Dranger, Paula; Ruggero, Camilo; Armour, Cherie

    2017-06-01

    A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder's (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD's symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Assessing the latent structure of DSM-5 PTSD among Chinese adolescents after the Ya'an earthquake.

    Science.gov (United States)

    Zhou, Xiao; Wu, Xinchun; Zhen, Rui

    2017-08-01

    To examine the underlying substructure of DSM-5 PTSD in an adolescent sample, this study used a confirmatory factor analysis alternative model approach to assess 813 adolescents two and a half years after the Ya'an earthquake. Participants completed the PTSD Checklist for DSM-5, the Center for Epidemiologic Studies Depression Scale for Children, and the Screen for Child Anxiety Related Emotional Disorders. The results found that the seven-factor hybrid PTSD model entailing intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal had significantly better fit indices than other alternative models. Depression and anxiety displayed high correlations with the seven-factor model. The findings suggested that the seven-factor model was more applicable to adolescents following the earthquake, and may carry important implications for further clinical practice and research on posttraumatic stress symptomatology. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  8. Risk, coping and PTSD symptom trajectories in World Trade Center responders.

    Science.gov (United States)

    Feder, Adriana; Mota, Natalie; Salim, Ryan; Rodriguez, Janice; Singh, Ritika; Schaffer, Jamie; Schechter, Clyde B; Cancelmo, Leo M; Bromet, Evelyn J; Katz, Craig L; Reissman, Dori B; Ozbay, Fatih; Kotov, Roman; Crane, Michael; Harrison, Denise J; Herbert, Robin; Levin, Stephen M; Luft, Benjamin J; Moline, Jacqueline M; Stellman, Jeanne M; Udasin, Iris G; Landrigan, Philip J; Zvolensky, Michael J; Yehuda, Rachel; Southwick, Steven M; Pietrzak, Robert H

    2016-11-01

    Trajectories of disaster-related posttraumatic stress disorder (PTSD) symptoms are often heterogeneous, and associated with common and unique risk factors, yet little is known about potentially modifiable psychosocial characteristics associated with low-symptom and recovering trajectories in disaster responders. A total of 4487 rescue and recovery workers (1874 police and 2613 non-traditional responders) involved during and in the aftermath of the unprecedented World Trade Center (WTC) attacks, were assessed an average of 3, 6, 8, and 12 years post-9/11/2001. Among police responders, WTC-related PTSD symptoms were characterized by four trajectories, including no/low-symptom (76.1%), worsening (12.1%), improving (7.5%), and chronic (4.4%) trajectories. In non-traditional responders, a five-trajectory solution was optimal, with fewer responders in a no/low-symptom trajectory (55.5%), and the remainder in subtly worsening (19.3%), chronic (10.8%), improving (8.5%), and steeply worsening (5.9%) trajectories. Consistent factors associated with symptomatic PTSD trajectories across responder groups included Hispanic ethnicity, pre-9/11 psychiatric history, greater WTC exposure, greater medical illness burden, life stressors and post-9/11 traumas, and maladaptive coping (e.g., substance use, avoidance coping). Higher perceived preparedness, greater sense of purpose in life, and positive emotion-focused coping (e.g., positive reframing, acceptance) were negatively associated with symptomatic trajectories. Findings in this unique cohort indicate considerable heterogeneity in WTC-related PTSD symptom trajectories over 12 years post-9/11/2001, with lower rates of elevated PTSD symptoms in police than in non-traditional responders. They further provide a comprehensive risk prediction model of PTSD symptom trajectories, which can inform prevention, monitoring, and treatment efforts in WTC and other disaster responders.

  9. Identification and characterization of HPA-axis reactivity endophenotypes in a cohort of female PTSD patients.

    Science.gov (United States)

    Zaba, Monika; Kirmeier, Thomas; Ionescu, Irina A; Wollweber, Bastian; Buell, Dominik R; Gall-Kleebach, Dominique J; Schubert, Christine F; Novak, Bozidar; Huber, Christine; Köhler, Katharina; Holsboer, Florian; Pütz, Benno; Müller-Myhsok, Bertram; Höhne, Nina; Uhr, Manfred; Ising, Marcus; Herrmann, Leonie; Schmidt, Ulrike

    2015-05-01

    Analysis of the function of the hypothalamic-pituitary-adrenal (HPA)-axis in patients suffering from posttraumatic stress disorder (PTSD) has hitherto produced inconsistent findings, inter alia in the Trier Social Stress Test (TSST). To address these inconsistencies, we compared a sample of 23 female PTSD patients with either early life trauma (ELT) or adult trauma (AT) or combined ELT and AT to 18 age-matched non-traumatized female healthy controls in the TSST which was preceded by intensive baseline assessments. During the TSST, we determined a variety of clinical, psychological, endocrine and cardiovascular parameters as well as expression levels of four HPA-axis related genes. Using a previously reported definition of HPA-axis responsive versus non-responsive phenotypes, we identified for the first time two clinically and biologically distinct HPA-axis reactivity subgroups of PTSD. One subgroup ("non-responders") showed a blunted HPA-axis response and distinct clinical and biological characteristics such as a higher prevalence of trauma-related dissociative symptoms and of combined AT and ELT as well as alterations in the expression kinetics of the genes encoding for the mineralocorticoid receptor (MR) and for FK506 binding protein 51 (FKBP51). Interestingly, this non-responder subgroup largely drove the relatively diminished HPA axis response of the total cohort of PTSD patients. These findings are limited by the facts that the majority of patients was medicated, by the lack of traumatized controls and by the relatively small sample size. The here for the first time identified and characterized HPA-axis reactivity endophenotypes offer an explanation for the inconsistent reports on HPA-axis function in PTSD and, moreover, suggest that most likely other factors than HPA-axis reactivity play a decisive role in determination of PTSD core symptom severity.

  10. Type and severity of intimate partner violence and its relationship with PTSD in HIV-infected women.

    Science.gov (United States)

    Hansrod, Fatima; Spies, Georgina; Seedat, Soraya

    2015-01-01

    HIV has an impact on the presence and severity of both intimate partner violence (IPV) and posttraumatic stress disorder (PTSD) in infected women. However, the relationship of type and severity of IPV with PTSD in this population has not been adequately explored. We focus on the association between the type and severity of IPV and HIV status and PTSD in a sample of South African women. One hundred and sixty-nine women (114 HIV-positive and 55 HIV-negative controls), matched for geographical area, education, and socio-economic status, were recruited from HIV clinics. Clinical and demographic data were collected, including data on childhood trauma, other traumatic life events, IPV, posttraumatic stress symptoms, problematic alcohol use, and depressive symptoms. HIV-positive women had significantly more depressive symptoms, alcohol abuse, and childhood trauma exposure as well as significantly higher rates of PTSD (25.4%) when compared with uninfected women (10.9%). No significant group differences in the rate, pattern, and severity of physical, sexual, psychological, injury, and negotiation IPV were found. In logistic regression analysis, the rate and severity category of IPV did not significantly predict PTSD in HIV-positive women when childhood trauma and life events were controlled for. Our results indicate the need for screening for alcohol abuse, PTSD and depressive symptoms at HIV wellness, and ARV clinics. The high rates of PTSD in HIV-positive women indicate the need for specialized programs to manage PTSD and minimize negative sequelae in this population. These results also highlight the need for improved screening and prevention of childhood trauma and IPV both in infected and uninfected women.

  11. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2015-03-01

    Full Text Available Background: Three intrinsic connectivity networks in the brain, namely the central executive, salience, and default mode networks, have been identified as crucial to the understanding of higher cognitive functioning, and the functioning of these networks has been suggested to be impaired in psychopathology, including posttraumatic stress disorder (PTSD. Objective: 1 To describe three main large-scale networks of the human brain; 2 to discuss the functioning of these neural networks in PTSD and related symptoms; and 3 to offer hypotheses for neuroscientifically-informed interventions based on treating the abnormalities observed in these neural networks in PTSD and related disorders. Method: Literature relevant to this commentary was reviewed. Results: Increasing evidence for altered functioning of the central executive, salience, and default mode networks in PTSD has been demonstrated. We suggest that each network is associated with specific clinical symptoms observed in PTSD, including cognitive dysfunction (central executive network, increased and decreased arousal/interoception (salience network, and an altered sense of self (default mode network. Specific testable neuroscientifically-informed treatments aimed to restore each of these neural networks and related clinical dysfunction are proposed. Conclusions: Neuroscientifically-informed treatment interventions will be essential to future research agendas aimed at targeting specific PTSD and related symptoms.

  12. Validity of PTSD diagnoses in VA administrative data: Comparison of VA administrative PTSD diagnoses to self-reported PTSD Checklist scores

    Directory of Open Access Journals (Sweden)

    Amy A. Gravely, MA

    2011-01-01

    Full Text Available Little research has been done on the validity of posttraumatic stress disorder (PTSD diagnoses that are found in Department of Veterans Affairs (VA administrative data, even though they are often used in VA research. We compared PTSD diagnoses found in VA administrative data with PTSD Checklist (PCL scores self-reported by 4,777 newly diagnosed participants in a national postal survey study. Using PCL scores of at least 50 as the gold standard, we compared positive predictive values (PPVs for at least one versus at least two PTSD diagnoses (found within 4 months of the first in VA administrative data overall and by subgroups of interest: age, sex, and clinic where first diagnosed. The overall PPV was 75% for at least one PTSD diagnosis and 82% for at least two PTSD diagnoses. Similarly, the PPV significantly increased for all subgroup analyses when at least two PTSD diagnoses were used. The increase in PPV was greatest for those first diagnosed in primary care and for those older than 65. To select a sample of veterans with more definitive PTSD from administrative data, researchers should select those veterans with at least two PTSD diagnoses as opposed to at least one.

  13. Posttraumatic stress disorder: An exploratory study examining rates of trauma and PTSD and its effect on client outcomes in community mental health

    Directory of Open Access Journals (Sweden)

    Yellowlees Peter

    2005-04-01

    Full Text Available Abstract Background Rates of trauma and Posttraumatic Stress Disorder (PTSD were examined in order to compare the profile in clients of an Australian Public Mental Health Service with that reported in the international literature for clients with major mental illness and to explore the effect of this on client health outcomes. Potential factors contributing to increased levels of trauma/PTSD in this group of clients and the issue of causality between PTSD and subsequent mental illness was also explored. Methods A convenience sample of 29 clients was screened for trauma and PTSD using the Posttraumatic Stress Diagnostic Scale™ (PDS and selected outcome measures. Paired and independent samples t-test and ANOVA were applied to the data. Results High levels of undocumented trauma and PTSD were found. Twenty clients, (74% reported exposure to multiple traumatic events; 33.3% (9 met DSM IV diagnostic criteria for PTSD. Significant difference was found for PTSD symptomatology, severity and impairment and for client and clinician-rated scores of Quality of Life (QOL outcomes in the PTSD group. No effect for PTSD symptomatology on the Working Alliance (WA was found. Factors that may influence higher rates of PTSD in this group were identified and included issues associated with the population studied, the predominance of assaultive violence found, and vulnerability and risks factors associated with re-traumatisation within the social and treating environments. Conclusion A similar trauma and PTSD profile to that reported in the international literature, including greater levels of trauma and PTSD and a poorer QOL, was found in this small sample of clients. It is postulated that the increased levels of trauma/PTSD as reported for persons with major mental illness, including those found in the current study, are primarily related to the characteristics of the population that access public mainstream psychiatric services and that these factors have

  14. [Complex PTSD following early-childhood trauma: emotion-regulation training as addition to the PTSD guideline].

    Science.gov (United States)

    Thomaes, K; Dorrepaal, E; van Balkom, A J L M; Veltman, D J; Smit, J H; Hoogendoorn, A W; Draijer, N

    2015-01-01

    Posttraumatic stress disorder (PTSD) symptoms in individuals who have experienced repeated trauma (sexual and/or physical) in early childhood can lead to problems associated with emotion regulation, interpersonal functioning and self-image. This so-called complex PTSD is often accompanied by a comorbid personality disorder. Although ptsd is associated with structural and functional abnormalities in emotion-regulation areas in the brain, it is not known whether complex PTSD shows similar abnormalities. Experts take the view that before individuals with complex PTSD are given appropriate therapy they should receive a course of emotion-regulation therapy such as the one tested by Zlotnick e.a. (1997) in a randomised controlled trial (RCT).   To replicate Zlotnick's RCT in the Netherlands and to find out whether complex PTSD patients show specific structural and functional brain abnormalities and whether psychological recovery is linked to the 'normalisation' of these abnormalities. In a RCT with complex PTSD patients (n = 71) who had experienced trauma in early childhood, we compared normal individual treatment with treatment supported by 'Before and beyond', which consists of emotion-regulation therapy combined with cognitive group therapy. In a subsample (n= 33) we also performed an mri (repeated, n = 9) in which individuals were required to execute an emotional memory and attention task. In complex PTSD, structural abnormalities in the brain seemed to be more extensive than in PTSD and brain activity in complex PTSD seemed to be strikingly different from the brain activity seen in PTSD patients who had experienced only single trauma. The results of the RCT indicate that 'Before and beyond' is a clinically meaningful treatment (with minimal drop-out) for complex PTSD patients with a variety of personality disorders. The psychological recovery of patients who received the emotion regulation and cognitive group treatment was associated with normalisation of brain

  15. Functional neuroimaging with default mode network regions distinguishes PTSD from TBI in a military veteran population.

    Science.gov (United States)

    Raji, Cyrus A; Willeumier, Kristen; Taylor, Derek; Tarzwell, Robert; Newberg, Andrew; Henderson, Theodore A; Amen, Daniel G

    2015-09-01

    PTSD and TBI are two common conditions in veteran populations that can be difficult to distinguish clinically. The default mode network (DMN) is abnormal in a multitude of neurological and psychiatric disorders. We hypothesize that brain perfusion SPECT can be applied to diagnostically separate PTSD from TBI reliably in a veteran cohort using DMN regions. A group of 196 veterans (36 with PTSD, 115 with TBI, 45 with PTSD/TBI) were selected from a large multi-site population cohort of individuals with psychiatric disease. Inclusion criteria were peacetime or wartime veterans regardless of branch of service and included those for whom the traumatic brain injury was not service related. SPECT imaging was performed on this group both at rest and during a concentration task. These measures, as well as the baseline-concentration difference, were then inputted from DMN regions into separate binary logistic regression models controlling for age, gender, race, clinic site, co-morbid psychiatric diseases, TBI severity, whether or not the TBI was service related, and branch of armed service. Predicted probabilities were then inputted into a receiver operating characteristic analysis to compute sensitivity, specificity, and accuracy. Compared to PSTD, persons with TBI were older, male, and had higher rates of bipolar and major depressive disorder (p TBI in the veterans with 92 % sensitivity, 85 % specificity, and 94 % accuracy. With concentration scans, there was 85 % sensitivity, 83 % specificity and 89 % accuracy. Baseline-concentration (the difference metric between the two scans) scans were 85 % sensitivity, 80 % specificity, and 87 % accuracy. In separating TBI from PTSD/TBI visual readings of baseline scans had 85 % sensitivity, 81 % specificity, and 83 % accuracy. Concentration scans had 80 % sensitivity, 65 % specificity, and 79 % accuracy. Baseline-concentration scans had 82 % sensitivity, 69 % specificity, and 81 % accuracy. For separating PTSD

  16. Cardiac-disease-induced PTSD (CDI-PTSD): A systematic review.

    Science.gov (United States)

    Vilchinsky, Noa; Ginzburg, Karni; Fait, Keren; Foa, Edna B

    2017-07-01

    The goal of the current systematic review was to provide an overview of the findings in the field of Cardiac-Disease-Induced Posttraumatic Stress Disorder (CDI-PTSD) in order to establish CDI-PTSD as a valid diagnostic entity for a wide spectrum of cardiac diseases and related medical procedures. In accordance with PRISMA guidelines, we conducted a systematic electronic literature search. Of the 3202 citations identified, 150 studies meeting the selection criteria were reviewed. Our main findings were that the prevalence of CDI-PTSD ranged between 0% and 38% (averaging at 12%) and was highly dependent on the assessment tool used. The most consistent risk factors are of a psychological nature (e.g., pre-morbid distress). The consequences of CDI-PTSD range from psychosocial difficulties to lack of adherence and heightened mortality rates. Much inconsistency in the field was found with regard to patients who present with diagnoses other than acute coronary syndrome (e.g., cardiac arrest) and who undergo potentially traumatic medical procedures (e.g., defibrillator implantation). Yet the current review seems to strengthen the conceptualization of CDI-PTSD as a valid diagnostic entity, at least with regard to acute cardiac events. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Forskning i musikterapi - posttraumatisk stressbelastning (PTSD)

    DEFF Research Database (Denmark)

    Beck, Bolette Daniels; Mumm, Helle

    2015-01-01

    Denne artikel præsenterer videnskabelige undersøgelser af musikterapi med mennesker, der har fået diagnosen PTSD. Der er forskningsmæssig evidens for at musikterapi kan reducere symptomer på posttraumatisk stress hos børn, unge og voksne. Undersøgelser af musikterapi med voksne med posttraumatisk...... musikterapi med børn og unge med indlæringsproblemer som følge af PTSD viser reduktion af hyperaktivitet, aggression og depression samt øget lydhørhed og forbedrede sociale kompetencer....... stress viser reduktion af symptomer som flashbacks, undgåelsesadfærd, stress samt dissociation, depression og angst. Musikterapi med voksne kan endvidere skabe forbedringer i forhold til søvnkvalitet og social kontakt, samt styrke oplevelsen af mening og sammenhæng i tilværelsen. Undersøgelser af...

  18. Efficacy of Adjunct Sleep Interventions for PTSD

    Science.gov (United States)

    2007-03-01

    dorsed symptoms of restless legs syndrome , periodic leg move- ment disorder, or delayed sleep phase syndrome on most nights associated with difficulty...cycle are offered. & 2007 Elsevier Ltd. All rights reserved.O 57 59 61UN C Introduction Posttraumatic stress disorder (PTSD) is a clinical syndrome ...sleep consolidation is proportional to lesion size.43 The medial prefrontal cortex, and especially the orbitofrontal cortex (OFC), influence sleep, and

  19. Evaluation of a Yoga Intervention for PTSD

    Science.gov (United States)

    2011-10-01

    AD_________________ Award Number: W81XWH-10-1-1066 TITLE: Evaluation of a Yoga Intervention for...CONTRACT NUMBER Evaluation of a Yoga Intervention for PTSD 5b. GRANT NUMBER W81XWH-10-1-1066 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Objective: This pilot study was designed to ascertain whether yoga is a feasible and

  20. Salivary Cortisol: A Psychophysiological Marker for PTSD

    Science.gov (United States)

    2011-04-01

    focused on the effects of pain killers ( morphine ) and the development of PTSD. The results indicated that for Soldiers who received morphine ... hippocampus and prevent neurogenesis in the same regions, both of which can interfere with cognition and the future adaptation to stress (Ganzel, Morris...cortisol can damage areas of the hippocampus . The damage caused by the cortisol then causes a lack of ability to cope with stress in the future. This

  1. Epigenetic Risk Factors in PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Florian Joachim Raabe

    2013-08-01

    Full Text Available Epidemiological and clinical studies have shown that children exposed to adverse experiences are at increased risk for the development of depression, anxiety disorders and PTSD. A history of child abuse and maltreatment increases the likelihood of being subsequently exposed to traumatic events or of developing PTSD as an adult. The brain is highly plastic during early life and encodes acquired information into lasting memories that normally subserve adaptation. Translational studies in rodents showed that enduring sensitization of neuronal and neuroendocrine circuits in response to early life adversity are likely risk factors of life time vulnerability to stress. Hereby, the hypothalamic-pituitary-adrenal (HPA axis integrates cognitive, behavioural and emotional responses to early-life stress and can be epigenetically programmed during sensitive windows of development. Epigenetic mechanisms, comprising reciprocal regulation of chromatin structure and DNA methylation, are important to establish and maintain sustained, yet potentially reversible, changes in gene transcription. The relevance of these findings for the development of PTSD requires further studies in humans where experience-dependent epigenetic programming can additionally depend on genetic variation in the underlying substrates which may protect from or advance disease development. Overall, identification of early-life stress associated epigenetic risk markers informing on previous stress history can help to advance early diagnosis, personalized prevention and timely therapeutic interventions, thus reducing long-term social and health costs.

  2. Cognitive behavioral therapy for PTSD and somatization: an open trial.

    Science.gov (United States)

    Pérez Benítez, Carlos I; Zlotnick, Caron; Gomez, Judelysse; Rendón, Maria J; Swanson, Amelia

    2013-06-01

    No treatment, to date, has been developed to improve both posttraumatic stress disorder (PTSD) and medically unexplained physical symptoms (MUPS), despite mounting evidence of high comorbidity between PTSD and MUPS. This study assessed the feasibility, acceptability, and treatment outcomes of an adapted cognitive behavioral therapy for PTSD and abridged somatization in a sample of eight participants. Fifteen percent of completers did not meet PTSD criteria after treatment completion and 62.5% improved their somatic symptoms. There was a significant difference between pre- and post-treatment depression symptoms, as well as in psychological and physical functioning measures. Results indicated a small to moderate effect size (d = 0.27-0.78) in PTSD severity scores, and moderate to large effect size in depression symptoms and psychosocial and physical functioning variables (d = 0.39-1.12). Preliminary evidence of acceptability indicates that the current CBT intervention may be suitable for Latinos individuals with PTSD and MUPS.

  3. Stress Detection for PTSD via the StartleMart Game

    DEFF Research Database (Denmark)

    Holmgard, C.; Yannakakis, Georgios; Karstoft, K.I.

    2013-01-01

    , we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while...... a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD...... for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools. I....

  4. Stress Detection for PTSD via the StartleMart Game

    DEFF Research Database (Denmark)

    Holmgård, Christoffer; Yannakakis, Georgios; Karstoft, Karen-Inge

    2013-01-01

    Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the positive impact of affect detection and advanced game technology on the treatment of mental diagnoses such as Post Traumatic Stress Disorder (PTSD). For that purpose......, we couple game design and game technology with stress detection for the automatic profiling and the personalized treatment of PTSD via game-based exposure therapy and stress inoculation training. The PTSD treatment game we designed forces the player to go through various stressful experiences while...... a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD...

  5. Evidence for a unique PTSD construct represented by PTSD's D1-D3 symptoms.

    Science.gov (United States)

    Elhai, Jon D; Biehn, Tracey L; Armour, Cherie; Klopper, Jessica J; Frueh, B Christopher; Palmieri, Patrick A

    2011-04-01

    Two models of posttraumatic stress disorder (PTSD) have received the most empirical support in confirmatory factor analytic studies: King, Leskin, King, and Weathers' (1998) Emotional Numbing model of reexperiencing, avoidance, emotional numbing and hyperarousal; and Simms, Watson, and Doebbeling's (2002) Dysphoria model of reexperiencing, avoidance, dysphoria and hyperarousal. These models only differ in placement of three PTSD symptoms: sleep problems (D1), irritability (D2), and concentration problems (D3). In the present study, we recruited 252 women victims of domestic violence and tested whether there is empirical support to separate these three PTSD symptoms into a fifth factor, while retaining the Emotional Numbing and Dysphoria models' remaining four factors. Confirmatory factor analytic findings demonstrated that separating the three symptoms into a separate factor significantly enhanced model fit for the Emotional Numbing and Dysphoria models. These three symptoms may represent a unique latent construct. Implications are discussed.

  6. Compensation and treatment: disability benefits and outcomes of U.S. veterans receiving residential PTSD treatment.

    Science.gov (United States)

    Belsher, Bradley E; Tiet, Quyen Q; Garvert, Donn W; Rosen, Craig S

    2012-10-01

    The U.S. Department of Veterans Affairs (VA) provides specialized intensive posttraumatic stress disorder (PTSD) programs to treat trauma-related symptoms in addition to providing service-connected disability to compensate veterans for injury sustained while serving in the military. Given the percentage of veterans who are receiving treatment for PTSD, in addition to seeking compensation for PTSD, a debate has emerged about the impact of compensation on symptom recovery. This study examined the associations among status of compensation, treatment expectations, military cohort, length of stay, and outcomes for 776 veterans who were enrolled in 5 VA residential PTSD programs between the years of 2005 and 2010. Mixed model longitudinal analyses, with age, gender, and baseline symptoms nested within treatment site in the model, found that treatment expectations were modestly predictive of treatment outcomes. Veterans seeking increased compensation reported marginally lower treatment expectations (d = .008), and did not experience poorer outcomes compared to veterans not seeking increased compensation with the effect of baseline symptoms partialled out. Veterans from the era of the Iraq and Afghanistan conflicts reported lower treatment expectations (d = .020) and slightly higher symptoms at intake (d = .021), but had outcomes at discharge equivalent to veterans from other eras with baseline symptoms partialled out. These findings help further inform the debate concerning disability benefits and symptom changes across time. Published 2012. This article is a US Government work and is in the public domain in the USA.

  7. Gender and offender status predicting treatment success in refugees and asylum seekers with PTSD

    Directory of Open Access Journals (Sweden)

    Håkon Stenmark

    2014-01-01

    Full Text Available Background: Current knowledge is limited regarding patient characteristics related to treatment outcome of posttraumatic stress disorders (PTSD in refugees and asylum seekers. Objective: Gender, torture status, offender status, level of anger, and level of depression were investigated for possible effects on the treatment outcome. Method: Patient characteristics were explored in 54 refugees and asylum seekers who had completed a treatment program for PTSD. Non-responders (10, those who had the same or higher levels of symptom severity after treatment, were compared with responders, those who had lower symptom severity after treatment (44. Symptom severity was measured by Clinician-Administered PTSD Scale. The non-responders and responders constituted the dichotomous, dependent variable. The independent variables were gender, torture status, offender status, level of anger, and level of depression. T-tests and Exact Unconditional Homogeneity/Independence Tests for 2X2 Tables were used to study the relationship to treatment outcome. Results: Being male and reporting to have been a violent offender were significantly more frequent characteristics among the non-responders compared to the responders. The levels of pretreatment anger, depression and torture status did not affect the treatment outcome. Conclusions: The study adds support to findings that females benefit more from treatment of PTSD than males and that violent offenders are difficult to treat within the standard treatment programs.

  8. Prazosin for Treatment With PTSD And Comorbid Alcohol Dependence

    Science.gov (United States)

    2010-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD and alcohol dependence . The objective of this study is to evaluate the efficacy of prazosis (16mg

  9. Intensive Cognitive Therapy for PTSD: A Feasibility Study

    OpenAIRE

    Ehlers, Anke; Clark, David M.; Hackmann, Ann; Grey, Nick; Liness, Sheena; Wild, Jennifer; Manley, John; Waddington, Louise; McManus, Freda

    2010-01-01

    Background: Cognitive Behaviour Therapy (CBT) of anxiety disorders is usually delivered in weekly or biweekly sessions. There is evidence that intensive CBT can be effective in phobias and obsessive compulsive disorder. Studies of intensive CBT for posttraumatic stress disorder (PTSD) are lacking. Method: A feasibility study tested the acceptability and efficacy of an intensive version of Cognitive Therapy for PTSD (CT-PTSD) in 14 patients drawn from consecutive referrals. Patients received u...

  10. Sleep disturbances in veterans with chronic war-induced PTSD

    Science.gov (United States)

    Khazaie, Habibolah; Ghadami, Mohammad Rasoul; Masoudi, Maryam

    2016-01-01

    Abstract: Post-traumatic stress disorder is related to a wide range of medical problems, with a majority of neurological, psychological, cardiovascular, respiratory, gastrointestinal disorders, diabetes, as well as sleep disorders. Although the majority of studies reveal the association between PTSD and sleep disturbances, there are few studies on the assessment of sleep disruption among veterans with PTSD. In this review, we attempt to study the sleep disorders including insomnia, nightmare, sleep-related breathing disorders, sleep-related movement disorders and parasomnias among veterans with chronic war-induced PTSD. It is an important area for further research among veterans with PTSD. PMID:27093088

  11. Cortisol at the Emergency Room Rape Visit as a Predictor of PTSD and Depression Symptoms Over Time

    Science.gov (United States)

    Walsh, Kate; Nugent, Nicole R.; Kotte, Amelia; Amstadter, Ananda B.; Wang, Sheila; Guille, Constance; Acierno, Ron; Kilpatrick, Dean G.; Resnick, Heidi S.

    2013-01-01

    Background Dysregulation of the hypothalamic-pituitary-adrenal axis, typically reflected by alterations in cortisol responsivity, has been associated with exposure to traumatic events and the development of stress-related disorders such as posttraumatic stress disorder (PTSD) and depression. Methods Serum cortisol was measured at the time of a post sexual assault medical exam among a sample of 323 female victims of recent sexual assault. Analyses were conducted among 235 participants who provided data regarding history of previous assault as well as PTSD and depression symptoms during at least one of three follow-ups. Results Growth curve models suggested that prior history of assault and serum cortisol were positively associated with the intercept and negatively associated with the slope of PTSD and depression symptoms after controlling for covariates. Prior history of assault and serum cortisol also interacted to predict the intercept and slope of PTSD and depression symptoms such that women with a prior history of assault and lower ER cortisol had higher initial symptoms that decreased at a slower rate relative to women without a prior history and those with higher ER cortisol. Conclusions Prior history of assault was associated with diminished acute cortisol responsivity at the emergency room visit. Prior assault history and cortisol both independently and interactively predicted PTSD and depression symptoms at first follow-up and over the course a six-month follow-up. PMID:23806832

  12. War trauma, child labor, and family violence: life adversities and PTSD in a sample of school children in Kabul.

    Science.gov (United States)

    Catani, Claudia; Schauer, Elisabeth; Elbert, Thomas; Missmahl, Inge; Bette, Jean-Paul; Neuner, Frank

    2009-06-01

    The extent of cumulative adverse childhood experiences such as war, family violence, child labor, and poverty were assessed in a sample of school children (122 girls, 165 boys) in Kabul, Afghanistan. Strong gender differences were found with respect to both the frequency of such experiences and the association of different types of stressors with posttraumatic stress disorder (PTSD) symptoms. Boys reported higher overall amounts of traumatic events, specifically experiences of violence at home. This was reflected in a 26% prevalence of probable PTSD in boys compared to 14% in girls. Child labor emerged as a common phenomenon in the examined sample and was furthermore associated with an increased likelihood of experiencing family violence for girls. The results suggest that the interplay of multilevel stressors in Afghan children contributes to a higher vulnerability for the development of PTSD.

  13. Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers.

    Science.gov (United States)

    Berger, William; Coutinho, Evandro Silva Freire; Figueira, Ivan; Marques-Portella, Carla; Luz, Mariana Pires; Neylan, Thomas C; Marmar, Charles R; Mendlowicz, Mauro Vitor

    2012-06-01

    We sought to estimate the pooled current prevalence of posttraumatic stress disorder (PTSD) among rescue workers and to determine the variables implicated in the heterogeneity observed among the prevalences of individual studies. A systematic review covering studies reporting on the PTSD prevalence in rescue teams was conducted following four sequential steps: (1) research in specialized online databases, (2) review of abstracts and selection of studies, (3) review of reference list, and (4) contact with authors and experts. Prevalence data from all studies were pooled using random effects model. Multivariate meta-regression models were fitted to identify variables related to the prevalences heterogeneity. A total of 28 studies, reporting on 40 samples with 20,424 rescuers, were selected. The worldwide pooled current prevalence was 10%. Meta-regression modeling in studies carried out in the Asian continent had, on average, higher estimated prevalences than those from Europe, but not higher than the North American estimates. Studies of ambulance personnel also showed higher estimated PTSD prevalence than studies with firefighters and police officers. Rescue workers in general have a pooled current prevalence of PTSD that is much higher than that of the general population. Ambulance personnel and rescuers from Asia may be more susceptible to PTSD. These results indicate the need for improving pre-employment strategies to select the most resilient individuals for rescue work, to implement continuous preventive measures for personnel, and to promote educational campaigns about PTSD and its therapeutic possibilities.

  14. Integrated Treatment of PTSD and Substance Use Disorders: The Mediating Role of PTSD Improvement in the Reduction of Depression

    Directory of Open Access Journals (Sweden)

    Kristina J. Korte

    2017-01-01

    Full Text Available Posttraumatic stress disorder (PTSD represents one of the most common mental health disorders, particularly among veterans, and is associated with significant distress and impairment. This highly debilitating disorder is further complicated by common comorbid psychiatric disorders, such as substance use disorders (SUD. Individuals with PTSD and co-occurring SUD also commonly present with secondary symptoms, such as elevated depression. Little is known, however, about how these secondary symptoms are related to treatment outcome. The aim of the present study, therefore, was to examine (1 the effects of treatment of comorbid PTSD/SUD on depressive symptoms; and (2 whether this effect was mediated by changes in PTSD severity or changes in SUD severity. Participants were 81 U.S. military veterans (90.1% male with PTSD and SUD enrolled in a randomized controlled trial examining the efficacy of an integrated, exposure-based treatment (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure; n = 54 versus relapse prevention (n = 27. Results revealed significantly lower depressive symptoms at post-treatment in the COPE group, as compared to the relapse prevention group. Examination of the mechanisms associated with change in depression revealed that reduction in PTSD severity, but not substance use severity, mediated the association between the treatment group and post-treatment depression. The findings underscore the importance of treating PTSD symptoms in order to help reduce co-occurring symptoms of depression in individuals with PTSD/SUD. Clinical implications and avenues for future research are discussed.

  15. Lifetime history of traumatic events in a young adult Mexican American sample: Relation to substance dependence, affective disorder, acculturation stress, and PTSD.

    Science.gov (United States)

    Ehlers, Cindy L; Kim, Corinne; Gilder, David A; Stouffer, Gina M; Caetano, Raul; Yehuda, Rachel

    2016-12-01

    Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18-30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure.

  16. Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: a study of within-person processes

    Science.gov (United States)

    Hoffart, Asle; Øktedalen, Tuva; Langkaas, Tomas F.

    2015-01-01

    Although self-compassion is considered a promising change agent in the treatment of posttraumatic stress disorder (PTSD), no studies of this hypothesis exist. This study examined the within-person relationship of self-compassion components (self-kindness, common humanity, mindfulness, self-judgment, isolation, over-identification) and subsequent PTSD symptoms over the course of therapy. Method: PTSD patients (n = 65) were randomized to either standard prolonged exposure, which includes imaginal exposure (IE) to the traumatic memory, or modified prolonged exposure, where imagery re-scripting (IR) of the memory replaced IE as the imagery component of prolonged exposure in a 10 weeks residential program. They were assessed weekly on self-compassion and PTSD symptom measures. The centering method of detrending was used to separate the variance related to the within-person process of change over the course of treatment from between-person variance. Results: The self-compassion components self-kindness, self-judgment, isolation, and over-identification had a within-person effect on subsequent PTSD symptoms. These relationships were independent of therapy form. The within-person relationship between self-judgment and subsequent PTSD symptoms was stronger in patients with higher initial self-judgment. By contrast, there were few indications that within-person variations in PTSD symptoms predict subsequent self-compassion components. Conclusion: The results support the role of self-compassion components in maintaining PTSD and imply the recommendation to facilitate decrease of self-judgment, isolation, and over-identification and increase of self-kindness in the treatment of PTSD patients. The reduction of self-judgment appears to be most important, especially for patients with a high initial level of self-judgment. PMID:26379596

  17. Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: A study of within-person processes

    Directory of Open Access Journals (Sweden)

    Asle eHoffart

    2015-08-01

    Full Text Available AbstractAlthough self-compassion is considered a promising change agent in the treatment of PTSD, no studies of this hypothesis exist. This study examined the within-person relationship of self-compassion components (self-kindness, common humanity, mindfulness, self-judgment, isolation, over-identification and subsequent PTSD symptoms over the course of therapy. Method: PTSD patients (n = 65 were randomized to either standard prolonged exposure, which includes imaginal exposure (IE to the traumatic memory, or modified prolonged exposure, where imagery re-scripting (IR of the memory replaced IE as the imagery component of prolonged exposure in a 10 week residential program. They were assessed weekly on self-compassion and PTSD symptom measures. The centering method of detrending was used to separate the variance related to the within-person process of change over the course of treatment from between-person variance. Results: The self-compassion components self-kindness, self-judgment, isolation, and over-identification had a within-person effect on subsequent PTSD symptoms. These relationships were independent of therapy form. The within-person relationship between self-judgment and subsequent PTSD symptoms was stronger in patients with higher initial self-judgment. By contrast, there were few indications that within-person variations in PTSD symptoms predict subsequent self-compassion components. Conclusion: The results support the role of self-compassion components in maintaining PTSD and imply the recommendation to facilitate decrease of self-judgment, isolation, and over-identification and increase of self-kindness in the treatment of PTSD patients. The reduction of self-judgment appears to be most important, especially for patients with a high initial level of self-judgment.

  18. Estrogen-dependent association of HDAC4 with fear in female mice and women with PTSD.

    Science.gov (United States)

    Maddox, S A; Kilaru, V; Shin, J; Jovanovic, T; Almli, L M; Dias, B G; Norrholm, S D; Fani, N; Michopoulos, V; Ding, Z; Conneely, K N; Binder, E B; Ressler, K J; Smith, A K

    2017-01-17

    Women are at increased risk of developing post-traumatic stress disorder (PTSD) following a traumatic event. Recent studies suggest that this may be mediated, in part, by circulating estrogen levels. This study evaluated the hypothesis that individual variation in response to estrogen levels contributes to fear regulation and PTSD risk in women. We evaluated DNA methylation from blood of female participants in the Grady Trauma Project and found that serum estradiol levels associates with DNA methylation across the genome. For genes expressed in blood, we examined the association between each CpG site and PTSD diagnosis using linear models that adjusted for cell proportions and age. After multiple test correction, PTSD associated with methylation of CpG sites in the HDAC4 gene, which encodes histone deacetylase 4, and is involved in long-term memory formation and behavior. DNA methylation of HDAC4 CpG sites were tagged by a nearby single-nucleotide polymorphism (rs7570903), which also associated with HDAC4 expression, fear-potentiated startle and resting-state functional connectivity of the amygdala in traumatized humans. Using auditory Pavlovian fear conditioning in a rodent model, we examined the regulation of Hdac4 in the amygdala of ovariectomized (OVX) female mice. Hdac4 messenger RNA levels were higher in the amygdala 2 h after tone-shock presentations, compared with OVX-homecage control females. In naturally cycling females, tone-shock presentations increased Hdac4 expression relative to homecage controls for metestrous (low estrogen) but not the proestrous (high estrogen) group. Together, these results support an estrogenic influence of HDAC4 regulation and expression that may contribute to PTSD in women.Molecular Psychiatry advance online publication, 17 January 2017; doi:10.1038/mp.2016.250.

  19. Complex PTSD and phased treatment in refugees: a debate piece.

    Science.gov (United States)

    Ter Heide, F Jackie June; Mooren, Trudy M; Kleber, Rolf J

    2016-01-01

    Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD. The aim of this debate piece is to defend two theses: (1) that complex trauma leads to complex PTSD in a minority of refugees only and (2) that trauma-focused treatment should be offered to all refugees who seek treatment for PTSD. The first thesis is defended by comparing data on the prevalence of complex PTSD in refugees to those in other trauma-exposed populations, using studies derived from a systematic review. The second thesis is defended using conclusions of systematic reviews and a meta-analysis of the efficacy of psychotherapeutic treatment in refugees. Research shows that refugees are more likely to meet a regular PTSD diagnosis or no diagnosis than a complex PTSD diagnosis and that prevalence of complex PTSD in refugees is relatively low compared to that in survivors of childhood trauma. Effect sizes for trauma-focused treatment in refugees, especially narrative exposure therapy (NET) and culturally adapted cognitive-behaviour therapy (CA-CBT), have consistently been found to be high. Complex PTSD in refugees should not be assumed to be present on the basis of complex traumatic experiences but should be carefully diagnosed using a validated interview. In line with treatment guidelines for PTSD, a course of trauma-focused treatment should be offered to all refugees seeking treatment for PTSD, including asylum seekers.

  20. Complex PTSD and phased treatment in refugees: a debate piece

    Directory of Open Access Journals (Sweden)

    F. Jackie June ter Heide

    2016-02-01

    Full Text Available Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD. Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD. Objective: The aim of this debate piece is to defend two theses: (1 that complex trauma leads to complex PTSD in a minority of refugees only and (2 that trauma-focused treatment should be offered to all refugees who seek treatment for PTSD. Methods: The first thesis is defended by comparing data on the prevalence of complex PTSD in refugees to those in other trauma-exposed populations, using studies derived from a systematic review. The second thesis is defended using conclusions of systematic reviews and a meta-analysis of the efficacy of psychotherapeutic treatment in refugees. Results: Research shows that refugees are more likely to meet a regular PTSD diagnosis or no diagnosis than a complex PTSD diagnosis and that prevalence of complex PTSD in refugees is relatively low compared to that in survivors of childhood trauma. Effect sizes for trauma-focused treatment in refugees, especially narrative exposure therapy (NET and culturally adapted cognitive-behaviour therapy (CA-CBT, have consistently been found to be high. Conclusions: Complex PTSD in refugees should not be assumed to be present on the basis of complex traumatic experiences but should be carefully diagnosed using a validated interview. In line with treatment guidelines for PTSD, a course of trauma-focused treatment should be offered to all refugees seeking treatment for PTSD, including asylum seekers.

  1. Demonstrating the Efficacy of Group Prolonged Exposure Treatment of PTSD in OEF/OIF/OND Male Veterans

    Science.gov (United States)

    2015-12-01

    other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a...behaviors. PCT is a non-trauma focused treatment for PTSD, where the mechanisms of change include altering current maladaptive relational patterns and...RESPONSIBLE PERSON USAMRMC a. REPORT Unclassified b. ABSTRACT Unclassified c. THIS PAGE Unclassified Unclassified 19b. TELEPHONE NUMBER (include

  2. A Longitudinal Analysis of PTSD Symptom Course: Delayed-Onset PTSD in Somalia Peacekeepers

    Science.gov (United States)

    Gray, Matt J.; Bolton, Elisa E.; Litz, Brett T.

    2004-01-01

    Posttraumatic stress disorder (PTSD) typically follows an acute to chronic course. However, some trauma victims do not report significant symptoms until a period of time has elapsed after the event. Although originally dismissed as an artifact of retrospective methodologies, recent prospective studies document apparent instances of delayed-onset…

  3. Symptom structure of PTSD: support for a hierarchical model separating core PTSD symptoms from dysphoria

    NARCIS (Netherlands)

    Rademaker, A.R.; Minnen, A. van; Ebberink, F.; Zuiden, M. van; Geuze, E.

    2012-01-01

    Background: As of yet, no collective agreement has been reached regarding the precise factor structure of posttraumatic stress disorder (PTSD). Several alternative factor-models have been proposed in the last decades. Objective: The current study examined the fit of a hierarchical adaptation of the

  4. MDMA and PTSD treatment: "PTSD: From novel pathophysiology to innovative therapeutics".

    Science.gov (United States)

    Sessa, Ben

    2017-05-10

    There is a range of therapies to treat Post Traumatic Stress Disorder (PTSD) but treatment resistance remains high, with many sufferers experiencing the chronic condition. Engagement in trauma-focused psychotherapy is difficult for some patients with PTSD, especially those with extreme affect dysregulation associated with recall of traumatic memories. In recent years there have been a number of neuroscientific and clinical studies examining the potential role for adjunctive drug-assisted psychotherapy using 3,4,-methylenedioxmethamphetamine (MDMA) as a treatment for PTSD. re-visiting of a novel approach to trauma-focused psychotherapy with Used just two or three times, under careful medical supervision and specialised psychotherapy support MDMA appears to facilitate the recall of traumatic memories without the user feeling overwhelmed by the negative affect that usually accompanies such memories. This therapeutic approach began in the 1980s and was subsequently shelved in the midst of public health concerns surrounding the recreational use of the drug ecstasy. When pharmaceutical grade MDMA is used in a clinical setting it does not share the same risk profiles as ecstasy. Recent phase one neurophysiological studies and phase two clinical studies are showing promise as a potential new approach to managing treatment-resistant PTSD. Crown Copyright © 2016. Published by Elsevier B.V. All rights reserved.

  5. Military display market segment: helicopters

    Science.gov (United States)

    Desjardins, Daniel D.; Hopper, Darrel G.

    2004-09-01

    The military display market is analyzed in terms of one of its segments: helicopter displays. Parameters requiring special consideration, to include luminance ranges, contrast ratio, viewing angles, and chromaticity coordinates, are examined. Performance requirements for rotary-wing displays relative to several premier applications are summarized. Display sizes having aggregate defense applications of 5,000 units or greater and having DoD applications across 10 or more platforms, are tabulated. The issue of size commonality is addressed where distribution of active area sizes across helicopter platforms, individually, in groups of two through nine, and ten or greater, is illustrated. Rotary-wing displays are also analyzed by technology, where total quantities of such displays are broken out into CRT, LCD, AMLCD, EM, LED, Incandescent, Plasma and TFEL percentages. Custom, versus Rugged commercial, versus commercial off-the-shelf designs are contrasted. High and low information content designs are identified. Displays for several high-profile military helicopter programs are discussed, to include both technical specifications and program history. The military display market study is summarized with breakouts for the helicopter market segment. Our defense-wide study as of March 2004 has documented 1,015,494 direct view and virtual image displays distributed across 1,181 display sizes and 503 weapon systems. Helicopter displays account for 67,472 displays (just 6.6% of DoD total) and comprise 83 sizes (7.0% of total DoD) in 76 platforms (15.1% of total DoD). Some 47.6% of these rotary-wing applications involve low information content displays comprising just a few characters in one color; however, as per fixed-wing aircraft, the predominant instantiation involves higher information content units capable of showing changeable graphics, color and video.

  6. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders

    Directory of Open Access Journals (Sweden)

    Pascal Wabnitz

    2013-11-01

    Full Text Available Background: The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Methods: Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Results: Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Conclusion: Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

  7. National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria.

    Science.gov (United States)

    Kilpatrick, Dean G; Resnick, Heidi S; Milanak, Melissa E; Miller, Mark W; Keyes, Katherine M; Friedman, Matthew J

    2013-10-01

    Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association's Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom.

  8. Differences in trauma history and psychopathology between PTSD patients with and without co-occurring dissociative disorders.

    Science.gov (United States)

    Wabnitz, Pascal; Gast, Ursula; Catani, Claudia

    2013-01-01

    The interplay between different types of potentially traumatizing events, posttraumatic symptoms, and the pathogenesis of PTSD or major dissociative disorders (DD) has been extensively studied during the last decade. However, the phenomenology and nosological classification of posttraumatic disorders is currently under debate. The current study was conducted to investigate differences between PTSD patients with and without co-occurring major DD with regard to general psychopathology, trauma history, and trauma-specific symptoms. Twenty-four inpatients were administered the Clinician-Administered PTSD Scale for DSM-IV (CAPS) and the Mini-Structured Clinical Interview for DSM-IV Dissociative Disorders (MINI-SKID-D) to assess DD and PTSD. Additionally, participants completed questionnaires to assess general psychopathology and health status. Symptom profiles and axis I comorbidity were similar in all patients. Traumatic experiences did not differ between the two groups, with both reporting high levels of childhood trauma. Only trauma-specific avoidance behavior and dissociative symptoms differed between groups. Results support the view that PTSD and DD are affiliated disorders that could be classified within the same diagnostic category. Our results accord with a typological model of dissociation in which profound forms of dissociation are specific to DD and are accompanied with higher levels of trauma-specific avoidance in DD patients.

  9. Aggression in US soldiers post-deployment: Associations with combat exposure and PTSD and the moderating role of trait anger.

    Science.gov (United States)

    Wilk, Joshua E; Quartana, Phillip J; Clarke-Walper, Kristina; Kok, Brian C; Riviere, Lyndon A

    2015-01-01

    Anger and aggression are among the most common issues reported by returning service members from combat deployments. However, the pathways between combat exposure and anger and aggression have not been comprehensively characterized. The present study aimed to characterize the relationship between trait anger, combat exposure, post-deployment PTSD, and aggression. U.S. Army soldiers (N = 2,420) were administered anonymous surveys assessing combat exposure, current PTSD symptoms and aggression, as well as trait anger items 3 months after returning from deployment to Afghanistan. PTSD symptom levels were related to aggression at higher levels of trait anger, but not evident among soldiers who had lower levels of trait anger. The pathway from combat exposure to PTSD, and then to aggression, was conditional upon levels of trait anger, such that the pathway was most evident at high levels of trait anger. This was the first study to our knowledge that concurrently modeled unconditional and conditional direct and indirect associations between combat exposure, PTSD, trait anger, and aggression. The findings can be helpful clinically and for developing screening protocols for combat exposed Soldiers. The results of this study suggest the importance of assessing and managing anger and aggression in soldiers returning from combat deployment. Anger is one of the most common complaints of returning soldiers and can have debilitating effects across all domains of functioning. It is imperative that future research efforts are directed toward understanding this phenomenon and developing and validating effective treatments for it.

  10. The A1 allele of the DRD2 TaqA1/A2 polymorphism as risk factor for PTSD

    Directory of Open Access Journals (Sweden)

    Ahmed Rady

    2011-09-01

    Full Text Available Background and Objectives: Dopaminergic neurotransmission is implicated in stress responses. The dopamine D2 receptor gene (DRD2 has been studied by the authors to assess its possible role as a predictor of those who are at a higher risk to develop PTSD after major psychological trauma. Methods: Over one year period 75 children and adolescents 6-18 yrs of age who had been exposed to moderate to severe burns were recruited from the burn unit at the Alexandria University Hospital for the study. Patients and their family were interviewed within the first 10 days of exposure. After signing a written consent form a 2 ml blood sample was obtained for genetic studies of the TaqA1/A2 polymorphism site of the DRD2 gene. Patients were reevaluated three and six months later for assessment of PTSD. Results: Among the 75 children recruited in the study, 26 died due to their burn injury, 19 dropped out as parents refused follow up and 30 continued the study follow up visits. Fourteen carried the A1A2 genotype. Of these 11 (78.6% developed PTSD. Sixteen carried the A2A2 genotype. Of these only one child (6.3% developed PTSD. The results were significant at p < 0.001 with a relative risk 12.5. Conclusions: Following exposure to severe stress, the presence of the Taq A1 allele of the DRD2 gene results in a significant increase in the risk of developing PTSD.

  11. National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using DSM-IV and DSM-5 Criteria

    Science.gov (United States)

    Kilpatrick, Dean G.; Resnick, Heidi S.; Milanak, Melissa E.; Miller, Mark W.; Keyes, Katherine M.; Friedman, Matthew J.

    2014-01-01

    Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association’s Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom. PMID:24151000

  12. Negative Responses to Disclosure of Sexual Victimization and Victims' Symptoms of PTSD and Depression: The Protective Role of Ethnic Identity.

    Science.gov (United States)

    Nikulina, Valentina; Bautista, Adrian; Brown, Elissa J

    2016-11-03

    College-aged women experience high rates of sexual victimization. Their postassault symptoms are associated with the types of responses they receive from the people to whom they disclose these experiences. Negative responses are pervasive and associated with poorer outcomes. The current study examined whether a strong sense of ethnic identity and comfort with the mainstream culture moderate the association between negative responses to the first disclosure of sexual victimization and symptoms of posttraumatic stress disorder (PTSD) and depression. A diverse sample (10% Black/African American, 51% White, 39% Other, and 66% Hispanic) of undergraduate women was recruited from two urban, Eastern United States universities for this online study. Participants reported histories of sexual victimization, demographics, responses to sexual assault disclosure (i.e., victim blame, treating the victim differently, taking control, distraction, and egocentric reactions), symptoms of PTSD and depression, and their ethnic identity and mainstream cultural comfort. Thirty-seven percent (n = 221) endorsed an experience of sexual victimization, and 165 disclosed it to someone. Hierarchical ordinary least squares regressions revealed that a stronger sense of ethnic identity was associated with fewer symptoms of PTSD for those women who experienced higher levels of control, distraction, and egocentric responses from the first disclosure recipient. A strong sense of affiliation with the mainstream culture did not protect survivors who reported receiving negative responses to disclosure against symptoms of PTSD or depression. Ethnic affiliation may protect women against PTSD when they receive high levels of negative messages about sexual victimization experiences.

  13. Different regional gray matter loss in recent onset PTSD and non PTSD after a single prolonged trauma exposure.

    Directory of Open Access Journals (Sweden)

    Yunchun Chen

    Full Text Available OBJECTIVE: Gray matter loss in the limbic structures was found in recent onset post traumatic stress disorder (PTSD patients. In the present study, we measured regional gray matter volume in trauma survivors to verify the hypothesis that stress may cause different regional gray matter loss in trauma survivors with and without recent onset PTSD. METHOD: High resolution T1-weighted magnetic resonance imaging (MRI were obtained from coal mine flood disaster survivors with (n = 10 and without (n = 10 recent onset PTSD and 20 no trauma exposed normal controls. The voxel-based morphometry (VBM method was used to measure the regional gray matter volume in three groups, the correlations of PTSD symptom severities with the gray matter volume in trauma survivors were also analyzed by multiple regression. RESULTS: Compared with normal controls, recent onset PTSD patients had smaller gray matter volume in left dorsal anterior cingulate cortex (ACC, and non PTSD subjects had smaller gray matter volume in the right pulvinar and left pallidum. The gray matter volume of the trauma survivors correlated negatively with CAPS scores in the right frontal lobe, left anterior and middle cingulate cortex, bilateral cuneus cortex, right middle occipital lobe, while in the recent onset PTSD, the gray matter volume correlated negatively with CAPS scores in bilateral superior medial frontal lobe and right ACC. CONCLUSION: The present study identified gray matter loss in different regions in recent onset PTSD and non PTSD after a single prolonged trauma exposure. The gray matter volume of left dorsal ACC associated with the development of PTSD, while the gray matter volume of right pulvinar and left pallidum associated with the response to the severe stress. The atrophy of the frontal and limbic cortices predicts the symptom severities of the PTSD.

  14. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias; Spindler, Helle

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinatio...

  15. Childhood Maltreatment, PTSD, and Suicidal Behavior among African American Females.

    Science.gov (United States)

    Thompson, Martie P.; Kaslow, Nadine J.; Lane, Danielle Bradshaw; Kingree, J. B.

    2000-01-01

    Investigates how childhood maltreatment and current post-traumatic stress disorder (PTSD) predict nonfatal suicide attempts among 335 African American women. PTSD in combination with any of the maltreatments of childhood increased the risk of suicide attempts. Suggests that interventions designed to reduce suicidal behavior should focus on women…

  16. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias; Spindler, Helle

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinatio...

  17. Revisiting propranolol and PTSD: Memory erasure or extinction enhancement?

    Science.gov (United States)

    Giustino, Thomas F; Fitzgerald, Paul J; Maren, Stephen

    2016-04-01

    Posttraumatic stress disorder (PTSD) has been described as the only neuropsychiatric disorder with a known cause, yet effective behavioral and pharmacotherapies remain elusive for many afflicted individuals. PTSD is characterized by heightened noradrenergic signaling, as well as a resistance to extinction learning. Research aimed at promoting more effective treatment of PTSD has focused on memory erasure (disrupting reconsolidation) and/or enhancing extinction retention through pharmacological manipulations. Propranolol, a β-adrenoceptor antagonist, has received considerable attention for its therapeutic potential in PTSD, although its impact on patients is not always effective. In this review, we briefly examine the consequences of β-noradrenergic manipulations on both reconsolidation and extinction learning in rodents and in humans. We suggest that propranolol is effective as a fear-reducing agent when paired with behavioral therapy soon after trauma when psychological stress is high, possibly preventing or dampening the later development of PTSD. In individuals who have already suffered from PTSD for a significant period of time, propranolol may be less effective at disrupting reconsolidation of strong fear memories. Also, when PTSD has already developed, chronic treatment with propranolol may be more effective than acute intervention, given that individuals with PTSD tend to experience long-term, elevated noradrenergic hyperarousal.

  18. [Development and Validation of a Screening Instrument for Complex PTSD].

    Science.gov (United States)

    Dorr, Florence; Firus, Christian; Kramer, Rolf; Bengel, Jürgen

    2016-11-01

    Chronic interpersonal traumata systematically result in psychological impairments referred to as complex post-traumatic stress disorder (cPTSD or DESNOS). This diagnosis will be newly established in the ICD-11 system. However, there is need for diagnostic instruments to assess cPTSD. The aim was to develop a screening form to identify patients at risk for cPTSD. The Screening for complex PTSD (SkPTBS) tests a) experience of potential traumatic events, b) related influential features and risk factors, and c) symptoms of cPTSD. 325 patients (mean age 51.5±8.7 years; 62.1% female) filled out the screening instrument at the beginning of their inpatient psychotherapy. The primary criterion for testing SkPTBS validity was the diagnosis of complex PTSD at the end of the inpatient treatment. The proportion of patients with cPTSD was 8.9% (n=29). SkPTBS items were selective, and the scale showed very good reliability (α=0.91). Factor analysis revealed a one-dimensional structure. SkPTBS total values predicted having cPTSD diagnosis and were correlated with global symptom severity (SCL-90-R) and depressive symptoms (BDI-II). There is evidence for high clinical utility of SkPTBS. A revised version was developed. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Pathways to PTSD, part I: Children with burns.

    Science.gov (United States)

    Saxe, Glenn N; Stoddard, Frederick; Hall, Erin; Chawla, Neharika; Lopez, Carlos; Sheridan, Robert; King, Daniel; King, Lynda; Yehuda, Rachel

    2005-07-01

    The goal of this study was to develop a model of risk factors for posttraumatic stress disorder (PTSD) in a group of acutely burned children. Seventy-two children between the ages of 7 and 17 who were admitted to the hospital for an acute burn were eligible for study. Members of families who consented completed the Child PTSD Reaction Index, the Multidimensional Anxiety Scale for Children, and other self-report measures of psychopathology and environmental stress both during the hospitalization and 3 months following the burn. A path analytic strategy was used to build a model of risk factors for PTSD. Two pathways to PTSD were discerned: 1) from the size of the burn and level of pain following the burn to the child's level of acute separation anxiety, and then to PTSD, and 2) from the size of the burn to the child's level of acute dissociation following the burn, and then to PTSD. Together these pathways accounted for almost 60% of the variance in PTSD symptoms and constituted a model with excellent fit indices. These findings support a model of complex etiology for childhood PTSD in which two independent pathways may be mediated by different biobehavioral systems.

  20. Psychophysiological assessment of PTSD: a potential research domain criteria construct.

    Science.gov (United States)

    Bauer, Margaret R; Ruef, Anna M; Pineles, Suzanne L; Japuntich, Sandra J; Macklin, Michael L; Lasko, Natasha B; Orr, Scott P

    2013-09-01

    Most research on posttraumatic stress disorder (PTSD) relies on clinician-administered interview and self-report measures to establish the presence/absence and severity of the disorder. Accurate diagnosis of PTSD is made challenging by the presence of symptoms shared with other psychopathologies and the subjective nature of patients' descriptions of their symptoms. A physiological assessment capable of reliably "diagnosing" PTSD could provide adjunctive information that might mitigate these diagnostic limitations. In the present study, we examined the construct validity of a potential psychophysiological measure of PTSD, that is, psychophysiological reactivity to script-driven imagery (SDI-PR), as measured against the current diagnostic "gold-standard" for PTSD, the Clinician-Administered PTSD Scale (CAPS). Convergent and predictive validity and stability were examined. Thirty-six individuals completed an SDI-PR procedure, the CAPS, and self-report measures of mental and physical health at their initial visit and approximately 6 months later. SDI-PR and the CAPS demonstrated excellent stability across measurement occasions. SDI-PR showed moderately strong convergent validity with the CAPS. After adjusting for self-reported depression, predictive validity for the CAPS, with regard to health sequelae, was reduced, whereas it remained mostly unchanged for SDI-PR. Findings support SDI-PR as a valid and stable measure of PTSD that captures a pathophysiologic process in individuals with PTSD. Results are discussed with regard to the research domain criteria framework.

  1. Alternative models of DSM-5 PTSD: Examining diagnostic implications.

    Science.gov (United States)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask; Yong Chen, Yoke; Raudzah Ghazali, Siti; Shevlin, Mark

    2017-09-09

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed models. This study aimed to generate PTSD prevalence estimates derived from the 7 alternative factor models and assess whether pre-established risk factors associated with PTSD (e.g., transportation accidents and sexual victimisation) produce consistent risk estimates. Seven alternative models were estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n = 481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit with statistical superiority for the Externalising Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models, with substantial variation emerging for sexual victimisation. These findings have important implications for research and practice and highlight that more research attention is needed to examine the diagnostic implications emerging from the alternative models of PTSD. Copyright © 2017. Published by Elsevier B.V.

  2. Attachment typologies and posttraumatic stress disorder (PTSD, depression and anxiety: a latent profile analysis approach

    Directory of Open Access Journals (Sweden)

    Cherie Armour

    2011-12-01

    Full Text Available Bartholomew (1990 proposed a four category adult attachment model based on Bowlby's (1973 proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS. In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990. Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. A large sample of Danish trauma victims (N=1577 participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. The three class solution was considered optimal. Class one was termed Fearful (18.6%, Class two Preoccupied (34.5%, and Class three Secure (46.9%. The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post

  3. Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Shevlin, Mark

    2011-01-01

    Background Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. Objective The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. Method A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. Results The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. Conclusions The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display

  4. Prevalence of PTSD and Depression, and Associated Sexual Risk Factors, among Male Rwanda Defense Forces Military Personnel

    Science.gov (United States)

    2013-08-01

    discharge from your penis ?’ and ‘Have you had an ulcer or sore on or near your penis ?’); specific sex partner types in the past 3 months: (i) regular...differ- ent by PTSD status (likely because of insufficient sample size ), it was higher in those who screened positive for PTSD than those who did not (3.9...reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching

  5. Alternative models of DSM-5 PTSD: Examining diagnostic implications

    DEFF Research Database (Denmark)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask

    2017-01-01

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed...... estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n=481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit...... with statistical superiority for the Externalizing Behaviours and seven-factor Hybrid models. The PTSD prevalence estimates varied substantially ranging from 21.8% for the DSM-5 model to 10.0% for the Hybrid model. Estimates of risk associated with PTSD were inconsistent across the alternative models...

  6. PTSD in railroad drivers under the Federal employers' liability act.

    Science.gov (United States)

    Weiss, Kenneth J; Farrell, J Michael

    2006-01-01

    Railroad and subway drivers can experience psychological trauma when trains strike or nearly miss other trains, motor vehicles, or persons or become instruments of death. Derailments, collisions, and suicides on the tracks can induce feelings of helplessness, horror, guilt, and anxiety in the drivers. Although some drivers experience acute stress disorder (ASD) or post-traumatic stress disorder (PTSD), their conditions are not always acknowledged within the occupational setting. The world literature suggests that PTSD has been an increasing focus of concern, giving rise to detailed intervention protocols. In the United States, the Federal Employers' Liability Act (FELA) governs the adjudication of work-related injuries among railroad employees. In practice, it is difficult for railroad drivers with PTSD to receive benefits if there was no "direct impact" linked to the employer's negligence. In this article, the authors review the literature on PTSD among railroad drivers, discuss relevant case law, and explain how the FELA militates against some employees with PTSD.

  7. Sexual Harassment and Assault as Predictors of PTSD Symptomatology among U.S. Female Persian Gulf Military Personnel.

    Science.gov (United States)

    Wolfe, Jessica; Sharkansky, Erica J.; Read, Jennifer P.; Dawson, Ree; Ouimette, Paige Crosby; Martin, James A.

    1998-01-01

    Examines sexual harassment and assault of women in a wartime military example. Explores the impacts of these stressors and combat exposure on posttraumatic stress disorder (PTSD) symptomatology. Harassment and assault were higher than in civilian and peacetime military samples. The number of postwar stressful life events mediated the relationship…

  8. Effects of interpersonal violence-related post-traumatic stress disorder (PTSD) on mother and child diurnal cortisol rhythm and cortisol reactivity to a laboratory stressor involving separation.

    Science.gov (United States)

    Cordero, Maria I; Moser, Dominik A; Manini, Aurelia; Suardi, Francesca; Sancho-Rossignol, Ana; Torrisi, Raffaella; Rossier, Michel F; Ansermet, François; Dayer, Alexandre G; Rusconi-Serpa, Sandra; Schechter, Daniel S

    2017-04-01

    Women who have experienced interpersonal violence (IPV) are at a higher risk to develop posttraumatic stress disorder (PTSD), with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and impaired social behavior. Previously, we had reported impaired maternal sensitivity and increased difficulty in identifying emotions (i.e. alexithymia) among IPV-PTSD mothers. One of the aims of the present study was to examine maternal IPV-PTSD salivary cortisol levels diurnally and reactive to their child's distress in relation to maternal alexithymia. Given that mother-child interaction during infancy and early childhood has important long-term consequences on the stress response system, toddlers' cortisol levels were assessed during the day and in response to a laboratory stressor. Mothers collected their own and their 12-48month-old toddlers' salivary samples at home three times: 30min after waking up, between 2-3pm and at bedtime. Moreover, mother-child dyads participated in a 120-min laboratory session, consisting of 3 phases: baseline, stress situation (involving mother-child separation and exposure to novelty) and a 60-min regulation phase. Compared to non-PTSD controls, IPV-PTSD mothers - but not their toddlers, had lower morning cortisol and higher bedtime cortisol levels. As expected, IPV-PTSD mothers and their children showed blunted cortisol reactivity to the laboratory stressor. Maternal cortisol levels were negatively correlated to difficulty in identifying emotions. Our data highlights PTSD-IPV-related alterations in the HPA system and its relevance to maternal behavior. Toddlers of IPV-PTSD mothers also showed an altered pattern of cortisol reactivity to stress that potentially may predispose them to later psychological disorders. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Impaired contextual modulation of memories in PTSD: an fMRI and psychophysiological study of extinction retention and fear renewal.

    Science.gov (United States)

    Garfinkel, Sarah N; Abelson, James L; King, Anthony P; Sripada, Rebecca K; Wang, Xin; Gaines, Laura M; Liberzon, Israel

    2014-10-01

    Post-traumatic stress disorder (PTSD) patients display pervasive fear memories, expressed indiscriminately. Proposed mechanisms include enhanced fear learning and impaired extinction or extinction recall. Documented extinction recall deficits and failure to use safety signals could result from general failure to use contextual information, a hippocampus-dependent process. This can be probed by adding a renewal phase to standard conditioning and extinction paradigms. Human subjects with PTSD and combat controls were conditioned (skin conductance response), extinguished, and tested for extinction retention and renewal in a scanner (fMRI). Fear conditioning (light paired with shock) occurred in one context, followed by extinction in another, to create danger and safety contexts. The next day, the extinguished conditioned stimulus (CS+E) was re-presented to assess extinction recall (safety context) and fear renewal (danger context). PTSD patients showed impaired extinction recall, with increased skin conductance and heightened amygdala activity to the extinguished CS+ in the safety context. However, they also showed impaired fear renewal; in the danger context, they had less skin conductance response to CS+E and lower activity in amygdala and ventral-medial prefrontal cortex compared with combat controls. Control subjects displayed appropriate contextual modulation of memory recall, with extinction (safety) memory prevailing in the safety context, and fear memory prevailing in the danger context. PTSD patients could not use safety context to sustain suppression of extinguished fear memory, but they also less effectively used danger context to enhance fear. They did not display globally enhanced fear expression, but rather showed a globally diminished capacity to use contextual information to modulate fear expression.

  10. Gender differences in the expression of PTSD symptoms among active duty military personnel.

    Science.gov (United States)

    Hourani, Laurel; Williams, Jason; Bray, Robert; Kandel, Denise

    2015-01-01

    This study examined gender differences in posttraumatic stress disorder (PTSD) symptoms and symptom factors in the total U.S. active duty force. Data were drawn from the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel including 17,939 men and 6751 women from all services. The results indicated that women expressed more distress than men across almost all the symptoms on the PTSD Checklist except for hypervigilance. Women also scored significantly higher on all four factors examined: Re-experiencing, Avoidance, Emotionally Numb, Hyperarousal. More women than men were distressed by combat experiences that involved some type of violence, such as being wounded, witnessing or engaging in acts of cruelty, engaging in hand-to-hand combat, and, to a lesser extent, handling dead bodies. Men who had been sexually abused had a greater number of symptoms and were consistently more distressed than women on individual symptoms and symptom factors.

  11. Project VALOR: Trajectories of Change in PTSD in Combat-Exposed Veterans

    Science.gov (United States)

    2015-10-01

    suicidal ideation. 2. KEYWORDS: Post-traumatic stress disorder (PTSD), military sexual trauma (MST), suicide , combat-exposed veterans, PTSD... affects employment in our sample longitudinally; how different types of combat affect rates of PTSD; factors that influence treatment seeking behaviors...to better understand how PTSD affects other outcomes across time. For example, our interim analyses have provided insight into how psychopathology

  12. On the role of noradrenergic system in PTSD and related sleep disturbances. The use of terazosin in PTSD related nightmares: a case report.

    Science.gov (United States)

    Salviati, M; Pallagrosi, M; Valeriani, G; Carlone, C; Todini, L; Biondi, M

    2013-01-01

    In PTSD, sleep disorders represent an important symptoms dimension which is associated with more severe PTSD and increased risk of relapse. The basic treatment for PTSD is not always associated to an improvement of sleep disturbances and nightmares. Alpha-blockers, and more specifically Prazosin, have shown a specific action on sleep disorders in PTSD. We report the clinical case of a young women with PTSD, who was suffering from severe sleep disorder and distressing nightmare. The patient was treated with Terazosin, a conger of Prazosin, and has shown symptom remission. Further studies on the use of alpha-blokers might reveal new therapeutic options in PTSD.

  13. Displaying gray shades in liquid crystal displays

    Indian Academy of Sciences (India)

    T N Ruckmongathan

    2003-08-01

    Quality of image in a display depends on the contrast, colour, resolution and the number of gray shades. A large number of gray shades is necessary to display images without any contour lines. These contours are due to limited number of gray shades in the display causing abrupt changes in grayness of the image, while the original image has a gradual change in brightness. Amplitude modulation has the capability to display a large number of gray shades with minimum number of time intervals [1,2]. This paper will cover the underlying principle of amplitude modulation, some variants and its extension to multi-line addressing. Other techniques for displaying gray shades in passive matrix displays are reviewed for the sake of comparison.

  14. Examining potential contraindications for prolonged exposure therapy for PTSD

    Directory of Open Access Journals (Sweden)

    Agnes van Minnen

    2012-07-01

    Full Text Available Although prolonged exposure (PE has received the most empirical support of any treatment for post-traumatic stress disorder (PTSD, clinicians are often hesitant to use PE due to beliefs that it is contraindicated for many patients with PTSD. This is especially true for PTSD patients with comorbid problems. Because PTSD has high rates of comorbidity, it is important to consider whether PE is indeed contraindicated for patients with various comorbid problems. Therefore, in this study, we examine the evidence for or against the use of PE with patients with problems that often co-occur with PTSD, including dissociation, borderline personality disorder, psychosis, suicidal behavior and non-suicidal self-injury, substance use disorders, and major depression. It is concluded that PE can be safely and effectively used with patients with these comorbidities, and is often associated with a decrease in PTSD as well as the comorbid problem. In cases with severe comorbidity, however, it is recommended to treat PTSD with PE while providing integrated or concurrent treatment to monitor and address the comorbid problems.

  15. Cognitive therapy of trauma related guilt in patients with PTSD

    Directory of Open Access Journals (Sweden)

    Popiel, Agnieszka

    2014-06-01

    Full Text Available Various aspects of guilt are frequent problems of patients suffering from PTSD, though they have been included into the diagnostic criteria for PTSD just in the present version DSM-5. Some studies indicate limitation of effectiveness of exposure therapy in PTSD patients with predominant emotions of anger or guilt. The aim of this paper is to present cognitive conceptualization of guilt in PTSD proposed by Kubany, and a treatment protocol resulting from this conceptualization. The clinical application of the protocol is illustrated with preliminary results of systematic observation of 8 patients with moderate to severe PTSD who were treated with cognitive therapy for guilt followed by a standard prolonged exposure protocol. The cognitive therapy of guilt can be a valuable supplement for treatment of PTSD. This protocol can also be an inspiration for therapists working with patients with dysfunctional guilt as a problem in other than PTSD disorders – like depression or adjustment disorders. In discussion the place of guilt in treatment according to different (PE-Foa et al.; CPT-Resick et al.; CT-Ehlers and Clark trauma focused therapy approaches is addressed, and the need for further studies is underlined.

  16. Oxytocin improves compassion toward women among patients with PTSD.

    Science.gov (United States)

    Palgi, Sharon; Klein, Ehud; Shamay-Tsoory, Simone G

    2016-02-01

    Although impairments in social skills, including empathic abilities, are common in post-traumatic stress disorder (PTSD), the ability to feel compassion-a pro-social behavior that is based on empathy and drives us to help others-has never been assessed among these patients. The first aim of this study was to examine whether patients with PTSD suffer from deficits in compassion and to examine the association between the clusters of PTSD symptoms and these deficits. Furthermore, given that intranasal oxytocin (OT) has been suggested to possibly modulate social behaviors, the second aim of this study was to investigate whether intranasal OT may enhance compassion in these patients. Using a randomized, double-blind, placebo-controlled crossover design, we administered 24 IU of OT and placebo at a one-week interval to 32 patients with PTSD and to 30 matched healthy control participants. The results indicate that patients with PTSD exhibit deficits in compassion and that the numbing cluster emerged as the key predictor of those deficits. Moreover, the results indicate that a single intranasal dose of OT enhances compassion toward women (but not towards men), both in patients with PTSD and in controls. These results offer support for recent suggestions that intranasal OT may potentially be an effective pharmacological intervention for patients with PTSD.

  17. Targeting memory processes with drugs to prevent or cure PTSD.

    Science.gov (United States)

    Cain, Christopher K; Maynard, George D; Kehne, John H

    2012-09-01

    Post-traumatic stress disorder (PTSD) is a chronic debilitating psychiatric disorder resulting from exposure to a severe traumatic stressor and an area of great unmet medical need. Advances in pharmacological treatments beyond the currently approved SSRIs are needed. Background on PTSD, as well as the neurobiology of stress responding and fear conditioning, is provided. Clinical and preclinical data for investigational agents with diverse pharmacological mechanisms are summarized. Advances in the understanding of stress biology and mechanisms of fear conditioning plasticity provide a rationale for treatment approaches that may reduce hyperarousal and dysfunctional aversive memories in PTSD. One challenge is to determine if these components are independent or reflect a common underlying neurobiological alteration. Numerous agents reviewed have potential for reducing PTSD core symptoms or targeted symptoms in chronic PTSD. Promising early data support drug approaches that seek to disrupt dysfunctional aversive memories by interfering with consolidation soon after trauma exposure, or in chronic PTSD, by blocking reconsolidation and/or enhancing extinction. Challenges remain for achieving selectivity when attempting to alter aversive memories. Targeting the underlying traumatic memory with a combination of pharmacological therapies applied with appropriate chronicity, and in combination with psychotherapy, is expected to substantially improve PTSD treatment.

  18. From war to classroom: PTSD and depression in formerly abducted youth in Uganda

    Directory of Open Access Journals (Sweden)

    Nina eWinkler

    2015-03-01

    Full Text Available Background: Trained local screeners assessed the mental health status of male and female students in Northern Ugandan schools. The study aimed to disclose potential differences in mental health-related impairment in two groups, former child soldiers (n=354 and other war-affected youth (n=489, as well as to separate factors predicting mental suffering in learners. Methods: Participants were randomly selected. We used the Post-Traumatic Diagnostic Scale (PDS to assess symptoms of PTSD and for potential depression the respective section of the Hopkins Symptom Checklist (DHSCL with a locally validated cut-off. Results: Almost all respondents had been displaced at least once in their life. Thirty percent of girls and 50% of the boys in the study reported past abduction history. Trauma exposure was notably higher in the group of abductees. In former child soldiers a PTSD rate of 32% was remarkably higher than that for non-abductees (12%. Especially in girls rates of potential depression were double those in the group of former abductees (17% than in the group of non-abductees (8%. In all groups trauma exposure increased the risk of developing PTSD. A path-analytic model for developing PTSD and potential depression revealed both previous trauma exposure as well as duration of abduction to have significant influences on trauma-related mental suffering. Findings also suggest that in Northern Ugandan schools trauma spectrum disorders are common among war-affected learners. Conclusions: Therefore, it is suggested the school context should be used to provide mental health support structures within the education system for war-affected youth at likely risk of developing war-related mental distress.

  19. PTSD and gene variants: new pathways and new thinking.

    Science.gov (United States)

    Skelton, Kelly; Ressler, Kerry J; Norrholm, Seth D; Jovanovic, Tanja; Bradley-Davino, Bekh

    2012-02-01

    Posttraumatic Stress Disorder (PTSD) is an anxiety disorder which can develop as a result of exposure to a traumatic event and is associated with significant functional impairment. Family and twin studies have found that risk for PTSD is associated with an underlying genetic vulnerability and that more than 30% of the variance associated with PTSD is related to a heritable component. Using a fear conditioning model to conceptualize the neurobiology of PTSD, three primary neuronal systems have been investigated - the hypothalamic-pituitary-adrenal axis, the locus coeruleus-noradrenergic system, and neurocircuitry interconnecting the limbic system and frontal cortex. The majority of the initial investigations into main effects of candidate genes hypothesized to be associated with PTSD risk have been negative, but studies examining the interaction of genetic polymorphisms with specific environments in predicting PTSD have produced several positive results which have increased our understanding of the determinants of risk and resilience in the aftermath of trauma. Promising avenues of inquiry into the role of epigenetic modification have also been proposed to explain the enduring impact of environmental exposures which occur during key, often early, developmental periods on gene expression. Studies of PTSD endophenotypes, which are heritable biomarkers associated with a circumscribed trait within the more complex psychiatric disorder, may be more directly amenable to analysis of the underlying genetics and neural pathways and have provided promising targets for elucidating the neurobiology of PTSD. Knowledge of the genetic underpinnings and neuronal pathways involved in the etiology and maintenance of PTSD will allow for improved targeting of primary prevention amongst vulnerable individuals or populations, as well as timely, targeted treatment interventions. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'. Copyright © 2011 Elsevier

  20. The Role of PTSD in Bi-directional Intimate Partner Violence in Military and Veteran Populations: A Research Review

    Directory of Open Access Journals (Sweden)

    Gabriela Misca

    2017-08-01

    Full Text Available Evidence supporting the higher prevalence of PTSD linked to combat-related trauma in military personnel and veteran populations is well-established. Consequently, much research has explored the effects that combat related trauma and the subsequent PTSD may have on different aspects of relationship functioning and adjustment. In particular, PTSD in military and veterans has been linked with perpetrating intimate partner violence (IPV. New research and theoretical perspectives suggest that in order to respond effectively to IPV, a more accurate understanding of the direction of the violence experienced within each relationship is critical. In both civilian and military populations, research that has examined the direction of IPV's, bi-directional violence have been found to be highly prevalent. Evidence is also emerging as to how these bi-directional violence differ in relation to severity, motivation, physical and psychological consequences and risk factors. Of particular importance within military IPV research is the need to deepen understanding about the role of PTSD in bi-directional IPV not only as a risk factor for perpetration but also as a vulnerability risk factor for victimization, as findings from recent research suggest. This paper provides a timely, critical review of emergent literature to disentangle what is known about bi-directional IPV patterns in military and veteran populations and the roles that military or veterans' PTSD may play within these patterns. Although, this review aimed to identify global research on the topic, the majority of research meeting the inclusion criteria was from US, with only one study identified from outside, from Canada. Strengths and limitations in the extant research are identified. Directions for future research are proposed with a particular focus on the kinds of instruments and designs needed to better capture the complex interplay of PTSD and bi-directional IPV in military populations and

  1. DSM-5 and ICD-11 as competing models of PTSD in preadolescent children exposed to a natural disaster: assessing validity and co-occurring symptomatology.

    Science.gov (United States)

    La Greca, Annette M; Danzi, BreAnne A; Chan, Sherilynn F

    2017-01-01

    Background: Major revisions have been made to the DSM and ICD models of post-traumatic stress disorder (PTSD). However, it is not known whether these models fit children's post-trauma responses, even though children are a vulnerable population following disasters. Objective: Using data from Hurricane Ike, we examined how well trauma-exposed children's symptoms fit the DSM-IV, DSM-5 and ICD-11 models, and whether the models varied by gender. We also evaluated whether elevated symptoms of depression and anxiety characterized children meeting PTSD criteria based on DSM-5 and ICD-11. Method: Eight-months post-disaster, children (N = 327, 7-11 years) affected by Hurricane Ike completed measures of PTSD, anxiety and depression. Algorithms approximated a PTSD diagnosis based on DSM-5 and ICD-11 models. Results: Using confirmatory factor analysis, ICD-11 had the best-fitting model, followed by DSM-IV and DSM-5. The ICD-11 model also demonstrated strong measurement invariance across gender. Analyses revealed poor overlap between DSM-5 and ICD-11, although children meeting either set of criteria reported severe PTSD symptoms. Further, children who met PTSD criteria for DSM-5, but not for ICD-11, reported significantly higher levels of depression and general anxiety than children not meeting DSM-5 criteria. Conclusions: Findings support the parsimonious ICD-11 model of PTSD for trauma-exposed children, although adequate fit also was obtained for DSM-5. Use of only one model of PTSD, be it DSM-5 or ICD-11, will likely miss children with significant post-traumatic stress. DSM-5 may identify children with high levels of comorbid symptomatology, which may require additional clinical intervention.

  2. Persistent Serious Mental Illness Among Former Applicants for VA PTSD Disability Benefits and Long-Term Outcomes: Symptoms, Functioning, and Employment.

    Science.gov (United States)

    Murdoch, Maureen; Spoont, Michele Roxanne; Kehle-Forbes, Shannon Marie; Harwood, Eileen Mae; Sayer, Nina Aileen; Clothier, Barbara Ann; Bangerter, Ann Kay

    2017-02-01

    Millions of U.S. veterans have returned from military service with posttraumatic stress disorder (PTSD), for which a substantial number receive U.S. Department of Veterans Affairs (VA) disability benefits. Although PTSD is treatable, comorbid serious mental illness (defined here as schizophrenia, schizoaffective disorder, and bipolar spectrum disorders) could complicate these veterans' recovery. Using VA administrative data, we examined the burden of persistent serious mental illness in a nationally representative cohort of 1,067 men and 1,513 women who applied for VA PTSD disability benefits between 1994 and 1998 and served during or after the Vietnam conflict. Self-reported outcomes were restricted to the 713 men and 1,015 women who returned surveys at each of 3 collection points. More than 10.0% of men and 20.0% of women had persistent serious mental illness; of these, more than 80.0% also had persistent PTSD. On repeated measures modeling, those with persistent serious mental illness consistently reported more severe PTSD symptoms and poorer functioning in comparison to other participants (ps mental illness and PTSD were significant only for employment (p = .002). Persistent serious mental illness in this population was almost 2 to 19 times higher than in the general U.S. The implications of these findings are discussed. Copyright © 2017 International Society for Traumatic Stress Studies.

  3. PTSD prevalence and associated risk factors after a fire disaster that broke out in a paediatric hospital: a cross-sectional study.

    Science.gov (United States)

    Zaffina, S; Camisa, V; Monducci, Elena; Vinci, Maria Rosaria; Vicari, S; Bergamaschi, A

    2014-01-01

    Several studies have shown a higher risk of psychological problems in health care workers exposed to serious occupational stressors. The aim of the present study was to assess the presence of Post-traumatic Stress Disorder (PTSD) and possible risk factors in a sample of 32 workers who were at the same time rescuers and victims of a fire that broke out in the neonatal intensive care unit of a large paediatric hospital. Immediately and six months after the event, the subjects underwent a study protocol aimed at the diagnostic assessment of PTSD, investigated via the Clinician-Administered PTSD Scale (CAPS) and the Impact of Event Scale-Revised (IES-R). Out of the 30 subjects examined (two were missing), six showed the diagnostic criteria for a current PTSD. Risk factors for PTSD onset were a prior psychiatric disorder, the level of involvement in the fire disaster and the presence of phobias in the days immediately after the event. Gender and level of education approached statistical significance. The high prevalence of PTSD found in this sample was due to the fact that the risk of death or serious injury involved infants.

  4. Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study.

    Science.gov (United States)

    Dorrepaal, Ethy; Thomaes, Kathleen; Smit, Johannes H; Veltman, Dick J; Hoogendoorn, Adriaan W; van Balkom, Anton J L M; Draijer, Nel

    2013-01-01

    In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD) and personality disorders (PDs) are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT) for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive) (N=14) with the non-adaptive patients (N=24) as revealed by a cluster analysis. We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles "withdrawn" and "aggressive," were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

  5. Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: a preliminary study

    Directory of Open Access Journals (Sweden)

    Ethy Dorrepaal

    2013-11-01

    Full Text Available Background: In the empirical and clinical literature, complex posttraumatic stress disorder (PTSD and personality disorders (PDs are suggested to be predictive of drop-out or reduced treatment effectiveness in trauma-focused PTSD treatment. Objective: In this study, we aimed to investigate if personality characteristics would predict treatment compliance and effectiveness in stabilizing complex PTSD treatment. Method: In a randomized controlled trial on a 20-week stabilizing group cognitive behavioral treatment (CBT for child-abuse-related complex PTSD, we included 71 patients of whom 38 were randomized to a psycho-educational and cognitive behavioral stabilizing group treatment. We compared the patients with few PD symptoms (adaptive (N=14 with the non-adaptive patients (N=24 as revealed by a cluster analysis. Results: We found that non-adaptive patients compared to the adaptive patients showed very low drop-out rates. Both non-adaptive patients, classified with highly different personality profiles “withdrawn” and “aggressive,” were equally compliant. With regard to symptom reduction, we found no significant differences between subtypes. Post-hoc, patients with a PD showed lower drop-out rates and higher effect sizes in terms of complex PTSD severity, especially on domains that affect regulation and interpersonal problems. Conclusion: Contrary to our expectations, these preliminary findings indicate that this treatment is well tolerated by patients with a variety of personality pathology. Larger sample sizes are needed to study effectiveness for subgroups of complex PTSD patients.

  6. The underlying dimensions of DSM-5 PTSD symptoms and their relations with anxiety and depression in a sample of adolescents exposed to an explosion accident.

    Science.gov (United States)

    Yang, Haibo; Wang, Li; Cao, Chengqi; Cao, Xing; Fang, Ruojiao; Zhang, Jianxin; Elhai, Jon D

    2017-01-01

    Background: A large number of empirical studies pertaining to the latent dimensions of DSM-5 PTSD symptoms have accumulated. However, there is still a lack of studies specific to youths. Objective: This study sought to investigate the latent dimensions of DSM-5 PTSD symptoms in a sample of adolescents exposed to an explosion accident. Method: Participants were 836 students (407 females and 428 males). Self-reported measures including the PTSD Checklist for DSM-5 and the anxiety and depression subscales of the 21-item Depression Anxiety Stress Scale were administered to participants. Confirmatory factor analysis (CFA) was implemented to test competing factor models. Results: A seven-factor model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, anxious arousal and dysphoric arousal factors emerged as the best fitting model, and PTSD's factors displayed distinguishable correlations with external measures of anxiety and depression. Conclusions: The findings provide and extend empirical evidence supporting the newly refined seven-factor hybrid model of DSM-5 PTSD symptoms, and have implications for further trauma-related clinical practice and research.

  7. Mental health and PTSD in female North Korean refugees.

    Science.gov (United States)

    Shin, Gisoo; Lee, Suk Jeong

    2015-01-01

    This study was conducted to identify mental health status, post-traumatic stress disorder (PTSD), and psychophysiological change in female North Korean refugees. Data were collected using questionnaires and symptom checklists that measured PTSD and the psychosomatic state of the subjects. As many as 97 subjects, who had settled in and around Seoul, South Korea, were selected by snowball sampling. Mental health and PTSD levels of the participants were above a moderate level. We conclude that health care professionals need to provide female North Korean defectors with services to improve mental health and make the sociocultural transition successfully.

  8. COGNITIVE-BEHAVIORAL INTERVENTION FOR PTSD IN COLOMBIAN COMBAT VETERANS

    Directory of Open Access Journals (Sweden)

    CAROLINA BOTERO GARCÍA

    2005-07-01

    Full Text Available The results of cognitive-behavioral group interventions applied from 2002 to 2004 to 42 colombian combat veteranswith Post Traumatic Stress Disorder (PTSD are presented. The goal of the study was to stablish the effectiveness ofthe group interventions based in Prolonged Exposition and Stress Inoculation treatment processes. Differencesbetween pre-in-post symptomatology scores of PTSD were measured by Foa Posttraumatic Stress Diagnostic Scale(PDS and the Beck Depression Inventory. The statistical analysis was made by t test for paired samples, with alpha of0.05. Results show significant decrease in symptomatology and severity level after the intervention both in depressionand PTSD symptoms.

  9. Psychological Mechanisms of PTSD and Its Treatment.

    Science.gov (United States)

    Sripada, Rebecca K; Rauch, Sheila A M; Liberzon, Israel

    2016-11-01

    Psychological mechanisms can be defined as processes or events that are responsible for specific changes in psychological outcomes. In psychotherapy research, mechanisms are the factors through which interventions produce change. In this article, we explain the importance of identifying psychological mechanisms, describe methods for identifying them, and analyze recent literature on the psychological mechanisms underlying the development and treatment of posttraumatic stress disorder (PTSD). Based on the findings of recent investigations (from 2013 to present), we focus on four putative mechanisms: emotional engagement, extinction and contextualization, distress tolerance, and negative posttraumatic cognitions. Future directions for psychological mechanism research are also outlined, including possible opportunities for capitalizing on the most promising mechanisms identified to date.

  10. Gender differences in relationships among PTSD severity, drinking motives, and alcohol use in a comorbid alcohol dependence and PTSD sample.

    Science.gov (United States)

    Lehavot, Keren; Stappenbeck, Cynthia A; Luterek, Jane A; Kaysen, Debra; Simpson, Tracy L

    2014-03-01

    Alcohol dependence (AD) and posttraumatic stress disorder (PTSD) are highly prevalent and comorbid conditions associated with a significant level of impairment. Little systematic study has focused on gender differences specific to individuals with both AD and PTSD. The current study examined gender-specific associations between PTSD symptom severity, drinking to cope (i.e., reduce negative affect), drinking for enhancement (i.e., increase positive affect), and average alcohol use in a clinical sample of men (n = 46) and women (n = 46) with comorbid AD and PTSD. Results indicated that PTSD symptoms were highly associated with drinking-to-cope motives for both men and women, but with greater drinking for enhancement motives for men only. Enhancement motives were positively associated with average alcohol quantity for both men and women, but coping motives were significantly associated with average alcohol quantity for women only. These findings suggest that for individuals with comorbid AD and PTSD, interventions that focus on reducing PTSD symptoms are likely to lower coping motives for both genders, and targeting coping motives is likely to result in decreased drinking for women but not for men, whereas targeting enhancement motives is likely to lead to reduced drinking for both genders.

  11. Testing the validity of the proposed ICD-11 PTSD and complex PTSD criteria using a sample from Northern Uganda

    Directory of Open Access Journals (Sweden)

    Siobhan Murphy

    2016-09-01

    Full Text Available Background: The International Classification of Diseases (ICD-11 is currently under development with proposed changes recommended for the posttraumatic stress disorder (PTSD diagnosis and the inclusion of a separate complex PTSD (CPTSD disorder. Empirical studies support the distinction between PTSD and CPTSD; however, less research has focused on non-western populations. Objective: The aim of this study was to investigate whether distinct PTSD and CPTSD symptom classes emerged and to identify potential risk factors and the severity of impairment associated with resultant classes. Methods: A latent class analysis (LCA and related analyses were conducted on 314 young adults from Northern Uganda. Fifty-one percent were female and participants were aged between 18 and 25 years. Forty percent of the participants were former child soldiers (n=124 while the remaining participants were civilians (n=190. Results: The LCA revealed three classes: a CPTSD class (40.2%, a PTSD class (43.8%, and a low symptom class (16%. Child soldier status was a significant predictor of both CPTSD and PTSD classes (OR=5.96 and 2.82, respectively. Classes differed significantly on measures of anxiety/depression, conduct problems, somatic complaints, and war experiences. Conclusions: To conclude, this study provides preliminary support for the proposed distinction between PTSD and CPTSD in a young adult sample from Northern Uganda. However, future studies are needed using larger samples to test alternative models before firm conclusions can be made.

  12. An updated animal model capturing both the cognitive and emotional features of post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Berardi, Andrea; Trezza, Viviana; Palmery, Maura; Trabace, Luigia; Cuomo, Vincenzo; Campolongo, Patrizia

    2014-01-01

    The new-released Diagnostic and Statistical Manual of Mental Disorders (DSM-5) defines post-traumatic stress disorder (PTSD) as a "trauma and stressor-related disorder". PTSD pathogenesis relies on paradoxical changes of emotional memory processing induced by the trauma exposure and associated with emotional dysfunction. Several animal models of PTSD have been validated and are currently used. Each one mimics a particular subset of the disorder with particular emphasis, mainly driven by the past classification of PTSD in the DSM-4, on the emotional features. In view of the recent update in the DSM-5, our aim was to develop, by using well-validated paradigms, a modified model of PTSD able to mimic at the same time both the cognitive and emotional features of the disease. We exposed male rats to either a piece of worn cat collar or to a series of inescapable footshocks paired with a PTSD risk factor, i.e., social isolation. Animals were subsequently re-exposed to the conditioned contexts at different time intervals in order to test memory retention for the stressors. In addition, footshock-exposed rats were tested in the elevated-plus-maze and social interaction tests. We found that rats exposed to a cat collar exhibited an acute fear response that did not lead to enduring memory retention. Conversely, footshock-exposed rats expressed a successful retention of the stressful experience at 1, 7, 14, 21 and 56 post-exposure days. Footshock-exposed rats displayed an anxious behavioral profile in the social interaction test and a significantly reduced locomotor activity in the elevated-plus-maze test. These dysfunctions were not observed when animals were socially housed, thus highlighting a social buffering effect in the development of the pathology. Our results underline the good validity of a footshock-based paradigm paired with social isolation as a PTSD animal model, able to mimic at the same time both some of the enduring cognitive and emotional facets of the

  13. Capturing both the cognitive and emotional features of post-traumatic stress disorder (PTSD in rats: An updated animal model

    Directory of Open Access Journals (Sweden)

    Andrea eBerardi

    2014-04-01

    Full Text Available The new-released Diagnostic and Statistical Manual of Mental Disorders (DSM-5 defines post-traumatic stress disorder (PTSD as a trauma and stressor-related disorder. PTSD pathogenesis relies on paradoxical changes of emotional memory processing induced by the trauma exposure and associated with emotional dysfunction. Several animal models of PTSD have been validated and are currently used. Each one mimics a particular subset of the disorder with particular emphasis, mainly driven by the past classification of PTSD in the DSM-4, on the emotional features. In view of the recent update in the DSM-5, our aim was to develop, by using well-validated paradigms, a modified model of PTSD able to mimic at the same time both the cognitive and emotional features of the disease. We exposed male rats to either a piece of worn cat collar or to a series of inescapable footshocks paired with a PTSD risk factor, i.e. social isolation. Animals were subsequently re-exposed to the conditioned contexts at different time intervals in order to test memory retention for the stressors. In addition, footshock-exposed rats were tested in the elevated-plus-maze and social interaction tests. We found that rats exposed to a cat collar exhibited an acute fear response that did not lead to enduring memory retention. Conversely, footshock-exposed rats expressed a successful retention of the stressful experience at 1, 7, 14, 21 and 56 post-exposure days. Footshock-exposed rats displayed an anxious behavioral profile in the social interaction test and a significantly reduced locomotor activity in the elevated-plus-maze test. These dysfunctions were not observed when animals were socially housed, thus highlighting a social buffer effect in the development of the pathology. Our results underline the good validity of a footshock-based paradigm paired with social isolation as a PTSD animal model, able to mimic at the same time both some of the enduring cognitive and emotional facets

  14. Invisible Display in Aluminum

    DEFF Research Database (Denmark)

    Prichystal, Jan Phuklin; Hansen, Hans Nørgaard; Bladt, Henrik Henriksen

    2005-01-01

    for an integrated display in a metal surface is often ruled by design and functionality of a product. The integration of displays in metal surfaces requires metal removal in order to clear the area of the display to some extent. The idea behind an invisible display in Aluminum concerns the processing of a metal...

  15. Treatment of residual insomnia after CBT for PTSD: case studies.

    Science.gov (United States)

    DeViva, Jason C; Zayfert, Claudia; Pigeon, Wilfred R; Mellman, Thomas A

    2005-04-01

    Insomnia is one of the most common symptoms of posttraumatic stress disorder (PTSD). Evidence suggests that insomnia may persist for many PTSD patients after other symptoms have responded to cognitive-behavioral therapy (CBT). The present article reports the effects of administering a five-session cognitive-behavioral insomnia treatment to 5 patients who responded to CBT for PTSD yet continued to report insomnia. Insomnia treatment was associated with improvements on subjective sleep measures (Pittsburgh Sleep Quality Index, Insomnia Severity Index, and Beliefs and Attitudes about Sleep Scale) and self-monitored sleep efficiency and related measures in 4 of 5 cases. Results highlight issues specific to treating insomnia in trauma populations and future directions for examining treatment of insomnia associated with PTSD.

  16. [Historical perspective of PTSD and future revision in DSM-5].

    Science.gov (United States)

    Kim, Yoshiharu

    2012-01-01

    One of prototypes of PTSD is a fright neurosis conceptualized by Kraepelin and is on the line of traditional psychogenic reaction category defined by Sommers in so far as the re-experience symptoms reflects the content of a traumatic experience. Other key components of PTSD, such as avoidance of traumatic memory and hyperarousal, overlap respectively with dissociative disorders and the somatoform autonomic dysfunction (ICD-10), which may consist, together with comorbid mood and anxiety disorders of PTSD, a spectrum of posttraumatic mental disorders. The DSM-5 draft of PTSD restricts the category in terms of the event and re-experience criterion, put an emphasis upon dissociation and enlarges numbing symptom in that it is re-categorized as a cognitive and affective alterations to be separated from avoidance symptom. This change partly reflects insight into the nature of the disorder brought by CBT-based clinical experience.

  17. Vintage treatments for PTSD: a reconsideration of tricyclic drugs.

    Science.gov (United States)

    Davidson, Jonathan

    2015-03-01

    Serotonin (SSRI) and serotonin-norepinephrine (SNRI) reuptake inhibitors (SSRI) are the first-line recommended drug treatments for post-traumatic stress disorder (PTSD); but despite their benefits, much residual pathology remains and no new drugs have yet emerged with a clearly demonstrated benefit for treating the disorder. A case is made that tricyclic drugs deserve a closer look, based on their ability to affect several of the main neurotransmitters that are relevant to PTSD. Their promising efficacy, which was shown 30 years ago, had not been followed up, until a recent trial of desipramine found advantages over a SSRI in PTSD with comorbid alcohol dependence. Opportunities exist for studying newer and purportedly safer tricyclic formulations, as well as further the work with older, established compounds. A reappraisal of their risk:benefit ratio seems in order, when treating PTSD.

  18. Using qualitative evidence to optimize child PTSD treatment guidelines.

    NARCIS (Netherlands)

    Wesel, F. van; Alisic, E.; Boeije, H.

    2014-01-01

    The importance of patients’ perspectives in the treatment of posttraumatic stress disorder (PTSD) is increasingly emphasized in recent years. However, qualitative evidence regarding these perspectives, is not systematically included in treatment guidelines. The possibilities of adding systematically

  19. Multimodal PTSD characterization via the StartleMart game

    DEFF Research Database (Denmark)

    Holmgard, C.; Yannakakis, G. N.; Martinez, H. P.

    2015-01-01

    at the treatment of mental diagnoses such as post traumatic stress disorder (PTSD). For that purpose, we couple game design and game technology to create a game-based tool for exposure therapy and stress inoculation training that utilizes stress detection for the automatic profiling and potential personalization...... of PTSD treatments. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD by analyzing the physiological responses to those in-game stress elicitors in two separate modalities: skin...... conductance (SC) and blood volume pulse (BVP). SC is often used to monitor stress as it is connected to the activation of the sympathetic nervous system (SNS). By including BVP into the model we introduce information about para-sympathetic activation, which offers a more complete view of the psycho...

  20. Dynamic brain connectivity is a better predictor of PTSD than static connectivity.

    Science.gov (United States)

    Jin, Changfeng; Jia, Hao; Lanka, Pradyumna; Rangaprakash, D; Li, Lingjiang; Liu, Tianming; Hu, Xiaoping; Deshpande, Gopikrishna

    2017-09-01

    Using resting-state functional magnetic resonance imaging, we test the hypothesis that subjects with post-traumatic stress disorder (PTSD) are characterized by reduced temporal variability of brain connectivity compared to matched healthy controls. Specifically, we test whether PTSD is characterized by elevated static connectivity, coupled with decreased temporal variability of those connections, with the latter providing greater sensitivity toward the pathology than the former. Static functional connectivity (FC; nondirectional zero-lag correlation) and static effective connectivity (EC; directional time-lagged relationships) were obtained over the entire brain using conventional models. Dynamic FC and dynamic EC were estimated by letting the conventional models to vary as a function of time. Statistical separation and discriminability of these metrics between the groups and their ability to accurately predict the diagnostic label of a novel subject were ascertained using separate support vector machine classifiers. Our findings support our hypothesis that PTSD subjects have stronger static connectivity, but reduced temporal variability of connectivity. Further, machine learning classification accuracy obtained with dynamic FC and dynamic EC was significantly higher than that obtained with static FC and static EC, respectively. Furthermore, results also indicate that the ease with which brain regions engage or disengage with other regions may be more sensitive to underlying pathology than the strength with which they are engaged. Future studies must examine whether this is true only in the case of PTSD or is a general organizing principle in the human brain. Hum Brain Mapp 38:4479-4496, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  1. DSM-5 PTSD and posttraumatic stress spectrum in Italian emergency personnel: correlations with work and social adjustment

    Directory of Open Access Journals (Sweden)

    Carmassi C

    2016-02-01

    Full Text Available Claudia Carmassi,1 Camilla Gesi,1 Marly Simoncini,1 Luca Favilla,1 Gabriele Massimetti,1 Maria Cristina Olivieri,1 Ciro Conversano,2 Massimo Santini,2 Liliana Dell’Osso1 1Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy; 2Emergency Medicine and Emergency Room Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP, Pisa, Italy Abstract: The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5 has recently recognized a particular risk for posttraumatic stress disorder (PTSD among first responders (criterion A4, acknowledging emergency units as stressful places of employment. Little data is yet available on DSM-5 among emergency health operators. The aim of this study was to assess DSM-5 symptomatological PTSD and posttraumatic stress spectrum, as well as their impact on work and social functioning, in the emergency staff of a major university hospital in Italy. One hundred and ten subjects (doctors, nurses, and health-care assistants were recruited at the Emergency Unit of the Azienda Ospedaliero-Universitaria Pisana (Italy and assessed by the Trauma and Loss Spectrum-Self Report (TALS-SR and Work and Social Adjustment Scale (WSAS. A 15.7% DSM-5 symptomatological PTSD prevalence rate was found. Nongraduated persons reported significantly higher TALS-SR Domain IV (reaction to loss or traumatic events scores and a significantly higher proportion of individuals presenting at least one maladaptive behavior (TALS-SR Domain VII, with respect to graduate ones. Women reported significantly higher WSAS scores. Significant correlations emerged between PTSD symptoms and WSAS total scores among health-care assistants, nongraduates and women. Our results showed emergency workers to be at risk for posttraumatic stress spectrum and related work and social impairment, particularly among women and nongraduated subjects. Keywords: posttraumatic stress disorder (PTSD, emergency, emergency

  2. A VA medical center's PTSD residential recovery program.

    Science.gov (United States)

    Devaney, Donald E

    2010-01-01

    With the influx of military veterans with Post Traumatic Stress Disorder (PTSD) increasingly affecting all healthcare facilities, including acute care and long term, learning from the experience of VA hospitals in treating those with PTSD may prove valuable. In this article, Tripler/VA Provost Marshal Donald E. Delaney describes a program that has been in operation since 1994. He may be contacted for further in formation at (808) 433-4465 or Donald.devaney@amedd.army .mil

  3. Complex PTSD and phased treatment in refugees: a debate piece

    OpenAIRE

    ter Heide, F. Jackie June; Trudy M. Mooren; Kleber, Rolf J.

    2016-01-01

    Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD.Objective: The aim of this debate piece is to defend two theses:...

  4. Serotonin and Cortisol as Suicidogenic Factors in Patients with PTSD

    OpenAIRE

    Grah, Majda; Mihanović, Mate; Svrdlin, Pero; Vuk Pisk, Sandra; Restek-Petrović, Branka

    2010-01-01

    Post-traumatic Stress Disorder (PTSD) frequently occurs in commorbidity with different mental disorders, including suicidal behaviour. Group of biological factors, including serotonergic system, HPA axis and some genetic factors, are being studied as potential markers, able to differentiate suicidal and non-suicidal behaviour across the group of PTSD patients. This study is examining statistical relation between platelet serotonine concentration and serum cortisole concentration, within the g...

  5. Complex PTSD and phased treatment in refugees : a debate piece

    OpenAIRE

    ter Heide, F. Jackie June; Mooren, Trudy M.; Kleber, Rolf J.

    2016-01-01

    Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD.Objective: The aim of this debate piece is to defend two theses:...

  6. Menstrual cycle effects on psychological symptoms in women with PTSD.

    Science.gov (United States)

    Nillni, Yael I; Pineles, Suzanne L; Patton, Samantha C; Rouse, Matthew H; Sawyer, Alice T; Rasmusson, Ann M

    2015-02-01

    The menstrual cycle has been implicated as a sex-specific biological process influencing psychological symptoms across a variety of disorders. Limited research exists regarding the role of the menstrual cycle in psychological symptoms among women with posttraumatic stress disorder (PTSD). The current study examined the severity of a broad range of psychological symptoms in both the early follicular (Days 2-6) and midluteal (6-10 days postlutenizing hormone surge) phases of the menstrual cycle in a sample of trauma-exposed women with and without PTSD (N = 49). In the sample overall, total psychological symptoms (d = 0.63), as well as depression (d = 0.81) and phobic anxiety (d = 0.81) symptoms, specifically, were increased in the early follicular compared to midluteal phase. The impact of menstrual cycle phase on phobic anxiety was modified by a significant PTSD × Menstrual Phase interaction (d = 0.63). Women with PTSD reported more severe phobic anxiety during the early follicular versus midluteal phase, whereas phobic anxiety did not differ across the menstrual cycle in women without PTSD. Thus, the menstrual cycle appears to impact fear-related symptoms in women with PTSD. The clinical implications of the findings and future research directions are discussed.

  7. PTSD, depression and anxiety among former abductees in Northern Uganda

    Directory of Open Access Journals (Sweden)

    Elbert Thomas

    2011-08-01

    Full Text Available Abstract Background The population in Northern Uganda has been exposed to extreme levels of traumatic stress and thousands abducted forcibly became rebel combatants. Methods Using structured interviews, the prevalence and severity of posttraumatic stress disorder (PTSD, depression and anxiety was assessed in 72 former abducted adults, 62 of them being former child soldiers. Results As retrospective reports of exposure to traumatic stress increased, anxiety and PTSD occurrence increased (r = .45. 49% of respondents were diagnosed with PTSD, 70% presented with symptoms of depression, and 59% with those of anxiety. In a multiple linear regression analysis four factors could best explain the development of PTSD symptoms: male respondents (sex living in an IDP-Camp (location with a kinship murdered in the war (family members killed in the war and having experienced a high number of traumatic events (number of traumatic events were more likely to develop symptoms of PTSD than others. In disagreement to a simple dose-response-effect though, we also observed a negative correlation between the time spent with the rebels and the PTSD symptom level. Conclusions Former abductees continue to suffer from severe mental ill-health. Adaptation to the living condition of rebels, however, may lower trauma-related mental suffering.

  8. New DSM-5 maladaptive symptoms in PTSD: gender differences and correlations with mood spectrum symptoms in a sample of high school students following survival of an earthquake.

    Science.gov (United States)

    Carmassi, Claudia; Stratta, Paolo; Massimetti, Gabriele; Bertelloni, Carlo Antonio; Conversano, Ciro; Cremone, Ivan Mirko; Miccoli, Mario; Baggiani, Angelo; Rossi, Alessandro; Dell'Osso, Liliana

    2014-01-01

    Gender differences in post-traumatic stress disorder (PTSD) rates were confirmed across different DSM editions as well as the role of bipolar disorder (BD) comorbidity on prevalence and course, but little data is available upon new DSM-5 criteria, including maladaptive behaviors. The aim of this study was to investigate gender differences in DSM-5 PTSD in a sample of young adult earthquake survivors and the impact of lifetime mood spectrum comorbidity. Five hundred twelve young adult survivors from the L'Aquila 2009 earthquake were evaluated by Trauma and Loss Spectrum-Self Report (TALS-SR) and Mood Spectrum-Self Report (MOODS-SR). Females showed significantly higher DSM-5 PTSD prevalence rates than men. Similarly, female survivors with DSM-5 PTSD showed significantly higher scores in several of the MOODS-SR and TALS-SR domains with respect to males. Males showed significantly higher scores in the TALS-SR maladaptive coping domain only. A significant positive association between the MOODS-SR manic-hypomanic component and TALS-SR potentially traumatic events and maladaptive coping domains emerged in the whole sample, particularly among men. This study allows a first glimpse on gender differences in DSM-5 PTSD criteria in a sample of earthquake survivors. Further, possible correlations with subthreshold manic-hypomanic comorbidity are suggested among males, showing a significant trend particularly for lifetime trauma exposure and for the newly introduced maladaptive behaviors.

  9. Prevalence of post-traumatic stress disorder among patients with substance use disorder: it is higher than clinicians think it is

    Directory of Open Access Journals (Sweden)

    Nele Gielen

    2012-08-01

    Full Text Available Objectives: This study had three objectives. Firstly, the prevalence of post-traumatic stress disorder (PTSD and trauma exposure was compared between individuals with and without substance use disorder (SUD. Secondly, we compared self-rating of PTSD and clinical judgement. Thirdly, an analysis of the characteristics of SUD/PTSD patients was performed. Methods: The sample consisted of 423 patients with SUD and 206 healthy controls. All individuals were screened on PTSD using the self-rating inventory for PTSD. Results: Significantly higher numbers of PTSD and trauma exposure were found in the SUD group (resp. 36.6 and 97.4%. PTSD went frequently unnoticed when relying on clinical judgement alone. Patients with SUD/PTSD were significantly more often unemployed and had a lower educational level. Axis I comorbidity and especially depressive disorders were more common in the SUD/PTSD group. Conclusion: It is concluded that patients with SUD/PTSD are a substantial and vulnerable subgroup in addiction treatment facilities and that a systematic screening for PTSD is required.

  10. Handbook of display technology

    CERN Document Server

    Castellano, Joseph A

    1992-01-01

    This book presents a comprehensive review of technical and commercial aspects of display technology. It provides design engineers with the information needed to select proper technology for new products. The book focuses on flat, thin displays such as light-emitting diodes, plasma display panels, and liquid crystal displays, but it also includes material on cathode ray tubes. Displays include a large number of products from televisions, auto dashboards, radios, and household appliances, to gasoline pumps, heart monitors, microwave ovens, and more.For more information on display tech

  11. Lifetime history of traumatic events in an American Indian community sample: heritability and relation to substance dependence, affective disorder, conduct disorder and PTSD.

    Science.gov (United States)

    Ehlers, Cindy L; Gizer, Ian R; Gilder, David A; Yehuda, Rachael

    2013-02-01

    American Indians appear to experience a higher rate of traumatic events than what has been reported in general population surveys. American Indians also suffer higher alcohol related death rates than any other ethnic group in the U.S. population. Therefore efforts to delineate factors which may uniquely contribute to increased likelihood of trauma, post traumatic stress disorder (PTSD), and substance use disorders (SUD) over the lifetime in American Indians are important because of the high burden of morbidity and mortality that they pose to American Indian communities. Participants were American Indians recruited from reservations that were assessed with the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA), family history assessment and the stressful-life-events scale. Of the 309 participants, equivalent numbers of men and women (94%) reported experiencing traumas; however, a larger proportion of women received a PTSD diagnosis (38%) than men (29%). Having experienced multiple trauma and sexual abuse were most highly associated with PTSD. Having experienced assaultive trauma and having PTSD symptoms were both found to be moderately heritable (30-50%). Logistic regression revealed that having an anxiety and/or affective disorder and having a substance dependent diagnosis, but not having antisocial personality disorder/conduct disorder, were significantly correlated with having a diagnosis of PTSD. These studies suggest that trauma is highly prevalent in this American Indian community, it is heritable, is associated with PTSD, affective/anxiety disorders and substance dependence. Additionally, trauma, PTSD and substance dependence appear to all co-emerge in early adulthood in this high-risk population.

  12. Efficacy of virtual reality exposure therapy in the treatment of PTSD: a systematic review.

    Directory of Open Access Journals (Sweden)

    Raquel Gonçalves

    Full Text Available The use of Information and Communication Technologies, such as virtual reality, has been employed in the treatment of anxiety disorders with the goal of augmenting exposure treatment, which is already considered to be the first-line treatment for Post-traumatic Stress Disorder (PTSD. To evaluate the efficacy of virtual reality exposure therapy (VRET in the treatment of PTSD, we performed a systematic review of published articles using the following electronic databases: Web of Science, PubMed, PsycINFO, and PILOTS. Eligibility criteria included the use of patients diagnosed with PTSD according to DSM-IV, the use of cognitive behavioral therapy (CBT and the use of virtual reality for performing exposure. 10 articles were selected, seven of which showed that VRET produced statistically significant results in comparison to the waiting list. However, no difference was found between VRET and exposure treatment. Of these 10, four were randomized, two were controlled but not randomized and four were non-controlled. The majority of the articles used head-mounted display virtual reality (VR equipment and VR systems specific for the population that was being treated. Dropout rates do not seem to be lower than in traditional exposure treatment. However, there are a few limitations. Because this is a new field of research, there are few studies in the literature. There is also a need to standardize the number of sessions used. The randomized studies were analyzed to assess the quality of the methodology, and important deficiencies were noted, such as the non-use of intent-to- treat-analysis and the absence of description of possible concomitant treatments and comorbidities. Preliminary data suggest that VRET is as efficacious as traditional exposure treatment and can be especially useful in the treatment of patients who are resistant to traditional exposure.

  13. Efficacy of virtual reality exposure therapy in the treatment of PTSD: a systematic review.

    Science.gov (United States)

    Gonçalves, Raquel; Pedrozo, Ana Lúcia; Coutinho, Evandro Silva Freire; Figueira, Ivan; Ventura, Paula

    2012-01-01

    The use of Information and Communication Technologies, such as virtual reality, has been employed in the treatment of anxiety disorders with the goal of augmenting exposure treatment, which is already considered to be the first-line treatment for Post-traumatic Stress Disorder (PTSD). To evaluate the efficacy of virtual reality exposure therapy (VRET) in the treatment of PTSD, we performed a systematic review of published articles using the following electronic databases: Web of Science, PubMed, PsycINFO, and PILOTS. Eligibility criteria included the use of patients diagnosed with PTSD according to DSM-IV, the use of cognitive behavioral therapy (CBT) and the use of virtual reality for performing exposure. 10 articles were selected, seven of which showed that VRET produced statistically significant results in comparison to the waiting list. However, no difference was found between VRET and exposure treatment. Of these 10, four were randomized, two were controlled but not randomized and four were non-controlled. The majority of the articles used head-mounted display virtual reality (VR) equipment and VR systems specific for the population that was being treated. Dropout rates do not seem to be lower than in traditional exposure treatment. However, there are a few limitations. Because this is a new field of research, there are few studies in the literature. There is also a need to standardize the number of sessions used. The randomized studies were analyzed to assess the quality of the methodology, and important deficiencies were noted, such as the non-use of intent-to- treat-analysis and the absence of description of possible concomitant treatments and comorbidities. Preliminary data suggest that VRET is as efficacious as traditional exposure treatment and can be especially useful in the treatment of patients who are resistant to traditional exposure.

  14. A Compressive Superresolution Display

    KAUST Repository

    Heide, Felix

    2014-06-22

    In this paper, we introduce a new compressive display architecture for superresolution image presentation that exploits co-design of the optical device configuration and compressive computation. Our display allows for superresolution, HDR, or glasses-free 3D presentation.

  15. Lunar Sample Display Locations

    Data.gov (United States)

    National Aeronautics and Space Administration — NASA provides a number of lunar samples for display at museums, planetariums, and scientific expositions around the world. Lunar displays are open to the public....

  16. Prevalence and correlates of posttrauma distorted beliefs: evaluating DSM-5 PTSD expanded cognitive symptoms in a national sample.

    Science.gov (United States)

    Cox, Keith S; Resnick, Heidi S; Kilpatrick, Dean G

    2014-06-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association [APA], 2013) modified the diagnostic criteria for posttraumatic stress disorder (PTSD), including expanding the scope of dysfunctional, posttrauma changes in belief (symptoms D2-persistent negative beliefs and expectations about oneself or the world, and D3-persistent distorted blame of self or others for the cause or consequences of the traumatic event). D2 and D3 were investigated using a national sample of U.S. adults (N = 2,498) recruited from an online panel. The prevalence of D2 and D3 was substantially higher among those with lifetime PTSD than among trauma-exposed individuals without lifetime PTSD (D2: 74.6% vs 23.9%; D3: 80.6% vs 35.7%). In multivariate analyses, the strongest associates of D2 were interpersonal assault (OR = 2.39), witnessing interpersonal assault (OR = 1.63), gender (female, OR = 2.11), and number of reported traumatic events (OR = 1.88). The strongest correlates of D3 were interpersonal assault (OR = 3.08), witnessing interpersonal assault (OR = 1.57), gender (female, OR = 2.30), and number of reported traumatic events (OR = 1.91). The findings suggested the expanded cognitive symptoms in the DSM-5 diagnostic criteria better capture the cognitive complexity of PTSD than those of the DSM-IV.

  17. Appetitive aggression as a resilience factor against trauma disorders: appetitive aggression and PTSD in German World War II veterans.

    Science.gov (United States)

    Weierstall, Roland; Huth, Sina; Knecht, Jasmin; Nandi, Corina; Elbert, Thomas

    2012-01-01

    Repeated exposure to traumatic stressors such as combat results in chronic symptoms of PTSD. However, previous findings suggest that former soldiers who report combat-related aggression to be appetitive are more resilient to develop PTSD. Appetitive Aggression should therefore prevent widespread mental suffering in perpetrators of severe atrocities even after decades. To test the long-term relationship between trauma-related illness and attraction to aggression, we surveyed a sample of 51 German male World-War II veterans (age: M = 86.7, SD = 2.8). War-related appetitive aggression was assessed with the Appetitive Aggression Scale (AAS). Current- and lifetime PTSD symptoms were assessed with the PSS-I. In a linear regression analysis accounting for 31% of the variance we found that veterans that score higher on the AAS show lower PSS-I symptom severity scores across their whole post-war lifetime (β = - .31, p = .014). The effect size and power were sufficient (f(2) = 0.51, (1-β) = .99). The same was true for current PTSD (β = - .27, p = .030). Appetitive Aggression appears to be a resilience factor for negative long-term effects of combat experiences in perpetrators of violence. This result has practical relevance for preventing trauma-related mental suffering in Peace Corps and for designing adequate homecoming reception for veterans.

  18. Appetitive aggression as a resilience factor against trauma disorders: appetitive aggression and PTSD in German World War II veterans.

    Directory of Open Access Journals (Sweden)

    Roland Weierstall

    Full Text Available BACKGROUND: Repeated exposure to traumatic stressors such as combat results in chronic symptoms of PTSD. However, previous findings suggest that former soldiers who report combat-related aggression to be appetitive are more resilient to develop PTSD. Appetitive Aggression should therefore prevent widespread mental suffering in perpetrators of severe atrocities even after decades. METHODS AND FINDINGS: To test the long-term relationship between trauma-related illness and attraction to aggression, we surveyed a sample of 51 German male World-War II veterans (age: M = 86.7, SD = 2.8. War-related appetitive aggression was assessed with the Appetitive Aggression Scale (AAS. Current- and lifetime PTSD symptoms were assessed with the PSS-I. In a linear regression analysis accounting for 31% of the variance we found that veterans that score higher on the AAS show lower PSS-I symptom severity scores across their whole post-war lifetime (β = - .31, p = .014. The effect size and power were sufficient (f(2 = 0.51, (1-β = .99. The same was true for current PTSD (β = - .27, p = .030. CONCLUSIONS: Appetitive Aggression appears to be a resilience factor for negative long-term effects of combat experiences in perpetrators of violence. This result has practical relevance for preventing trauma-related mental suffering in Peace Corps and for designing adequate homecoming reception for veterans.

  19. PTSD Symptom Trajectories in Disaster Volunteers: The Role of Self-Efficacy, Social Acknowledgement, and Tasks Carried Out.

    Science.gov (United States)

    Thormar, Sigridur B; Sijbrandij, Marit; Gersons, Berthold P R; Van de Schoot, Rens; Juen, Barbara; Karlsson, Thorlakur; Olff, Miranda

    2016-02-01

    Millions of volunteers respond after disasters, with a 24% to 46% risk of developing posttraumatic stress disorder (PTSD). It is unclear which symptom trajectories develop and how they differ between core (volunteering before the disaster) and noncore volunteers (joining after the disaster) and which factors predict trajectories. Symptoms of PTSD were assessed at 6-, 12-, and 18-months postearthquake in 449 volunteers in Indonesia. Demographics, previous mental health service use, self-efficacy, social acknowledgment, and type of tasks were assessed at 6 months. In both core and noncore volunteers, 2 PTSD symptom trajectories emerged: a resilient trajectory (moderate levels of symptoms with a slow decrease over time; 90.9%) and a chronic trajectory (higher levels of symptoms with an increase over time; 9.1%). In both trajectories, core volunteers had fewer symptoms than noncore volunteers. Core volunteers in the chronic trajectory were characterized by having sought prior mental help, reported lower levels of self-efficacy and social acknowledgment, and were more likely to have provided psychosocial support to beneficiaries (Cramér's V = .17 to .27, partial η(2) = .02 to .06). Aid organizations should identify and follow up chronic PTSD trajectories in volunteers, including the noncore, who may be out of sight to the organization after the acute response phase.

  20. Prazosin for military combat-related PTSD nightmares: a critical review.

    Science.gov (United States)

    Writer, Brian W; Meyer, Eric G; Schillerstrom, Jason E

    2014-01-01

    Military combat is a common trauma experience associated with posttraumatic stress disorder (PTSD). Trauma-related nightmares are a hallmark symptom of PTSD. They can be resistant to label-pharmacological PTSD treatment, and they are associated with a variety of adverse health outcomes. The purpose of this article is to review and evaluate prazosin therapy for combat-related PTSD nightmares. Consistent with available literature for all-causes PTSD nightmares, prazosin is an effective off-label option for combat-related PTSD nightmares. Future trials may further instruct use in specific combat-exposure profiles.

  1. EMDR beyond PTSD: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Alicia Valiente-Gómez

    2017-09-01

    Full Text Available Background: Eye Movement Desensitization and Reprocessing (EMDR is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD through several randomized controlled trials (RCT. Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain.Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions.Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement.Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions.

  2. Relationship of early-life trauma, war-related trauma, personality traits, and PTSD symptom severity: a retrospective study on female civilian victims of war

    Directory of Open Access Journals (Sweden)

    Aleksandra Stevanović

    2016-04-01

    Full Text Available Background: Consequences of war-related traumatisation have mostly been investigated in military and predominant male populations, while research on female civilian victims of war has been neglected. Furthermore, research of post-war posttraumatic stress disorder (PTSD in women has rarely included early-life trauma in their prediction models, so the contribution of trauma in childhood and early youth is still unexplored. Objective: To examine the relationship of early-life trauma, war-related trauma, personality traits, and symptoms of posttraumatic stress among female civilian victims of the recent war in Croatia. Method: The cross-sectional study included 394 participants, 293 war-traumatised adult women civilians, and 101 women without war-related trauma. Participants were recruited using the snowball sampling method. The applied instruments included the Clinician-Administrated PTSD Scale (CAPS, the NEO Personality Inventory-Revised (NEO-PI-R, the War Stressors Assessment Questionnaire (WSAQ, and the Early Trauma Inventory Self Report-Short Form (ETISR-SF. A hierarchical multiple regression analysis was performed to assess the prediction model of PTSD symptom severity measured by CAPS score for current PTSD. Results: The prevalence of current PTSD (CAPS cut-off score=65 in this cohort was 20.7%. The regression model that included age, early-life trauma, war-related trauma, neuroticism, and extraversion as statistically significant predictors explained 45.8% of variance in PTSD symptoms. Conclusions: Older age, exposure to early-life trauma, exposure to war-related traumatic events, high neuroticism, and low extraversion are independent factors associated with higher level of PTSD symptoms among women civilian victims of war.

  3. Optogenetic Stimulation of Peripheral Vagus Nerves using Flexible OLED Display Technology to Treat Chronic Inflammatory Disease and Mental Health Disorders

    Science.gov (United States)

    2016-03-31

    and veterans, including arthritis, systemic inflammatory response syndrome, inflammatory bowel disease, post -traumatic stress disorder (PTSD...provide the desired specificity and minimize unwanted physiological side effects during treatment. Low Cost Mass Production Technology The notional...transcutaneous VNS OLED ‘bandage’ would be manufactured on a thin plastic substrate using commercial thin- film , flexible-display technology

  4. Depression, not PTSD, is associated with attentional biases for emotional visual cues in early traumatized individuals with PTSD

    Directory of Open Access Journals (Sweden)

    Charlotte Elisabeth Wittekind

    2015-01-01

    Full Text Available Using variants of the emotional Stroop task (EST, a large number of studies demonstrated attentional biases in individuals with PTSD across different types of trauma. However, the specificity and robustness of the emotional Stroop effect in PTSD were questioned recently. In particular, the paradigm cannot disentangle underlying cognitive mechanisms. Transgenerational studies provide evidence that consequences of trauma are not limited to the traumatized people, but extend to close relatives, especially the children. To further investigate attentional biases in PTSD and to shed light on the underlying cognitive mechanism(s, a spatial-cueing paradigm with pictures of different emotional valence (neutral, anxiety, depression, trauma was administered to individuals displaced as children during World War II with (n = 22 and without PTSD (n = 26 as well as to nontraumatized controls (n = 22. To assess whether parental PTSD is associated with biased information processing in children, each one adult offspring was also included in the study. PTSD was not associated with attentional biases for trauma-related stimuli. There was no evidence for a transgenerational transmission of biased information processing. However, when samples were regrouped based on current depression, a reduced inhibition of return (IOR effect emerged for depression-related cues. IOR refers to the phenomenon that with longer intervals between cue and target the validity effect is reversed: uncued locations are associated with shorter and cued locations with longer RTs. The results diverge from EST studies and demonstrate that findings on attentional biases yield equivocal results across different paradigms. Attentional biases for trauma-related material may only appear for verbal but not for visual stimuli in an elderly population with childhood trauma with PTSD. Future studies should more closely investigate whether findings from younger trauma populations also manifest in older

  5. Long-term responses to treatment in UK veterans with military-related PTSD: an observational study

    Science.gov (United States)

    Murphy, Dominic; Spencer-Harper, Lucy; Carson, Carron; Palmer, Emily; Hill, Kate; Sorfleet, Nicola; Wessely, Simon; Busuttil, Walter

    2016-01-01

    Objectives Military-related trauma can be difficult to treat. Evaluating longer term responses to treatment and identifying which individuals may need additional support could inform clinical practice. We assessed 1-year outcomes in UK veterans treated for post-traumatic stress disorder (PTSD). Design Within-participant design. Setting The intervention was offered by Combat Stress, a mental health charity for veterans in the UK. Participants The sample included 401 veterans who completed a standardised 6-week residential treatment. Of these, 268 (67%) were successfully followed up a year after the end of treatment. Methods A range of health outcomes were collected pretreatment and repeated at standard intervals post-treatment. The primary outcome was severity of PTSD symptoms, and secondary outcomes included measures of other mental health difficulties (depression, anxiety and anger), problems with alcohol, and social and occupational functioning. Results Significant reductions in PTSD severity were observed a year after treatment (PSS-I: −11.9, 95% CI −13.1 to −10.7). Reductions in the secondary outcomes were also reported. Higher levels of post-treatment functional impairment (0.24, 95% CI 0.08 to 0.41) and alcohol problems (0.18, 95% CI 0.03 to 0.32) were associated with poorer PTSD treatment response at 12 months. Conclusions This uncontrolled study suggests the longer term benefits of a structured programme to treat UK veterans with PTSD. Our findings point to the importance of continued support targeted for particular individuals post-treatment to improve longer term outcomes. PMID:27638494

  6. Effects of acculturative stress on PTSD, depressive, and anxiety symptoms among refugees resettled in Australia and Austria

    Directory of Open Access Journals (Sweden)

    Dzenana Kartal

    2016-02-01

    Full Text Available Background: Research indicates that exposure to war-related traumatic events impacts on the mental health of refugees and leads to higher rates of posttraumatic stress disorder (PTSD, depression, and anxiety symptoms. Furthermore, stress associated with the migration process has also been shown to impact negatively on refugees’ mental health, but the extent of these experiences is highly debatable as the relationships between traumatic events, migration, and mental health outcomes are complex and poorly understood. Objective: This study aimed to examine the influence of trauma-related and post-migratory factors on symptoms of PTSD, depression, and anxiety in two samples of Bosnian refugees that have resettled in two different host nations—Austria and Australia. Method: Using multiple recruitment methods, 138 participants were recruited to complete self-report measures assessing acculturative stress, PTSD, depressive, and anxiety symptoms. Results: Hierarchical regressions indicated that after controlling for age, sex, and exposure to traumatic events, acculturative stress associated with post-migratory experiences predicted severity of PTSD and anxiety symptoms, while depressive symptoms were only predicted by exposure to traumatic events. This model, however, was only significant for Bosnian refugees resettled in Austria, as PTSD, depressive, and anxiety symptoms were only predicted by traumatic exposure in the Bosnian refugees resettled in Australia. Conclusion: These findings point toward the importance of assessing both psychological and social stressors when assessing mental health of refugees. Furthermore, these results draw attention to the influence of the host society on post-migratory adaptation and mental health of refugees. Further research is needed to replicate these findings among other refugee samples in other host nations.

  7. Personality heterogeneity in PTSD: distinct temperament and interpersonal typologies.

    Science.gov (United States)

    Thomas, Katherine M; Hopwood, Christopher J; Donnellan, M Brent; Wright, Aidan G C; Sanislow, Charles A; McDevitt-Murphy, Meghan E; Ansell, Emily B; Grilo, Carlos M; McGlashan, Thomas H; Shea, M Tracie; Markowitz, John C; Skodol, Andrew E; Zanarini, Mary C; Morey, Leslie C

    2014-03-01

    Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD.

  8. Sleep Disturbances, TBI and PTSD: Implications for Treatment and Recovery

    Science.gov (United States)

    Gilbert, Karina Stavitsky; Kark, Sarah M.; Gehrman, Philip; Bogdanova, Yelena

    2015-01-01

    Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties. PMID:26164549

  9. Sleep disturbances, TBI and PTSD: Implications for treatment and recovery.

    Science.gov (United States)

    Gilbert, Karina Stavitsky; Kark, Sarah M; Gehrman, Philip; Bogdanova, Yelena

    2015-08-01

    Post-Traumatic Stress Disorder (PTSD), traumatic brain injury (TBI), and sleep problems significantly affect recovery and functional status in military personnel and Veterans returning from combat. Despite recent attention, sleep is understudied in the Veteran population. Few treatments and rehabilitation protocols target sleep, although poor sleep remains at clinical levels and continues to adversely impact functioning even after the resolution of PTSD or mild TBI symptoms. Recent developments in non-pharmacologic sleep treatments have proven efficacious as stand-alone interventions and have potential to improve treatment outcomes by augmenting traditional behavioral and cognitive therapies. This review discusses the extensive scope of work in the area of sleep as it relates to TBI and PTSD, including pathophysiology and neurobiology of sleep; existing and emerging treatment options; as well as methodological issues in sleep measurements for TBI and PTSD. Understanding sleep problems and their role in the development and maintenance of PTSD and TBI symptoms may lead to improvement in overall treatment outcomes while offering a non-stigmatizing entry in mental health services and make current treatments more comprehensive by helping to address a broader spectrum of difficulties.

  10. Trauma Histories, Substance Use Coping, PTSD, and Problem Substance Use Among Sexual Assault Victims

    OpenAIRE

    Ullman, Sarah E.; Relyea, Mark; Peter-Hagene, Liana; Vasquez, Amanda L.

    2013-01-01

    Sexual assault history is associated with higher risk of problem drinking and drug use in women, yet little is known about mechanisms linking trauma histories in general to women’s drinking or drug use problems. This study examined how various types of trauma, substance use coping, and PTSD relate to past-year problem drinking and drug use in women who experienced sexual assault. Data from a large, diverse sample of women who had experienced adult sexual assault was analyzed with structural e...

  11. Invisible Display in Aluminum

    DEFF Research Database (Denmark)

    Prichystal, Jan Phuklin; Hansen, Hans Nørgaard; Bladt, Henrik Henriksen

    2005-01-01

    Bang & Olufsen a/s has been working with ideas for invisible integration of displays in metal surfaces. Invisible integration of information displays traditionally has been possible by placing displays behind transparent or semitransparent materials such as plastic or glass. The wish for an integ...... be obtained by shining light from the backside of the workpiece. When there is no light from the backside, the front surface seems totally untouched. This was achieved by laser ablation with ultra-short pulses.......Bang & Olufsen a/s has been working with ideas for invisible integration of displays in metal surfaces. Invisible integration of information displays traditionally has been possible by placing displays behind transparent or semitransparent materials such as plastic or glass. The wish...... for an integrated display in a metal surface is often ruled by design and functionality of a product. The integration of displays in metal surfaces requires metal removal in order to clear the area of the display to some extent. The idea behind an invisible display in Aluminum concerns the processing of a metal...

  12. The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD

    NARCIS (Netherlands)

    Hagenaars, M.A.; Minnen, A. van; Hoogduin, C.A.L.

    2010-01-01

    This study investigates the impact of dissociative phenomena and depression on the efficacy of prolonged exposure treatment in 71 patients with posttraumatic stress disorder (PTSD). Diagnoses, comorbidity, pretreatment depressive symptoms, PTSD symptom severity, and dissociative phenomena (trait dis

  13. Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review

    National Research Council Canada - National Science Library

    Edmondson, Donald; Richardson, Safiya; Fausett, Jennifer K; Falzon, Louise; Howard, Virginia J; Kronish, Ian M

    2013-01-01

    Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke and transient ischemic attack (TIA...

  14. Polyplanar optic display

    Energy Technology Data Exchange (ETDEWEB)

    Veligdan, J.; Biscardi, C.; Brewster, C.; DeSanto, L. [Brookhaven National Lab., Upton, NY (United States). Dept. of Advanced Technology; Beiser, L. [Leo Beiser Inc., Flushing, NY (United States)

    1997-07-01

    The Polyplanar Optical Display (POD) is a unique display screen which can be used with any projection source. This display screen is 2 inches thick and has a matte black face which allows for high contrast images. The prototype being developed is a form, fit and functional replacement display for the B-52 aircraft which uses a monochrome ten-inch display. The new display uses a 100 milliwatt green solid state laser (532 nm) as its optical source. In order to produce real-time video, the laser light is being modulated by a Digital Light Processing (DLP{trademark}) chip manufactured by Texas Instruments, Inc. A variable astigmatic focusing system is used to produce a stigmatic image on the viewing face of the POD. In addition to the optical design, the authors discuss the electronic interfacing to the DLP{trademark} chip, the opto-mechanical design and viewing angle characteristics.

  15. Cognitive-behavioral therapy versus other PTSD psychotherapies as treatment for women victims of war-related violence: a systematic review.

    Science.gov (United States)

    Dossa, N Inès; Hatem, Marie

    2012-01-01

    Although war-trauma victims are at a higher risk of developing PTSD, there is no consensus on the effective treatments for this condition among civilians who experienced war/conflict-related trauma. This paper assessed the effectiveness of the various forms of cognitive-behavioral therapy (CBT) at lowering PTSD and depression severity. All published and unpublished randomized controlled trials studying the effectiveness of CBT at reducing PTSD and/or depression severity in the population of interest were searched. Out of 738 trials identified, 33 analysed a form of CBTs effectiveness, and ten were included in the paper. The subgroup analysis shows that cognitive processing therapy (CPT), culturally adapted CPT, and narrative exposure therapy (NET) contribute to the reduction of PTSD and depression severity in the population of interest. The effect size was also significant at a level of 0.01 with the exception of the effect of NET on depression score. The test of subgroup differences was also significant, suggesting CPT is more effective than NET in our population of interest. CPT as well as its culturallyadapted form and NET seem effective in helping war/conflict traumatised civilians cope with their PTSD symptoms. However, more studies are required if one wishes to recommend one of these therapies above the other.

  16. Joint Effect of Childhood Abuse and Family History of Major Depressive Disorder on Rates of PTSD in People with Personality Disorders

    Directory of Open Access Journals (Sweden)

    Janine D. Flory

    2012-01-01

    Full Text Available Objective. Childhood maltreatment and familial psychopathology both lead to an increased risk of the development of posttraumatic stress disorder (PTSD in adulthood. While family history of psychopathology has traditionally been viewed as a proxy for genetic predisposition, such pathology can also contribute to a stress-laden environment for the child. Method. Analyses were conducted to evaluate the joint effect of childhood abuse and a family history of major depressive disorder (MDD on diagnoses of PTSD and MDD in a sample of 225 adults with DSM-IV Axis II disorders. Results. Results showed that the rate of PTSD in the presence of both childhood abuse and MDD family history was almost six-fold (OR=5.89,  P=.001 higher relative to the absence of both factors. In contrast, the rate of MDD in the presence of both factors was associated with a nearly three-fold risk relative to the reference group (OR=2.75,  P=.01. Conclusions. The results from this observational study contribute to a growing understanding of predisposing factors for the development of PTSD and suggest that joint effects of family history of MDD and childhood abuse on PTSD are greater than either factor alone.

  17. OLED displays and lighting

    CERN Document Server

    Koden, Mitsuhiro

    2017-01-01

    Organic light-emitting diodes (OLEDs) have emerged as the leading technology for the new display and lighting market. OLEDs are solid-state devices composed of thin films of organic molecules that create light with the application of electricity. OLEDs can provide brighter, crisper displays on electronic devices and use less power than conventional light-emitting diodes (LEDs) or liquid crystal displays (LCDs) used today. This book covers both the fundamentals and practical applications of flat and flexible OLEDs.

  18. Scalable Resolution Display Walls

    KAUST Repository

    Leigh, Jason

    2013-01-01

    This article will describe the progress since 2000 on research and development in 2-D and 3-D scalable resolution display walls that are built from tiling individual lower resolution flat panel displays. The article will describe approaches and trends in display hardware construction, middleware architecture, and user-interaction design. The article will also highlight examples of use cases and the benefits the technology has brought to their respective disciplines. © 1963-2012 IEEE.

  19. EMDR therapy for PTSD after motor vehicle accidents: meta-analytic evidence for specific treatment

    OpenAIRE

    Maddalena eBoccia; Laura ePiccardi; Pierluigi eCordellieri; Cecilia eGuariglia; Anna Maria eGiannini

    2015-01-01

    Motor vehicle accident (MVA) victims may suffer both acute and post-traumatic stress disorders (PTSD). With PTSD affecting social, interpersonal and occupational functioning, clinicians as well as the National Institute of Health are very interested in identifying the most effective psychological treatment to reduce PTSD. From research findings, eye movement desensitization and reprocessing (EMDR) therapy is considered as one of the effective treatment of PTSD. In this paper, we present the r...

  20. Maternal Age at Holocaust Exposure and Maternal PTSD Independently Influence Urinary Cortisol Levels in Adult Offspring

    OpenAIRE

    2014-01-01

    Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal posttraumatic stress disorder (PTSD) appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: Ninety-five Holocaust offspring and Jewish comparison subjects r...

  1. Maternal age at Holocaust exposure and maternal PTSD independently influence urinary cortisol levels in adult offspring

    OpenAIRE

    2014-01-01

    Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal PTSD appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: 95 Holocaust offspring and Jewish comparison subjects received diagnostic and psychological evaluat...

  2. Identifying Risk Factors for PTSD in Women Seeking Medical Help after Rape

    OpenAIRE

    Anna Tiihonen Möller; Torbjörn Bäckström; Hans Peter Söndergaard; Lotti Helström

    2014-01-01

    Objectives: Rape has been found to be the trauma most commonly associated with Posttraumatic Stress Disorder (PTSD) among women. It is therefore important to be able to identify those women at greatest risk of developing PTSD. The aims of the present study were to analyze the PTSD prevalence six months after sexual assaults and identify the major risk factors for developing PTSD. Methods: Participants were 317 female victims of rape who sought help at the Emergency Clinic for Raped Women at S...

  3. Commentary: deconstructing critiques on the internationalization of PTSD.

    Science.gov (United States)

    de Jong, Joop T V M

    2005-09-01

    When PTSD entered the DSM, advocacy for the diagnosis was a critical part of advocacy for Vietnam veterans. Over the next two decades, the range of contexts in which this clinical concept was applied increased dramatically. In a recent article in Culture, Medicine and Psychiatry, Breslau (2004) describes PTSD as a "prominent cultural model" to account for suffering as well as the synergy between human rights or political advocacy and traumatic stress advocacy. In this article I question the sequence of steps that Breslau took to critique the internationalization of the PTSD construct. I also question Breslau's critique on our work in Nepal. Finally, I will formulate some future challenges for psychiatry and anthropology to bridge their universalistic and relativistic points of view.

  4. Common paths to ASD severity and PTSD severity

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

    Numerous studies have identified risk factors for acute and long term posttraumatic symptoms following traumatic exposure. However, little is known about possible common pathways to the development of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD). Research suggests...... that a common pathway to ASD and PTSD may lie in peritraumatic responses and cognitions. Using structural equation modeling we examined the role of three peritraumatic factors (tonic immobility, panic and dissociation) and three cognitive factors (anxiety sensitivity, negative cognitions about the world......, and negative cognitions about self ) on the development of ASD and PTSD severity in a national study of Danish bank robbery victims (N = 450). Peritraumatic panic, anxiety sensitivity, and negative cognitions about self were found to be significant common risk factors, whereas peritraumatic dissociation...

  5. Rhythms dysregulation: A new perspective for understanding PTSD?

    Science.gov (United States)

    Dayan, Jacques; Rauchs, Géraldine; Guillery-Girard, Bérengère

    2017-02-01

    Post-traumatic stress disorder (PTSD) is a complex syndrome that may occur after exposure to one or more traumatic events. It associates physiological, emotional, and cognitive changes Brain and hormonal modifications contribute to some impairments in learning, memory, and emotion regulation. Some of these biological dysfunctions may be analyzed in terms of rhythms dysregulation that would be expressed through endocrine rhythmicity, sleep organization, and temporal synchrony in brain activity. In the first part of this article, we report studies on endocrine rhythmicity revealing that some rhythms abnormalities are frequently observed, although not constantly, for both cortisol and sympathetic nervous system (SNS) activity. The most typical changes are a flattening of the diurnal secretion of cortisol and the hyperactivation of the SNS. These results may explain why cognitive functioning, in particular consolidation of emotional memories, attention, learning, vigilance and arousal, is altered in patients with PTSD. The second part of this article focuses on sleep disturbances, one of the core features of PTSD. Abnormal REM sleep reported in various studies may have a pathophysiological role in PTSD and may exacerbate some symptoms such as emotional regulation and memory. In addition, sleep disorders, such as paradoxical insomnia, increase the risk of developing PTSD. We also discuss the potential impact of sleep disturbances on cognition. Finally, temporal synchrony of brain activity and functional connectivity, explored using electroencephalography and functional magnetic resonance imaging, are addressed. Several studies reported abnormalities in alpha, beta and gamma frequency bands that may affect both attentional and memory processes. Other studies confirmed abnormalities in connectivity and recent fMRI data suggest that this could limit top-down control and may be associated with flashback intrusive memories. These data illustrate that a better knowledge of

  6. Relationships among Adult Attachment, Social Support, and PTSD Symptoms in Trauma-Exposed College Students

    Science.gov (United States)

    Pruneau, Genevieve Mary Catherine

    2010-01-01

    Although many people are exposed to trauma, substantially fewer develop posttraumatic stress disorder (PTSD). Given this, studies have examined risk and protective factors for developing PTSD. This literature has established that there is a robust negative correlation between social support and PTSD. Attachment insecurity may be an informative…

  7. Heterogeneity in the Latent Structure of PTSD Symptoms among Canadian Veterans

    Science.gov (United States)

    Naifeh, James A.; Richardson, J. Don; Del Ben, Kevin S.; Elhai, Jon D.

    2010-01-01

    The current study used factor mixture modeling to identify heterogeneity (i.e., latent classes) in 2 well-supported models of posttraumatic stress disorder's (PTSD) factor structure. Data were analyzed from a clinical sample of 405 Canadian veterans evaluated for PTSD. Results were consistent with our hypotheses. Each PTSD factor model was best…

  8. Validation of two screening instruments for PTSD in Dutch substance use disorder inpatients

    NARCIS (Netherlands)

    Kok, T.; Haan, H.A. de; Velden, H.J.W. van der; Meer, M. van der; Jong, C.A.J. de

    2013-01-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in substance use disorder (SUD) populations. Because resources for extensive and thorough diagnostic assessment are often limited, reliable screening instruments for PTSD are needed. The aim of the current study was to test two short PTSD meas

  9. Critical analysis of the current treatment guidelines for complex ptsd in adults

    NARCIS (Netherlands)

    de Jongh, A.; Resick, P.A.; Zoelner, L.A.; van Minnen, A.; Lee, C.W.; Monson, C.M.; Foa, E.B.; Wheeler, K.; ten Broeke, E.; Feeny, N.; Rauch, S.A.M.; Chard, K.M.; Mueser, K.T.; Sloan, D.M.; van der Gaag, M.; Rothbaum, B.O.; Neuner, F.; de Roos, C.; Hehenkamp, L.M.J.; Rosner, R.; Bicanic, I.A.E.

    2016-01-01

    According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a “stabilization phase.” This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused

  10. CRITICAL ANALYSIS of the CURRENT TREATMENT GUIDELINES for COMPLEX PTSD in ADULTS

    NARCIS (Netherlands)

    De Jongh, Ad; Resick, Patricia A.; Zoellner, Lori A.; Van Minnen, Agnes; Lee, Christopher W.; Monson, Candice M.; Foa, Edna B.; Wheeler, Kathleen; Broeke, Erik Ten; Feeny, Norah; Rauch, Sheila A M; Chard, Kathleen M.; Mueser, Kim T.; Sloan, Denise M.; Van Der Gaag, Mark; Rothbaum, Barbara Olasov; Neuner, Frank; De Roos, Carlijn; Hehenkamp, Lieve M J; Rosner, Rita; Bicanic, Iva A E

    2016-01-01

    According to current treatment guidelines for Complex PTSD (cPTSD), psychotherapy for adults with cPTSD should start with a "stabilization phase." This phase, focusing on teaching self-regulation strategies, was designed to ensure that an individual would be better able to tolerate trauma-focused

  11. Common paths to ASD severity and PTSD severity

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz;

    , and negative cognitions about self ) on the development of ASD and PTSD severity in a national study of Danish bank robbery victims (N = 450). Peritraumatic panic, anxiety sensitivity, and negative cognitions about self were found to be significant common risk factors, whereas peritraumatic dissociation...... was only a significant risk factor of ASD severity. Together with two control factors these factors explained 73 % of the variance in ASD severity and 52 % of the variance in PTSD severity. Future research should focus on replicating these results across different trauma populations as they point...

  12. Standardizing visual display quality

    NARCIS (Netherlands)

    Besuijen, Ko; Spenkelink, Gerd P.J.

    1998-01-01

    The current ISO 9241–3 standard for visual display quality and the proposed user performance tests are reviewed. The standard is found to be more engineering than ergonomic and problems with system configuration, software applications, display settings, user behaviour, wear and physical environment

  13. Polyplanar optical display electronics

    Energy Technology Data Exchange (ETDEWEB)

    DeSanto, L.; Biscardi, C. [Brookhaven National Lab., Upton, NY (United States). Dept. of Advanced Technology

    1997-07-01

    The Polyplanar Optical Display (POD) is a unique display screen which can be used with any projection source. The prototype ten inch display is two inches thick and has a matte black face which allows for high contrast images. The prototype being developed is a form, fit and functional replacement display for the B-52 aircraft which uses a monochrome ten-inch display. In order to achieve a long lifetime, the new display uses a 100 milliwatt green solid-state laser (10,000 hr. life) at 532 nm as its light source. To produce real-time video, the laser light is being modulated by a Digital Light Processing (DLP{trademark}) chip manufactured by Texas Instruments. In order to use the solid-state laser as the light source and also fit within the constraints of the B-52 display, the Digital Micromirror Device (DMD{trademark}) circuit board is removed from the Texas Instruments DLP light engine assembly. Due to the compact architecture of the projection system within the display chassis, the DMD{trademark} chip is operated remotely from the Texas Instruments circuit board. The authors discuss the operation of the DMD{trademark} divorced from the light engine and the interfacing of the DMD{trademark} board with various video formats (CVBS, Y/C or S-video and RGB) including the format specific to the B-52 aircraft. A brief discussion of the electronics required to drive the laser is also presented.

  14. Helmet-Mounted Displays (HMD)

    Data.gov (United States)

    Federal Laboratory Consortium — The Helmet-Mounted Display labis responsible for monocular HMD day display evaluations; monocular HMD night vision performance processes; binocular HMD day display...

  15. Visual merchandising window display

    Directory of Open Access Journals (Sweden)

    Opris (Cas. Stanila M.

    2013-12-01

    Full Text Available Window display plays a major part in the selling strategies; it does not only include the simple display of goods, nowadays it is a form of art, also having the purpose of sustaining the brand image. This article wants to reveal the tools that are essential in creating a fabulous window display. Being a window designer is not an easy job, you have to always think ahead trends, to have a sense of colour, to know how to use light to attract customers in the store after only one glance at the window. The big store window displays are theatre scenes: with expensive backgrounds, special effects and high fashion mannequins. The final role of the displays is to convince customers to enter the store and trigger the purchasing act which is the final goal of the retail activity.

  16. Defense display market assessment

    Science.gov (United States)

    Desjardins, Daniel D.; Hopper, Darrel G.

    1998-09-01

    This paper addresses the number, function and size of principal military displays and establishes a basis to determine the opportunities for technology insertion in the immediate future and into the next millennium. Principal military displays are defined as those occupying appreciable crewstation real-estate and/or those without which the platform could not carry out its intended mission. DoD 'office' applications are excluded from this study. The military displays market is specified by such parameters as active area and footprint size, and other characteristics such as luminance, gray scale, resolution, angle, color, video capability, and night vision imaging system (NVIS) compatibility. Funded, future acquisitions, planned and predicted crewstation modification kits, and form-fit upgrades are taken into account. This paper provides an overview of the DoD niche market, allowing both government and industry a necessary reference by which to meet DoD requirements for military displays in a timely and cost-effective manner. The aggregate DoD market for direct-view and large-area military displays is presently estimated to be in excess of 242,000. Miniature displays are those which must be magnified to be viewed, involve a significantly different manufacturing paradigm and are used in helmet mounted displays and thermal weapon sight applications. Some 114,000 miniature displays are presently included within Service weapon system acquisition plans. For vendor production planning purposes it is noted that foreign military sales could substantially increase these quantities. The vanishing vendor syndrome (VVS) for older display technologies continues to be a growing, pervasive problem throughout DoD, which consequently must leverage the more modern display technologies being developed for civil- commercial markets.

  17. Epigenetic Biomarkers as Predictors and Correlates of Symptom Improvement Following Psychotherapy in Combat Veterans with PTSD

    Directory of Open Access Journals (Sweden)

    Rachel eYehuda

    2013-09-01

    Full Text Available Epigenetic alterations offer promise as prognostic or diagnostic markers, but it is not known whether these measures associate with, or predict, clinical state. These questions were addressed in a pilot study with combat veterans with PTSD to determine whether cytosine methylation in promoter regions of the glucocorticoid related NR3C1 and FKBP51 genes would predict or associate with treatment outcome. Veterans with PTSD received prolonged exposure (PE psychotherapy, yielding responders (n=8, defined by no longer meeting diagnostic criteria for PTSD, and non-responders (n=8. Blood samples were obtained at pre-treatment, after 12 weeks of psychotherapy (post-treatment, and after a 3 month follow-up. Methylation was examined in DNA extracted from lymphocytes. Measures reflecting glucocorticoid receptor (GR activity were also obtained from lymphocytes (i.e., plasma and 24h-urinary cortisol, plasma ACTH, lysozyme IC50-DEX, and plasma neuropetide-Y. Methylation of the GR gene (NR3C1 exon 1F promoter assessed at pre-treatment predicted treatment outcome, but was not significantly altered in responders or non-responders at post-treatment or follow-up. In contrast, methylation of the FKBP5 gene (FKBP51 exon 1 promoter region did not predict treatment response, but decreased in association with recovery. In a subset, a corresponding group difference in FKBP5 gene expression was observed, with responders showing higher gene expression at post-treatment than non-responders. Endocrine markers also changed in association with symptom change. These preliminary observations require replication and validation. However, the results support research indicating that some glucocorticoid related genes are subject to environmental regulation throughout life. Moreover, psychotherapy constitutes a form of ‘environmental regulation’ that may alter epigenetic state. Finally, the results further suggest that different genes may be associated with prognosis and symptom

  18. Children's enduring PTSD symptoms are related to their family's adaptability and cohesion.

    Science.gov (United States)

    Birmes, Philippe; Raynaud, Jean-Philippe; Daubisse, Laetitia; Brunet, Alain; Arbus, Christophe; Klein, Rémy; Cailhol, Lionel; Allenou, Charlotte; Hazane, Franck; Grandjean, Hélène; Schmitt, Laurent

    2009-08-01

    This study compared, 18-24 months after an industrial disaster, in two groups of children (those with clinically relevant PTSD symptoms versus those with low PTSD symptoms), the child's perception of family cohesion and adaptability, the child's experience of the explosion, and parental characteristics. Enmeshed family cohesion or rigid family adaptability were more frequently found in children with low PTSD symptoms. PTSD symptoms in the mother, living in a family of 3 or more children, and being female were significantly associated with PTSD symptoms in the children. The assessment of traumatized children should include assessment of family's adaptability and cohesion.

  19. Panoramic projection avionics displays

    Science.gov (United States)

    Kalmanash, Michael H.

    2003-09-01

    Avionics projection displays are entering production in advanced tactical aircraft. Early adopters of this technology in the avionics community used projection displays to replace or upgrade earlier units incorporating direct-view CRT or AMLCD devices. Typical motivation for these upgrades were the alleviation of performance, cost and display device availability concerns. In these systems, the upgraded (projection) displays were one-for-one form / fit replacements for the earlier units. As projection technology has matured, this situation has begun to evolve. The Lockheed-Martin F-35 is the first program in which the cockpit has been specifically designed to take advantage of one of the more unique capabilities of rear projection display technology, namely the ability to replace multiple small screens with a single large conformal viewing surface in the form of a panoramic display. Other programs are expected to follow, since the panoramic formats enable increased mission effectiveness, reduced cost and greater information transfer to the pilot. Some of the advantages and technical challenges associated with panoramic projection displays for avionics applications are described below.

  20. PTSD or not PTSD? Comparing the proposed ICD-11 and the DSM-5 PTSD criteria among young survivors of the 2011 Norway attacks and their parents

    OpenAIRE

    Hafstad, G S; Thoresen, S.; Wentzel-Larsen, T; Maercker, Andreas; Dyb, G

    2017-01-01

    BACKGROUND The conceptualization of post-traumatic stress disorder (PTSD) in the upcoming International Classification of Diseases (ICD)-11 differs in many respects from the diagnostic criteria in the Diagnostic and Statistical Manual for Mental Disorders, fifth edition (DSM-5). The consequences of these differences for individuals and for estimation of prevalence rates are largely unknown. This study investigated the concordance of the two diagnostic systems in two separate samples at two...

  1. Telerehabilitation for Veterans with Combat Related TBI/PTSD

    Science.gov (United States)

    2011-04-01

    signed by a proxy. Veterans and/or care givers must also possess basic computer literacy such as being able to access a web page and making entrees in...with Combat Related TBI/PTSD RTO-MP-HFM-205 15 - 7 or intervention ( diabetes , CHF, dementia etc), our cohort exhibits a very diverse population in

  2. Contextual Behavior Therapies in the Treatment of PTSD: A Review

    Science.gov (United States)

    Mulick, Patrick S.; Landers, Sara J.; Kanter, Jonathan W.

    2005-01-01

    Empirical evidence supports cognitive-behavioral interventions for the treatment Posttraumatic Stress Disorder (PTSD), with exposure therapy typically being the most frequently utilized. While the success of exposure treatments is well established there are factors which may hinder their use in "real-world" settings (e.g., poor treatment…

  3. Randomized, Controlled Trial of CBT Training for PTSD Providers

    Science.gov (United States)

    2013-10-01

    Training’; ‘ Cognitive - Behavioral Therapy ’; ‘Behavioral Task Assignment’; ‘Chain Analysis’. 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF... cognitive behavioral therapy (CBT) interventions have been shown to be effective in alleviating symptoms of Post-Traumatic Stress Disorder (PTSD) and...target groups: VA clinicians, community practitioners, and cognitive behavioral therapy experts. The surveys collected both qualitative and quantitative

  4. Biomarkers of Risk for Post-Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    2011-04-01

    NPY ). None of these genes predicted PTSD diagnoses in this sample. Next, because there was variability in the degree of combat exposure as...Lappalainen J. A sequencing -based survey of functional APAF1 alleles in a large sample of individuals with affective illness and population controls. Am J

  5. Treatment of a Case Example with PTSD and Chronic Pain

    Science.gov (United States)

    Shipherd, Jillian C.

    2006-01-01

    This commentary reviews the case of GH, a survivor of a road traffic collision, who has chronic pain and posttraumatic stress disorder (PTSD). The case formulation, assessment strategy, and treatment plan are informed by the relevant experimental literature and empirically supported treatments using a cognitive behavioral perspective. Given this…

  6. Complex PTSD and phased treatment in refugees : a debate piece

    NARCIS (Netherlands)

    Ter Heide, F Jackie June; Mooren, Trudy M; Kleber, Rolf J

    2016-01-01

    BACKGROUND: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused

  7. Psychosocial and Moral Development of PTSD-Diagnosed Combat Veterans

    Science.gov (United States)

    Taylor, John G.; Baker, Stanley B.

    2007-01-01

    Two related studies were conducted in order to investigate whether psychosocial and moral development appeared to have been disrupted and arrested in veterans diagnosed as having posttraumatic stress disorder (PTSD). Study 1 was devoted to developing a measure of late adolescence, early adulthood, and adulthood stages of psychosocial…

  8. Identification of Risk Factors for Chronic Posttraumatic Stress Disorder (PTSD)

    Science.gov (United States)

    2009-06-01

    Miller, Wolf, Martin , Kaloupek, & Keane, 2008). Furthermore, PTSD hyperarousal symptoms have been linked to greater aggressive tendencies among male...dimensional conceptualization of posttraumatic stress reactions on the basis of taxometric procedures (e.g. Forbes, Haslam, Williams, & Creamer , 2005) and...New York State Psychiatric Institute, Biometrics Research. Forbes, D., Haslam, N., Williams, B. J., & Creamer , M. (2005). Testing the latent

  9. The Role and Importance of the D in PTSD

    Science.gov (United States)

    2013-01-01

    Hell: Post-Traumatic Stress, Vietnam, and the Civil War. Cambridge, MA: Harvard University Press. Dumit, J. (2006). “Illnesses You Have to Fight to...Discrimination American Style: Institutional Racism and Sexism . Englewood Cliffs, NJ: Prentice-Hall. Finley, E. P. (2011). Fields of Combat: Understanding PTSD

  10. Alienation Appraisals Distinguish Adults Diagnosed With DID From PTSD

    NARCIS (Netherlands)

    DePrince, Anne P.; Huntjens, Rafaële J.C.; Dorahy, Martin J.

    2015-01-01

    Studies are beginning to show the importance of appraisals to different types and severities of psychiatric disorders. Yet, little work in this area has assessed whether trauma-related appraisals can differentiate complex trauma-related disorders, such as posttraumatic stress disorder (PTSD) and

  11. Depression and PTSD in Pashtun Women in Kandahar, Afghanistan

    Directory of Open Access Journals (Sweden)

    Sung-Man Shin, DSc

    2009-06-01

    Conclusions: The high prevalence of depression and PTSD indicate the continuing need for mental health intervention. While education has been found to be a protective factor for mental health in previous studies, the relationship between education and mental health appear to be more complex among Afghan women. Quality of life variables could be further investigated and incorporated into mental health interventions for Afghan women.

  12. Alienation appraisals distinguish adults diagnosed with DID from PTSD.

    Science.gov (United States)

    DePrince, Anne P; Huntjens, Rafaële J C; Dorahy, Martin J

    2015-11-01

    Studies are beginning to show the importance of appraisals to different types and severities of psychiatric disorders. Yet, little work in this area has assessed whether trauma-related appraisals can differentiate complex trauma-related disorders, such as posttraumatic stress disorder (PTSD) and dissociative identity disorder (DID). The current study evaluated whether any of 6 trauma-related appraisals distinguished adults diagnosed with DID from those diagnosed with PTSD. To accomplish this, we first examined the basic psychometric properties of a Dutch-translated short-form of the Trauma Appraisals Questionnaire (TAQ) in healthy control (n = 57), PTSD (n = 27) and DID (n = 12) samples. The short-form Dutch translation of the TAQ showed good internal reliability and criterion-related validity for all 6 subscales (betrayal, self-blame, fear, alienation, shame, anger). Of the 6 subscales, the alienation appraisal subscale specifically differentiated DID from PTSD, with the former group reporting more alienation. Abuse-related appraisals that emphasize disconnection from self and others may contribute to reported problems of memory and identity common in DID. The current findings suggest that addressing experiences of alienation may be particularly important in treatment for clients diagnosed with DID. (c) 2015 APA, all rights reserved).

  13. Complex PTSD and phased treatment in refugees : a debate piece

    NARCIS (Netherlands)

    Ter Heide, F Jackie June; Mooren, Trudy M; Kleber, Rolf J

    2016-01-01

    BACKGROUND: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD). Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatme

  14. Secondary traumatization among wives of PTSD and post-concussion casualties: distress, caregiver burden and psychological separation.

    Science.gov (United States)

    Ben Arzi, N; Solomon, Z; Dekel, R

    2000-08-01

    This study has two aims. First, it assesses the implication of husbands' post-traumatic stress disorder (PTSD) and post-concussion syndrome (PC) on their wives' sense of burden and emotional distress. The second aim was to examine the implication of the women's separation-individuation on their adjustment. Sixty women participated in study: 20 women married to war veterans diagnosed as suffering to PTSD, 20 women married to war veterans suffering from PC, and 20 women married to healthy controls. Data was collected using self report questionnaires assessing psychiatric symptomatology, caregiver burden and psychological separation-individuation. Results indicate that women from both research groups suffer from higher levels of burden and distress than controls. The level of separation-individuation was found to be correlated to levels of burden and distress. The complex implications of living with a traumatized spouse are discussed.

  15. PTSD and depression in refugee children: associations with pre-migration trauma and post-migration stress.

    Science.gov (United States)

    Heptinstall, Ellen; Sethna, Vaheshta; Taylor, Eric

    2004-12-01

    This paper describes the effect of pre-migration and post-migration experiences on the mental health of a sample of 40 refugee children aged 8-16 who lived in London with at least one parent or a refugee relative. Children's post-traumatic stress disorder (PTSD) and depression symptoms were assessed with standardised self-report measures (Impact of Event Scale and Depression Self-Rating Scale for Children, respectively). Information regarding past and present experiences were gathered during an interview with parents. There was a significant correlation between the number of pre-migration traumas experienced by the families and the children's PTSD scores. There was also a significant correlation between the families' number of post-migration stresses and children's depression scores. Higher PTSD scores were significantly associated with the pre-migration experience of violent death of family members and the post-migration experience of an insecure asylum status. Higher depression scores were significantly associated with insecure asylum status and severe financial difficulties. The clinical implications of these findings are discussed.

  16. Military display market segment: wearable and portable

    Science.gov (United States)

    Desjardins, Daniel D.; Hopper, Darrel G.

    2003-09-01

    The military display market (MDM) is analyzed in terms of one of its segments, wearable and portable displays. Wearable and portable displays are those embedded in gear worn or carried by warfighters. Categories include hand-mobile (direct-view and monocular/binocular), palm-held, head/helmet-mounted, body-strapped, knee-attached, lap-born, neck-lanyard, and pocket/backpack-stowed. Some 62 fielded and developmental display sizes are identified in this wearable/portable MDM segment. Parameters requiring special consideration, such as weight, luminance ranges, light emission, viewing angles, and chromaticity coordinates, are summarized and compared. Ruggedized commercial versus commercial off-the-shelf designs are contrasted; and a number of custom displays are also found in this MDM category. Display sizes having aggregate quantities of 5,000 units or greater or having 2 or more program applications are identified. Wearable and portable displays are also analyzed by technology (LCD, LED, CRT, OLED and plasma). The technical specifications and program history of several high-profile military programs are discussed to provide a systems context for some representative displays and their function. As of August 2002 our defense-wide military display market study has documented 438,882 total display units distributed across 1,163 display sizes and 438 weapon systems. Wearable and portable displays account for 202,593 displays (46% of total DoD) yet comprise just 62 sizes (5% of total DoD) in 120 weapons systems (27% of total DoD). Some 66% of these wearable and portable applications involve low information content displays comprising just a few characters in one color; however, there is an accelerating trend towards higher information content units capable of showing changeable graphics, color and video.

  17. Augmenting CPT to Improve Sleep Impairment in PTSD: A Randomized Clinical Trial

    Science.gov (United States)

    Galovski, Tara E.; Mott, Juliette; Blain, Leah M.; Elwood, Lisa; Gloth, Chelsea; Fletcher, Thomas

    2015-01-01

    Objective Despite the success of empirically supported treatments for posttraumatic stress disorder (PTSD), sleep impairment frequently remains refractory following treatment for PTSD. This single-site, randomized controlled trial examined the effectiveness of sleep-directed hypnosis as a complement to an empirically supported psychotherapy for PTSD (cognitive processing therapy; CPT). Method Participants completed either 3 weeks of hypnosis (n = 52) or a symptom monitoring control condition (n = 56) before beginning standard CPT. Multilevel modeling was used to investigate differential patterns of change to determine whether hypnosis resulted in improvements in sleep, PTSD, and depression. An intervening variable approach was then used to determine whether improvements in sleep achieved during hypnosis augmented change in PTSD and depression during CPT. Results After the initial phase of treatment (hypnosis or symptom monitoring), the hypnosis condition showed significantly greater improvement than the control condition in sleep and depression, but not PTSD. After CPT, both conditions demonstrated significant improvement in sleep and PTSD; however, the hypnosis condition demonstrated greater improvement in depressive symptoms. As sleep improved, there were corresponding improvements in PTSD and depression, with a stronger relationship between sleep and PTSD. Conclusion Hypnosis was effective in improving sleep impairment, but those improvements did not augment gains in PTSD recovery during the trauma-focused intervention. Public Health Significance: This study suggests that hypnosis may be a viable treatment option in a stepped-care approach for treating sleep impairment in individuals suffering from PTSD. PMID:26689303

  18. Psychometric properties of the IES-R in traumatized substance dependent individuals with and without PTSD.

    Science.gov (United States)

    Rash, Carla J; Coffey, Scott F; Baschnagel, Joseph S; Drobes, David J; Saladin, Michael E

    2008-08-01

    Posttraumatic stress disorder (PTSD) is common among treatment-seeking substance abusers. Despite the high prevalence of these co-occurring conditions, few PTSD screening tools have been evaluated for their utility in identifying PTSD in substance use disorder (SUD) populations. The present study evaluated the psychometric properties of the Impact of Event Scale-Revised (IES-R) in a sample of 124 substance dependent individuals. All participants had a history of a DSM-IV Criterion A traumatic event, and 71 individuals met diagnostic criteria for PTSD. Participants with comorbid PTSD reported significantly more symptoms of anxiety, depression, and PTSD compared to substance dependent individuals without PTSD. Acceptable internal consistency and convergent validity of the IES-R were established among a substance dependent sample. Examination of diagnostic effectiveness suggested a cutoff value of 22 as optimal for a substance using population, resulting in adequate classification accuracy, sensitivity, and specificity.

  19. Small - Display Cartography

    DEFF Research Database (Denmark)

    Nissen, Flemming; Hvas, Anders; Münster-Swendsen, Jørgen

    This report comprises the work carried out in the work-package of small display cartography. The work-package has aimed at creating a general framework for the small-display cartography. A solid framework facilitates an increased use of spatial data in mobile devices - thus enabling, together...... with the rapidly evolving positioning techniques, a new category of position-dependent, map-based services to be introduced. The report consists of the following parts: Part I: Categorization of handheld devices, Part II: Cartographic design for small-display devices, Part III: Study on the GiMoDig Client ? Portal...... Service Communication and finally, Part IV: Concluding remarks and topics for further research on small-display cartography. Part II includes a separate Appendix D consisting of a cartographic design specification. Part III includes a separate Appendix C consisting of a schema specification, a separate...

  20. Flexible displays, rigid designs?

    DEFF Research Database (Denmark)

    Hornbæk, Kasper

    2015-01-01

    Rapid technological progress has enabled a wide range of flexible displays for computing devices, but the user experience--which we're only beginning to understand--will be the key driver for successful designs....

  1. Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers.

    Science.gov (United States)

    Maslow, Carey B; Caramanica, Kimberly; Welch, Alice E; Stellman, Steven D; Brackbill, Robert M; Farfel, Mark R

    2015-06-01

    The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster. © 2015 International Society for Traumatic Stress Studies.

  2. Victimisation and PTSD in a Greenlandic youth sample

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    Sidsel H. Karsberg

    2012-08-01

    Full Text Available Background. Despite a growing number of studies and reports indicating a very high and increasing prevalence of trauma exposure in Greenlandic adolescents, the knowledge on this subject is still very limited. The purpose of the present study was twofold: To estimate the lifetime prevalence of potentially traumatic events (PTEs and post-traumatic stress disorder (PTSD and to examine the relationship between PTEs, estimated PTSD, and sociodemographic variables. Methods. In a Greenlandic sample from 4 different schools in 2 different minor towns in Northern Greenland, 269 students, aged 12–18 (M=15.4; SD=1.84 were assessed for their level of exposure to 20 PTEs along with the psychological impact of these events. Results. Of the Greenlandic students, 86% had been directly exposed to at least 1 PTE and 74.3% had been indirectly exposed to at least 1 PTE. The mean number of directly experienced PTEs was 2.8 and the mean number of indirectly experienced PTEs was 3.9. The most frequent direct events recorded were death of someone close, near drowning, threat of assault/beating, humiliation or persecution by others and attempted suicide. The estimated lifetime prevalence of PTSD was 17.1%, whereas another 14.2% reached a subclinical level of PTSD (missing the full diagnosis by 1 symptom. Education level of the father, and being exposed to multiple direct and indirect PTEs were significantly associated with an increase in PTSD symptoms. Conclusion. The findings indicate substantial mental health problems in Greenlandic adolescents and that these are associated with various types of PTEs. Furthermore, the findings indicate that Greenlandic adolescents are more exposed to certain specific PTEs than adolescents in similar studies from other nations. The present study revealed that Greenlandic girls are particularly vulnerable towards experiencing PTEs. Indeed, in general, girls reported more experiences of direct and indirect PTEs. Furthermore, girls

  3. Women's experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal.

    Science.gov (United States)

    James, Stella

    2015-12-01

    This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that women following traumatic childbirth do experience postnatal PTSD; postnatal PTSD symptoms are similar to PTSD symptoms of other events and that CBT for PTSD of other events is just as effective for postnatal PTSD. Future recommendations include more qualitative studies with interpretative phenomenological approach in order to establish evidence-based CBT treatment for this client group, and more referrals need to be sent to the psychological services for CBT intervention.

  4. Liquid Crystal Airborne Display

    Science.gov (United States)

    1977-08-01

    81/2X 11- 10 -9 .8 display using a large advertising alphanimeric ( TCI ) has been added to the front of the optical box used in the F-4 aircraft for HUD...properties over a wide range of tempera - tures, including normal room temperature. What are Liquid Crystals? Liquid crystals have been classified in three...natic fanctions and to present data needed for the semi- automatic and manual control of system functions. Existing aircraft using CRT display

  5. Military display performance parameters

    Science.gov (United States)

    Desjardins, Daniel D.; Meyer, Frederick

    2012-06-01

    The military display market is analyzed in terms of four of its segments: avionics, vetronics, dismounted soldier, and command and control. Requirements are summarized for a number of technology-driving parameters, to include luminance, night vision imaging system compatibility, gray levels, resolution, dimming range, viewing angle, video capability, altitude, temperature, shock and vibration, etc., for direct-view and virtual-view displays in cockpits and crew stations. Technical specifications are discussed for selected programs.

  6. Raster graphics display library

    Science.gov (United States)

    Grimsrud, Anders; Stephenson, Michael B.

    1987-01-01

    The Raster Graphics Display Library (RGDL) is a high level subroutine package that give the advanced raster graphics display capabilities needed. The RGDL uses FORTRAN source code routines to build subroutines modular enough to use as stand-alone routines in a black box type of environment. Six examples are presented which will teach the use of RGDL in the fastest, most complete way possible. Routines within the display library that are used to produce raster graphics are presented in alphabetical order, each on a separate page. Each user-callable routine is described by function and calling parameters. All common blocks that are used in the display library are listed and the use of each variable within each common block is discussed. A reference on the include files that are necessary to compile the display library is contained. Each include file and its purpose are listed. The link map for MOVIE.BYU version 6, a general purpose computer graphics display system that uses RGDL software, is also contained.

  7. Internet-delivered cognitive therapy for PTSD: a development pilot series

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    Jennifer Wild

    2016-11-01

    Full Text Available Background: Randomised controlled trials have established that face-to-face cognitive therapy for posttraumatic stress disorder (CT-PTSD based on Ehlers and Clark's cognitive model of PTSD is highly effective and feasible with low rates of dropout. Access to evidence-based psychological treatments for PTSD is insufficient. Several studies have shown that therapist-assisted treatment delivery over the Internet is a promising way of improving access to cognitive behavioural therapy interventions. Objective: To develop an Internet version of CT-PTSD that significantly reduces therapist contact time without compromising treatment integrity or retention rates. Methods: We describe the development of an Internet version of CT-PTSD. It implements all the key procedures of face-to-face CT-PTSD, including techniques that focus on the trauma memory, such as memory updating, stimulus discrimination and revisiting the trauma site, as well as restructuring individually relevant appraisals relating to overgeneralisation of danger, guilt, shame or anger, behavioural experiments and planning activities to reclaim quality of life. A cohort of 10 patients meeting DSM-IV criteria for PTSD worked through the programme, with remote guidance from a therapist, and they were assessed at pre- and post-treatment on PTSD outcome, mood, work and social adjustment and process measures. Results: No patients dropped out. Therapists facilitated the treatment with 192 min of contact time per patient, plus 57 min for reviewing the patient's progress and messages. Internet-delivered CT-PTSD was associated with very large improvements on all outcome and process measures, with 80% of patients achieving clinically significant change and remission from PTSD. Conclusions: Internet-delivered cognitive therapy for PTSD (iCT-PTSD appears to be an acceptable and efficacious treatment. Therapist time was reduced to less than 25% of time in face-to-face CT-PTSD. Randomised controlled trials

  8. Women’s experiences of symptoms of posttraumatic stress disorder (PTSD) after traumatic childbirth: a review and critical appraisal

    OpenAIRE

    James, Stella

    2015-01-01

    This paper critically analyses nine studies on postnatal posttraumatic stress disorder (PTSD) following traumatic childbirth, in order to find common themes of PTSD symptoms, using the cognitive model of PTSD as a guide; it critically appraised one of the studies in depth and it attempted to explain the lived experience of women suffering from postnatal PTSD following traumatic childbirth and the suitability of cognitive behavioural therapy (CBT) for postnatal PTSD. This paper found that wome...

  9. The clinical picture of late-onset PTSD: a 20-year longitudinal study of Israeli war veterans.

    Science.gov (United States)

    Horesh, Danny; Solomon, Zahava; Keinan, Giora; Ein-Dor, Tsachi

    2013-08-15

    Delayed-onset posttraumatic stress disorder (PTSD) has been under medico-legal debate for years. Previous studies examining the prevalence and clinical characteristics of delayed-onset PTSD have yielded inconclusive findings. This study prospectively examines the prevalence and clinical picture of late-onset PTSD among Israeli war veterans. It also evaluates whether or not late-onset PTSD erupts after a completely non-symptomatic period. 675 Israeli veterans from the 1982 Lebanon War, with and without antecedent combat stress reaction (CSR), have been assessed 1, 2 and 20 years post-war. They were divided into 4 groups, according to the duration of delay in PTSD onset. Participants completed self-report questionnaires tapping psychopathology, combat exposure and socio-demographics. 16.5% of the veterans suffered from late-onset PTSD. A longer delay in PTSD onset was associated with less severe psychopathology. Also, CSR was associated with a shorter delay in PTSD onset. Finally, the vast majority of veterans already suffered from PTSD symptoms prior to late PTSD onset. Our results offer further validation for the existence of delayed-onset PTSD. Delayed-onset PTSD appears to be a unique sub-type of PTSD, with an attenuated clinical picture. In addition, delayed-onset PTSD may be the result of an incubation process, wherein symptoms already exist prior to PTSD onset.

  10. Ethnic Differences in Personality Disorder Patterns among Women Veterans Diagnosed with PTSD

    Directory of Open Access Journals (Sweden)

    Janet C'de Baca

    2014-03-01

    Full Text Available Personality Disorders (PDs impair the ability to function socially and occupationally. PD prevalence rates among veterans who have also been diagnosed with posttraumatic stress disorder (PTSD range from 45%–79%. This study examined ethnic differences in PDs assessed with the Millon Clinical Multiaxial Inventory-III in 260 non-Hispanic white (64%, Hispanic (27%, and African American (9%, mostly single, women veterans in treatment for PTSD. After adjusting for covariates including number and sexual-nature of trauma, findings revealed the adjusted odds ratio of having a cluster A PD was almost three times higher for African Americans (p = 0.046 then the other two ethnic groups, which may be driven by the paranoid PD scale and potentially reflects an adaptive response to racial discrimination. In cluster designation analysis, the odds were twice as high of having a cluster B PD with childhood trauma (p = 0.046, and a cluster C PD with sexual trauma (p = 0.004, demonstrating the significance of childhood and sexual trauma on long-term chronic personality patterns in women veterans. These results highlight the importance of using instruments with demonstrated diagnostic validity for minority populations.

  11. Ethnic Differences in Personality Disorder Patterns among Women Veterans Diagnosed with PTSD.

    Science.gov (United States)

    C'de Baca, Janet; Castillo, Diane T; Mackaronis, Julia E; Qualls, Clifford

    2014-03-01

    Personality Disorders (PDs) impair the ability to function socially and occupationally. PD prevalence rates among veterans who have also been diagnosed with posttraumatic stress disorder (PTSD) range from 45%-79%. This study examined ethnic differences in PDs assessed with the Millon Clinical Multiaxial Inventory-III in 260 non-Hispanic white (64%), Hispanic (27%), and African American (9%), mostly single, women veterans in treatment for PTSD. After adjusting for covariates including number and sexual-nature of trauma, findings revealed the adjusted odds ratio of having a cluster A PD was almost three times higher for African Americans (p = 0.046) then the other two ethnic groups, which may be driven by the paranoid PD scale and potentially reflects an adaptive response to racial discrimination. In cluster designation analysis, the odds were twice as high of having a cluster B PD with childhood trauma (p = 0.046), and a cluster C PD with sexual trauma (p = 0.004), demonstrating the significance of childhood and sexual trauma on long-term chronic personality patterns in women veterans. These results highlight the importance of using instruments with demonstrated diagnostic validity for minority populations.

  12. When combat prevents PTSD symptoms—results from a survey with former child soldiers in Northern Uganda

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    Weierstall Roland

    2012-05-01

    Full Text Available Abstract Background Human beings from time immemorial have eradicated neighbouring tribes, languages, religions, and cultures. In war and crisis, the cumulative exposure to traumatic stress constitutes a predictor of the development of post traumatic stress disorder (PTSD. However, homicide has evolved as a profitable strategy in man, leading to greater reproductive success. Thus, an evolutionary advantage of perpetrating violence would be eliminated if the exposure to aggressive acts would traumatize the perpetrator. We argue that perpetrating violence could actually ‘immunize’ a person against adverse effects of traumatic stressors, significantly reducing the risk of developing PTSD. Methods We surveyed 42 former child soldiers in Northern Uganda that have all been abducted by the Lord Resistance Army (LRA as well as 41 non-abducted controls. Results Linear regression analyses revealed a dose–response effect between the exposure to traumatic events and the Posttraumatic Diagnostic Scale (PDS sum score. However, the vulnerability to develop trauma related symptoms was reduced in those with higher scores on the Appetitive Aggression Scale (AAS. This effect was more pronounced in the formerly abducted group. Conclusions We conclude that attraction to aggression when being exposed to the victim’s struggling can lead to a substantial risk-reduction for developing PTSD.

  13. Personality traits as moderators of the associations between deployment experiences and PTSD symptoms in OEF/OIF service members.

    Science.gov (United States)

    Caska, Catherine M; Renshaw, Keith D

    2013-01-01

    This investigation examined traits from the five-factor model of personality as moderators of the associations of combat and aftermath of battle experiences with symptoms of posttraumatic stress disorder (PTSD) in 214 National Guard/Reserve service members deployed to operations enduring and Iraqi freedom. Extraversion significantly moderated the associations of both combat experiences and aftermath of battle experiences with PTSD severity, with associations weakening as levels of extraversion increased. The relation between aftermath of battle experiences and PTSD was also moderated by the other four personality factors, with the relation being weaker at higher levels of agreeableness, conscientiousness, and openness, and lower levels of neuroticism. These results suggest that personality traits may impact individual responses to war trauma, particularly war-related experiences that are not directly threatening to one's safety (i.e., aftermath of battle events vs. actual combat events). Although this investigation was cross-sectional, these findings indicate that personality traits are an important risk/resiliency factor to consider in people's responses to traumatic events.

  14. When combat prevents PTSD symptoms--results from a survey with former child soldiers in Northern Uganda.

    Science.gov (United States)

    Weierstall, Roland; Schalinski, Inga; Crombach, Anselm; Hecker, Tobias; Elbert, Thomas

    2012-05-14

    Human beings from time immemorial have eradicated neighbouring tribes, languages, religions, and cultures. In war and crisis, the cumulative exposure to traumatic stress constitutes a predictor of the development of post traumatic stress disorder (PTSD). However, homicide has evolved as a profitable strategy in man, leading to greater reproductive success. Thus, an evolutionary advantage of perpetrating violence would be eliminated if the exposure to aggressive acts would traumatize the perpetrator. We argue that perpetrating violence could actually 'immunize' a person against adverse effects of traumatic stressors, significantly reducing the risk of developing PTSD. We surveyed 42 former child soldiers in Northern Uganda that have all been abducted by the Lord Resistance Army (LRA) as well as 41 non-abducted controls. Linear regression analyses revealed a dose-response effect between the exposure to traumatic events and the Posttraumatic Diagnostic Scale (PDS) sum score. However, the vulnerability to develop trauma related symptoms was reduced in those with higher scores on the Appetitive Aggression Scale (AAS). This effect was more pronounced in the formerly abducted group. We conclude that attraction to aggression when being exposed to the victim's struggling can lead to a substantial risk-reduction for developing PTSD.

  15. Contribution of criterion A2 to PTSD screening in the presence of traumatic events.

    Science.gov (United States)

    Pereda, Noemí; Forero, Carlos G

    2012-10-01

    Criterion A2 according to the Diagnostic and Statistical Manual of Mental Disorders (4(th) ed.; DSM-IV; American Psychiatric Association [APA], 1994) for posttraumatic stress disorder (PTSD) aims to assess the individual's subjective appraisal of an event, but it has been claimed that it might not be sufficiently specific for diagnostic purposes. We analyse the contribution of Criterion A2 and DSM-IV criteria to detect PTSD for the most distressing life events experienced by our subjects. Young adults (N = 1,033) reported their most distressing life events, together with PTSD criteria (Criteria A2, B, C, D, E, and F). PTSD prevalence and criterion specificity and agreement with probable diagnoses were estimated. Our results indicate 80.30% of the individuals experienced traumatic events and met one or more PTSD criteria; 13.22% cases received a positive diagnosis of PTSD. Criterion A2 showed poor agreement with the final probable PTSD diagnosis (correlation with PTSD .13, specificity = .10); excluding it from PTSD diagnosis did not the change the estimated disorder prevalence significantly. Based on these findings it appears that Criterion A2 is scarcely specific and provides little information to confirm a probable PTSD case.

  16. Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms.

    Science.gov (United States)

    Kuhn, Eric; Greene, Carolyn; Hoffman, Julia; Nguyen, Tam; Wald, Laura; Schmidt, Janet; Ramsey, Kelly M; Ruzek, Josef

    2014-01-01

    PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  17. Oxytocin is associated with PTSD's anxious arousal symptoms in Chinese male earthquake survivors.

    Science.gov (United States)

    Cao, Chengqi; Wang, Li; Wang, Richu; Qing, Yulan; Zhang, Jianxin

    2014-01-01

    Posttraumatic stress disorder (PTSD) is a complex and severe mental disorder triggered by exposure to an extraordinarily traumatic event. Human and animal studies have implied the functional role of the oxytocin system in the development of PTSD (Cochran, Fallon, Hill, & Frazier, 2013; Koch et al., 2014; Olff, 2012). Specification of the role of the oxytocin system in the emergence and progression of PTSD symptomatology would provide evidence to inform both theory and clinical practice. This study examined the association between oxytocin serum levels and PTSD symptoms. A total of 106 Chinese male adults who suffered from the deadly 2008 Wenchuan earthquake participated in this study. PTSD symptoms were measured with PTSD Checklist for DSM-5 (PCL-5), and serum oxytocin level was determined with ELISA oxytocin kits. The mean score on the PCL-5 was 19.30 (SD=14.50, range: 1-65) in this sample. The mean oxytocin level was 101.59 pg/ml (SD=55.89, range: 31.50-286.71). The results indicated that although the oxytocin was not associated with total PTSD symptoms, it was associated with PTSD's anxious arousal symptoms. These findings support that the oxytocin may play an important functional role in the development of PTSD and contribute to the extant knowledge on the genetic basis of the PTSD symptoms.

  18. Oxytocin is associated with PTSD's anxious arousal symptoms in Chinese male earthquake survivors

    Directory of Open Access Journals (Sweden)

    Chengqi Cao

    2014-12-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD is a complex and severe mental disorder triggered by exposure to an extraordinarily traumatic event. Human and animal studies have implied the functional role of the oxytocin system in the development of PTSD (Cochran, Fallon, Hill, & Frazier, 2013; Koch et al., 2014; Olff, 2012. Specification of the role of the oxytocin system in the emergence and progression of PTSD symptomatology would provide evidence to inform both theory and clinical practice. Methods: This study examined the association between oxytocin serum levels and PTSD symptoms. A total of 106 Chinese male adults who suffered from the deadly 2008 Wenchuan earthquake participated in this study. PTSD symptoms were measured with PTSD Checklist for DSM-5 (PCL-5, and serum oxytocin level was determined with ELISA oxytocin kits. Results: The mean score on the PCL-5 was 19.30 (SD=14.50, range: 1–65 in this sample. The mean oxytocin level was 101.59 pg/ml (SD=55.89, range: 31.50–286.71. The results indicated that although the oxytocin was not associated with total PTSD symptoms, it was associated with PTSD's anxious arousal symptoms. Conclusion: These findings support that the oxytocin may play an important functional role in the development of PTSD and contribute to the extant knowledge on the genetic basis of the PTSD symptoms.

  19. Identifying risk factors for PTSD in women seeking medical help after rape.

    Directory of Open Access Journals (Sweden)

    Anna Tiihonen Möller

    Full Text Available Rape has been found to be the trauma most commonly associated with Posttraumatic Stress Disorder (PTSD among women. It is therefore important to be able to identify those women at greatest risk of developing PTSD. The aims of the present study were to analyze the PTSD prevalence six months after sexual assaults and identify the major risk factors for developing PTSD.Participants were 317 female victims of rape who sought help at the Emergency Clinic for Raped Women at Stockholm South Hospital, Sweden. Baseline assessments of mental health were carried out and followed up after six months.Thirty-nine percent of the women had developed PTSD at the six month assessment, and 47% suffered from moderate or severe depression. The major risk factors for PTSD were having been sexually assaulted by more than one person, suffering from acute stress disorder (ASD shortly after the assault, having been exposed to several acts during the assault, having been injured, having co-morbid depression, and having a history of more than two earlier traumas. Further, ASD on its own was found to be a poor predictor of PTSD because of the substantial ceiling effect after sexual assaults.Development of PTSD is common in the aftermath of sexual assaults. Increased risk of developing PTSD is caused by a combination of victim vulnerability and the extent of the dramatic nature of the current assault. By identifying those women at greatest risk of developing PTSD appropriate therapeutic resources can be directed.

  20. Relationship of PTSD Symptoms With Combat Exposure, Stress, and Inflammation in American Soldiers.

    Science.gov (United States)

    Groer, Maureen W; Kane, Bradley; Williams, S Nicole; Duffy, Allyson

    2015-05-01

    Posttraumatic stress disorder (PTSD) is of great concern in veterans. PTSD usually occurs after a person is exposed to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Active duty soldiers deployed to war zones are at risk for PTSD. Psychoneuroimmunological theory predicts that PTSD, depression, and stress can lead to low-grade, chronic inflammation. We asked whether there were relationships between PTSD symptoms and chronic stress, depression and inflammation in active duty U.S. soldiers. We enrolled 52 active duty enlisted and reservist soldiers in a cross-sectional study while they participated in a week of military training in fall 2011. They completed a demographic questionnaire, the Center for Epidemiological Studies-Depression Scale, the Combat Exposure Scale, and the PTSD symptom Checklist-Military version (PCL-M). Blood samples were taken for analysis of cytokines and C-reactive protein (CRP). Hair samples shaved from the forearm were measured for cortisol. Of the soldiers, 11 had PCL-M scores in the moderate to severe range. Regression analysis demonstrated that depression and war zone deployment were strong predictors of PTSD symptoms. CRP and hair cortisol were correlated with each other and with depression and PTSD symptoms. These results suggest relationships among war zone deployment, depression, and PTSD. Chronic stress associated with depression, PTSD, and war zone experiences may be related to inflammation in active duty soldiers.

  1. Dynamic plasmonic colour display

    Science.gov (United States)

    Duan, Xiaoyang; Kamin, Simon; Liu, Na

    2017-02-01

    Plasmonic colour printing based on engineered metasurfaces has revolutionized colour display science due to its unprecedented subwavelength resolution and high-density optical data storage. However, advanced plasmonic displays with novel functionalities including dynamic multicolour printing, animations, and highly secure encryption have remained in their infancy. Here we demonstrate a dynamic plasmonic colour display technique that enables all the aforementioned functionalities using catalytic magnesium metasurfaces. Controlled hydrogenation and dehydrogenation of the constituent magnesium nanoparticles, which serve as dynamic pixels, allow for plasmonic colour printing, tuning, erasing and restoration of colour. Different dynamic pixels feature distinct colour transformation kinetics, enabling plasmonic animations. Through smart material processing, information encoded on selected pixels, which are indiscernible to both optical and scanning electron microscopies, can only be read out using hydrogen as a decoding key, suggesting a new generation of information encryption and anti-counterfeiting applications.

  2. The Ultimate Display

    CERN Document Server

    Fluke, C J

    2016-01-01

    Astronomical images and datasets are increasingly high-resolution and multi-dimensional. The vast majority of astronomers perform all of their visualisation and analysis tasks on low-resolution, two-dimensional desktop monitors. If there were no technological barriers to designing the ultimate stereoscopic display for astronomy, what would it look like? What capabilities would we require of our compute hardware to drive it? And are existing technologies even close to providing a true 3D experience that is compatible with the depth resolution of human stereoscopic vision? We consider the CAVE2 (an 80 Megapixel, hybrid 2D and 3D virtual reality environment directly integrated with a 100 Tflop/s GPU-powered supercomputer) and the Oculus Rift (a low- cost, head-mounted display) as examples at opposite financial ends of the immersive display spectrum.

  3. Association between facial expression and PTSD symptoms among young children exposed to the Great East Japan Earthquake: A pilot study

    Directory of Open Access Journals (Sweden)

    Takeo eFujiwara

    2015-10-01

    Full Text Available Emotional numbing is a symptom of post-traumatic stress disorder (PTSD characterized by a loss of interest in usually enjoyable activities, feeling detached from others, and an inability to express a full range of emotions. Emotional numbing is usually assessed through self-report, and is particularly difficult to ascertain among young children. We conducted a pilot study to explore the use of facial expression ratings in response to a comedy video clip, and to assess emotional reactivity among preschool children directly exposed to the Great East Japan Earthquake. This study included 23 child participants. Child PTSD symptoms were measured using a modified version of the Parent’s Report of the Child’s Reaction to Stress scale. Children were filmed while watching a 2-minute video compilation of natural scenes (‘baseline video’ followed by a 2-minute video clip from a television comedy (‘comedy video’. Children’s facial expressions were processed using Noldus FaceReader software, which implements the Facial Action Coding System (FACS. We investigated the association between PTSD symptom scores and facial emotion reactivity using linear regression analysis. Children with higher PTSD symptom scores showed a significantly greater proportion of neutral facial expressions, controlling for sex, age and baseline facial expression (p < .05. This pilot study suggests that facial emotion reactivity could provide an index against which emotional numbing could be measured in young children, using facial expression recognition software. This pilot study adds to the emerging literature on using experimental psychopathology methods to characterize children’s reactions to disasters.

  4. Impact of Mood Spectrum Spirituality and Mysticism Symptoms on Suicidality in Earthquake Survivors with PTSD.

    Science.gov (United States)

    Carmassi, Claudia; Stratta, P; Calderani, E; Bertelloni, C A; Menichini, M; Massimetti, E; Rossi, A; Dell'Osso, L

    2016-04-01

    The aim of the present study was to explore the correlations between Spirituality/Mysticism/Psychoticism symptoms and suicidality in young adult survivors of the L'Aquila earthquake. The sample included 475 subjects recruited among high school seniors who had experienced the April 6, 2009, earthquake. Assessments included: Trauma and Loss Spectrum-Self Report and Mood Spectrum-Self Report (MOODS-SR). Mysticism/Spirituality dimension and suicidality were evaluated by means of some specific items of the MOOD-SR. The Spirituality/Mysticism/Psychoticism MOODS-SR factor score was significantly higher among subjects with PTSD diagnosis with respect to those without. Similarly, subjects with suicidal ideation, as well as those who committed a suicide attempt, reported significantly higher scores than those without.

  5. Preliminary Study of Acute Changes in Emotion Processing in Trauma Survivors with PTSD Symptoms.

    Directory of Open Access Journals (Sweden)

    Xin Wang

    Full Text Available Accumulating evidence suggests traumatic experience can rapidly alter brain activation associated with emotion processing. However, little is known about acute changes in emotion neurocircuits that underlie PTSD symptom development. To examine acute alterations in emotion circuit activation and structure that may be linked to PTSD symptoms, thirty-eight subjects performed a task of appraisal of emotional faces as their brains were functionally and structurally studied with MRI at both two weeks and three months after motor vehicle collision (MVC. As determined by symptoms reported in the PTSD Checklist at three months, sixteen survivors developed probable PTSD, whereas the remaining 22 did not meet criteria for PTSD diagnosis (non-PTSD. The probable PTSD group had greater activation than the non-PTSD group in dorsal and ventral medial prefrontal cortex (dmPFC and vmPFC while appraising fearful faces within two weeks after MVC and in left insular cortex (IC three months after MVC. dmPFC activation at two weeks significantly positively correlated with PTSD symptom severity at two weeks (R = 0.462, P = 0.006 and three months (R = 0.418, p = 0.012. Changes over time in dmPFC activation and in PTSD symptom severity were also significantly positively correlated in the probable PTSD group (R = 0.641, P = 0.018. A significant time by group interaction was found for volume changes in left superior frontal gyrus (SFG, F = 6.048, p = 0.019 that partially overlapped dmPFC active region. Between two weeks and three months, left SFG volume decreased in probable PTSD survivors. These findings identify alterations in frontal cortical activity and structure during the early post-trauma period that appear to be associated with development of PTSD symptoms.

  6. Genetic Markers for PTSD Risk and Resilience Among Survivors of the World Trade Center Attacks

    Directory of Open Access Journals (Sweden)

    Casey Sarapas

    2011-01-01

    Full Text Available We have previously reported the differential expression of 17 probe sets in survivors of the 9/11 attacks with current posttraumatic stress disorder (PTSD compared to similarly exposed survivors with no lifetime PTSD. The current study presents an expanded analysis of these subjects, including genotype at FKBP5, a modulator of glucocorticoid receptor (GR sensitivity. It includes data from additional subjects who developed PTSD following 9/11 but then recovered, distinguishing expression profiles associated with risk for developing PTSD, resilience, and symptom recovery. 40 Caucasians (20 with and 20 without PTSD, matched for exposure, age, and gender were selected from a population-representative sample of persons exposed to the 9/11 attacks from which longitudinal data had been collected in four previous waves. Whole blood gene expression and cortisol levels were obtained and genome-wide gene expression was analyzed. 25 probe sets were differentially expressed in PTSD. Identified genes were generally involved in hypothalamic-pituitary-adrenal axis, signal transduction, or in brain and immune cell function. STAT5B, a direct inhibitor of GR, and nuclear factor I/A, both showed reduced expression in PTSD. Comparison of lifetime versus current PTSD identified overlapping genes with altered expression suggesting enduring markers, while some markers present only in current PTSD may reflect state measures. As a follow-up, direct comparisons of expression in current PTSD, lifetime-only PTSD, and control groups identified FKBP5 and MHC Class II as state markers, and also identified several trait markers. An analysis of indirect effects revealed that homozygosity for any of 4 PTSD risk-related polymorphisms at FKBP5 predicted FKBP5 expression, which mediated indirect effects of genotype on plasma cortisol and PTSD severity.

  7. Efficacy of structured approach therapy in reducing PTSD in returning veterans: A randomized clinical trial.

    Science.gov (United States)

    Sautter, Frederic J; Glynn, Shirley M; Cretu, Julia Becker; Senturk, Damla; Vaught, Amanda S

    2015-08-01

    The U.S. military deployed in support to Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) show high rates of posttraumatic stress disorder (PTSD) and relationship, partner, and parenting distress. Given the pervasive effect of combat-related PTSD on returning veterans and its effect on their loved ones, the investigators have developed a couples-based treatment, structured approach therapy (SAT), to reduce PTSD while simultaneously decreasing relationship and partner distress. This study presents treatment outcome data measuring PTSD and relationship outcomes from a randomized clinical trial (RCT) comparing SAT, a manualized 12-session novel couples-based PTSD treatment, to a manualized 12-session couples-based educational intervention (PTSD Family Education [PFE]). Data were collected from 57 returning veterans meeting Diagnostic and Statistical Manual of Mental Disorders (fourth edition, text revision; DSM-IV-TR) criteria for PTSD and their cohabiting partners; data collection was scheduled for pretreatment, posttreatment, and 3-month follow-up. Findings from an intent-to-treat analysis revealed that veterans receiving SAT showed significantly greater reductions in self-rated (PTSD Checklist; p < .0006) and Clinician-Administered PTSD Scale (CAPS)-rated PTSD (p < .0001) through the 3-month follow-up compared with veterans receiving PFE; 15 of 29 (52%) veterans receiving SAT and 2 of 28 (7%) receiving PFE no longer met DSM-IV-TR criteria for PTSD. Furthermore, SAT was associated with significant improvements in veteran relationship adjustment, attachment avoidance, and state anxiety. Partners showed significant reductions in attachment anxiety. This couples-based treatment for combat-related PTSD appears to have a strong therapeutic effect on combat-related PTSD in recently returned veterans.

  8. Maternal age at Holocaust exposure and maternal PTSD independently influence urinary cortisol levels in adult offspring

    Directory of Open Access Journals (Sweden)

    Heather N Bader

    2014-07-01

    Full Text Available Background: Parental traumatization has been associated with increased risk for the expression of psychopathology in offspring, and maternal PTSD appears to increase the risk for the development of offspring PTSD. In this study, Holocaust-related maternal age of exposure and PTSD were evaluated for their association with offspring ambient cortisol and PTSD-associated symptom expression. Method: 95 Holocaust offspring and Jewish comparison subjects received diagnostic and psychological evaluations, and 24 hour urinary cortisol was assayed by RIA. Offspring completed the Parental PTSD Questionnaire to assess maternal PTSD status. Maternal Holocaust exposure was identified as having occurred in childhood, adolescence or adulthood and examined in relation to offspring psychobiology. Results: Urinary cortisol levels did not differ for Holocaust offspring and comparison subjects but differed significantly in offspring based on maternal age of exposure and maternal PTSD status. Increased maternal age of exposure and maternal PTSD were each associated with lower urinary cortisol in offspring, but did not exhibit a significant interaction. In addition, offspring PTSD-associated symptom severity increased with maternal age at exposure and PTSD diagnosis. A regression analysis of correlates of offspring cortisol indicated that both maternal age of exposure and maternal PTSD were significant predictors of lower offspring urinary cortisol, whereas childhood adversity and offspring PTSD symptoms were not. Conclusions: Offspring low cortisol and PTSD-associated symptom expression are related to maternal age of exposure, with the greatest effects associated with increased age at exposure. These effects are relatively independent of the negative consequences of being raised by a trauma survivor. These observations highlight the importance of maternal age of exposure in determining a psychobiology in offspring that is consistent with increased risk for stress

  9. Parenting with PTSD: A Review of Research on the Influence of PTSD on Parent-Child Functioning in Military and Veteran Families

    Directory of Open Access Journals (Sweden)

    Suzannah K. Creech

    2017-06-01

    Full Text Available Posttraumatic stress disorder (PTSD is strongly associated with exposure to war related trauma in military and veteran populations. In growing recognition that PTSD may influence and be influenced by social support and family systems, research has begun to explore the effects that war related trauma and the ensuing PTSD may have on varied aspects of close relationship and family functioning. Far less research, however, has examined the influence of war-related PTSD on parent-child functioning in this population. This paper provides a timely review of emergent literature to examine the impacts that PTSD may have on parenting behaviors and children’s outcomes with a focus on studies of military and veterans of international conflicts since post-9/11. The review sheds light on the pathways through which PTSD may impact parent-child relationships, and proposes the cognitive-behavioral interpersonal theory of PTSD as a theoretical formulation and extends this to parenting/children. The review identifies the strengths and limitations in the extant research and proposes directions for future research and methodological practice to better capture the complex interplay of PTSD and parenting in military and veteran families.

  10. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample.

    Science.gov (United States)

    Prins, Annabel; Bovin, Michelle J; Smolenski, Derek J; Marx, Brian P; Kimerling, Rachel; Jenkins-Guarnieri, Michael A; Kaloupek, Danny G; Schnurr, Paula P; Kaiser, Anica Pless; Leyva, Yani E; Tiet, Quyen Q

    2016-10-01

    Posttraumatic Stress Disorder (PTSD) is associated with increased health care utilization, medical morbidity, and tobacco and alcohol use. Consequently, screening for PTSD has become increasingly common in primary care clinics, especially in Veteran healthcare settings where trauma exposure among patients is common. The objective of this study was to revise the Primary Care PTSD screen (PC-PTSD) to reflect the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD (PC-PTSD-5) and to examine both the diagnostic accuracy and the patient acceptability of the revised measure. We compared the PC-PTSD-5 results with those from a brief psychiatric interview for PTSD. Participants also rated screening preferences and acceptability of the PC-PTSD-5. A convenience sample of 398 Veterans participated in the study (response rate = 41 %). Most of the participants were male, in their 60s, and the majority identified as non-Hispanic White. The PC-PTSD-5 was used as the screening measure, a modified version of the PTSD module of the MINI-International Neuropsychiatric Interview was used to diagnose DSM-5 PTSD, and five brief survey items were used to assess acceptability and preferences. The PC-PTSD-5 demonstrated excellent diagnostic accuracy (AUC = 0.941; 95 % C.I.: 0.912- 0.969). Whereas a cut score of 3 maximized sensitivity (κ[1]) = 0.93; SE = .041; 95 % C.I.: 0.849-1.00), a cut score of 4 maximized efficiency (κ[0.5] = 0.63; SE = 0.052; 95 % C.I.: 0.527-0.731), and a cut score of 5 maximized specificity (κ[0] = 0.70; SE = 0.077; 95 % C.I.: 0.550-0.853). Patients found the screen acceptable and indicated a preference for administration by their primary care providers as opposed to by other providers or via self-report. The PC-PTSD-5 demonstrated strong preliminary results for diagnostic accuracy, and was broadly acceptable to patients.

  11. Review of exposure therapy: A gold standard for PTSD treatment

    Directory of Open Access Journals (Sweden)

    Sheila A. M. Rauch, PhD

    2012-06-01

    Full Text Available Prolonged exposure (PE is an effective first-line treatment for posttraumatic stress disorder (PTSD, regardless of the type of trauma, for Veterans and military personnel. Extensive research and clinical practice guidelines from various organizations support this conclusion. PE is effective in reducing PTSD symptoms and has also demonstrated efficacy in reducing comorbid issues such as anger, guilt, negative health perceptions, and depression. PE has demonstrated efficacy in diagnostically complex populations and survivors of single- and multiple-incident traumas. The PE protocol includes four main therapeutic components (i.e., psychoeducation, in vivo exposure, imaginal exposure, and emotional processing. In light of PE’s efficacy, the Veterans Health Administration designed and supported a PE training program for mental health professionals that has trained over 1,300 providers. Research examining the mechanisms involved in PE and working to improve its acceptability, efficacy, and efficiency is underway with promising results.

  12. Implementing an Assessment Clinic in a Residential PTSD Program

    Directory of Open Access Journals (Sweden)

    Joan McDowell

    2014-08-01

    Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.

  13. Refreshing Refreshable Braille Displays.

    Science.gov (United States)

    Russomanno, Alexander; O'Modhrain, Sile; Gillespie, R Brent; Rodger, Matthew W M

    2015-01-01

    The increased access to books afforded to blind people via e-publishing has given them long-sought independence for both recreational and educational reading. In most cases, blind readers access materials using speech output. For some content such as highly technical texts, music, and graphics, speech is not an appropriate access modality as it does not promote deep understanding. Therefore blind braille readers often prefer electronic braille displays. But, these are prohibitively expensive. The search is on, therefore, for a low-cost refreshable display that would go beyond current technologies and deliver graphical content as well as text. And many solutions have been proposed, some of which reduce costs by restricting the number of characters that can be displayed, even down to a single braille cell. In this paper, we demonstrate that restricting tactile cues during braille reading leads to poorer performance in a letter recognition task. In particular, we show that lack of sliding contact between the fingertip and the braille reading surface results in more errors and that the number of errors increases as a function of presentation speed. These findings suggest that single cell displays which do not incorporate sliding contact are likely to be less effective for braille reading.

  14. Virtual Auditory Displays

    Science.gov (United States)

    2000-01-01

    timbre , intensity, distance, room modeling, radio communication Virtual Environments Handbook Chapter 4 Virtual Auditory Displays Russell D... musical note “A” as a pure sinusoid, there will be 440 condensations and rarefactions per second. The distance between two adjacent condensations or...and complexity are pitch, loudness, and timbre respectively. This distinction between physical and perceptual measures of sound properties is an

  15. Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression.

    Science.gov (United States)

    Olff, Miranda; Polak, A Rosaura; Witteveen, Anke B; Denys, Damiaan

    2014-07-01

    Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be associated with comorbid depressive symptoms, but their role in executive function impairments is still unclear. To examine several domains of executive functioning in PTSD and the potentially mediating role of comorbid depressive symptoms in the relationship between executive function and PTSD. Executive functioning was assessed in 28 PTSD patients and 28 matched trauma-exposed controls. The Cambridge Neuropsychological Test Automated Battery (CANTAB) with subtests measuring response inhibition (SST), flexibility/set shifting (IED), planning/working memory (OTS) and spatial working memory (SWM) was administered in PTSD patients and trauma-exposed controls. Regression analyses were used to assess the predictive factor of PTSD symptoms (CAPS) and depressive symptoms (HADS-D) in relation to executive function when taking into account the type of trauma. Pearson's correlations were used to examine the association between PTSD symptom clusters (CAPS) and executive function. The mediating effects of depression and PTSD were assessed using regression coefficients and the Sobel's test for mediation. Our findings indicate that PTSD patients performed significantly worse on executive function than trauma-exposed controls in all domains assessed. PTSD symptoms contributed to executive functioning impairments (SST median correct, IED total errors, OTS latency to correct, SWM total errors and SWM strategy). Adding depressive symptoms to the model attenuated these effects. PTSD symptom clusters 'numbing' and to a lesser extent 'avoidance' were more frequently associated with worse executive function (i.e., IED total errors, OTS latency to correct and SWM total errors) than

  16. Male combat veterans' narratives of PTSD, masculinity, and health.

    Science.gov (United States)

    Caddick, Nick; Smith, Brett; Phoenix, Cassandra

    2015-01-01

    This article uniquely examines the ways a group of male combat veterans talk about masculinity and how, following post-traumatic stress disorder (PTSD), they performed masculinities in the context of a surfing group, and what effects this had upon their health and wellbeing. Participant observations and life history interviews were conducted with a group of combat veterans who belonged to a surfing charity for veterans experiencing PTSD. Data were rigorously explored via narrative analysis. Our findings revealed the ways in which veterans enacted masculinities in accordance with the values that were cultivated during military service. These masculine performances in the surfing group had important effects both on and for the veterans' wellbeing. Significantly, the study highlights how masculine performances can be seen alternately as a danger and as a resource for health and wellbeing in relation to PTSD. The article advances knowledge on combat veterans and mental health with critical implications for the promotion of male veterans' mental health. These include the original suggestion that health-promoting masculine performances might be recognised and supported in PTSD treatment settings. Rather than automatically viewing masculinity as problematic, this article moves the field forward by highlighting how hegemonic masculinities can be reconstructed in positive ways which might improve veterans' health and wellbeing. A video abstract of this article can be found at: https://www.youtube.com/watch?v=BaYzaOP1kAY. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  17. Regional Center of Excellence for PTSD: Phoebe Putney Memorial Hospital

    Science.gov (United States)

    2011-09-01

    under regulatory review, with initial patient enrollment predicted for Fall 2011. 15. SUBJECT TERMS Cognitive Behavioral Therapy , Telepsychiatry...The purpose of the present study is to demonstrate that Cognitive Behavioral Therapy (CBT) delivered via telepsychiatry can be as effective for the...of Veteran Affairs, Department of Defense, 2004). Studies have shown that Cognitive Behavioral Therapy (CBT) is effective in the treatment of PTSD

  18. Understanding resilience: New approaches for preventing and treating PTSD.

    Science.gov (United States)

    Horn, Sarah R; Charney, Dennis S; Feder, Adriana

    2016-10-01

    All individuals experience stressful life events, and up to 84% of the general population will experience at least one potentially traumatic event. In some cases, acute or chronic stressors lead to the development of posttraumatic stress disorder (PTSD) or other psychopathology; however, the majority of people are resilient to such effects. Resilience is the ability to adapt successfully in the face of stress and adversity. A wealth of research has begun to identify the genetic, epigenetic, neural, and environmental underpinnings of resilience, and has indicated that resilience is mediated by adaptive changes encompassing several environmental factors, neural circuits, numerous neurotransmitters, and molecular pathways. The first part of this review focuses on recent findings regarding the genetic, epigenetic, developmental, psychosocial, and neurochemical factors as well as neural circuits and molecular pathways that underlie the development of resilience. Emerging and exciting areas of research and novel methodological approaches, including genome-wide gene expression studies, immune, endocannabinoid, oxytocin, and glutamatergic systems, are explored to help delineate innovative mechanisms that may contribute to resilience. The second part reviews several interventions and preventative approaches designed to enhance resilience in both developmental and adult populations. Specifically, the review will delineate approaches aimed to bolster resilience in individuals with PTSD. Furthermore, we discuss novel pharmacologic approaches, including the N-methyl-d-aspartate (NMDA) receptor ketamine and neuropeptide Y (NPY), as exciting new prospects for not only the treatment of PTSD but as new targets to enhance resilience. Our growing understanding of resilience and interventions will hopefully lead to the development of new strategies for not just treating PTSD but also screening and early identification of at-risk youth and adults. Taken together, efforts aimed at

  19. Adaptive Disclosure: A Combat-Specific PTSD Treatment

    Science.gov (United States)

    2014-10-01

    based interventions for treating PTSD, however, were not developed for military trauma and thus may be suboptimal for this population. This study...in conducting pre- and post-treatment psychosocial assessments that will be used to determine treatment efficacy. 15. SUBJECT TERMS Active-duty...behavioral therapy strategies packaged and sequenced to target the three high base-rate combat and operational traumas , namely, life-threat trauma

  20. Online PTSD Diagnosis and Treatment Training for Primary Care Physicians

    Science.gov (United States)

    2013-03-01

    care capacity,9 there are also other well-described patient-level barriers to mental health care such as stigma , cultural attitudes, negative...including hypothesized underlying mechanisms, their knowledge and understanding of these psychotherapies were not maintained after 30 days. Having...a trusted PCP explain in plain language the rationale for evidence-based trauma-focused psychotherapies to a patient suffering from PTSD can be

  1. Enhancing Battlemind: Preventing PTSD by Coping with Intrusive Thoughts

    Science.gov (United States)

    2015-09-01

    condition [t = -2.15, p = .03; t = -1.93, p = .05, respectively]. D AS S- An xi et y Ra ng e 0- 21 Results Depression, Anxiety, and Stress Scale ( DASS ...and interference) caused by the intrusions. The EIS has demonstrated good internal consistency and excellent test-retest reliability, as well as...PTSD. (32) General Psychological Symptoms. The Depression Anxiety Stress Scales- 21 ( DASS - 21 ) (33) is a 21 -item measure that distinguishes between

  2. Development & Validation of a PTSD-Related Impairment Scale

    Science.gov (United States)

    2013-06-01

    funded randomized controlled study will be on the effectiveness of mind-body skills like meditation , biofeedback, guided imagery on PTSD, sleep...Education: This scale assesses the extent to which the individual can focus in the classroom and complete homework assignments in an effective and...December 2009. The data collections will be done in on-post facilities such as theaters, gymnasiums, classrooms , and at assigned training locations

  3. PTSD and traumatic brain injury: folklore and fact?

    Science.gov (United States)

    King, Nigel S

    2008-01-01

    A number of controversies and debates have arisen over the years surrounding the dual diagnosis of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Many of these have centred around the around the degree of protection provided by TBI against developing the disorder. The following is brief review of the literature in this area to help resolve some of these issues and to address a number of specific challenges which arise when working with this patient group.

  4. Neural and Behavioral Correlates of PTSD and Alcohol Use

    Science.gov (United States)

    2014-12-01

    fixation to the eyes and mouth of the stimulus. Variation in the degree to which this distracted the participants may have caused the variation among...associated with anxiety disorders, and these include hyperthyroidism , Cushing’s disease and mitral value prolapse [4,5]. Thus, anxiety disorders are...associated text) has caused much excitement and controversy about the use of propranolol to prevent PTSD [196-198]. Thus far, initial trials have

  5. Virtual acoustic displays

    Science.gov (United States)

    Wenzel, Elizabeth M.

    1991-01-01

    A 3D auditory display can potentially enhance information transfer by combining directional and iconic information in a quite naturalistic representation of dynamic objects in the interface. Another aspect of auditory spatial clues is that, in conjunction with other modalities, it can act as a potentiator of information in the display. For example, visual and auditory cues together can reinforce the information content of the display and provide a greater sense of presence or realism in a manner not readily achievable by either modality alone. This phenomenon will be particularly useful in telepresence applications, such as advanced teleconferencing environments, shared electronic workspaces, and monitoring telerobotic activities in remote or hazardous situations. Thus, the combination of direct spatial cues with good principles of iconic design could provide an extremely powerful and information-rich display which is also quite easy to use. An alternative approach, recently developed at ARC, generates externalized, 3D sound cues over headphones in realtime using digital signal processing. Here, the synthesis technique involves the digital generation of stimuli using Head-Related Transfer Functions (HRTF's) measured in the two ear-canals of individual subjects. Other similar approaches include an analog system developed by Loomis, et. al., (1990) and digital systems which make use of transforms derived from normative mannikins and simulations of room acoustics. Such an interface also requires the careful psychophysical evaluation of listener's ability to accurately localize the virtual or synthetic sound sources. From an applied standpoint, measurement of each potential listener's HRTF's may not be possible in practice. For experienced listeners, localization performance was only slightly degraded compared to a subject's inherent ability. Alternatively, even inexperienced listeners may be able to adapt to a particular set of HRTF's as long as they provide adequate

  6. The PTSD supremacy: Criterion F in three Voyager cases.

    Science.gov (United States)

    Gaughwin, Peter

    2009-04-01

    The aim is to consider whether the courts and experts in their application of Criterion F for posttraumatic stress disorder (PTSD) have applied it consistently in civil claims brought years after the event. Three cases for compensation relating to the Voyager disaster are considered. It appears, from the cases considered in this paper, that while courts consider that Criterion F is crucial in making a diagnosis of PTSD, there are some inconsistencies in terms of understanding and applying this criterion, both by the courts and experts. This may be because of a lack of guidance in psychiatric texts as to how to apply Criterion F. Criterion F is, after the satisfaction of Criterion A(1), arguably the most important of the criteria for PTSD for, while the symptoms referred to in Criteria B-D have been shown to be fairly easy to simulate, it is arguably harder to do this with Criterion F, particularly in cases that arise a long time after the event. It is important therefore that psychiatrists assessing persons so long after an event adhere rigorously to Criterion F, because it is based on facts open to objective corroboration, while criteria B, C and D tend to rely on subjective experiences which are the most sensitive to distortion. Thus, it is to be hoped that if DSM-V is to maintain a criterion of clinically significant distress or impairment in the majority of the disorders described therein, it will provide some assistance as to how this criteria should be applied.

  7. Healing Touch with Guided Imagery for PTSD in returning active duty military: a randomized controlled trial.

    Science.gov (United States)

    Jain, Shamini; McMahon, George F; Hasen, Patricia; Kozub, Madelyn P; Porter, Valencia; King, Rauni; Guarneri, Erminia M

    2012-09-01

    Post-traumatic stress disorder (PTSD) remains a significant problem in returning military and warrants swift and effective treatment. We conducted a randomized controlled trial to determine whether a complementary medicine intervention (Healing Touch with Guided Imagery [HT+GI]) reduced PTSD symptoms as compared to treatment as usual (TAU) returning combat-exposed active duty military with significant PTSD symptoms. Active duty military (n = 123) were randomized to 6 sessions (within 3 weeks) of HT+GI vs. TAU. The primary outcome was PTSD symptoms; secondary outcomes were depression, quality of life, and hostility. Repeated measures analysis of covariance with intent-to-treat analyses revealed statistically and clinically significant reduction in PTSD symptoms (p biofield therapy approaches for mitigating PTSD in military populations is warranted.

  8. PTSD as a mediator of sexual revictimization: the role of reexperiencing, avoidance, and arousal symptoms.

    Science.gov (United States)

    Risser, Heather J; Hetzel-Riggin, Melanie D; Thomsen, Cynthia J; McCanne, Thomas R

    2006-10-01

    Theory and research suggest that posttraumatic stress disorder (PTSD) may mediate the relationship between child sexual abuse and adult sexual assault. However, little empirical research has examined the mediational role of PTSD. In the present study, the authors use structural equation modeling to examine the degree to which the three symptom clusters that define PTSD (reexperiencing, avoidance, and hyperarousal) contribute to sexual revictimization. To assess PTSD symptomatology, undergraduate women completed questionnaires (N = 1,449), which detailed the history and severity of childhood and adult sexual assault experiences. Results indicated that PTSD mediated sexual revictimization. When PTSD symptom clusters were examined individually, only the hyperarousal cluster was a significant mediator. Results are discussed in terms of information-processing mechanisms that may underlie sexual revictimization.

  9. Does negative affect mediate the relationship between daily PTSD symptoms and daily alcohol involvement in female rape victims? Evidence from 14 days of interactive voice response assessment.

    Science.gov (United States)

    Cohn, Amy; Hagman, Brett T; Moore, Kathleen; Mitchell, Jessica; Ehlke, Sarah

    2014-03-01

    The negative reinforcement model of addiction posits that individuals may use alcohol to reduce negative affective (NA) distress. The current study investigated the mediating effect of daily NA on the relationship between daily PTSD symptoms and same-day and next-day alcohol involvement (consumption and desire to drink) in a sample of 54 non-treatment-seeking female rape victims who completed 14 days of interactive voice response assessment. The moderating effect of lifetime alcohol use disorder diagnosis (AUD) on daily relationships was also examined. Multilevel models suggested that NA mediated the relationship between PTSD and same-day, but not next-day alcohol involvement. NA was greater on days characterized by more severe PTSD symptoms, and alcohol consumption and desire to drink were greater on days characterized by higher NA. Furthermore, daily PTSD symptoms and NA were more strongly associated with same-day (but not next-day) alcohol consumption and desire to drink for women with an AUD than without. Results suggest that NA plays an important role in female rape victims' daily alcohol use. Differences between women with and without an AUD indicate the need for treatment matching to subtypes of female rape victims.

  10. Exposure and non-fear emotions: A randomized controlled study of exposure-based and rescripting-based imagery in PTSD treatment.

    Science.gov (United States)

    Langkaas, Tomas Formo; Hoffart, Asle; Øktedalen, Tuva; Ulvenes, Pål G; Hembree, Elizabeth A; Smucker, Mervin

    2017-10-01

    Interventions involving rescripting-based imagery have been proposed as a better approach than exposure-based imagery when posttraumatic stress disorder (PTSD) is associated with emotions other than fear. Prior research led to the study's hypotheses that (a) higher pretreatment non-fear emotions would predict relatively better response to rescripting as compared to exposure, (b) rescripting would be associated with greater reduction in non-fear emotions, and (c) pretreatment non-fear emotions would predict poor response to exposure. A clinically representative sample of 65 patients presenting a wide range of traumas was recruited from patients seeking and being offered PTSD treatment in an inpatient setting. Subjects were randomly assigned to 10 weeks of treatment involving either rescripting-based imagery (Imagery Rescripting; IR) or exposure-based imagery (Prolonged Exposure; PE). Patients were assessed on outcome and emotion measures at pretreatment, posttreatment and 12 months follow-up. Comparison to control benchmarks indicated that both treatments were effective, but no outcome differences between them appeared. None of the initial hypotheses were supported. The results from this study challenge previous observations and hypotheses about exposure mainly being effective for fear-based PTSD and strengthen the notion that exposure-based treatment is a generally effective treatment for all types of PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Post-traumatic Stress Disorder (PTSD) in Children of Conflict Region of Kashmir (India): A Review.

    Science.gov (United States)

    Mushtaq, Raheel; Shah, Tabindah; Mushtaq, Sahil

    2016-01-01

    Post-traumatic stress disorder (PTSD) occurs due to traumatic events. The last two decades have seen various traumatic events in Kashmiri population, which has led to psychological impact on all population, especially children. PTSD is one of the psychiatric disorders occurring after witnessing of traumatic events. A review of literature regarding PTSD in children of Kashmir (India) has been done to assess the prevalence, causes, neurobiology, risk factors and psychiatric co morbidity associated with it.

  12. CLINICAL EXPERIENCES IN TREATING PTSD PATIENTS BY COMBINIG INDIVIDUAL AND GROUP PSYCHOTERAPY

    OpenAIRE

    Bilić, Vedran; Nemčić-Moro, Iva; Karšić, Vana; Grgić, Vesna; Stojanović-Špehar, Stanislava; Marčinko, Darko

    2010-01-01

    PTSD is a complex psychobiological disorder that couses disfunctionality in many areas. In treating PTSD different models have been applied, however, no general consensus on the method of treatment has yet been achieved. At the Clinic for Psychol.ogical Medicine we have developed the model of combined treatment for PTSD patients that involves outpatient individual psychoterapy, psychopharmacotherapy and group psyhoterapeutic techniques introduced within repeated day-hospital treatments. In th...

  13. Förebyggande metoder och behandlingar för Posttraumatiskt stressyndrom (PTSD): : Systematisk litteraturstudie

    OpenAIRE

    Brinkman, Johan

    2012-01-01

    Aim: The aim of this study was to describe the impact of debriefing, brief eclectic psychotherapy, cognitive behavioral therapy and EMDR therapy for PTSD and other stress-like reactions in emergency personnel. Background: In 1980, PTSD got a name and a place in the modern psychiatric diagnosis. Interest in the treatment and prevention of PTSD has increased over the past 20 years. Responders (ambulance, police and firefighters) are professionals who often meet human pain and suffering and are ...

  14. Prazosin for Treatment of Patients With PTSD and Comorbid Alcohol Dependence

    Science.gov (United States)

    2013-07-01

    There is a high rate of comorbidity with alcohol dependence (AD) and post traumatic stress disorder (PTSD). The rates of PTSD among individuals with...AD are at least twice as high as those in the general population. In addition, alcohol dependence is the most common comorbid condition in men with...sleep disturbance in combat veterans with PTSD, and alcohol dependence . Objective: The objective of this study is to evaluate the efficacy of

  15. POSTRAUMATIC STRESS DISORDERS (PTSD) FROM DIFFERENT PERSPECTIVES: A TRANSDISCIPLINARY INTEGRATIVE APPROACH

    OpenAIRE

    Jakovljević, Miro; Brajković, Lovorka; Jakšić, Nenad; Lončar, Mladen; Aukst-Margetić, Branka; Lasić, Davor

    2012-01-01

    Background: Psychotraumatization continues to be a pervasive aspect of life in the 21st century all over the world so we should better understand psychological trauma and PTSD for the sake of prevention and healing. Method: We have made an overview of available literature on PTSD to identify explanatory models, hypotheses and theories. Results: In this paper we describe our transdisciplinary multiperspective integrative model of PTSD based on the seven perspective explanatory appr...

  16. Firearm Ownership Among Military Veterans with PTSD: A Profile of Demographic and Psychosocial Correlates

    OpenAIRE

    Heinz, Adrienne J.; Cohen, Nicole L.; Holleran, Lori; Alvarez, Jennifer A.; Bonn-Miller, Marcel O.

    2016-01-01

    Posttraumatic stress disorder (PTSD), a condition that disproportionately affects military veterans, is associated with heightened rates of aggression and suicide. Although experience with firearms is common among this population, virtually nothing is known regarding who is more likely to own a firearm and whether firearm ownership is differentially associated with psychological and behavioral risk factors among veterans with PTSD. Of 465 veterans (79% male) entering PTSD treatment, 28% owned...

  17. Resilient But Addicted: The Impact of Resilience on the Relationship between Smoking Withdrawal and PTSD

    OpenAIRE

    Asnaani, Anu; Alpert, Elizabeth; McLean, Carmen P.; Foa, Edna B.

    2015-01-01

    Nicotine use is common among people with posttraumatic stress disorder (PTSD). Resilience, which is reflected in one's ability to cope with stress, has been shown to be associated with lower cigarette smoking and posttraumatic stress symptoms, but relationships among these three variables have not been examined. This study investigates the relationships of resilience and nicotine withdrawal with each other and in relation to PTSD symptoms. Participants were 118 cigarette smokers with PTSD see...

  18. Worry, Worry Attacks, and PTSD among Cambodian Refugees: A Path Analysis Investigation

    OpenAIRE

    Hinton, Devon E.; Nickerson, Angela; Bryant, Richard A

    2011-01-01

    Among traumatized Cambodian refugees, this article investigates worry (e.g., the types of current life concerns) and how worry worsens posttraumatic stress disorder (PTSD). To explore how worry worsens PTSD, we examine a path model of worry to see whether certain key variables (e.g., worry-induced somatic arousal and worry-induced trauma recall) mediate the relationship between worry and PTSD. Survey data were collected from March 2010 until May 2010 in a convenience sample of 201 adult Cambo...

  19. Future directions for interventions targeting PTSD in HIV-infected adults

    OpenAIRE

    Applebaum, Allison J.; Bedoya, C. Andres; Hendriksen, Ellen S.; Wilkinson, Jesse L.; Safren, Steven A.; O’Cleirigh, Conall

    2014-01-01

    Although studies consistently report high rates of comorbid Post Traumatic Stress Disorder (PTSD) and HIV infection, development and testing of PTSD treatment interventions in HIV-infected adults is limited. As such, the purpose of this review was twofold. First, this review augments the 3 existing reviews of research for PTSD in HIV-infected adults conducted within the past 10 years. We found 2 empirically supported cognitive-behavioral therapy (CBT)-based interventions for the treatment of ...

  20. Self-study assisted cognitive therapy for PTSD: a case study

    OpenAIRE

    2010-01-01

    Background: Research has demonstrated that Cognitive Therapy for PTSD (CT-PTSD), a version of traumafocused cognitive-behavioural therapy developed by Ehlers and Clark’s group (2000), is effective and feasible when offered in weekly and intensive daily formats. It is unknown whether patients with post-traumatic stress disorder (PTSD) could engage in and benefit from self-study assisted cognitive therapy, which would reduce therapist contact time. Objectives: This case report aims to ill...

  1. The Relationship between PTSD and Chronic Pain: Mediating Role of Coping Strategies and Depression

    OpenAIRE

    Morasco, Benjamin J.; Lovejoy, Travis I.; Lu, Mary; Turk, Dennis C.; Lewis, Lynsey; Dobscha, Steven K

    2013-01-01

    People with chronic pain and comorbid posttraumatic stress disorder (PTSD) report more severe pain and poorer quality of life than those with chronic pain alone. This study evaluated the extent to which associations between PTSD and chronic pain interference and severity are mediated by pain-related coping strategies and depressive symptoms. Veterans with chronic pain were divided into two groups, those with (n=65) and those without (n=136) concurrent PTSD. All participants completed measures...

  2. Spouses/Family Members of Service Members at Risk for PTSD or Suicide

    Science.gov (United States)

    2015-10-01

    installations, colleagues with connections to units, press releases, interviews with news outlets, guest blogs on popular social media sites, contacts at...are experiencing symptoms of PTSD or severe depression . The study is multi-method, with an initial qualitative phase (Phase 1), and a follow-up...for PTSD and/or suicidality. Social support is one of the strongest buffers against PTSD (Brewin, Andrews, & Valentine, 2000; Ozer, Best, Lipsey

  3. DSM-5 PTSD's symptom dimensions and relations with major depression's symptom dimensions in a primary care sample

    DEFF Research Database (Denmark)

    Contractor, A. A.; Durham, T. A.; Brennan, J. A.

    2014-01-01

    Existing literature indicates significant comorbidity between posttraumatic stress disorder (PTSD) and major depression. We examined whether PTSD's dysphoria and mood/cognitions factors, conceptualized by the empirically supported four-factor DSM-5 PTSD models, account for PTSD's inherent...... and somatic/non-somatic depression. Using 181 trauma-exposed primary care patients, confirmatory factor analyses (CFA) indicated a well-fitting DSM-5 PTSD dysphoria model, DSM-5 numbing model and two-factor depression model. Both somatic and non-somatic depression factors were more related to PTSD's dysphoria...

  4. Automated measurement of hippocampal subfields in PTSD: Evidence for smaller dentate gyrus volume.

    Science.gov (United States)

    Hayes, Jasmeet P; Hayes, Scott; Miller, Danielle R; Lafleche, Ginette; Logue, Mark W; Verfaellie, Mieke

    2017-09-09

    Smaller hippocampal volume has been consistently observed as a biomarker of posttraumatic stress disorder (PTSD). However, less is known about individual volumes of the subfields composing the hippocampus such as the dentate gyrus and cornu ammonis (CA) fields 1-4 in PTSD. The aim of the present study was to examine the hypothesis that volume of the dentate gyrus, a region putatively involved in distinctive encoding of similar events, is smaller in individuals with PTSD versus trauma-exposed controls. Ninety-seven recent war veterans underwent structural imaging on a 3T scanner and were assessed for PTSD using the Clinician-Administered PTSD Scale. The hippocampal subfield automated segmentation program available through FreeSurfer was used to segment the CA4/dentate gyrus, CA1, CA2/3, presubiculum, and subiculum of the hippocampus. Results showed that CA4/dentate gyrus subfield volume was significantly smaller in veterans with PTSD and scaled inversely with PTSD symptom severity. These results support the view that dentate gyrus abnormalities are associated with symptoms of PTSD, although additional evidence is necessary to determine whether these abnormalities underlie fear generalization and other memory alterations in PTSD. Published by Elsevier Ltd.

  5. Pupil Response to Threat in Trauma-Exposed Individuals With or Without PTSD.

    Science.gov (United States)

    Cascardi, Michele; Armstrong, Davine; Chung, Leeyup; Paré, Denis

    2015-08-01

    An infrequently studied and potentially promising physiological marker for posttraumatic stress disorder (PTSD) is pupil response. This study tested the hypothesis that pupil responses to threat would be significantly larger in trauma-exposed individuals with PTSD compared to those without PTSD. Eye-tracking technology was used to evaluate pupil response to threatening and neutral images. Recruited for participation were 40 trauma-exposed individuals; 40.0% (n = 16) met diagnostic criteria for PTSD. Individuals with PTSD showed significantly more pupil dilation to threat-relevant stimuli compared to the neutral elements (Cohen's d = 0.76), and to trauma-exposed controls (Cohen's d = 0.75). Pupil dilation significantly accounted for 12% of variability in PTSD after time elapsed since most recent trauma, cumulative violence exposure, and trait anxiety were statistically adjusted. The final logistic regression model was associated with 85% of variability in PTSD status and correctly classified 93.8% of individuals with PTSD and 95.8% of those without. Pupil reactivity showed promise as a physiological marker for PTSD.

  6. PTSD, emotion dysregulation, and dissociative symptoms in a highly traumatized sample

    Science.gov (United States)

    Powers, Abigail; Cross, Dorthie; Fani, Negar; Bradley, Bekh

    2015-01-01

    Exposure to multiple traumas has been shown to result in many negative mental health outcomes, including posttraumatic stress disorder (PTSD). Dissociation, which involves disruptions in memory, identity, and perceptions, may be a component of PTSD, particularly among individuals who have experienced childhood trauma. Emotion regulation difficulties are also strongly associated with childhood trauma and emotion dysregulation may be a particularly important factor to consider in the development and maintenance of dissociative symptoms. The goal of the present study was to determine whether emotion dysregulation mediated the relationship between PTSD symptoms and dissociation in a sample of 154 (80% female, 97% African-American) adults recruited from a public, urban hospital. PTSD was measured using the Clinician Administered PTSD Scale, emotion dysregulation was measured using the Difficulties in Emotion Regulation Scale, and dissociation was measured using the Multiscale Dissociation Inventory. A linear regression analysis showed that both PTSD and emotion dysregulation were statistically significant predictors of dissociation even after controlling for trauma exposure. Alexithymia and an inability to use emotion regulation strategies in particular were predictive of dissociation above and beyond other predictor variables. Using bootstrapping techniques, we found that overall emotion dyregulation partially mediated the effect of PTSD symptoms on dissociative symptoms. Our results suggest that emotion dysregulation may be important in understanding the relation between PTSD and dissociative symptoms. Treatment approaches may consider a focus on training in emotional understanding and the development of adaptive regulation strategies as a way to address dissociative symptoms in PTSD patients. PMID:25573648

  7. Physiological reactivity to nonideographic virtual reality stimuli in veterans with and without PTSD.

    Science.gov (United States)

    Webb, Andrea K; Vincent, Ashley L; Jin, Alvin B; Pollack, Mark H

    2015-02-01

    Post-traumatic stress disorder (PTSD) currently is diagnosed via clinical interview in which subjective self reports of traumatic events and associated experiences are discussed with a mental health professional. The reliability and validity of diagnoses can be improved with the use of objective physiological measures. In this study, physiological activity was recorded from 58 male veterans (PTSD Diagnosis n = 16; Trauma Exposed/No PTSD Diagnosis: n = 23; No Trauma/No PTSD Diagnosis: n = 19) with and without PTSD and combat trauma exposure in response to emotionally evocative non-idiographic virtual reality stimuli. Statistically significant differences among the Control, Trauma, and PTSD groups were present during the viewing of two virtual reality videos. Skin conductance and interbeat interval features were extracted for each of ten video events (five events of increasing severity per video). These features were submitted to three stepwise discriminant function analyses to assess classification accuracy for Control versus Trauma, Control versus PTSD, and Trauma versus PTSD pairings of participant groups. Leave-one-out cross-validation classification accuracy was between 71 and 94%. These results are promising and suggest the utility of objective physiological measures in assisting with PTSD diagnosis.

  8. Self-study assisted cognitive therapy for PTSD: a case study

    Directory of Open Access Journals (Sweden)

    Jennifer Wild

    2010-12-01

    Full Text Available Background: Research has demonstrated that Cognitive Therapy for PTSD (CT-PTSD, a version of trauma-focused cognitive-behavioural therapy developed by Ehlers and Clark's group (2000, is effective and feasible when offered in weekly and intensive daily formats. It is unknown whether patients with post-traumatic stress disorder (PTSD could engage in and benefit from self-study assisted cognitive therapy, which would reduce therapist contact time. Objectives: This case report aims to illustrate this possibility. Design: A patient with PTSD and comorbid major depression, who developed these problems following a road traffic accident, was treated in six sessions of cognitive therapy with six self-study modules completed in-between sessions. The patient made a complete recovery on measures of PTSD, anxiety, and depression as assessed by self-report and independent assessment. Conclusion: Self-study assisted cognitive CT-PTSD reduced the therapist contact time to half of that normally required in standard CT-PTSD. This highlights the potential feasibility and therapeutic benefits of self-study modules in the brief treatment of PTSD. Further research is required to systematically evaluate the acceptability and efficacy of brief self-study assisted CT-PTSD.

  9. Gene × environment vulnerability factors for PTSD: the HPA-axis.

    Science.gov (United States)

    Mehta, Divya; Binder, Elisabeth B

    2012-02-01

    Post-traumatic stress disorder (PTSD) is a severely debilitating psychiatric condition. Although a lifetime trauma incidence of 40-90% has been reported in the general population, the overall lifetime prevalence for PTSD ranges between 7-12%, suggesting individual-specific differences towards the susceptibility to PTSD. While studies investigating main genetic effects associated with PTSD have yielded inconsistent findings, there is growing evidence supporting the role of gene-environment (G × E) interactions in PTSD. The hypothalamus pituitary adrenal (HPA) axis is one of the main systems activated after exposure to a trauma and perturbations in this system are one of the more consistent neurobiological abnormalities observed in PTSD. Genes regulating the HPA-axis are therefore interesting candidates for G × E studies in PTSD. This article will review the concept and initial results of G × E interactions with polymorphisms in these genes for PTSD. In addition, the use of alternate phenotypes and more complex interaction models such as G × G × E or G × E × E will be explored. Finally, putative molecular mechanisms for these interactions will be presented. The research presented in this article indicates that a combined analysis of environmental, genetic, endophenotype and epigenetic data will be necessary to better understand pathomechanisms in PTSD. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Image Descriptors for Displays

    Science.gov (United States)

    1975-03-01

    hypothetical televison display. The viewing distance is 4 picture heights, and the bandwidth limitation has been set by the U.S. Monochrome Standards...significantly influence the power spectrum over most of the video frequency range. A large dc component and a small random component provide another scene... influences . It was Illuminated with natural light to a brightness of over 300 ft-L. The high brightness levels were chosen so as to nearly reproduce the

  11. Refrigerated display cabinets; Butikskyla

    Energy Technology Data Exchange (ETDEWEB)

    Fahlen, Per

    2000-07-01

    This report summarizes experience from SP research and assignments regarding refrigerated transport and storage of food, mainly in the retail sector. It presents the fundamentals of heat and mass transfer in display cabinets with special focus on indirect systems and secondary refrigerants. Moreover, the report includes a brief account of basic food hygiene and the related regulations. The material has been compiled for educational purposes in the Masters program at Chalmers Technical University.

  12. Acute child and mother psychophysiological responses and subsequent PTSD symptoms following a child's traumatic event.

    Science.gov (United States)

    Ostrowski, Sarah A; Christopher, Norman C; van Dulmen, Manfred H M; Delahanty, Douglas L

    2007-10-01

    This study examined the relationship between acute cortisol responses to trauma and subsequent PTSD symptoms (PTSS) in children and their biological mothers. Urinary cortisol levels were assessed in 54 children aged 8-18 upon admission to a level-1 trauma center. Six weeks posttrauma, 15-hour urine samples were collected from children and their mothers. Depression and PTSS were assessed at 6 weeks (N = 44) and 7 months (N = 38) posttrauma. Higher child in-hospital cortisol significantly predicted 6-week child PTSS. This was true only for boys at 7 months. In mothers, lower 6-week cortisol levels significantly predicted 7-month PTSS. Results extend findings of differing directions of acute hormonal predictors of PTSS in adults versus children to a sample of genetically related individuals.

  13. Neuropsychological effects of self-reported deployment-related mild TBI and current PTSD in OIF/OEF veterans.

    Science.gov (United States)

    Shandera-Ochsner, Anne L; Berry, David T R; Harp, Jordan P; Edmundson, Maryanne; Graue, Lili O; Roach, Abbey; High, Walter M

    2013-01-01

    Current combat veterans are exposed to many incidents that may result in mild traumatic brain injury (mTBI) and/or posttraumatic stress disorder (PTSD). While there is literature on the neuropsychological consequences of PTSD only (PTSD-o) and mTBI alone (mTBI-o), less has been done to explore their combined (mTBI+PTSD) effect. The goal of this study was to determine whether Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) veterans with mTBI+PTSD have poorer cognitive and psychological outcomes than veterans with PTSD-o, mTBI-o, or combat exposure-only. The final sample included 20 OIF/OEF veterans with histories of self-reported deployment mTBI (mTBI-o), 19 with current PTSD (PTSD-o), 21 with PTSD and self-reported mTBI (mTBI+PTSD), and 21 combat controls (CC) (no PTSD and no reported mTBI). Groups were formed using structured interviews for mTBI and PTSD. All participants underwent comprehensive neuropsychological testing, including neurocognitive and psychiatric feigning tests. Results of cognitive tests revealed significant differences in performance in the mTBI+PTSD and PTSD-o groups relative to mTBI-o and CC. Consistent with previous PTSD literature, significant differences were found on executive (switching) tasks, verbal fluency, and verbal memory. Effect sizes tended to be large in both groups with PTSD. Thus, PTSD seems to be an important variable affecting neuropsychological profiles in the post-deployment time period. Consistent with literature on civilian mTBI, the current study did not find evidence that combat-related mTBI in and of itself contributes to objective cognitive impairment in the late stage of injury.

  14. Relations between PTSD and distress dimensions in an Indian child/adolescent sample following the 2008 Mumbai terrorist attacks.

    Science.gov (United States)

    Contractor, Ateka A; Mehta, Panna; Tiamiyu, Mojisola F; Hovey, Joseph D; Geers, Andrew L; Charak, Ruby; Tamburrino, Marijo B; Elhai, Jon D

    2014-08-01

    Posttraumatic stress disorder's (PTSD) four-factor dysphoria model has substantial empirical support (reviewed in Elhai & Palmieri, Journal of Anxiety Disorders, 25, 849-854, 2011; Yufik & Simms, Journal of Abnormal Psychology, 119, 764-776, 2010). However, debatable is whether the model's dysphoria factor adequately captures all of PTSD's emotional distress (e.g., Marshall et al., Journal of Abnormal Psychology, 119(1), 126-135, 2010), which is relevant to understanding the assessment and psychopathology of PTSD. Thus, the present study assessed the factor-level relationship between PTSD and emotional distress in 818 children/adolescents attending school in the vicinity of the 2008 Mumbai terrorist attacks. The effective sample had a mean age of 12.85 years (SD = 1.33), with the majority being male (n = 435, 53.8 %). PTSD and emotional distress were measured by the UCLA PTSD Reaction Index (PTSD-RI) and Brief Symptom Inventory-18 (BSI-18) respectively. Confirmatory factor analyses (CFA) assessed the PTSD and BSI-18 model fit; Wald tests assessed hypothesized PTSD-distress latent-level relations; and invariance testing examined PTSD-distress parameter differences using age, gender and direct exposure as moderators. There were no moderating effects for the PTSD-distress structural parameters. BSI-18's depression and somatization factors related more to PTSD's dysphoria than PTSD's avoidance factor. The results emphasize assessing for specificity and distress variance of PTSD factors on a continuum, rather than assuming dysphoria factor's complete accountability for PTSD's inherent distress. Additionally, PTSD's dysphoria factor related more to BSI-18's depression than BSI-18's anxiety/somatization factors; this may explain PTSD's comorbidity mechanism with depressive disorders.

  15. PTSD and loss: preliminary findings from a territory-wide epidemiology study in Hong Kong

    Directory of Open Access Journals (Sweden)

    Kitty K. Wu

    2014-12-01

    Full Text Available Background: The study examined the prevalence of trauma and posttraumatic stress disorder (PTSD symptoms among community dwelling Chinese adults in Hong Kong. The relationship of traumatic life events (including loss and mental health has been investigated. Methods: The sampling of the collaborative study (HKMMS: Hong Kong Mental Morbidity Survey adopts a multi-stage stratification approach with the distribution of residential premises in different geographical districts and the relative proportion of private versus public housing units taken into consideration. In Phase I of this study, 4,644 adults were screened for PTSD with the Trauma Screening Questionnaire (TSQ and Life Event Checklist (LEC, Beck's scales and CIS-R (Revised Clinical Interview Schedule. In Phase II of the study, clinical psychologists conducted the Structured Clinical Interview for DSM Disorders (SCID for 92 participants (results not reported here. Results: Among Phase I participants, 65% reported traumatic experience (including 18% who reported personal experience of sudden death of significant others. Age and gender make a difference in traumatic experience. When compared to participants who reported no traumatic experience in the past, participants who reported to have personal experience of sudden death of significant others or other traumatic experiences were found to have higher TSQ scores, higher psychological distress, lower social support (PSS: Multidimensional Scale of Perceived Social Support, and lower life functioning (SOFAS: Social and Occupational Functioning Assessment Scale, p<0.001. Findings of hierarchical regression showed that type of trauma (i.e., loss, other trauma, or no trauma contributed significantly to the prediction of all the mental health indices after demographic and social variables were controlled. Conclusions: Public education on the association of traumatic experience and psychological health, as well as the monitoring of mental health

  16. Book Display as Adult Service

    Directory of Open Access Journals (Sweden)

    Matthew S. Moore

    1997-03-01

    Full Text Available 無Book display as an adult service is defined as choosing and positioning adult books from the collection to increase their circulation. The author contrasts bookstore arrangement for sales versus library arrangement for access. The paper considers the library-as-a-whole as a display, examines the right size for an in-library display, and discusses mass displays, end-caps, on-shelf displays, and the Tiffany approach. The author proposes that an effective display depends on an imaginative, unifying theme, and that book displays are part of the joy of libraries.

  17. Handbook of Visual Display Technology

    CERN Document Server

    Cranton, Wayne; Fihn, Mark

    2012-01-01

    The Handbook of Visual Display Technology is a unique work offering a comprehensive description of the science, technology, economic and human interface factors associated with the displays industry. An invaluable compilation of information, the Handbook will serve as a single reference source with expert contributions from over 150 international display professionals and academic researchers. All classes of display device are covered including LCDs, reflective displays, flexible solutions and emissive devices such as OLEDs and plasma displays, with discussion of established principles, emergent technologies, and particular areas of application. The wide-ranging content also encompasses the fundamental science of light and vision, image manipulation, core materials and processing techniques, display driving and metrology.

  18. SAFE for PTSD: noncontact psychophysiological measure based on high-resolution thermal imaging to aid in PTSD diagnosis and assessment of treatment

    Science.gov (United States)

    Familoni, Babajide O.; Ma, Lein; Hutchinson, J. Andrew; Morgan, C. Andrew, III; Rasmusson, Ann; O'Kane, Barbara L.

    2012-06-01

    Post Traumatic Stress Disorder (PTSD) sometimes develops following exposure to very stressful or traumatic events such as motor vehicle accidents, rape, and war. It is arguably the signature injury of the conflicts in Iraq and Afghanistan. Previous studies have demonstrated that PTSD sufferers exhibit autonomic hyper-responsiveness to both neutral and trauma-related stimuli. In this study, we propose using high resolution thermal imaging of sweat-pores to obtain a noncontact, remote, and quantifiable measure of the sympathetic autonomic nervous reactivity to guide diagnosis, assess response to treatment, and tease out important cues to suicidality as a PTSD comorbidity.

  19. Longitudinal Associations Between PTSD Symptoms and Dyadic Conflict Communication Following a Severe Motor Vehicle Accident.

    Science.gov (United States)

    Fredman, Steffany J; Beck, J Gayle; Shnaider, Philippe; Le, Yunying; Pukay-Martin, Nicole D; Pentel, Kimberly Z; Monson, Candice M; Simon, Naomi M; Marques, Luana

    2017-03-01

    There are well-documented associations between posttraumatic stress disorder (PTSD) symptoms and intimate relationship impairments, including dysfunctional communication at times of relationship conflict. To date, the extant research on the associations between PTSD symptom severity and conflict communication has been cross-sectional and focused on military and veteran couples. No published work has evaluated the extent to which PTSD symptom severity and communication at times of relationship conflict influence each other over time or in civilian samples. The current study examined the prospective bidirectional associations between PTSD symptom severity and dyadic conflict communication in a sample of 114 severe motor vehicle accident (MVA) survivors in a committed intimate relationship at the time of the accident. PTSD symptom severity and dyadic conflict communication were assessed at 4 and 16weeks post-MVA, and prospective associations were examined using path analysis. Total PTSD symptom severity at 4weeks prospectively predicted greater dysfunctional communication at 16weeks post-MVA but not vice versa. Examination at the level of PTSD symptom clusters revealed that effortful avoidance at 4weeks prospectively predicted greater dysfunctional communication at 16weeks, whereas dysfunctional communication 4weeks after the MVA predicted more severe emotional numbing at 16weeks. Findings highlight the role of PTSD symptoms in contributing to dysfunctional communication and the importance of considering PTSD symptom clusters separately when investigating the dynamic interplay between PTSD symptoms and relationship functioning over time, particularly during the early posttrauma period. Clinical implications for the prevention of chronic PTSD and associated relationship problems are discussed.

  20. Finalizing PTSD in DSM-5: getting here from there and where to go next.

    Science.gov (United States)

    Friedman, Matthew J

    2013-10-01

    The process that resulted in the diagnostic criteria for posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association; ) was empirically based and rigorous. There was a high threshold for any changes in any DSM-IV diagnostic criterion. The process is described in this article. The rationale is presented that led to the creation of the new chapter, "Trauma- and Stressor-Related Disorders," within the DSM-5 metastructure. Specific issues discussed about the DSM-5 PTSD criteria themselves include a broad versus narrow PTSD construct, the decisions regarding Criterion A, the evidence supporting other PTSD symptom clusters and specifiers, the addition of the dissociative and preschool subtypes, research on the new criteria from both Internet surveys and the DSM-5 field trials, the addition of PTSD subtypes, the noninclusion of complex PTSD, and comparisons between DSM-5 versus the World Health Association's forthcoming International Classification of Diseases (ICD-11) criteria for PTSD. The PTSD construct continues to evolve. In DSM-5, it has moved beyond a narrow fear-based anxiety disorder to include dysphoric/anhedonic and externalizing PTSD phenotypes. The dissociative subtype may open the way to a fresh approach to complex PTSD. The preschool subtype incorporates important developmental factors affecting the expression of PTSD in young children. Finally, the very different approaches taken by DSM-5 and ICD-11 should have a profound effect on future research and practice. Published 2013. This article is a US Government work and is in the public domain in the USA.

  1. Developing the PTSD Checklist-I/F for the DSM-IV (PCL-I/F: Assessing PTSD Symptom Frequency and Intensity in a Pilot Study of Male Veterans with Combat-Related PTSD

    Directory of Open Access Journals (Sweden)

    Ryan Holliday

    2015-02-01

    Full Text Available The widely used posttraumatic stress disorder (PTSD Checklist (PCL has established reliability and validity, but it does not differentiate posttraumatic symptom frequency from intensity as elements of posttraumatic symptom severity. Thus, the PCL in its existing form may not provide a comprehensive appraisal of posttraumatic symptomatology. Because of this, we modified the PCL to create the PCL-I/F that measures both frequency and intensity of PTSD symptoms via brief self-report. To establish validity and internal consistency of the PCL-I/F, we conducted a pilot study comparing PCL-I/F scores to structured diagnostic interview for PTSD (the Clinician Administered PTSD Scale [CAPS] in a male combat veteran sample of 92 participants. Statistically significant correlations between the PCL-I/F and the CAPS were found, suggesting initial validation of the PCL-I/F to screen and assess frequency and intensity of combat-related PTSD symptoms. Implications are discussed for screening and assessment of PTSD related to combat and non-combat trauma.

  2. Prevalence of PTSD in Survivors of Stroke and Transient Ischemic Attack: A Meta-Analytic Review: e66435

    National Research Council Canada - National Science Library

    Donald Edmondson; Safiya Richardson; Jennifer K Fausett; Louise Falzon; Virginia J Howard; Ian M Kronish

    2013-01-01

      Background and Purpose Posttraumatic stress disorder (PTSD) is common in survivors of acute life-threatening illness, but little is known about the burden of PTSD in survivors of stroke and transient ischemic attack (TIA...

  3. Influences of Maternal and Paternal PTSD on Epigenetic Regulation of the Glucocorticoid Receptor Gene in Holocaust Survivor Offspring

    National Research Council Canada - National Science Library

    Yehuda, Rachel; Daskalakis, Nikolaos P; Lehrner, Amy; Desarnaud, Frank; Bader, Heather N; Makotkine, Iouri; Flory, Janine D; Bierer, Linda M; Meaney, Michael J

    2014-01-01

    Important differences in the expression and effect of maternal and paternal PTSD were found when examining parental PTSD in the offspring of Holocaust survivors and methylation of the glucocorticoid...

  4. [Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context].

    Science.gov (United States)

    Auxéméry, Y

    2012-10-01

    Why are some individuals more likely than others to develop a posttraumatic stress disorder (PTSD) in the face of similar levels of trauma exposure? Monitoring the traumatic process combining the antecedents, the determinants of the psychic trauma and the acute symptoms can clarify the causes of the final onset of a chronic repetition syndrome. Epidemiologic research has clarified risk factors that increase the likelihood of PTSD after exposure to a potentially traumatic event. PTSD is an interaction between a subject, a traumatogenic factor and a social context. With each epidemiological, psychopathological and more particularly neurogenetic study, we will expand on the impact of these interactions on the therapeutic treatment of psycho-traumatised persons. Most studies have shown that unrelated to the traumatic event, additional risk factors for developing PTSD include younger age at the time of the trauma, female gender, lower social economic statuts, lack of social support, premorbid personality characteristics and preexisting anxiety or depressive disorders increase the risk of PTSD. The psychic trauma is firmly attached to the repetition and the previous traumas are as many risks of developing a subsequent PTSD in the wake of a new trauma: PTSD in adults may represent a prolonged symptomatic reaction to prior traumatic assault, child abuse and childhood adversities. Related to the traumatic event, the organic pain, the traumatic brain injury, but also the sight of blood can lead to a trauma being considered as more serious or more harmful to life. It is useful to recognize the acute reactions of exhaustion stress as they can guide both the pharmacotherapeutic and the psychotherapeutic treatment thanks to debriefings. Even though the majority of people with acute stress disorder subsequently develop PTSD, the current data indicate that too many people can develop PTSD without initially displaying acute stress disorder. Though peritraumatic dissociation and

  5. Latest development of display technologies

    Science.gov (United States)

    Gao, Hong-Yue; Yao, Qiu-Xiang; Liu, Pan; Zheng, Zhi-Qiang; Liu, Ji-Cheng; Zheng, Hua-Dong; Zeng, Chao; Yu, Ying-Jie; Sun, Tao; Zeng, Zhen-Xiang

    2016-09-01

    In this review we will focus on recent progress in the field of two-dimensional (2D) and three-dimensional (3D) display technologies. We present the current display materials and their applications, including organic light-emitting diodes (OLEDs), flexible OLEDs quantum dot light emitting diodes (QLEDs), active-matrix organic light emitting diodes (AMOLEDs), electronic paper (E-paper), curved displays, stereoscopic 3D displays, volumetric 3D displays, light field 3D displays, and holographic 3D displays. Conventional 2D display devices, such as liquid crystal devices (LCDs) often result in ambiguity in high-dimensional data images because of lacking true depth information. This review thus provides a detailed description of 3D display technologies.

  6. Breathing Biofeedback as an Adjunct to Exposure in Cognitive Behavioral Therapy Hastens the Reduction of PTSD Symptoms: A Pilot Study

    OpenAIRE

    Rosaura Polak, A.; Witteveen, Anke B.; Denys, Damiaan; Olff, Miranda

    2015-01-01

    Although trauma-focused cognitive behavioral therapy (TF-CBT) with exposure is an effective treatment for posttraumatic stress disorder (PTSD), not all patients recover. Addition of breathing biofeedback to exposure in TF-CBT is suggested as a promising complementary technique to improve recovery of PTSD symptoms. Patients (n = 8) with chronic PTSD were randomized to regular TF-CBT or TF-CBT with complementary breathing biofeedback to exposure. PTSD symptoms were measured before, during and a...

  7. Evidence-based treatment for adult women with child abuse-related Complex PTSD: a quantitative review

    OpenAIRE

    Dorrepaal, Ethy; Thomaes, Kathleen; Hoogendoorn, Adriaan W.; Veltman, Dick J.; Draijer, Nel; van Balkom, Anton J. L. M.

    2014-01-01

    Introduction: Effective first-line treatments for posttraumatic stress disorder (PTSD) are well established, but their generalizability to child abuse (CA)-related Complex PTSD is largely unknown.Method: A quantitative review of the literature was performed, identifying seven studies, with treatments specifically targeting CA-related PTSD or Complex PTSD, which were meta-analyzed, including variables such as effect size, drop-out, recovery, and improvement rates.Results: Only six studies with...

  8. POSTRAUMATIC STRESS DISORDERS (PTSD) BETWEEN FALLACY AND FACTS: WHAT WE KNOW AND WHAT WE DON'T KNOW?

    OpenAIRE

    Jakovljević, Miro; Brajković, Lovorka; Lončar, Mladen; Čima, Ana

    2012-01-01

    Background: PTSD been recognized as a major problem in public health and has attracted an ever-growing scientific, epistemological and clinical interest. On the other side, PTSD is one of the most controversial diagnosis in psychiatry as well as in medicine in general. Method: We have made an overview of available literature on PTSD to identify what is our real knowledge about PTSD with all dilemmas, controversies and challenges. Results: We have various options as to how to ev...

  9. PTSD in ICD-10 and proposed ICD-11 in elderly with childhood trauma: prevalence, factor structure, and symptom profiles

    OpenAIRE

    Glück, Tobias M.; Knefel, Matthias; Tran, Ulrich S.; Lueger-Schuster, Brigitte

    2016-01-01

    Background: The proposal for ICD-11 postulates major changes for posttraumatic stress disorder (PTSD) diagnosis, which needs investigation in different samples.Aims: To investigate differences of PTSD prevalence and diagnostic agreement between ICD-10 and ICD-11, factor structure of proposed ICD-11 PTSD, and diagnostic value of PTSD symptom severity classes.Method: Confirmatory factor analysis and latent profile analysis were used on data of elderly survivors of childhood trauma (>60 years...

  10. Using Propranolol to Block Memory Reconsolidation in Female Veterans with PTSD

    Science.gov (United States)

    2015-11-01

    traumatic memory recall was psychophysiologically assessed by measuring Service Members’ facial corrugator electromyography (EMG), skin conductance, and...increased heart rate, galvanic skin conductance, and facial corrugator muscle tension as Service Members are presented with stimuli associated with...understanding of sex-related differences in PTSD and associated physiological expressions of fear are incomplete. Despite a 2:1 prevalence of PTSD in

  11. Study adaptation, design, and methods of a web-based PTSD intervention for women Veterans.

    Science.gov (United States)

    Lehavot, Keren; Litz, Brett; Millard, Steven P; Hamilton, Alison B; Sadler, Anne; Simpson, Tracy

    2017-02-01

    Women Veterans are a rapidly growing population with high risk of exposure to potentially traumatizing events and PTSD diagnoses. Despite the dissemination of evidence-based treatments for PTSD in the VA, most women Veteran VA users underutilize these treatments. Web-based PTSD treatment has the potential to reach and engage women Veterans with PTSD who do not receive treatment in VA settings. Our objective is to modify and evaluate Delivery of Self Training and Education for Stressful Situations (DESTRESSS), a web-based cognitive-behavioral intervention for PTSD, to target PTSD symptoms among women Veterans. The specific aims are to: (1) obtain feedback about DESTRESS, particularly on its relevance and sensitivity to women, using semi-structured interviews with expert clinicians and women Veterans with PTSD, and make modifications based on this feedback; (2) conduct a pilot study to finalize study procedures and make further refinements to the intervention; and (3) conduct a randomized clinical trial (RCT) evaluating a revised, telephone-assisted DESTRESS compared to telephone monitoring only. We describe the results from the first two aims, and the study design and procedures for the ongoing RCT. This line of research has the potential to result in a gender-sensitive, empirically-based, online treatment option for women Veterans with PTSD.

  12. Emotion Regulatory Brain Function and SSRI Treatment in PTSD: Neural Correlates and Predictors of Change.

    Science.gov (United States)

    MacNamara, Annmarie; Rabinak, Christine A; Kennedy, Amy E; Fitzgerald, Daniel A; Liberzon, Israel; Stein, Murray B; Phan, K Luan

    2016-01-01

    Posttraumatic stress disorder (PTSD)-a chronic, debilitating condition, broadly characterized by emotion dysregulation-is prevalent among US military personnel who have returned from Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF). Selective serotonin reuptake inhibitors (SSRIs) are a first-line treatment for PTSD, but treatment mechanisms are unknown and patient response varies. SSRIs may exert their effects by remediating emotion regulatory brain activity and individual differences in patient response might be explained, in part, by pre-treatment differences in neural systems supporting the downregulation of negative affect. Thirty-four OEF/OIF veterans, 17 with PTSD and 17 without PTSD underwent 2 functional magnetic resonance imaging scans 12 weeks apart. At each scan, they performed an emotion regulation task; in the interim, veterans with PTSD were treated with the SSRI, paroxetine. SSRI treatment increased activation in both the left dorsolateral prefrontal cortex (PFC) and supplementary motor area (SMA) during emotion regulation, although only change in the SMA over time occurred in veterans with PTSD and not those without PTSD. Less activation of the right ventrolateral PFC/inferior frontal gyrus during pre-treatment emotion regulation was associated with greater reduction in PTSD symptoms with SSRI treatment, irrespective of pre-treatment severity. Patients with the least recruitment of prefrontal emotion regulatory brain regions may benefit most from treatment with SSRIs, which appear to augment activity in these regions.

  13. The validity of the DSM-IV PTSD criteria in children and adolescents: a review

    NARCIS (Netherlands)

    Blom, M.; Oberink, R.

    2012-01-01

    Objective: DSM-V is on its way and doubts have been raised regarding the validity of pediatric PTSD. It is the goal of the current review to critically review the empirical literature on PTSD in youth. Method: A search of PsycINFO, PubMed and reference lists was conducted. Empirical information cons

  14. What happened to harmonization of the PTSD diagnosis? The divergence of ICD11 and DSM5.

    Science.gov (United States)

    Bisson, J I

    2013-09-01

    The development of ICD11 and DSM5 was seen as an opportunity to harmonize the two major classification systems for mental disorders. The proposed ICD11 and DSM5 diagnostic criteria for PTSD are markedly different. The implications of this remain to be seen, but have the potential to cause confusion to PTSD sufferers, clinicians, researchers and others impacted on by the condition.

  15. Virtual Reality Exposure Therapy for PTSD Symptoms after a Road Accident: An Uncontrolled Case Series

    Science.gov (United States)

    Beck, J. Gayle; Palyo, Sarah A.; Winer, Eliot H.; Schwagler, Brad E.; Ang, Eu Jin

    2007-01-01

    This report examined whether Virtual Reality Exposure Therapy (VRET) could be used in the treatment of posttraumatic stress disorder (PTSD) symptoms in the aftermath of a serious motor vehicle accident. Six individuals reporting either full or severe subsyndromal PTSD completed 10 sessions of VRET, which was conducted using software designed to…

  16. Neural correlates of inhibition and contextual cue processing related to treatment response in PTSD

    NARCIS (Netherlands)

    van Rooij, Sanne J H; Geuze, Elbert; Kennis, Mitzy; Rademaker, Arthur R; Vink, Matthijs

    2015-01-01

    Thirty to fifty percent of posttraumatic stress disorder (PTSD) patients do not respond to treatment. Understanding the neural mechanisms underlying treatment response could contribute to improve response rates. PTSD is often associated with decreased inhibition of fear responses in a safe environme

  17. Behavioral Activation for Comorbid PTSD and Major Depression: A Case Study

    Science.gov (United States)

    Mulick, Patrick S.; Naugle, Amy E.

    2004-01-01

    The present investigation details the assessment and use of Behavioral Activation (BA) therapy to treat a 37-year-old male police officer/military veteran suffering from posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). This case study is an attempt to expand empirical knowledge regarding BA, comorbid PTSD and MDD, and…

  18. Cognitive-Behavioral Therapy for PTSD in Children and Adolescents: A Preliminary Randomized Controlled Trial

    Science.gov (United States)

    Smith, Patrick; Yule, William; Perrin, Sean; Tranah, Troy; Dagleish, Tim; Clark, David M.

    2007-01-01

    Objective: To evaluate the efficacy of individual trauma-focused cognitive-behavioral therapy (CBT) for treating posttraumatic stress disorder (PTSD) in children and young people. Method: Following a 4-week symptom-monitoring baseline period, 24 children and young people (8-18 years old) who met full "DSM-IV" PTSD diagnostic criteria after…

  19. A Memory-Based Model of Posttraumatic Stress Disorder: Evaluating Basic Assumptions Underlying the PTSD Diagnosis

    Science.gov (United States)

    Rubin, David C.; Berntsen, Dorthe; Bohni, Malene Klindt

    2008-01-01

    In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; American Psychiatric Association,…

  20. The role of behavioral inhibition and parenting for an unfavorable emotional trauma response and PTSD.

    Science.gov (United States)

    Asselmann, E; Wittchen, H-U; Lieb, R; Höfler, M; Beesdo-Baum, K

    2015-04-01

    The role of behavioral inhibition (BI) and parenting for an unfavorable emotional trauma response (DSM-IV criterion A2) and post-traumatic stress disorder (PTSD) development is unclear. A community sample of adolescents and young adults (aged 14-24) was followed up over 10 years (N=2378). Traumatic events, criterion A2, and PTSD (according to DSM-IV-TR) were assessed using the M-CIDI. BI and parenting were assessed using the Retrospective Self-Report of Inhibition and the Questionnaire of Recalled Parenting Rearing Behavior. Multiple logistic regressions adjusted for sex, age, and number of traumata were used to examine associations of BI as well as maternal and paternal overprotection, rejection, and reduced emotional warmth with (i) criterion A2 in those with trauma (N=1794) and (ii) subsequent PTSD in those with criterion A2 (N=1160). Behavioral inhibition (BI; odds ratio, OR=1.32) and paternal overprotection (OR=1.27) predicted criterion A2 in those with trauma, while only BI (OR=1.53) predicted subsequent PTSD. BI and paternal emotional warmth interacted on subsequent PTSD (OR=1.32), that is, BI only predicted PTSD in those with low paternal emotional warmth. Our findings suggest that BI and adverse parenting increase the risk of an unfavorable emotional trauma response and subsequent PTSD. Paternal emotional warmth buffers the association between BI and PTSD development. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.