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  1. 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 ...

  2. 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 ...

  3. 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.

  4. GUIDED IMAGERY: KONSEP KONSELING KREATIF UNTUK PENANGGANAN POST TRAUMATIC STRESS DISORDER (PTSD

    Directory of Open Access Journals (Sweden)

    author Yulianto

    2015-01-01

    Full Text Available Everyone has a different reaction in facing the extraordinary events that are triggered by the teribble events. They clash psychic cause post traumatic stress disorder or in Post Traumatic Stress Disorder (PTSD. To solve it can be done through treatment with pharmacotherapy and psychotherapy. In psychotherapy handling, one of the techniques that can be used is the technique of guided imagery as one of the PTSD treatment efforts. This technique is an effort that can be used to deal with a difficult client to communicate verbally. Communication is the basis of the counseling relationship. Implementation of counseling through guided imagery techniques are considered able to help clients resolve client’s problems. In this technique, clients are guided to be able to focus on positive thoughts and imaginations that lead to negative events experienced to be able to create a positive picture of the imagination.Keywords: Guided imagery, post traumatic stress disorder (PTSD, Creative counseling

  5. 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.

  6. The Relationship Between Post Traumatic Stress Disorder (PTSD) Symptoms and Career Outcomes of Army Enlisted Servicemembers

    Science.gov (United States)

    2015-01-01

    less likely to get promoted or promoted quickly (Lyness & Thompson, 1997; Powell, Butterfield, & Parent , 2002; Ragins, 1997). As a result, the career ...PTSD) Symptoms and Career Outcomes of Army Enlisted Servicemembers 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d...Post Traumatic Stress Disorder (PTSD) Symptoms and Career Outcomes of Army Enlisted Servicemembers Jennifer N. Walters Dissertation The Relationship

  7. Post-traumatic Stress Disorder Post Partum: The Impact of Birth on the Prevalence of Post-traumatic Stress Disorder (PTSD) in Multiparous Women.

    Science.gov (United States)

    Schwab, W; Marth, C; Bergant, A M

    2012-01-01

    Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD), in some cases in a subsyndromal form. Until now, the possibility that postpartum psychological symptoms might be a continuum of a pre-existing disorder in pregnancy has rarely been considered. This study therefore aimed to evaluate the proportion of women who develop post-traumatic stress disorder as a result of childbirth. Materials and Methods: 56 multiparous women were recruited for the study. The diagnosis of PTSD was made according to the criteria for psychological disorders in the DSM-IV (Diagnostics and Statistical Manual of Mental Disorders). The data were collected in structured interviews in the 30th to 38th week of gestation and in the 6th week post partum. Results: Of the 56 women participating, 52 (93 %) completed the survey. Uncontrolled results showed that 21.15 % of the multiparous women met the full diagnostic PTSD criteria in the 6th week post partum. After the exclusion of all cases already characterised by all criteria or a subsyndromal form of PTSD caused by previous traumatisation, the PTSD rate was below 8 % at 6 weeks postpartum (= incidence rate of PTSD post partum). Conclusions: The present study is the first prospective longitudinal study to demonstrate the occurrence of full criteria PTSD in multiparous women as a result of childbirth after having excluded pre-existing PTSD. The results of our study show a high prevalence rate of PTSD during pregnancy. A number of women report all aspects of post-traumatic stress disorder as a result of childbirth.

  8. 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

  9. Changes in Galanin Systems in a Rat Model of Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Barnabas, Karen; Zhang, Lin; Wang, Huiying; Kirouac, Gilbert; Vrontakis, Maria

    2016-01-01

    Post-traumatic stress disorder (PTSD) is a chronic syndrome triggered by exposure to trauma and a failure to recover from a normal negative emotional reaction to traumatic stress. The neurobiology of PTSD and the participation of neuropeptides in the neural systems and circuits that control fear and anxiety are not fully understood. The long-term dysregulation of neuropeptide systems contributes to the development of anxiety disorders, including PTSD. The neuropeptide galanin (Gal) and its receptors participate in anxiety-like and depression-related behaviors via the modulation of neuroendocrine and monoaminergic systems. The objective of this research was to investigate how Gal expression changes in the brain of rats 2 weeks after exposure to footshock. Rats exposed to footshocks were subdivided into high responders (HR; immobility>60%) and low responders (LR; immobilityanxiety and PTSD development.

  10. Post-Traumatic Stress Disorder

    Science.gov (United States)

    Post-traumatic stress disorder (PTSD) is a real illness. You can get PTSD after living through or seeing a traumatic event, such as war, a ... sexual assault, physical abuse, or a bad accident. PTSD makes you feel stressed and afraid after the ...

  11. 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.

  12. 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.

  13. The Effectiveness of Art Therapy Interventions in Reducing Post Traumatic Stress Disorder (PTSD) Symptoms in Pediatric Trauma Patients.

    Science.gov (United States)

    Chapman, Linda M.; Morabito, Diane; Ladakakos, Chris; Schreier, Herbert; Knudson, M. Margaret

    2001-01-01

    Chapman Art Therapy Intervention (CATTI), an art therapy research project at an urban trauma center, was designed to reduce Post Traumatic Stress Disorder (PTSD) symptoms in pediatric patients. Early analysis does not indicate statistically significant differences in reduction of PTSD symptoms between experimental and control groups. Children…

  14. A longitudinal fMRI investigation in acute post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Ke, Jun; Zhang, Li; Qi, Rongfeng; Li, Weihui; Hou, Cailan; Zhong, Yuan; He, Zhong; Li, Lingjiang; Lu, Guangming

    2016-11-01

    Background Neuroimaging studies have implicated limbic, paralimbic, and prefrontal cortex in the pathophysiology of chronic post-traumatic stress disorder (PTSD). However, little is known about the neural substrates of acute PTSD and how they change with symptom improvement. Purpose To examine the neural circuitry underlying acute PTSD and brain function changes during clinical recovery from this disorder. Material and Methods Nineteen acute PTSD patients and nine non-PTSD subjects who all experienced a devastating mining accident underwent clinical assessment as well as functional magnetic resonance imaging (fMRI) scanning while viewing trauma-related and neutral pictures. Two years after the accident, a subgroup of 17 patients completed a second clinical evaluation, of which 13 were given an identical follow-up scan. Results Acute PTSD patients demonstrated greater activation in the vermis and right posterior cingulate, and greater deactivation in the bilateral medial prefrontal cortex and inferior parietal lobules than controls in the traumatic versus neutral condition. At follow-up, PTSD patients showed symptom reduction and decreased activation in the right middle frontal gyrus, bilateral posterior cingulate/precuneus, and cerebellum. Correlation results confirmed these findings and indicated that brain activation in the posterior cingulate/precuneus and vermis was predictive of PTSD symptom improvement. Conclusion The findings support the involvement of the medial prefrontal cortex, inferior parietal lobule, posterior cingulate, and vermis in the pathogenesis of acute PTSD. Brain activation in the vermis and posterior cingulate/precuneus appears to be a biological marker of recovery potential from PTSD. Furthermore, decreased activation of the middle frontal gyrus, posterior cingulate/precuneus, and cerebellum may reflect symptom improvement.

  15. The management of post traumatic stress disorder (PTSD) in the primary care setting.

    Science.gov (United States)

    Bobo, William V; Warner, Christopher H; Warner, Carolynn M

    2007-08-01

    Recent geopolitical events, including the terrorist attacks on the United States on September 11, 2001, and ongoing military operations in Iraq, have raised awareness of the often severe psychological after-effects of these and other types of traumatic events. Post traumatic stress disorder (PTSD) represents the most severe of these sequelae. PTSD is an under-recognized and under-treated chronic anxiety disorder associated with significant psychosocial morbidity, substance abuse, and a number of other negative health outcomes. Fortunately, the biologic underpinnings of this complex disorder and new advances in treatment are being realized. Early detection by primary care providers and rapid initiation of treatment are the keys to successful management of the disorder.

  16. 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.

  17. Reconsidering Post-Traumatic Stress

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    Berman, Dene S.; Davis-Berman, Jennifer

    2005-01-01

    This article serves to challenge the prevailing wisdom that suggests that most trauma is followed by post-traumatic stress disorder (PTSD), and is best treated with critical incident stress debriefing (CISD). Instead, recent evidence suggests that many individuals exposed to stress do not experience stress responses. Even those who do, however,…

  18. Post-Traumatic Stress Disorder (PTSD): What We Have Learned and What We Still Have Not Found Out

    Science.gov (United States)

    Flouri, Eirini

    2005-01-01

    This article discusses the biomedical and the social constructionist models applied to response to trauma, presents the prevalence and the etiology of post-traumatic stress disorder (PTSD), and describes its biological and psychological correlates in children and adults. It concludes that future research might benefit from investigating factors…

  19. Adolescent Post-Traumatic Stress Disorder

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    Yule, William

    2003-01-01

    Based on over a decade of work in the area of PTSD, including a longitudinal study of PTSD among adolescents, Dr. Yule provides an introduction to post-traumatic stress disorder as it occurs in youth. This includes a look at the manifestations of stress reactions, the incidence and prevalence of PTSD, and the relationship between levels of…

  20. The endocannabinoid system and Post Traumatic Stress Disorder (PTSD): From preclinical findings to innovative therapeutic approaches in clinical settings.

    Science.gov (United States)

    Berardi, Andrea; Schelling, Gustav; Campolongo, Patrizia

    2016-09-01

    Post-Traumatic Stress Disorder (PTSD) is a psychiatric chronic disease developing in individuals after the experience of an intense and life-threatening traumatic event. The post-traumatic symptomatology encompasses alterations in memory processes, mood, anxiety and arousal. There is now consensus in considering the disease as an aberrant adaptation to traumatic stress. Pharmacological research, aimed at the discovery of new potential effective treatments, has lately directed its attention towards the "so-called" cognitive enhancers. This class of substances, by modulating cognitive processes involved in the development and/or persistence of the post-traumatic symptomatology, could be of great help in improving the outcome of psychotherapies and patients' prognosis. In this perspective, drugs acting on the endocannabinoid system are receiving great attention due to their dual ability to modulate memory processes on one hand, and to reduce anxiety and depression on the other. The purpose of the present review is to offer a thorough overview of both animal and human studies investigating the effects of cannabinoids on memory processes. First, we will briefly describe the characteristics of the endocannabinoid system and the most commonly used animal models of learning and memory. Then, studies investigating cannabinoid modulatory influences on memory consolidation, retrieval and extinction will be separately presented, and the potential benefits associated with each approach will be discussed. In the final section, we will review literature data reporting beneficial effects of cannabinoid drugs in PTSD patients.

  1. Telling the story and re-living the past: How speech analysis can reveal emotions in post-traumatic stress disorder (PTSD) patients

    NARCIS (Netherlands)

    Broek, van den Egon L.; Sluis, van der Frans; Dijkstra, Ton; Westerink, Joyce; Krans, Martijn; Ouwerkerk, Martin

    2011-01-01

    A post-traumatic stress disorder (PTSD) is a severe stress disorder and, as such, a severe handicap in daily life. To this date, its treatment is still a big endeavor for therapists. This chapter discusses an exploration towards automatic assistance in treating patients suffering from PTSD. Such ass

  2. 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.

  3. Beyond symptom self-report: use of a computer "avatar" to assess post-traumatic stress disorder (PTSD) symptoms.

    Science.gov (United States)

    Myers, Catherine E; Radell, Milen L; Shind, Christine; Ebanks-Williams, Yasheca; Beck, Kevin D; Gilbertson, Mark W

    2016-11-01

    Post-traumatic stress disorder (PTSD) can occur in the wake of exposure to a traumatic event. Currently, PTSD symptoms are assessed mainly through self-report in the form of questionnaire or clinical interview. Self-report has inherent limitations, particularly in psychiatric populations who may have limited awareness of deficit, reduced attention span, or poor vocabulary and/or literacy skills. Diagnosis and evaluation of treatment efficacy would be aided by behavioral measures. A viable alternative may be virtual environments, in which the participant guides an on-screen "avatar" through a series of onscreen events meant to simulate real-world situations. Here, a sample of 82 veterans, self-assessed for PTSD symptoms was administered such a task, in which the avatar was confronted with situations that might evoke avoidant behavior, a core feature of PTSD. Results showed a strong correlation between PTSD symptom burden and task performance; in fact, the ability to predict PTSD symptom burden based on simple demographic variables (age, sex, combat exposure) was significantly improved by adding task score as a predictor variable. The results therefore suggest that virtual environments may provide a new way to assess PTSD symptoms, while avoiding at least some of the limitations associated with symptom self-report, and thus might be a useful complement to questionnaire or clinical interview, potentially facilitating both diagnosis and evaluation of treatment efficacy.

  4. Discrepancy in diagnosis and treatment of post-traumatic stress disorder (PTSD): treatment for the wrong reason.

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    Meltzer, Ellen C; Averbuch, Tali; Samet, Jeffrey H; Saitz, Richard; Jabbar, Khelda; Lloyd-Travaglini, Christine; Liebschutz, Jane M

    2012-04-01

    In primary care (PC), patients with post-traumatic stress disorder (PTSD) are often undiagnosed. To determine variables associated with treatment, this cross-sectional study assessed 592 adult patients for PTSD. Electronic medical record (EMR) review of the prior 12 months assessed mental health (MH) diagnoses and MH treatments [selective serotonin reuptake inhibitor (SSRI) and/or ≥1 visit with MH professional]. Of 133 adults with PTSD, half (49%; 66/133) received an SSRI (18%), a visit with MH professional (14%), or both (17%). Of those treated, 88% (58/66) had an EMR MH diagnosis, the majority (71%; 47/66) depression and (18%; 12/66) PTSD. The odds of receiving MH treatment were increased 8.2 times (95% CI 3.1-21.5) for patients with an EMR MH diagnosis. Nearly 50% of patients with PTSD received MH treatment, yet few had this diagnosis documented. Treatment was likely due to overlap in the management of PTSD and other mental illnesses.

  5. The Anti-Inflammatory Effects of Blueberries in an Animal Model of Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Ebenezer, Philip J; Wilson, C Brad; Wilson, Leslie D; Nair, Anand R; J, Francis

    2016-01-01

    Post-traumatic stress disorder (PTSD) is a trauma and stressor-related disorder that results in a prolonged stress response. It is associated with increased oxidative stress and inflammation in the prefrontal cortex (PFC) and hippocampus (HC). The only approved therapy for PTSD is selective serotonin re-uptake inhibitors (SSRIs), but their efficacy is marginal. Recently, we demonstrated that over-production of norepinephrine (NE) as the possible reason for the lack of efficacy of SSRIs. Hence, there is a need for novel therapeutic approaches for the treatment of PTSD. In this study, we investigated the anti-inflammatory role of blueberries in modulating inflammatory markers and neurotransmitter levels in PTSD. Rats were fed either a blueberry enriched (2%) or a control diet. Rats were exposed to cats for one hour on days 1 and 11 of a 31-day schedule to simulate traumatic conditions. The rats were also subjected to psychosocial stress via daily cage cohort changes. At the end of the study, the rats were euthanized and the PFC and HC were isolated. Monoamines were measured by high-performance liquid chromatography. Reactive oxygen species (ROS), gene and protein expression levels of inflammatory cytokines were also measured. In our PTSD model, NE levels were increased and 5-HT levels were decreased when compared to control. In contrast, a blueberry enriched diet increased 5-HT without affecting NE levels. The rate limiting enzymes tyrosine hydroxylase and tryptophan hydroxylase were also studied and they confirmed our findings. The enhanced levels free radicals, gene and protein expression of inflammatory cytokines seen in the PTSD group were normalized with a blueberry enriched diet. Decreased anxiety in this group was shown by improved performance on the elevated plus-maze. These findings indicate blueberries can attenuate oxidative stress and inflammation and restore neurotransmitter imbalances in a rat model of PTSD.

  6. Ashamed and Afraid: A Scoping Review of the Role of Shame in Post-Traumatic Stress Disorder (PTSD

    Directory of Open Access Journals (Sweden)

    Tanya Saraiya

    2016-11-01

    Full Text Available Background: Despite considerable progress in the treatment of post-traumatic stress disorder (PTSD, a large percentage of individuals remain symptomatic following gold-standard therapies. One route to improving care is examining affective disturbances that involve other emotions beyond fear and threat. A growing body of research has implicated shame in PTSD’s development and course, although to date no review of this specific literature exists. This scoping review investigated the link between shame and PTSD and sought to identify research gaps. Methods: A systematic database search of PubMed, PsycInfo, Embase, Cochrane, and CINAHL was conducted to find original quantitative research related to shame and PTSD. Results: Forty-seven studies met inclusion criteria. Review found substantial support for an association between shame and PTSD as well as preliminary evidence suggesting its utility as a treatment target. Several design limitations and under-investigated areas were recognized, including the need for a multimodal assessment of shame and more longitudinal and treatment-focused research. Conclusion: This review provides crucial synthesis of research to date, highlighting the prominence of shame in PTSD, and its likely relevance in successful treatment outcomes. The present review serves as a guide to future work into this critical area of study.

  7. SKA2 Methylation is Involved in Cortisol Stress Reactivity and Predicts the Development of Post-Traumatic Stress Disorder (PTSD) after Military Deployment

    OpenAIRE

    Boks, Marco P; Rutten, Bart P. F.; Geuze, Elbert; Houtepen, Lotte C.; Vermetten, Eric; Kaminsky, Zachary; Vinkers, Christiaan H

    2016-01-01

    Genomic variation in the SKA2 gene has recently been identified as a promising suicide biomarker. In light of its role in glucocorticoid receptor transactivation, we investigated whether SKA2 DNA methylation influences cortisol stress reactivity and is involved in the development of post-traumatic stress disorder (PTSD). Increased SKA2 methylation was significantly associated with lower cortisol stress reactivity in 85 healthy individuals exposed to the Trier Social Stress Test (B=-173.40, t=...

  8. Whiplash and post-traumatic stress disorder

    NARCIS (Netherlands)

    Jaspers, JPC

    1998-01-01

    Purpose : This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed. Method: A review of the literature on psychological consequences of motor vehicle accidents and on ris

  9. 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

  10. 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

  11. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART(®)).

    Science.gov (United States)

    Kip, Kevin E; Elk, Carrie A; Sullivan, Kelly L; Kadel, Rajendra; Lengacher, Cecile A; Long, Christopher J; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F; Street, Jennifer D; Girling, Sue Ann; Diamond, David M

    2012-06-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART(®)) that incorporates the use of eye movements administered in a brief treatment period (1-5 one-hour sessions within three weeks). Eighty adults aged 21-60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants' mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD.

  12. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD by Use of Accelerated Resolution Therapy (ART®

    Directory of Open Access Journals (Sweden)

    Kevin E. Kip

    2012-06-01

    Full Text Available Post-Traumatic Stress Disorder (PTSD is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART® that incorporates the use of eye movements administered in a brief treatment period (1–5 one-hour sessions within three weeks. Eighty adults aged 21–60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants’ mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5% completed treatment, and 54 of 66 (81.8% provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p < 0.0001 for all pre-ART vs. post-ART and 2-month comparisons. No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD.

  13. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®)

    Science.gov (United States)

    Kip, Kevin E.; Elk, Carrie A.; Sullivan, Kelly L.; Kadel, Rajendra; Lengacher, Cecile A.; Long, Christopher J.; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F.; Street, Jennifer D.; Girling, Sue Ann; Diamond, David M.

    2012-01-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART®) that incorporates the use of eye movements administered in a brief treatment period (1–5 one-hour sessions within three weeks). Eighty adults aged 21–60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants’ mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD. PMID:25379218

  14. Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    M Yadollahie

    2011-12-01

    Full Text Available Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD. Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack, being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed “acute PTSD,” otherwise, it is called “chronic PTSD.” 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%–40%; the rate in rescue workers was 10%–20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%–32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%, firefighters (21%, and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work

  15. Post-traumatic Stress Disorder.

    Science.gov (United States)

    Javidi, H; Yadollahie, M

    2012-01-01

    Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with

  16. Economic Analysis of Post-Traumatic Stress Disorder (PTSD) in the Global War on Terrorism (GWOT)

    Science.gov (United States)

    2008-12-01

    include treatment costs, the costs of lives lost to suicide , and costs related to lost productivity (including reduced employment and lower earnings...the costs from treatment expenditures, lost productivity, and costs associated with suicide . The increasing trends in the treatment costs of PTSD...order to capture changes across the years. The fiscal-year variables indicate the fiscal year of the PSTD diagnosis date for the PTSD population and

  17. Utilization of machine learning for prediction of post-traumatic stress: a re-examination of cortisol in the prediction and pathways to non-remitting PTSD

    Science.gov (United States)

    Galatzer-Levy, I R; Ma, S; Statnikov, A; Yehuda, R; Shalev, A Y

    2017-01-01

    To date, studies of biological risk factors have revealed inconsistent relationships with subsequent post-traumatic stress disorder (PTSD). The inconsistent signal may reflect the use of data analytic tools that are ill equipped for modeling the complex interactions between biological and environmental factors that underlay post-traumatic psychopathology. Further, using symptom-based diagnostic status as the group outcome overlooks the inherent heterogeneity of PTSD, potentially contributing to failures to replicate. To examine the potential yield of novel analytic tools, we reanalyzed data from a large longitudinal study of individuals identified following trauma in the general emergency room (ER) that failed to find a linear association between cortisol response to traumatic events and subsequent PTSD. First, latent growth mixture modeling empirically identified trajectories of post-traumatic symptoms, which then were used as the study outcome. Next, support vector machines with feature selection identified sets of features with stable predictive accuracy and built robust classifiers of trajectory membership (area under the receiver operator characteristic curve (AUC)=0.82 (95% confidence interval (CI)=0.80–0.85)) that combined clinical, neuroendocrine, psychophysiological and demographic information. Finally, graph induction algorithms revealed a unique path from childhood trauma via lower cortisol during ER admission, to non-remitting PTSD. Traditional general linear modeling methods then confirmed the newly revealed association, thereby delineating a specific target population for early endocrine interventions. Advanced computational approaches offer innovative ways for uncovering clinically significant, non-shared biological signals in heterogeneous samples. PMID:28323285

  18. Xenon impairs reconsolidation of fear memories in a rat model of post-traumatic stress disorder (PTSD.

    Directory of Open Access Journals (Sweden)

    Edward G Meloni

    Full Text Available Xenon (Xe is a noble gas that has been developed for use in people as an inhalational anesthestic and a diagnostic imaging agent. Xe inhibits glutamatergic N-methyl-D-aspartate (NMDA receptors involved in learning and memory and can affect synaptic plasticity in the amygdala and hippocampus, two brain areas known to play a role in fear conditioning models of post-traumatic stress disorder (PTSD. Because glutamate receptors also have been shown to play a role in fear memory reconsolidation--a state in which recalled memories become susceptible to modification--we examined whether Xe administered after fear memory reactivation could affect subsequent expression of fear-like behavior (freezing in rats. Male Sprague-Dawley rats were trained for contextual and cued fear conditioning and the effects of inhaled Xe (25%, 1 hr on fear memory reconsolidation were tested using conditioned freezing measured days or weeks after reactivation/Xe administration. Xe administration immediately after fear memory reactivation significantly reduced conditioned freezing when tested 48 h, 96 h or 18 d after reactivation/Xe administration. Xe did not affect freezing when treatment was delayed until 2 h after reactivation or when administered in the absence of fear memory reactivation. These data suggest that Xe substantially and persistently inhibits memory reconsolidation in a reactivation and time-dependent manner, that it could be used as a new research tool to characterize reconsolidation and other memory processes, and that it could be developed to treat people with PTSD and other disorders related to emotional memory.

  19. Xenon impairs reconsolidation of fear memories in a rat model of post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Meloni, Edward G; Gillis, Timothy E; Manoukian, Jasmine; Kaufman, Marc J

    2014-01-01

    Xenon (Xe) is a noble gas that has been developed for use in people as an inhalational anesthestic and a diagnostic imaging agent. Xe inhibits glutamatergic N-methyl-D-aspartate (NMDA) receptors involved in learning and memory and can affect synaptic plasticity in the amygdala and hippocampus, two brain areas known to play a role in fear conditioning models of post-traumatic stress disorder (PTSD). Because glutamate receptors also have been shown to play a role in fear memory reconsolidation--a state in which recalled memories become susceptible to modification--we examined whether Xe administered after fear memory reactivation could affect subsequent expression of fear-like behavior (freezing) in rats. Male Sprague-Dawley rats were trained for contextual and cued fear conditioning and the effects of inhaled Xe (25%, 1 hr) on fear memory reconsolidation were tested using conditioned freezing measured days or weeks after reactivation/Xe administration. Xe administration immediately after fear memory reactivation significantly reduced conditioned freezing when tested 48 h, 96 h or 18 d after reactivation/Xe administration. Xe did not affect freezing when treatment was delayed until 2 h after reactivation or when administered in the absence of fear memory reactivation. These data suggest that Xe substantially and persistently inhibits memory reconsolidation in a reactivation and time-dependent manner, that it could be used as a new research tool to characterize reconsolidation and other memory processes, and that it could be developed to treat people with PTSD and other disorders related to emotional memory.

  20. post traumatic stress disorder among motor vehicle accident ...

    African Journals Online (AJOL)

    hi-tech

    2004-07-07

    Jul 7, 2004 ... the orthopaedic and trauma clinic at Kenyatta National Hospital, Nairobi. Design: A ... single leading cause of post traumatic stress disorder. (PTSD) in the ..... workers(13,16) who reported that "horrific and intensive memories" ...

  1. [The post-traumatic stress disorder].

    Science.gov (United States)

    Olff, Miranda

    2013-01-01

    Many people experience a potentially traumatic event during their lives, which can result in brief periods of post-traumatic stress symptoms; this is a normal reaction. Most people can deal with a traumatic event when supported by significant others, but 10% of them develop post-traumatic stress disorder (PTSD). The nature of the traumatic event, the duration of exposure and the age at which one experiences such an event partly determine whether a person will develop PTSD. Psychological debriefing (a single-session consultation) does not prevent the development of PTSD; it is therefore not useful to offer this to everyone who has experienced a traumatic event. New and promising developments have, however, arisen in this regard. Trauma-focused psychotherapy has proved to be effective for patients with PTSD, possibly in combination with medication. Individuals who experience many or severe initial symptoms after a traumatic event may benefit from early, short-term, trauma-focused psychotherapy for preventing the development of chronic PTSD. Developments pertaining to the DSM-5 pay more attention to 'complex' PTSD, a type which is often the result of long-term traumatisation during childhood.

  2. Pharmacotherapy of post-traumatic stress disorder.

    Science.gov (United States)

    Opler, Lewis A; Grennan, Michelle S; Opler, Mark G

    2006-12-01

    In the Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, DSM-III-R and DSM-IV, the diagnosis of post-traumatic stress disorder (PTSD) requires the presence of three symptom clusters: re-experiencing, avoidance and hyperarousal. The selective serotonin reuptake inhibitors (SSRIs), in particular sertraline and paroxetine, have emerged as the treatment of choice for trauma victims experiencing these three symptom clusters. While not approved by the U.S. Food and Drug Administration, other pharmacological agents are often used, some for symptoms found in victims of early, chronic or extreme stress. Referred to as having type II trauma, complex PTSD, disorders of extreme stress and enduring personality change after catastrophic experience, these patients, with symptoms such as dissociation, somatization and self-injurious behavior, need to be recognized as suffering from a trauma-related disorder qualitatively different from that presently captured in the DSM-IV. In this paper we will refer to DSM-IV's construct as simple PTSD (sPTSD); to complex PTSD/disorders of extreme stress as cPTSD/DES; and to both as PTSD. We will review existing evidence for the efficacy of SSRIs in treating sPTSD as well as different pharmacological interventions that are necessary for the treatment of cPTSD/DES. In addition, since both sPTSD and cPTSD/DES frequently coexist with other mental disorders, treatment of comorbid PTSD will be addressed. Finally, given that existing rating scales are not designed to measure symptoms of cPTSD/DES, we will describe the Symptoms of Trauma Scale (SOTS), designed to measure symptoms of both sPTSD and cPTSD.

  3. Occurrence of delayed-onset post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Utzon-Frank, Nicolai; Breinegaard, Nina; Bertelsen, Mette

    2014-01-01

    Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1-6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic...

  4. The synchronous neural interactions test as a functional neuromarker for post-traumatic stress disorder (PTSD): a robust classification method based on the bootstrap

    Science.gov (United States)

    Georgopoulos, A. P.; Tan, H.-R. M.; Lewis, S. M.; Leuthold, A. C.; Winskowski, A. M.; Lynch, J. K.; Engdahl, B.

    2010-02-01

    Traumatic experiences can produce post-traumatic stress disorder (PTSD) which is a debilitating condition and for which no biomarker currently exists (Institute of Medicine (US) 2006 Posttraumatic Stress Disorder: Diagnosis and Assessment (Washington, DC: National Academies)). Here we show that the synchronous neural interactions (SNI) test which assesses the functional interactions among neural populations derived from magnetoencephalographic (MEG) recordings (Georgopoulos A P et al 2007 J. Neural Eng. 4 349-55) can successfully differentiate PTSD patients from healthy control subjects. Externally cross-validated, bootstrap-based analyses yielded >90% overall accuracy of classification. In addition, all but one of 18 patients who were not receiving medications for their disease were correctly classified. Altogether, these findings document robust differences in brain function between the PTSD and control groups that can be used for differential diagnosis and which possess the potential for assessing and monitoring disease progression and effects of therapy.

  5. SKA2 Methylation is Involved in Cortisol Stress Reactivity and Predicts the Development of Post-Traumatic Stress Disorder (PTSD) After Military Deployment.

    Science.gov (United States)

    Boks, Marco P; Rutten, Bart P F; Geuze, Elbert; Houtepen, Lotte C; Vermetten, Eric; Kaminsky, Zachary; Vinkers, Christiaan H

    2016-04-01

    Genomic variation in the SKA2 gene has recently been identified as a promising suicide biomarker. In light of its role in glucocorticoid receptor transactivation, we investigated whether SKA2 DNA methylation influences cortisol stress reactivity and is involved in the development of post-traumatic stress disorder (PTSD). Increased SKA2 methylation was significantly associated with lower cortisol stress reactivity in 85 healthy individuals exposed to the Trier Social Stress Test (B=-173.40, t=-2.324, p-value=0.023). Next, we observed that longitudinal decreases in SKA2 methylation after deployment were associated with the emergence of post-deployment PTSD symptoms in a Dutch military cohort (N=93; B=-0.054, t=-3.706, p-value=3.66 × 10(-4)). In contrast, exposure to traumatic stress during deployment by itself resulted in longitudinal increases in SKA2 methylation (B=0.037, t=4.173, p-value=6.98 × 10(-5)). Using pre-deployment SKA2 methylation levels and childhood trauma exposure, we found that the previously published suicide prediction rule significantly predicted post-deployment PTSD symptoms (AUC=0.66, 95% CI: 0.53-0.79) with an optimal sensitivity of 0.81 and specificity of 0.91. Permutation analysis using random methylation loci supported these findings. Together, these data establish the importance of SKA2 for cortisol stress responsivity and the development of PTSD and provide further evidence that SKA2 is a promising biomarker for stress-related disorders including PTSD.

  6. [Clinical approach to post-traumatic stress disorders].

    Science.gov (United States)

    Boussaud, Marie

    2015-01-01

    A confrontation with death can lead to acute reactions of stress, followed possibly, after a phase of latency, by post-traumatic stress disorder (PTSD). PTSD is characterised by the appearance of a repetition syndrome combining reliving, hypervigilance and avoidance; comorbidities frequently arise, increasingthe risk of suicide. Caregivers have an important role to play in identifying them.

  7. The use of clonidine in post-traumatic stress disorder.

    Science.gov (United States)

    Porter, D M; Bell, C C

    1999-08-01

    This case report examines the use of clonidine to successfully treat a child suffering from post-traumatic stress disorder (PTSD). This case shows an unintentional washout period that exemplifies a cause-effect relationship between clonidine and the inhibition of reenactment symptoms of PTSD.

  8. A wait-list controlled pilot study of eye movement desensitization and reprocessing (EMDR) for children with post-traumatic stress disorder (PTSD) symptoms from motor vehicle accidents.

    Science.gov (United States)

    Kemp, Michael; Drummond, Peter; McDermott, Brett

    2010-01-01

    The present study investigated the efficacy of four EMDR sessions in comparison to a six-week wait-list control condition in the treatment of 27 children (aged 6 to 12 years) suffering from persistent PTSD symptoms after a motor vehicle accident. An effect for EMDR was identified on primary outcome and process measures including the Child Post-Traumatic Stress-Reaction Index, clinician rated diagnostic criteria for PTSD, Subjective Units of Disturbance and Validity of Cognition scales. All participants initially met two or more PTSD criteria. After EMDR treatment, this decreased to 25% in the EMDR group but remained at 100% in the wait-list group. Parent ratings of their child's PTSD symptoms showed no improvement, nor did a range of non-trauma child self-report and parent-reported symptoms. Treatment gains were maintained at three and 12 month follow-up. These findings support the use of EMDR for treating symptoms of PTSD in children, although further replication and comparison studies are required.

  9. Prefrontal responses to digit span memory phases in patients with post-traumatic stress disorder (PTSD: A functional near infrared spectroscopy study

    Directory of Open Access Journals (Sweden)

    Fenghua Tian

    2014-01-01

    Full Text Available Neuroimaging studies of post-traumatic stress disorder (PTSD-related memory impairments have consistently implicated abnormal activities in the frontal and parietal lobes. However, most studies have used block designs and could not dissociate the multiple phases of working memory. In this study, the involvement of the prefrontal cortex in working memory phases was assessed among veterans with PTSD and age-/gender-matched healthy controls. Multichannel functional near infrared spectroscopy (fNIRS was utilized to measure prefrontal cortex hemodynamic activations during memory of neutral (i.e., not trauma-related forward and backward digit span tasks. An event-related experimental design was utilized to dissociate the different phases (i.e., encoding, maintenance and retrieval of working memory. The healthy controls showed robust hemodynamic activations during the encoding and retrieval processes. In contrast, the veterans with PTSD were found to have activations during the encoding process, but followed by distinct deactivations during the retrieval process. The PTSD participants, but not the controls, appeared to suppress prefrontal activity during memory retrieval. This deactivation was more pronounced in the right dorsolateral prefrontal cortex during the retrieval phase. These deactivations in PTSD patients might implicate an active inhibition of dorsolateral prefrontal neural activity during retrieval of working memory.

  10. Prefrontal responses to digit span memory phases in patients with post-traumatic stress disorder (PTSD): a functional near infrared spectroscopy study.

    Science.gov (United States)

    Tian, Fenghua; Yennu, Amarnath; Smith-Osborne, Alexa; Gonzalez-Lima, F; North, Carol S; Liu, Hanli

    2014-01-01

    Neuroimaging studies of post-traumatic stress disorder (PTSD)-related memory impairments have consistently implicated abnormal activities in the frontal and parietal lobes. However, most studies have used block designs and could not dissociate the multiple phases of working memory. In this study, the involvement of the prefrontal cortex in working memory phases was assessed among veterans with PTSD and age-/gender-matched healthy controls. Multichannel functional near infrared spectroscopy (fNIRS) was utilized to measure prefrontal cortex hemodynamic activations during memory of neutral (i.e., not trauma-related) forward and backward digit span tasks. An event-related experimental design was utilized to dissociate the different phases (i.e., encoding, maintenance and retrieval) of working memory. The healthy controls showed robust hemodynamic activations during the encoding and retrieval processes. In contrast, the veterans with PTSD were found to have activations during the encoding process, but followed by distinct deactivations during the retrieval process. The PTSD participants, but not the controls, appeared to suppress prefrontal activity during memory retrieval. This deactivation was more pronounced in the right dorsolateral prefrontal cortex during the retrieval phase. These deactivations in PTSD patients might implicate an active inhibition of dorsolateral prefrontal neural activity during retrieval of working memory.

  11. Preventive effects of ginsenoside Rg1 on post-traumatic stress disorder (PTSD)-like behavior in male C57/B6 mice.

    Science.gov (United States)

    Wang, Zhongli; Zhu, Kexuan; Chen, Lin; Ou Yang, Liufeng; Huang, Yufang; Zhao, Yunan

    2015-09-25

    We investigated the preventive effects of Rg1 on a model of mouse post-traumatic stress disorder (PTSD) induced by electric shock combined with situation reminder and explored the underlying mechanism. In the experiment, before the PTSD animal model was developed, Rg1 (10, 5, and 2.5mg/kg) was orally administered for one week. After the animal model was established, PTSD-like behavior was observed using elevated plus maze, black and light box, and open field tests. One hour after the behavior test, all mice were sacrificed, and then serum corticosterone (CORT) and hypothalamus corticotrophin-releasing hormone (CRH) assays were performed. Results showed that Rg1 (5mg/kg) treatments relieved PTSD-like behavior by altering elevated serum corticosterone and hypothalamus CRH levels. By contrast, fluoxetine (3mg/kg) treatment reversed the behavior changes and had no effect on increased CORT and CRH levels. These findings confirmed the preventive effect of Rg1 in PTSD model. Decreasing CORT and CRH levels may be one of the underlying mechanisms.

  12. Early post-stressor intervention with minocycline, a second-generation tetracycline, attenuates post-traumatic stress response in an animal model of PTSD.

    Science.gov (United States)

    Levkovitz, Yechiel; Fenchel, Daphna; Kaplan, Zeev; Zohar, Joseph; Cohen, Hagit

    2015-01-01

    We assessed the effects of minocycline, a tetracycline with anti-inflammatory, anti-apoptotic and neuroprotective capacities, in an animal model of post-traumatic stress disorder (PTSD). Rats were exposed to psychogenic stress and treated 1h later with minocycline or saline. Behavioral measures included the elevated plus-maze (EPM) and acoustic startle response (ASR) 7 days post stress-exposure. One day after behavioral testing, animals were exposed to a trauma cue and freezing response was assessed. Local levels of cytokines interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the hippocampus, frontal cortex (FC) and hypothalamus were then examined. Minocycline attenuated anxious-like behaviors in stress-exposed rats. In addition, decreased levels of cytokines were measured in exposed rats treated with minocycline compared to their counterparts treated with saline. This study suggests a potential use of minocycline in preventing physiological and behavioral alternations resulting from acute exposure to psychological stress. As this is the first study to report beneficial outcomes for minocycline treatment in an animal model of PTSD, further investigations of the use of minocycline in stress-related conditions with emphasis on PTSD is needed.

  13. Postpartum Post-Traumatic Stress Disorder

    Science.gov (United States)

    ... Depression During Pregnancy & Postpartum Anxiety During Pregnancy & Postpartum Pregnancy or Postpartum Obsessive Symptoms Postpartum Post-Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Social Support ...

  14. CAM and Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Alex Hankey

    2007-01-01

    Full Text Available In the form of the Transcendental Meditation program CAM offers a method of eliminating deep-rooted stress, the efficacy of which has been demonstrated in several related studies. Any discussion of CAM and post-traumatic stress disorder should include a study of its application to Vietnam War Veterans in which improvements were observed on all variables, and several participants were able to return to work after several years of being unable to hold a job. The intervention has been studied for its impact on brain and autonomic nervous system function. It has been found to be highly effective against other stress-related conditions such as hypertension, and to improve brain coherence—a measure of effective brain function. It should be considered a possible ‘new and improved mode of treatment’ for PTSD, and further studies of its application made.

  15. Post traumatic stress disorder symptoms in a psychiatric population ...

    African Journals Online (AJOL)

    2006-05-12

    May 12, 2006 ... Post Traumatic Stress Disorder (PTSD) is an anxiety disorder currently defined by the ... emotional numbing and a sense of loss of pleasure. • Hyperarousal cluster ... being diagnosed with a life threatening illness and natural disasters.1 While primary care physicians may identify symptoms of depression ...

  16. The auditory startle response in post-traumatic stress disorder

    NARCIS (Netherlands)

    Siegelaar, S. E.; Olff, M.; Bour, L. J.; Veelo, D.; Zwinderman, A. H.; van Bruggen, G.; de Vries, G. J.; Raabe, S.; Cupido, C.; Koelman, J. H. T. M.; Tijssen, M. A. J.

    2006-01-01

    Post-traumatic stress disorder (PTSD) patients are considered to have excessive EMG responses in the orbicularis oculi (OO) muscle and excessive autonomic responses to startling stimuli. The aim of the present study was to gain more insight into the pattern of the generalized auditory startle reflex

  17. Children and adolescents treated for post-traumatic stress disorder ...

    African Journals Online (AJOL)

    Children and adolescents can develop post-traumatic stress disorder (PTSD) after ... political or community violence, violent crime, physical and sexual abuse, ... the Free State Psychiatric Complex (FSPC) were screened for the diagnosis of ... isolation (39%), fear or anxiety (37%), problematic family relationships (29%), ...

  18. Diagnosing and treating post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Buhmann, Cæcilie Böck; Andersen, Henrik Steen

    2017-01-01

    The post-traumatic stress disorder (PTSD) diagnosis has undergone large developments. With the changes in DSM-5 and the proposed changes in ICD-11, the two systems move in different directions. Treatment for PTSD is developing, but the evidence for the effect is lacking behind. Trauma-focused cog......-focused cognitive behavioural therapy and eye movement desensitization and reprocessing remain first choice. Pharmacotherapy is secondary. There is evidence for the effect of paroxetine, venlafaxine and fluoxetine and less so for sertraline....

  19. SKA2 Methylation is Involved in Cortisol Stress Reactivity and Predicts the Development of Post-Traumatic Stress Disorder (PTSD) after Military Deployment

    NARCIS (Netherlands)

    Boks, Marco P.; Rutten, Bart P F; Geuze, Elbert; Houtepen, Lotte C.; Vermetten, Eric; Kaminsky, Zachary; Vinkers, Christiaan H.

    2016-01-01

    Genomic variation in the SKA2 gene has recently been identified as a promising suicide biomarker. In light of its role in glucocorticoid receptor transactivation, we investigated whether SKA2 DNA methylation influences cortisol stress reactivity and is involved in the development of post-traumatic s

  20. ANIMAL MODELS OF POST-TRAUMATIC STRESS DISORDER: FACE VALIDITY

    Directory of Open Access Journals (Sweden)

    SONAL eGOSWAMI

    2013-05-01

    Full Text Available Post-traumatic stress disorder (PTSD is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma.

  1. Exercise augmentation compared to usual care for Post Traumatic Stress Disorder: A Randomised Controlled Trial (The REAP study: Randomised Exercise Augmentation for PTSD

    Directory of Open Access Journals (Sweden)

    van der Ploeg Hidde P

    2011-07-01

    Full Text Available Abstract Background The physical wellbeing of people with mental health conditions can often be overlooked in order to treat the primary mental health condition as a priority. Exercise however, can potentially improve both the primary psychiatric condition as well as physical measures that indicate risk of other conditions such as diabetes mellitus and cardiovascular disease. Evidence supports the role of exercise as an important component of treatment for depression and anxiety, yet no randomised controlled trials (RCT's have been conducted to evaluate the use of exercise in the treatment of people with post traumatic stress disorder (PTSD. This RCT will investigate the effects of structured, progressive exercise on PTSD symptoms, functional ability, body composition, physical activity levels, sleep patterns and medication usage. Methods and design Eighty participants with a Diagnostic and Statistical Manual of Mental Disorders (DSM-IV diagnosis of PTSD will be recruited. Participants will have no contraindications to exercise and will be cognitively able to provide consent to participate in the study. The primary outcome measures will be PTSD symptoms, measured through the PTSD Checklist Civilian (PCL-C scale. Secondary outcome measures will assess depression and anxiety, mobility and strength, body composition, physical activity levels, sleep patterns and medication usage. All outcomes will be assessed by a health or exercise professional masked to group allocation at baseline and 12 weeks after randomisation. The intervention will be a 12 week individualised program, primarily involving resistance exercises with the use of exercise bands. A walking component will also be incorporated. Participants will complete one supervised session per week, and will be asked to perform at least two other non-supervised exercise sessions per week. Both intervention and control groups will receive all usual non-exercise interventions including psychotherapy

  2. [Family-centered care and post-traumatic stress disorder].

    Science.gov (United States)

    Lin, Chia-Huei; Sun, Yin-Jhen; Tzeng, Wen-Chii; Chiang, Li-Chi

    2012-06-01

    A year has passed since a major earthquake and tsunami hit northeastern Honshu, Japan in March 2011. Amidst mourning for the tens of thousands of victims, survivors have just begun the difficult and urgent tasks of rebuilding. Many survivors suffer from post-traumatic stress disorder (PTSD). PTSD causes chronic, long-term suffering for patients and their families and inevitably burdens social and medical care systems. This article tries to integrate PTSD evidence-based treatment experiences into a practical and detailed nursing intervention protocol for PTSD. We also elicit the function and effect of "family-centered care." We hope that nursing professionals apply family-centered care principles to PTSD treatment and care approaches in order to promote PTSD patient resilience. Nurses can thus enhance PTSD care efficacy and improve the opportunity for PTSD patients to overcome their symptoms and recover their life.

  3. Lasting consequences of traumatic events on behavioral and skeletal parameters in a mouse model for post-traumatic stress disorder (PTSD.

    Directory of Open Access Journals (Sweden)

    Hongrun Yu

    Full Text Available BACKGROUND: Post-traumatic stress disorder (PTSD is an anxiety disorder that not only affects mental health, but may also affect bone health. However, there have been no studies to examine the direct relationship between PTSD and bone. METHODOLOGY/PRINCIPAL FINDINGS: We employed electric shocks in mice to simulate traumatic events that cause PTSD. We also injected the anxiogenic drug FG-7142 prior to electric shocks. Electric shocks created lasting conditioned fear memory in all mice. In young mice, electric shocks elicited not only behavioral response but also skeletal response, and injection of FG-7142 appeared to increase both types of response. For example in behavioral response within the first week, mice shocked alone froze an average of 6.2 sec in 10 sec tests, and mice injected with FG-7142 froze 7.6 sec, both significantly different (P<0.05 from control mice, which only froze 1.3 sec. In skeletal response at week 2, shocks alone reduced 6% bone mineral content (BMC in total body (P = 0.06, while shocks with FG-7142 injection reduced not only 11% BMC (P<0.05 but also 6% bone mineral density (BMD (P<0.05. In addition, FG-7142 injection also caused significant reductions of BMC in specific bones such as femur, lumbar vertebra, and tibia at week 3. Strong negative correlations (R(2 = -0.56, P<0.05 and regression (y = 0.2527-0.0037 * x, P<0.01 between freezing behavior and total body BMC in young mice indicated that increased contextual PTSD-like behavior was associated with reduced bone mass acquisition. CONCLUSIONS/SIGNIFICANCE: This is the first study to document evidence that traumatic events induce lasting consequences on both behavior and skeletal growth, and electric shocks coupled with injection of anxiogenic FG-7142 in young mice can be used as a model to study the effect of PTSD-like symptoms on bone development.

  4. The Mutual Prospective Influence of Child and Parental Post-Traumatic Stress Symptoms in Pediatric Patients

    Science.gov (United States)

    Landolt, Markus A.; Ystrom, Eivind; Sennhauser, Felix H.; Gnehm, Hanspeter E.; Vollrath, Margarete E.

    2012-01-01

    Background: Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study…

  5. The Mutual Prospective Influence of Child and Parental Post-Traumatic Stress Symptoms in Pediatric Patients

    Science.gov (United States)

    Landolt, Markus A.; Ystrom, Eivind; Sennhauser, Felix H.; Gnehm, Hanspeter E.; Vollrath, Margarete E.

    2012-01-01

    Background: Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study…

  6. Understanding the Impact of Having a Military Father with Post Traumatic Stress Disorder (PTSD) on Adolescent Children

    Science.gov (United States)

    2015-10-01

    Products 8 7. Participants & Other Collaborating Organisations 9 8. Special Reporting Requirements 10 9. References 10 10. Appendices 12 5 1...Risk Management Team Leader training Sept ‘15 KR, NP 7 Managing your research data Oct ‘15 KR Essentials of copyright - what academic staff need...symptomology on adolescent emotional well-being and behaviour . 2. Examine the influence of paternal PTSD symptomology on parent-child communication, family

  7. Post Traumatic Stress Disorder/PTSD in adolescent victims of sexual abuse: resilience and social support as protection factors

    Directory of Open Access Journals (Sweden)

    Martine Hébert

    2014-03-01

    Full Text Available This analysis examined the contribution of personal, family (maternal and paternal support; sibling support and extra-familiar (peer support; other adults resilience to the prediction of clinical levels of PTSD symptoms in adolescents reporting sexual abuse. Controls were established for abuse-related variables (type of abuse, severity and multiple abuse in a representative sample of high schools students in the province of Quebec. A total of 15.2% of adolescent females and 4.4% adolescent males in high school reported a history of sexual abuse in childhood. Sexually abused adolescent females (27.8% were more likely than adolescent males (14.9% to achieve scores with high clinical levels of PTSD. Hierarchical logistic regression revealed that over and above the characteristics of the sexual abuse experienced, resilience factors (maternal and peer support contributed to the prediction of symptoms of PTSD attaining the clinical threshold. Alternative intervention and prevention practices geared to adolescent victims of sexual assault are discussed.

  8. Reduction of prefrontal thickness in military police officers with post-traumatic stress disorder

    OpenAIRE

    Baldaçara,Leonardo; Araújo, Célia; Assunção,Idaiane; Silva,Ivaldo da; Jackowski, Andrea Parolin [UNIFESP

    2017-01-01

    Abstract Background Brain-imaging studies in post-traumatic stress disorder (PTSD) have consistently revealed alterations in brain structure and function and this is correlated to symptomatology. However, few studies have investigated the role of biomarkers in PTSD some specific groups, as police officers. Objective To evaluate prefrontal and limbic volumes, and cortical thickness of police officers exposed to trauma during work who developed post-traumatic stress disorder, resilient matc...

  9. Formation of the U.S. Air Force Aviator Post Traumatic Stress Disorder Study Group

    Science.gov (United States)

    2016-11-15

    ABSTRACT The first aviator mental health study groups (post-traumatic stress disorder (PTSD) and antidepressants) were approved by the Chief of Aerospace...mental health study groups (post-traumatic stress disorder (PTSD) and antidepressants) were approved by the Chief of Aerospace Medicine for the...traffic controllers were now required to meet enhanced medical standards similar to traditional aircrew such as pilots, navigators, and loadmasters. In

  10. Post-Traumatic Stress Disorder and Group Leadership Instruction for Rehabilitation Counselors-in-Training

    Science.gov (United States)

    Moore, Nykeisha; Wadsworth, John; Cory, James

    2009-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety syndrome that can develop after exposure to a traumatic event in which harm occurred or was threatened. PTSD is often treated with group therapy. Rehabilitation counselors need to be aware of the group treatments for PTSD because counselors may be leaders of group therapy, may work with consumers…

  11. The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: A prospective study.

    NARCIS (Netherlands)

    Engelhard, I.M.; van den Hout, M.; Kindt, M.

    2003-01-01

    The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively,

  12. The relationship between neuroticism, pre-traumatic stress, and post-traumatic stress: A prospective study.

    NARCIS (Netherlands)

    Engelhard, I.M.; van den Hout, M.; Kindt, M.

    2003-01-01

    The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively, t

  13. New drug development for post-traumatic stress disorder.

    Science.gov (United States)

    Berlant, Jeffrey

    2003-01-01

    US FDA approval of two serotonin-selective reuptake inhibitor (SSRI) agents for post-traumatic stress disorder (PTSD) has created new opportunities for drug development. This follows many years of exploring the potential utility of several classes of psychotropic agents for this very common, yet under-recognized and under-treated disorder. This review examines some of the basic neurobiological abnormalities observed in PTSD and summarizes open and controlled drug trials for major classes of medications, including SSRIs, other antidepressants, atypical neuroleptics, noradrenergic modulators and anticonvulsants, while critically evaluating the extent of effectiveness of these agents and reviewing unmet gaps in therapeutic need.

  14. Post-traumatic stress disorder: theory and treatment update.

    Science.gov (United States)

    Kirkpatrick, Heather A; Heller, Grant M

    2014-01-01

    Post-traumatic stress disorder (PTSD) is one of the few mental disorders in which the cause is readily identifiable. In this article, we review the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) diagnostic criteria, prevalence, and presentation of patients with PTSD in primary care. The purpose of this article is to review current literature regarding theory, etiology, and treatment effectiveness. Key findings in terms of neurobiological underpinnings with implications for future treatment are discussed. Recommendations regarding effective psychotherapy and pharmacotherapy, emerging treatment, and management issues in primary care settings are offered.

  15. Be vigilant for post-traumatic stress reactions.

    Science.gov (United States)

    Hull, Alastair M; Curran, Stephen A

    2016-05-01

    Most people experience at least one potentially traumatic event (PTE) during their life. Many will develop only transient distress and not a psychological illness. Even the most inherently horrific event does not invariably lead to the development of a psychological disorder while an individual with sufficient vulnerabilit may develop post-traumatic stress disorder (PTSD) after what appears be an event of low magnitude. The diagnosis of PTSD differs fro most psychiatric disorders as it includes an aetiological factor, the traumatic event, as a core criterion. The DSM 5 core symptoms of PTSD are grouped into four key symptom clusters: re-experiencing, avoidance, negative cognitions and mood, and arousal. Symptoms must be present for at least one month and cause functional impairment. PTSD patients can avoid engaging in treatment and assertive follow-up may be necessary.

  16. The structure of post-traumatic stress disorder and complex post-traumatic stress disorder amongst West Papuan refugees.

    Science.gov (United States)

    Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick

    2015-05-07

    The validity of applying the construct of post-traumatic stress disorder (PTSD) across cultures has been the subject of contention. Although PTSD symptoms have been identified across multiple cultures, questions remain whether the constellation represents a coherent construct with an interpretable factor structure across diverse populations, especially those naïve to western notions of mental disorder. An important additional question is whether a constellation of Complex-PTSD (C-PTSD) can be identified and if so, whether there are distinctions between that disorder and core PTSD in patterns of antecedent traumatic events. Our study amongst West Papuan refugees in Papua New Guinea (PNG) aimed to examine the factorial structure of PTSD based on the DSM-IV, DSM-5, ICD-10 and ICD-11 definitions, and C-PTSD according to proposed ICD-11 criteria. We also investigated domains of traumatic events (TEs) and broader psychosocial effects of conflict (sense of safety and injustice) associated with the factorial structures identified. Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), refugees' sense of safety and justice, and symptoms of PTSD and C-PTSD amongst 230 West Papuan refugees residing in Port Morseby, PNG. Confirmatory factor analysis (CFA) supported a unitary construct of both ICD-10 and ICD-11 PTSD, comprising the conventional symptom subdomains of intrusion, avoidance, and hyperarousal. In contrast, CFA did not identify a unitary construct underlying C-PTSD. The interaction of witnessing murders and sense of injustice was associated with both the intrusion and avoidance domains of PTSD, but not with the unique symptom clusters characterizing C-PTSD. Our findings support the ICD PTSD construct and its three-factor structure in this transcultural refugee population. Traumatic experiences of witnessing murder associated with a sense of injustice were specifically related to the intrusion and avoidance domains of

  17. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review

    OpenAIRE

    Kar N

    2011-01-01

    Nilamadhab KarDepartment of Psychiatry, Wolverhampton City Primary Care Trust, Wolverhampton, UKBackground: Post-traumatic stress disorder (PTSD) is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT) has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods us...

  18. POST TRAUMATIC STRESS DISORDERS (PTSD WITH SEVERE DEPRESSION SYMPTOMS WITH ACUTE PSYCHOTIC IN PATIENT WITH HISTORY AS A PEDOPHILE VICTIMS AND DOMESTIC VIOLENCE IN 22 YEARS OLD MAN : A CASE REPORT

    Directory of Open Access Journals (Sweden)

    I Ketut Agus Indra Adhiputra

    2014-02-01

    Full Text Available Post traumatic stress disorders (PTSD is a disorder that is fairly common in thecommunity. Every event in the life will have its own meaning in later, especially eventsthat occur in childhood. Data in the U.S. showed 60% men and 50% women have atraumatic experience, which develops into PTSD approximately 6.7% of the entirepopulation. While data from the Indonesian National Commission of Women, since 20072010there has been 91311 cases of sexual violence against women, as well as cases ofchild sexual abuse reported to reach 250 cases. Presenting symptoms can range fromanxiety disorders, depression, until psychotic. The severity of symptoms depends on eachself-defense mechanism thus the PTSD symptoms are very diverse.

  19. Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder

    NARCIS (Netherlands)

    van Rooij, S J H; Kennis, M; Sjouwerman, R; van den Heuvel, M P; Kahn, R S; Geuze, E

    2015-01-01

    BACKGROUND: Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether h

  20. Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder

    NARCIS (Netherlands)

    Van Rooij, S. J H; Kennis, M.; Sjouwerman, R.; Van Den Heuvel, M. P.|info:eu-repo/dai/nl/304820466; Kahn, R. S.|info:eu-repo/dai/nl/073778532; Geuze, E.

    2015-01-01

    Background Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether hi

  1. Post-traumatic stress disorder following disasters: a systematic review

    Science.gov (United States)

    Neria, Y.; Nandi, A.; Galea, S.

    2016-01-01

    Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed. PMID:17803838

  2. Differential effects of sertraline in a predator exposure animal model of post-traumatic stress disorder

    OpenAIRE

    C. Brad eWilson; McLaughlin, Leslie D.; Ebenezer, Philip J.; Nair, Anand R.; Rahul eDange; Joseph G. Harre; Shaak, Thomas L.; Diamond, David M.; Joseph eFrancis

    2014-01-01

    Serotonin (5-HT), norepinephrine (NE), and other neurotransmitters are modulated in post-traumatic stress disorder (PTSD). In addition, pro-inflammatory cytokines (PIC) are elevated during the progression of the disorder. Currently, the only approved pharmacologic treatments for PTSD are the selective serotonin reuptake inhibitors (SSRI) sertraline and paroxetine, but their efficacy in treating PTSD is marginal at best. In combat-related PTSD, SSRIs are of limited effectiveness. Thus, thi...

  3. Suicidal behavior in adolescents with post-traumatic stress disorder.

    Science.gov (United States)

    Ganz, D; Sher, L

    2010-08-01

    Recently, the prevalence of post-traumatic stress disorder (PTSD) in adolescence is higher than the prevalence of PTSD in adult populations. PTSD and suicidality are often found in populations of adolescents presenting with other emotional disorders (particularly mood disorders), traumatic grief, childhood abuse, and/or a family or peer history of suicide. The reasons and developments of the association between PTSD and suicidality in adolescence, however, remain unclear. Core psychobiological changes contributing to PTSD affect emotion, arousal, perception of the self and the world, irritability, impulsivity, anger, aggression and depression. There is evidence that the aforementioned factors, as well as alcohol and other drug use may act to moderate the influence of stressful life events and lead to eventual suicidality. Both PTSD and suicidality in adolescents have also been hypothesized to be a result of exposure to violence and negative coping styles. There are many treatment challenges for these populations, yet the most promising prevention and treatments include suicide risk screenings, suicide education, Dialectical Behavioral Therapy, addressing associated coping mechanisms and prescribing anti-depressant and anti-anxiety medications. However, when prescribing medications, physicians do need to be careful to consider the weaknesses and strengths of each of the pharmacological options as they apply to adolescents presenting with PTSD and suicidality.

  4. Post-traumatic stress disorder in children and adolescents.

    Science.gov (United States)

    Chowdhury, Uttom; Pancha, Amit

    2011-12-01

    Post-traumatic stress disorder (PTSD) is a syndrome defined by the intrusive re-experiencing of trauma, avoidance of reminders of the trauma and increased hyperarousal. Although the condition is well established in adults, there is little research into PTSD in children and adolescents. The available research shows that young people experience similar symptoms to adults. Risk factors include family dysfunction, peer problems, greater exposure to the trauma and the presence of pre-existing psychiatric disorder such as anxiety. Protective factors include good coping skills, good relationship with a parent and support from others in the community. This article reviews treatment approaches to PTSD in young people in particular the use of cognitive behavioural therapy (CBT).

  5. Post-traumatic stress disorder: emerging concepts of pharmacotherapy.

    Science.gov (United States)

    Baker, Dewleen G; Nievergelt, Caroline M; Risbrough, Victoria B

    2009-06-01

    Post-traumatic stress disorder (PTSD) can result from a traumatic experience that elicits emotions of fear, helpless or horror. Most individuals remain asymptomatic or symptoms quickly resolve, but in a minority intrusive imagery and nightmares, emotional numbing and avoidance, and hyperarousal persist for decades. PTSD is associated with psychiatric and medical co-morbidities, increased risk for suicide, and with poor social and occupational functioning. Psychotherapy and pharmacotherapy are common treatments. Whereas, research supports the efficacy of the cognitive behavioral psychotherapies, there is insufficient evidence to unequivocally support the efficacy of any specific pharmacotherapy. Proven effective pharmacologic agents are sorely needed to treat core and targeted PTSD symptoms, and for prevention. This review describes current and emerging pharmacotherapies that advance these goals.

  6. Biological studies of post-traumatic stress disorder.

    Science.gov (United States)

    Pitman, Roger K; Rasmusson, Ann M; Koenen, Karestan C; Shin, Lisa M; Orr, Scott P; Gilbertson, Mark W; Milad, Mohammed R; Liberzon, Israel

    2012-11-01

    Post-traumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known: that is, an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular and molecular levels. This Review attempts to present the current state of this understanding on the basis of psychophysiological, structural and functional neuroimaging, and endocrinological, genetic and molecular biological studies in humans and in animal models.

  7. Cognitive processes in post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Gamze Yıldırımlı

    2012-11-01

    Full Text Available Post-traumatic Stress disorder (PTSD consists of a pattern of symptoms that include cognitive, affective, sensory and behavioral systems. In PTSD, the individual experiences disturbing emotions and sensations such as anxiety, panic, depression, anger, tension, high startle response and hypervigilance as a result of reexperiencing traumatic memories, flashbacks, attention difficulties, memory loss, nightmares and intrusive thoughts. The cognitive approach asserts that cognitions play a triggering and maintaining role for these symptoms and tries to explain them with the information processing framework. According to this approach, the traumatic event that is experienced is processed differently from daily, ordinary events. This different information processing strategy stands out in attention, memory, dissociation, cognitive beliefs, cognition-affect processes and coping strategies. In the present paper, research on how these constructs that are parts of the information processing in cognitive systems function in PTSD will be reviewed.

  8. Analysis of the Metabolic and Structural Brain Changes in Patients With Torture-Related Post-Traumatic Stress Disorder (TR-PTSD) Using ¹⁸F-FDG PET and MRI.

    Science.gov (United States)

    Zandieh, Shahin; Bernt, Reinhard; Knoll, Peter; Wenzel, Thomas; Hittmair, Karl; Haller, Joerg; Hergan, Klaus; Mirzaei, Siroos

    2016-04-01

    Many people exposed to torture later suffer from torture-related post-traumatic stress disorder (TR-PTSD). The aim of this study was to analyze the morphologic and functional brain changes in patients with TR-PTSD using magnetic resonance imaging (MRI) and positron emission tomography (PET). This study evaluated 19 subjects. Thirteen subcortical brain structures were evaluated using FSL software. On the T1-weighted images, normalized brain volumes were measured using SIENAX software. The study compared the volume of the brain and 13 subcortical structures in 9 patients suffering from TR-PTSD after torture and 10 healthy volunteers (HV). Diffusion-weighted imaging (DWI) was performed in the transverse plane. In addition, the 18F-FDG PET data were evaluated to identify the activity of the elected regions. The mean left hippocampal volume for the TR-PTSD group was significantly lower than in the HV group (post hoc test (Bonferroni) P PTSD and the HV group (post hoc test (Bonferroni) P PTSD group showed low significant expansion of the ventricles in contrast to the HV group (post hoc test (Bonferroni) P PTSD and HV group (post hoc test (Bonferroni) P PTSD, in the temporal lobe in 1 of the 9 patients, and in the caudate nucleus in 5 of the 9 patients. In 2 cases, additional hypometabolism was observed in the posterior cingulate cortex and in the parietal and frontal lobes. The findings from this study show that TR-PTSD might have a deleterious influence on a set of specific brain structures. This study also demonstrated that PET combined with MRI is sensitive in detecting possible metabolic and structural brain changes in TR-PTSD.

  9. Salivary cortisol and dehydroepiandrosterone sulfate in adolescent rape victims with post traumatic stress disorder

    NARCIS (Netherlands)

    Bicanic, Iva A. E.; Postma, Riemke M.; Sinnema, Gerben; De Roos, Carlijn; Olff, Miranda; Van Wesel, Floryt; Van de Putte, Elise M.

    2013-01-01

    Background: In chronic sexual abuse victims with post traumatic stress disorder (PTSD), the hypothalamic pituitary adrenal (HPA) axis can be dysregulated. In single rape victims, PTSD symptoms are hypothesized to function as a chronic stressor leading to similar HPA-axis dysregulation. The objective

  10. Reduced recognition of fear and sadness in post-traumatic stress disorder

    NARCIS (Netherlands)

    Poljac, E.; Montagne, B.; Haan, E.H.F. de

    2011-01-01

    Post-traumatic stress disorder (PTSD) is associated with impairments in emotional experience and expression. The current study examined the recognition of emotional facial expressions in PTSD patients and matched healthy controls, both in terms of accuracy and sensitivity. The task involved short

  11. Salivary cortisol and dehydroepiandrosterone sulfate in adolescent rape victims with post traumatic stress disorder

    NARCIS (Netherlands)

    Bicanic, Iva A. E.; Postma, Riemke M.; Sinnema, Gerben; De Roos, Carlijn; Olff, Miranda; Van Wesel, Floryt; Van de Putte, Elise M.

    2013-01-01

    Background: In chronic sexual abuse victims with post traumatic stress disorder (PTSD), the hypothalamic pituitary adrenal (HPA) axis can be dysregulated. In single rape victims, PTSD symptoms are hypothesized to function as a chronic stressor leading to similar HPA-axis dysregulation. The objective

  12. Recognition of Facial Emotions among Maltreated Children with High Rates of Post-Traumatic Stress Disorder

    Science.gov (United States)

    Masten, Carrie L.; Guyer, Amanda E.; Hodgdon, Hilary B.; McClure, Erin B.; Charney, Dennis S.; Ernst, Monique; Kaufman, Joan; Pine, Daniel S.; Monk, Christopher S.

    2008-01-01

    Objective: The purpose of this study is to examine processing of facial emotions in a sample of maltreated children showing high rates of post-traumatic stress disorder (PTSD). Maltreatment during childhood has been associated independently with both atypical processing of emotion and the development of PTSD. However, research has provided little…

  13. Project VALOR: design and methods of a longitudinal registry of post-traumatic stress disorder (PTSD) in combat-exposed veterans in the Afghanistan and Iraqi military theaters of operations.

    Science.gov (United States)

    Rosen, Raymond C; Marx, Brian P; Maserejian, Nancy N; Holowka, Darren W; Gates, Margaret A; Sleeper, Lynn A; Vasterling, Jennifer J; Kang, Han K; Keane, Terence M

    2012-03-01

    Few studies have investigated the natural history of post-traumatic stress disorder (PTSD). Project VALOR (Veterans' After-discharge Longitudinal Registry) was designed as a longitudinal patient registry assessing the course of combat-related PTSD among 1600 male and female Veterans who served in Operation Enduring Freedom (OEF) in Afghanistan or Operation Iraqi Freedom (OIF). Aims of the study include investigating patterns and predictors of progression or remission of PTSD and treatment utilization. The study design was based on recommendations from the Agency for Healthcare Quality and Research for longitudinal disease registries and used a pre-specified theoretical model to select the measurement domains for data collection and interpretation of forthcoming results. The registry will include 1200 male and female Veterans with a recent diagnosis of PTSD in the Department of Veteran Affairs (VA) electronic medical record and a comparison group of 400 Veterans without a medical record-based PTSD diagnosis, to also allow for case-control analyses. Data are collected from administrative databases, electronic medical records, a self-administered questionnaire, and a semi-structured diagnostic telephone interview. Project VALOR is a unique and timely registry study that will evaluate the clinical course of PTSD, psychosocial correlates, and health outcomes in a carefully selected cohort of returning OEF/OIF Veterans.

  14. DIAGNOSIS AND MANAGEMENT POST TRAUMATIC STRESS DISORDER IN SEXUAL ABUSE

    Directory of Open Access Journals (Sweden)

    Ni Made Apriliani Saniti

    2013-05-01

    Full Text Available Traumatic experiences may happen anytime in our life. The more terrible the situation, the bigger chance for a person to have post traumatic psychological problem, that is the Post Traumatic Stress Disorder (PTSD. Sexual abuse is a kind of traumatic event that caused psychological trauma/stress for the victim. In order to be able to manage patient with PTSD, physician should comprehend properties regarding PTSD, including proper treatment and management. Normal 0 false false false EN-US X-NONE X-NONE /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  15. Nightmare Frequency, Nightmare Distress and the Efficiency of Trauma-Focused Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder

    OpenAIRE

    Levrier; Marchand,, J.F.; Belleville; Dominic; Guay

    2016-01-01

    Background Up to 71% of trauma victims diagnosed with PTSD have frequent nightmares (NM), compared to only 2% to 5% of the general population. Objectives The present study examined whether nightmares before the beginning of cognitive behavior therapy (CBT) for post-traumatic stress disorder (PTSD) could influence overall PTSD symptom reduction for 71 individuals with PTSD and different types of traumatic events. ...

  16. Course of post-traumatic stress disorder and health care utilisation among resettled refugees in the Netherlands

    NARCIS (Netherlands)

    Lamkaddem, M.; Stronks, K.; Devillé, W.; Olff, M.; Gerritsen, A.A.M.; Essink-Bot, M.-L.

    2014-01-01

    Background: Post-traumatic stress disorder (PTSD) is a major health problem among refugees worldwide. After resettlement, the prevalence of PTSD remains high despite the fact that various PTSD treatments are known to be effective. Methods: We examined the course of PTSD and the role of mental health

  17. Course of post-traumatic stress disorder and health care utilisation among resettled refugees in the Netherlands.

    NARCIS (Netherlands)

    Lamkaddem, M.; Stronks, K.; Devillé, W.D.; Olff, M.; Gerritsen, A.A.M.; Essink-Bot, M.L.

    2014-01-01

    Background: Post-traumatic stress disorder (PTSD) is a major health problem among refugees worldwide. After resettlement, the prevalence of PTSD remains high despite the fact that various PTSD treatments are known to be effective. Methods: We examined the course of PTSD and the role of mental health

  18. Intimate Partner Violence and Post-Traumatic Stress Disorder Symptoms in Women: What We Know and Need to Know

    Science.gov (United States)

    Woods, Stephanie J.

    2005-01-01

    This article presents a review of knowledge regarding post-traumatic stress disorder (PTSD) in women experiencing intimate partner violence. Knowledge related to the prevalence and predictors of PTSD in battered women, the association between PTSD and physical health, and the emerging science regarding PTSD and physiological and immune parameters…

  19. Post-Traumatic Stress Disorder in Kosovo Veterans

    Directory of Open Access Journals (Sweden)

    Mimoza Shahini

    2016-03-01

    Full Text Available Objective: The objective of this study was to explore the prevalence of post-traumatic stress disorder (PTSD at veterans 8 years after war, to find out relation of PTSD with other demographic and health related variables and discover the impact of depression and trauma on PTSD on 687 veterans from six municipalities in Kosovo. Method: Participants were 687 war veterans selected from six regions of Kosovo during 2008. The Harvard Trauma Questionnaire (HTQ-40, was administered to measure PTSD and Hopkins Symptom Checklist (HSCL-25 for depression and anxiety. Pearson chi-square, analysis of variance (ANOVA, and multiple regressions were used to analyze the data. Results: Results indicated that 11.2 % of veterans even 8 years after the war ended were suffering from PTSD. Six percent of veterans with PTSD did not seek medical help. They reported to have had emotional problems and physical problems, but they did not seek medical help. The findings suggest that self-medication may be one way of veterans dealing with PTSD symptoms. Veterans with PTSD symptoms were more concerned with “family issues” than those without PTSD symptoms. Conclusions: The study found that 8 years after the war the veterans of the war in Kosovo suffer PTSD symptoms and that a good number of them do not seek help for this problem. The establishment of adequate services by the state would transform these veterans’ dealing with PTSD not into a moral challenge but into a fundamental right to equal and high-quality services.

  20. Early predictors of chronic post-traumatic stress disorder in assault survivors

    OpenAIRE

    Kleim, Birgit; Ehlers, Anke; Glucksman, Edward

    2007-01-01

    Background Some studies suggest that early psychological treatment is effective in preventing chronic post-traumatic stress disorder (PTSD), but it is as yet unclear how best to identify trauma survivors who need such intervention. This prospective longitudinal study investigated the prognostic validity of acute stress disorder (ASD), of variables derived from a meta-analysis of risk factors for PTSD, and of candidate cognitive and biological variables in predicting chronic PTSD following ass...

  1. Review of somatic symptoms in post-traumatic stress disorder.

    Science.gov (United States)

    Gupta, Madhulika A

    2013-02-01

    Post-traumatic stress disorder (PTSD) is associated with both (1) 'ill-defined' or 'medically unexplained' somatic syndromes, e.g. unexplained dizziness, tinnitus and blurry vision, and syndromes that can be classified as somatoform disorders (DSM-IV-TR); and (2) a range of medical conditions, with a preponderance of cardiovascular, respiratory, musculoskeletal, neurological, and gastrointestinal disorders, diabetes, chronic pain, sleep disorders and other immune-mediated disorders in various studies. Frequently reported medical co-morbidities with PTSD across various studies include cardiovascular disease, especially hypertension, and immune-mediated disorders. PTSD is associated with limbic instability and alterations in both the hypothalamic- pituitary-adrenal and sympatho-adrenal medullary axes, which affect neuroendocrine and immune functions, have central nervous system effects resulting in pseudo-neurological symptoms and disorders of sleep-wake regulation, and result in autonomic nervous system dysregulation. Hypervigilance, a central feature of PTSD, can lead to 'local sleep' or regional arousal states, when the patient is partially asleep and partially awake, and manifests as complex motor and/or verbal behaviours in a partially conscious state. The few studies of the effects of standard PTSD treatments (medications, CBT) on PTSD-associated somatic syndromes report a reduction in the severity of ill-defined and autonomically mediated somatic symptoms, self-reported physical health problems, and some chronic pain syndromes.

  2. Life satisfaction in people with post-traumatic stress disorder.

    Science.gov (United States)

    Karatzias, Thanos; Chouliara, Zoë; Power, Kevin; Brown, Keith; Begum, Millia; McGoldrick, Therese; MacLean, Rory

    2013-12-01

    There is limited research on the association between post-traumatic stress disorder (PTSD) and life satisfaction in community samples. We set out to investigate levels of life satisfaction and its demographic, trauma related and clinical predictors in a sample of people with PTSD (n = 46). Participants completed a battery of standardised self-report measures including Satisfaction with Life Scale, the PTSD Checklist and The Hospital Anxiety and Depression Scale. Our results indicated that people with moderately severe PTSD in the community are likely to experience lower levels of life satisfaction compared with those with other psychiatric conditions or those without any diagnoses. Multivariate analysis revealed that marital status and trauma symptoms were the only significant predictors of life satisfaction. In specific, being married and presenting with less severe posttraumatic symptomatology were both significantly associated with higher levels of life satisfaction in people with PTSD. The strong association between traumatic symptomatology and life satisfaction may indicate that routine assessment for life satisfaction or similar positive constructs in people with PTSD, referred for psychological therapies might be useful. Information on positive psychology constructs may facilitate capitalising on clients' strengths and not just on pathology.

  3. Work-related post-traumatic stress disorder.

    Science.gov (United States)

    Skogstad, M; Skorstad, M; Lie, A; Conradi, H S; Heir, T; Weisæth, L

    2013-04-01

    Work-related post-traumatic stress disorder (PTSD) is an important condition encountered by many occupational health practitioners. To carry out an in-depth review of the research on occupational groups that are at particular risk of developing work-related PTSD. A literature search was conducted in the databases OVID MEDLINE, OVID Embase, Ovid PsycINFO, ISI Web of Science and CSA Health and Safety Science Abstracts. Professionals such as police officers, firefighters and ambulance personnel often experience incidents that satisfy the stressor criterion for the PTSD diagnosis. Other professional groups such as health care professionals, train drivers, divers, journalists, sailors and employees in bank, post offices or in stores may also be subjected to work-related traumatic events. Work-related PTSD usually diminishes with time. Mental health problems prior to the traumatic event and weak social support increase the risk of PTSD. Prevention of work-related PTSD includes a sound organizational and psychosocial work environment, systematic training of employees, social support from colleagues and managers and a proper follow-up of employees after a critical event.

  4. Post-traumatic stress disorder and traumatic brain injury.

    Science.gov (United States)

    Motzkin, Julian C; Koenigs, Michael R

    2015-01-01

    Disentangling the effects of "organic" neurologic damage and psychological distress after a traumatic brain injury poses a significant challenge to researchers and clinicians. Establishing a link between traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD) has been particularly contentious, reflecting difficulties in establishing a unique diagnosis for conditions with overlapping and sometimes contradictory symptom profiles. However, each disorder is linked to a variety of adverse health outcomes, underscoring the need to better understand how neurologic and psychiatric risk factors interact following trauma. Here, we present data showing that individuals with a TBI are more likely to develop PTSD, and that individuals with PTSD are more likely to develop persistent cognitive sequelae related to TBI. Further, we describe neurobiological models of PTSD, highlighting how patterns of neurologic damage typical in TBI may promote or protect against the development of PTSD in brain-injured populations. These data highlight the unique course of PTSD following a TBI and have important diagnostic, prognostic, and treatment implications for individuals with a dual diagnosis.

  5. 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.

  6. Reiki: Application as a Modality of Integrative Therapy for Treating Post-Traumatic Stress Disorder and Other Wounded Warrior Issues

    Science.gov (United States)

    2015-02-17

    SUPPLEMENTARY NOTES 14. ABSTRACT Post-Traumatic Stress Disorder (PTSD) and suicides are on the rise in our military. After more than a decade of war, a large...Lanoy is also a Reiki Master. Abstract Post-Traumatic Stress Disorder (PTSD) and suicides are on the rise in our military. After more than a...pain, stress , depression, chronic fatigue syndrome, orthopedic conditions, anxiety and overall well-being. Much of the analysis has been done in regard

  7. Complex trauma of war captivity: a prospective study of attachment and post-traumatic stress disorder.

    Science.gov (United States)

    Solomon, Z; Dekel, R; Mikulincer, M

    2008-10-01

    Victims of war captivity sometimes suffer from complex post-traumatic stress disorder (PTSD), a unique form of PTSD that entails various alterations in personality. These alterations may involve changes in attachment orientation. The sample comprised two groups of veterans from the 1973 Yom Kippur War: 103 ex-prisoners of war (ex-POWs) and 106 comparable control veterans. They were assessed at two points in time, 18 years and 30 years after the war. Ex-POWs suffered from more post-traumatic symptoms than controls at both measurements points and these symptoms increased only among ex-POWs from Time 1 to Time 2. In addition, both attachment anxiety and attachment avoidance increased with time among ex-POWs, whereas they decreased slightly or remained stable among controls. Finally, the increases in attachment anxiety and avoidance were positively associated with the increase in post-traumatic symptoms among both study groups. Further analyses indicated that early PTSD symptoms predicted later attachment better than early attachment predicted later PTSD symptoms. The results suggest that: (1) complex traumas are implicated in attachment orientations and PTSD symptoms even many years after captivity; (2) there is an increase in attachment insecurities (anxiety, avoidance) and an increase in PTSD symptoms decades after the captivity; (3) and post-traumatic stress symptoms predict attachment orientations better than attachment orientations predict an increase in PTSD symptoms.

  8. Prazosin for Trauma Nightmares and Sleep Disturbances in Combat Veterans with Post-Traumatic Stress Disorder

    OpenAIRE

    Khazaie, Habibolah; Nasouri, Marzie; Ghadami, Mohammad Rasoul

    2016-01-01

    Background Prazosin is significantly effective to reduce sleep disturbance and trauma nightmare in patients with post-traumatic stress disorder (PTSD); however, results of different studies were evaluated. Objectives The current randomized clinical trial aimed to assess the effects of prazosin on sleep parameters and nightmares among veterans with chronic PTSD. Materials and Methods Thirty-two veterans with chronic war-induced PTSD and distressing nightmares were randomized into prazosin and ...

  9. Attachment organization in Arabic-speaking refugees with post traumatic stress disorder

    DEFF Research Database (Denmark)

    Riber, Karin

    2016-01-01

    As a part of an ongoing clinical study of refugees with post traumatic stress disorder (PTSD), the primary objective of the current study was to examine and describe the distribution of adult attachment patterns as assessed by the Adult Attachment Interview (AAI) in Arabic-speaking refugees......, 42% Preoccupied, 5% Cannot Classify) was found, in addition to high intake levels of post traumatic stress symptoms and comorbidity. Findings are compared with AAI studies of other PTSD or trauma samples, and the paper elaborates upon the methodological challenges in administering the AAI...

  10. Ad lib smoking in post-traumatic stress disorder: an electronic diary study.

    Science.gov (United States)

    Beckham, Jean C; Wiley, Matthew T; Miller, Susannah C; Dennis, Michelle F; Wilson, Sarah M; McClernon, F Joseph; Calhoun, Patrick S

    2008-07-01

    Using ambulatory methods for 1 week of monitoring, this study investigated the association between smoking and situational cues in 22 smokers with post-traumatic stress disorder (PTSD) and 23 smokers without PTSD. Generalized estimating equations contrasted 1,759 smoking and 1,088 nonsmoking situations by group status controlling for multiple covariates. PTSD smokers reported higher stress and PTSD symptoms across daily activities. For all smokers, higher nicotine dependence, craving, food and caffeine consumption, and being outside were related to smoking. PTSD smokers were more likely to smoke when experiencing PTSD symptoms, anxiety, and stress. Following smoking, smokers with PTSD reported a significant reduction in negative affect. These results are consistent with previous ambulatory findings regarding mood in smokers, and underscore that in smokers with PTSD, PTSD symptom variables as well as stress and anxiety are significantly associated with ad lib smoking.

  11. Pharmacotherapy as prophylactic treatment of post-traumatic stress disorder: a review of the literature.

    Science.gov (United States)

    Roque, Autumn Pearl

    2015-01-01

    Post-traumatic stress disorder has a lifetime prevalence of almost 9% in the United States. The diagnosis is associated with increased rates of comorbid substance abuse and increased rates of depression. Providers are taught how to diagnose and treat PTSD, but little discussion is devoted to how to prevent the disorder. Behavioral research in animal studies has provided some evidence for the use of medications in decreasing the fear response and the reconsolidation of memories. A heightened fear response and the re-experience of traumatic memory are key components for diagnosis. The purpose of this literature review is to examine the evidence for pharmacotherapy as prophylactic treatment in acute stress/trauma in order to prevent the development of post-traumatic stress disorder. The body of the review includes discussions on medications, medications as adjunct to script-driven imagery, and special considerations for military, first responders, and women. This article concludes with implications for practice and recommendations for future research. The key words used for the literature search were "prophylactic treatment of PTSD," "pharmacotherapy and trauma," "pharmacological prevention of PTSD," "beta blockers and the prevention of PTSD," "acute stress and prevention of PTSD," "propranolol and PTSD," "secondary prevention of PTSD," and "medications used to prevent PTSD." Findings were categorized by medications and medications as adjunct to script-driven imagery. The literature suggests that hydrocortisone, propranolol, and morphine may decrease symptoms and diagnosis of post-traumatic stress disorder.

  12. Updates on Pharmacological Treatment of Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Koirala, R; Søegaard, E G I; Thapa, S B

    2017-01-01

    Post-Traumatic Stress Disorder affects a significant proportion of those who have been exposed to exceptionally threatening or catastrophic events or situations such as earthquakes, rape and civil war. The condition can often become chronic and disabling. Medical intervention can therefore be of paramount importance. There are no national guidelines for trauma disorders in Nepal and there is a lack of adequate knowledge regarding drug treatment of PTSD among doctors and other service providers. Though psychotherapy is internationally regarded as the first line treatment for PTSD, it is often not feasible in Nepal due to lack of resources and skilled health workers in this field. The use of right psycho-pharmacotherapy is therefore important to reduce the burden of disease. A wide range of pharmacotherapy has been tested in the treatment of PTSD. This article is based on a selected sample of relevant articles from PubMed, PsycINFO, national guidelines from other countries and our own clinical experience. We have tried to give a concise and practical review regarding the use of drugs, their side effects and available evidence in the treatment of PTSD. The main findings point to use of Selective Serotonin Reuptake Inhibitors as the first line pharmacotherapy, and they can have effect on the full range of symptoms in PTSD. SNRIs show similar efficacy. Adjuvant drugs like Alpha-blockers and atypical antipsychotics have shown strong evidence in treating partially remitted cases and resolving ancillary symptoms.

  13. Simple and Complex Post-Traumatic Stress Disorder: Strategies for Comprehensive Treatment in Clinical Practice.

    Science.gov (United States)

    Williams, Mary Beth; Sommer, John F., Jr.

    This book delivers state-of-the-art techniques and information for practitioners to help individuals, groups, families, and communities suffering from post-traumatic stress disorder (PTSD). It addresses concerns about the efficacy of critical incident stress debriefing, examines the value of a variety of innovative treatment methods, and explores…

  14. Clinical correlates of plasma brain-derived neurotrophic factor in post-traumatic stress disorder spectrum after a natural disaster.

    Science.gov (United States)

    Stratta, Paolo; Sanità, Patrizia; Bonanni, Roberto L; de Cataldo, Stefano; Angelucci, Adriano; Rossi, Rodolfo; Origlia, Nicola; Domenici, Luciano; Carmassi, Claudia; Piccinni, Armando; Dell'Osso, Liliana; Rossi, Alessandro

    2016-10-30

    Clinical correlates of plasma Brain-Derived Neurotrophic Factor (BDNF) have been investigated in a clinical population with Post Traumatic Stress Disorder (PTSD) symptoms and healthy control subjects who survived to the L'Aquila 2009 earthquake. Twenty-six outpatients and 14 control subjects were recruited. Assessments included: Structured Clinical Interview for DSM-IV Axis-I disorders Patient Version, Trauma and Loss Spectrum-Self Report (TALS-SR) for post-traumatic spectrum symptoms. Thirteen patients were diagnosed as Full PTSD and 13 as Partial PTSD. The subjects with full-blown PTSD showed lower BDNF level than subjects with partial PTSD and controls. Different relationship patterns of BDNF with post-traumatic stress spectrum symptoms have been reported in the three samples. Our findings add more insight on the mechanisms regulating BDNF levels in response to stress and further proofs of the utility of the distinction of PTSD into full and partial categories.

  15. The auditory startle response in post-traumatic stress disorder.

    Science.gov (United States)

    Siegelaar, S E; Olff, M; Bour, L J; Veelo, D; Zwinderman, A H; van Bruggen, G; de Vries, G J; Raabe, S; Cupido, C; Koelman, J H T M; Tijssen, M A J

    2006-09-01

    Post-traumatic stress disorder (PTSD) patients are considered to have excessive EMG responses in the orbicularis oculi (OO) muscle and excessive autonomic responses to startling stimuli. The aim of the present study was to gain more insight into the pattern of the generalized auditory startle reflex (ASR). Reflex EMG responses to auditory startling stimuli in seven muscles rather than the EMG response of the OO alone as well as the psychogalvanic reflex (PGR) were studied in PTSD patients and healthy controls. Ten subjects with chronic PTSD (>3 months) and a history of excessive startling and 11 healthy controls were included. Latency, amplitude and duration of the EMG responses and the amplitude of the PGR to 10 auditory stimuli of 110 dB SPL were investigated in seven left-sided muscles. The size of the startle reflex, defined by the number of muscles activated by the acoustic stimulus and by the amplitude of the EMG response of the OO muscle as well, did not differ significantly between patients and controls. Median latencies of activity in the sternocleidomastoid (SC) (patients 80 ms; controls 54 ms) and the deltoid (DE) muscles (patients 113 ms; controls 69 ms) were prolonged significantly in PTSD compared to controls (P < 0.05). In the OO muscle, a late response (median latency in patients 308 ms; in controls 522 ms), probably the orienting reflex, was more frequently present in patients (56%) than in controls (12%). In patients, the mean PGR was enlarged compared to controls (P < 0.05). The size of the ASR response is not enlarged in PTSD patients. EMG latencies in the PTSD patients are prolonged in SC and DE muscles. The presence of a late response in the OO muscle discriminates between groups of PTSD patients with a history of startling and healthy controls. In addition, the autonomic response, i.e. the enlarged amplitude of the PGR can discriminate between these groups.

  16. Update on post-traumatic stress syndrome after anesthesia.

    Science.gov (United States)

    Aceto, P; Perilli, V; Lai, C; Sacco, T; Ancona, P; Gasperin, E; Sollazzi, L

    2013-07-01

    Between 0.5% and 2% of surgical patients undergoing general anesthesia may experience awareness with explicit recall. These patients are at a risk for developing anxiety symptoms which may be transient or can lead to post-traumatic stress disorder (PTSD). The aim of this review was to assess the prevalence of PTSD after intraoperative awareness episodes and analyze patients' complaints, type and timing of assessment used. PubMed, MEDLINE and The Cochrane Library were searched up until October 2012. Prospective and retrospective studies on human adult subjects describing prevalence of PTSD and/or psychological sequalae after awareness episodes were included. Seven studies were identified. Prevalence of PTSD ranged from 0 to 71%. Acute emotions such as fear, panic, inability to communicate and feeling of helplessness were the only patients' complaints that were significantly correlated to psychological sequelae including PTDS. There were cases that reported psychological symptoms after 2-6 hours from awakening (%) or 30 days after (%). Previous studies used psychological scales lacking of dissociation assessment. Whenever an awareness episode is suspected, a psychological assessment with at least three interviews at 2-6 h, 2-36 h and 30 days must be performed in order to collect symptoms associated with both early and delayed retrieval of traumatic event. As a dissociative state could hide the expression of reactive symptoms after intraoperative awareness, future studies should be focused on detecting dissociative symptoms in order to carry out a prompt and appropriate treatment aimed at avoiding long-term psychological disability.

  17. Prevalence of post-traumatic stress disorder in patients with previous myocardial infarction consulting in general practice

    OpenAIRE

    Jones, Rupert CM; Chung, Man C; Berger, Zoë; Campbell, John L.

    2007-01-01

    Reported prevalence of myocardial infarction-related post-traumatic stress disorder (PTSD) varies from 0 to 25%. PTSD after myocardial infarction may affect quality of life, cardiovascular outcomes, and health service usage. Of 164 patients with previous myocardial infarction, 111 participated in the study and 36 had PTSD, giving a prevalence of 32%; the lowest possible estimate being 22%. PTSD was associated with significantly worse general health than that of individuals without PTSD. Preva...

  18. The Materiality of Virtual War: Post-Traumatic Stress Disorder and the Disabling Effects of Imperialism

    Science.gov (United States)

    Jaffee, Laura Jordan

    2016-01-01

    A slew of recent news coverage has reported favorably on the use of virtual reality video games as a treatment for post-traumatic stress disorder (PTSD) in U.S. soldiers returning from Iraq and Afghanistan. Drawing on critical disability studies work, this paper argues that such depictions (re)produce a depoliticized framework for understanding…

  19. Structural brain aberrations associated with the dissociative subtype of post-traumatic stress disorder

    NARCIS (Netherlands)

    Daniels, J. K.; Frewen, P.; Theberge, J.; Lanius, R. A.

    2016-01-01

    ObjectiveOne factor potentially contributing to the heterogeneity of previous results on structural grey matter alterations in adult participants suffering from post-traumatic stress disorder (PTSD) is the varying levels of dissociative symptomatology. The aim of this study was therefore to test whe

  20. Vulnerability associations and symptoms of post-traumatic stress disorder in soldiers deployed to Iraq

    NARCIS (Netherlands)

    Engelhard, Iris M.; Huijding, Jorg; van den Hout, Marcel A.; de Jong, Peter J.

    2007-01-01

    The purpose of this prospective study was to examine whether explicit and implicit vulnerability associations before and after trauma exposure predict the onset and persistence of post-traumatic stress disorder (PTSD) symptoms. The implicit association test (IAT) was modified to assess associations

  1. Design guidelines for a virtual coach for post-traumatic stress disorder patients

    NARCIS (Netherlands)

    Tielman, M.; Brinkman, W.P.; Neerincx, M.A.

    2014-01-01

    Patients with Post Traumatic Stress Disorder (PTSD) often need to specify and relive their traumatic memories in therapy to relieve their disorder, which can be a very painful process. One new development is an internet-based guided self-therapy system (IBGST), where people work at home and a

  2. Women of valor: post-traumatic stress disorder in the dental practice.

    Science.gov (United States)

    Kloeffler, G Davis

    2015-01-01

    Dental professionals can intervene in head, neck and facial pain found in female patients who suffer from post-traumatic stress disorder (PTSD). There are three theories for why women are predisposed to pain: hormonal differences, nervous system rewiring and sympathetic issues. This article includes case studies of three patients who are representative of these theories. A rapid, nonintrusive intervention will also be described.

  3. A vulnerability paradox in the cross-national prevalence of post-traumatic stress disorder.

    NARCIS (Netherlands)

    Dückers, M.L.A.; Alisic, E.; Brewin, C.R.

    2016-01-01

    Background: Determinants of cross-national differences in the prevalence of mental illness are poorly understood. Aims: To test whether national post-traumatic stress disorder (PTSD) rates can be explained by (a) rates of exposure to trauma and (b) countries’ overall cultural and socioeconomic vuln

  4. Alcohol use, cigarette consumption and chronic post-traumatic stress disorder

    NARCIS (Netherlands)

    Op den Velde, W; Aarts, PGH; Falger, PRJ; Hovens, JE; van Duijn, H; de Groen, JHM; van Duijn, MAJ

    2002-01-01

    Aims: The relationship between alcohol consumption, cigarette smoking and post-traumatic stress disorder (PTSD) was studied in 147 male former members of the civilian resistance against the Nazi occupation of Holland during World War II. Methods: The subjects were interviewed at home. Measures inclu

  5. Social ecology interventions for post-traumatic stress disorder: what can we learn from child soldiers?

    Science.gov (United States)

    Kohrt, Brandon

    2013-09-01

    Research with child soldiers is crucial to improving mental health services after war. This research also can illuminate innovative approaches to treating post-traumatic stress disorder (PTSD) among adult soldiers, veterans and other trauma survivors in high-income countries. A key contribution is the role of social ecology for trauma-healing interventions.

  6. Intensive care diaries reduce new onset post traumatic stress disorder following critical illness

    DEFF Research Database (Denmark)

    Jones, Christina; Bäckman, Carl; Capuzzo, Maurizia

    2010-01-01

    Patients recovering from critical illness have been shown to be at risk of developing Post Traumatic Stress disorder (PTSD). This study was to evaluate whether a prospectively collected diary of a patient's intensive care unit (ICU) stay when used during convalescence following critical illness...

  7. Toward a Psychotherapy Integration Approach for Complex Post Traumatic Stress Disorder: A Critical Literature Review

    Science.gov (United States)

    Confer, Jacob Russell

    2013-01-01

    The symptoms, assessment, and treatments of Post Traumatic Stress Disorder (PTSD) have been empirically investigated to the extent that there is a breadth of valid and reliable instruments investigating this psychopathological syndrome. There, too, exists a substantial evidence base for various treatment models demonstrating effectiveness in…

  8. Implications of Neuroscientific Evidence for the Cognitive Models of Post-Traumatic Stress Disorder

    Science.gov (United States)

    Cruwys, Tegan; O'Kearney, Richard

    2008-01-01

    Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of…

  9. Secondary psychotic features in refugees diagnosed with post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Nygaard, Mette Kathrine; Sonne, Charlotte Kærgaard; Carlsson, Jessica

    2017-01-01

    BACKGROUND: A substantial amount of refugees (10-30%) suffer from Post-Traumatic Stress Disorder (PTSD). In Denmark there are different facilities specialised in psychiatric treatment of trauma-affected refugees. A previously published case report from such a facility in Denmark shows that some...

  10. [Post-traumatic stress disorder in schoolchildren after the 2011 earthquake in Lorca (Spain)].

    Science.gov (United States)

    López-García, Juan José; López-Soler, Concepción

    2014-01-01

    To determine the prevalence of post-traumatic stress disorder (PTSD) in children after the 2011 earthquake in Lorca (Spain). By using a cross-sequential design, children aged from 8 to 12 years (495 students at 1 month and 374 at 1 year) were assessed for full and partial PTSD using the Post-traumatic Children's Symptoms Stress Disorder Scale. The percentage of children with PTSD was 55.4% (65.6% of girls and 46.9% of boys) at 1 month and 40.1% (44.5% girls and 35.9% children) at 1 year. One in two young girls (8-10 years) had PTSD 1 year after the earthquake. A differential effect was observed due to gender and age, in which younger children, especially girls, were particularly at risk, even 1 year after the earthquake. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.

    Science.gov (United States)

    Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J

    2017-03-01

    Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments. © 2016 The British Psychological Society.

  12. Trauma and post-traumatic stress symptoms in former German child soldiers of World War II.

    Science.gov (United States)

    Kuwert, Philipp; Spitzer, Carsten; Rosenthal, Jenny; Freyberger, Harald J

    2008-10-01

    The aim of the study was to determine the amount of trauma impact and significant post-traumatic stress symptoms, which can indicate a possible post-traumatic stress disorder (PTSD), in a sample of former German child soldiers of World War II. 103 participants were recruited through the press, then administered a modified Post-traumatic Diagnostic Scale (PDS). Subjects reported a high degree of trauma exposure, with 4.9% reporting significant post-traumatic stress symptoms after WW II, and 1.9% reporting that these symptoms persist to the present. In line with other studies on child soldiers in actual conflict settings, our data document a high degree of trauma exposure during war. Surprisingly, the prevalence of significant post-traumatic stress symptoms indicating a possible PTSD was low compared to other groups of aging, long-term survivors of war trauma. Despite some limitations our data highlight the need for further studies to identify resilience and coping factors in traumatized child soldiers.

  13. Self-Inflicted Burns in Patients with Chronic Combat-Related Post-Traumatic Stress Disorder

    OpenAIRE

    Braš, Marijana; Lončar, Zoran; Boban, Maja; Gregurek, Rudolf; Brajković, Lovorka; Tomičić, Hrvoje; Muljačić, Ante; Mičković, Vlatko; Kalenić, Barbara

    2007-01-01

    This study examined self-inflicted burns in case series of four patients with chronic combat-related post-traumatic stress disorder (PTSD). Those patients were hospitalized in the Burn Unit of the University Hospital of Traumatology in Zagreb because of severe burns and had a premorbid psychiatric history of PTSD. Demographic data and information regarding the circumstances surrounding the incident, burn severity, treatment and outcomes of these patients were collected. The author...

  14. Cognitive processes in post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Gamze Yıldırımlı

    2012-11-01

    Full Text Available Post-Traumatic Stress Disorder (PTSD consists of a pattern of symptoms that include cognitive, affective, sensory and behavioral systems. In PTSD, the individual experiences disturbing emotions and sensations such as anxiety, panic, depression, anger, tension, high startle response and hyper-vigilance as a result of re-experiencing traumatic memories, flashbacks, attention difficulties, memory loss, nightmares and intrusive thoughts. To get rid of these emotions, he avoids all stimuli that remind the traumatic event. The cognitive approach asserts that cognitions play a triggering and maintaining role for these symptoms and tries to explain them with the information processing framework. According to this approach, the traumatic event that is experienced is processed differently from daily, ordinary events. This different information processing strategy stands out in attention, memory, dissociation, cognitive beliefs, cognition-affect processes and coping strategies. In the present paper, research on how these constructs that are parts of the information processing in cognitive systems function in PTSD will be reviewed.

  15. Post-traumatic stress disorder: a right temporal lobe syndrome?

    Science.gov (United States)

    Engdahl, B.; Leuthold, A. C.; Tan, H.-R. M.; Lewis, S. M.; Winskowski, A. M.; Dikel, T. N.; Georgopoulos, A. P.

    2010-12-01

    In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the magnetoencephalography (MEG)-based synchronous neural interactions (SNI) test to differentiate post-traumatic stress disorder (PTSD) subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with PTSD in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of PTSD and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.

  16. Prolonged Exposure Therapy For Post Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Levent SÜTÇİGİL

    2012-07-01

    Full Text Available Post-traumatic Stress Disorder (PTSD is a psychiatric illness that usually develops after an event that threatens one’s life and body integrity and it affects quality of life and impairs social functioning significantly. Many studies have shown therapeutic effect of cognitive behavioral therapies on posttraumatic stress disorder, so that these therapies take part in the first step of treatment guides. Exposure is a practice that is generally used to reduce pathological fear and related emotions common in posttraumatic stress disorder (PTSD and other anxiety disorders. During exposure, patients intentionally confront with feared objects, situations, thoughts and similar stimuli in order to reduce anxiety level. Exposure can be divided into two main techniques as in vivo exposure and imaginal exposure. Prolonged exposure therapy is a specialized treatment program configured for the treatment of posttraumatic stress disorder and it is based on emotional processing theory. Program is comprised of four main components: (a Psycho-education about trauma and posttraumatic disorders, (b Training for breathing exercises, (c repeated facing with objects, persons, situations and thoughts which causes re-experience about trauma, (d Patient are instructed for telling repeatedly and loudly about traumatic experiences . Prolonged exposure usually involves 9 to 12 sessions, each lasting about 60-90 minutes, administered once or twice a week. Prolonged exposure therapy was started to be implemented since the 1980s, during this period the effectiveness of the therapy has been shown in various empirical studies.

  17. Comorbidity between post-traumatic stress disorder and major depressive disorder: alternative explanations and treatment considerations.

    Science.gov (United States)

    Flory, Janine D; Yehuda, Rachel

    2015-06-01

    Approximately half of people with post-traumatic stress disorder (PTSD) also suffer from Major Depressive Disorder (MDD). The current paper examines evidence for two explanations of this comorbidity. First, that the comorbidity reflects overlapping symptoms in the two disorders. Second, that the co-occurrence of PTSD and MDD is not an artifact, but represents a trauma-related phenotype, possibly a subtype of PTSD. Support for the latter explanation is inferred from literature that examines risk and biological correlates of PTSD and MDD, including molecular processes. Treatment implications of the comorbidity are considered.

  18. Deep brain stimulation of the basolateral amygdala for treatment-refractory combat post-traumatic stress disorder (PTSD): study protocol for a pilot randomized controlled trial with blinded, staggered onset of stimulation.

    Science.gov (United States)

    Koek, Ralph J; Langevin, Jean-Philippe; Krahl, Scott E; Kosoyan, Hovsep J; Schwartz, Holly N; Chen, James W Y; Melrose, Rebecca; Mandelkern, Mark J; Sultzer, David

    2014-09-10

    Combat post-traumatic stress disorder (PTSD) involves significant suffering, impairments in social and occupational functioning, substance use and medical comorbidity, and increased mortality from suicide and other causes. Many veterans continue to suffer despite current treatments. Deep brain stimulation (DBS) has shown promise in refractory movement disorders, depression and obsessive-compulsive disorder, with deep brain targets chosen by integration of clinical and neuroimaging literature. The basolateral amygdala (BLn) is an optimal target for high-frequency DBS in PTSD based on neurocircuitry findings from a variety of perspectives. DBS of the BLn was validated in a rat model of PTSD by our group, and limited data from humans support the potential safety and effectiveness of BLn DBS. We describe the protocol design for a first-ever Phase I pilot study of bilateral BLn high-frequency DBS for six severely ill, functionally impaired combat veterans with PTSD refractory to conventional treatments. After implantation, patients are monitored for a month with stimulators off. An electroencephalographic (EEG) telemetry session will test safety of stimulation before randomization to staggered-onset, double-blind sham versus active stimulation for two months. Thereafter, patients will undergo an open-label stimulation for a total of 24 months. Primary efficacy outcome is a 30% decrease in the Clinician Administered PTSD Scale (CAPS) total score. Safety outcomes include extensive assessments of psychiatric and neurologic symptoms, psychosocial function, amygdala-specific and general neuropsychological functions, and EEG changes. The protocol requires the veteran to have a cohabiting significant other who is willing to assist in monitoring safety and effect on social functioning. At baseline and after approximately one year of stimulation, trauma script-provoked 18FDG PET metabolic changes in limbic circuitry will also be evaluated. While the rationale for studying DBS

  19. Coping strategies predict post-traumatic stress in patients with head and neck cancer.

    Science.gov (United States)

    Richardson, Amy E; Morton, Randall P; Broadbent, Elizabeth

    2016-10-01

    Evidence suggests that patients with head and neck cancer (HNC) are susceptible to post-traumatic stress disorder (PTSD). However, research is yet to examine predictors of PTSD symptoms in this patient group. The objective of this study was to investigate whether coping strategies at HNC diagnosis were related to outcomes of post-traumatic stress and health-related quality of life (HRQL) 6 months later. Sixty-five patients with HNC completed an assessment of coping, distress, and health-related quality of life at diagnosis and again 6 months later, and an assessment of post-traumatic stress at 6 months. Correlations and regression analyses were performed to examine relationships between coping and outcomes over time. Regression analyses showed that denial, behavioural disengagement and self-blame at diagnosis predicted post-traumatic stress symptoms. Self-blame at diagnosis also predicted poor HRQL. Results have implications for the development of psychological interventions that provide alternative coping strategies to potentially reduce PTSD symptoms and improve HRQL.

  20. Update on the management of post-traumatic stress disorder.

    Science.gov (United States)

    Wallace, Duncan; Cooper, John

    2015-04-01

    Post-traumatic stress disorder occurs in people exposed to life-threatening trauma. GPs may be seeing more patients with post-traumatic stress disorder as military personnel return from overseas deployments. The condition can present in various ways. To reduce the likelihood of missed or delayed diagnosis GPs can screen at-risk populations. A comprehensive assessment is recommended. Specialist referral may be required, particularly if there are other mental health problems. Trauma-focused psychological therapies should be offered as the first line of treatment for post-traumatic stress disorder. Usually 8-12 sessions are needed for a therapeutic effect. If drug treatment is needed, selective serotonin reuptake inhibitors are the first line. Other drugs used in post-traumatic stress disorder include antipsychotics, anticonvulsants and prazosin.

  1. The Effects of Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Combined Mild Traumatic Brain Injury/Post-Traumatic Stress Disorder on Returning Veterans.

    Science.gov (United States)

    Combs, Hannah L; Berry, David T R; Pape, Theresa; Babcock-Parziale, Judith; Smith, Bridget; Schleenbaker, Randal; Shandera-Ochsner, Anne; Harp, Jordan P; High, Walter M

    2015-07-01

    United States veterans of the Iraqi (Operation Iraqi Freedom [OIF]) and Afghanistan (Operation Enduring Freedom [OEF]) conflicts have frequently returned from deployment after sustaining mild traumatic brain injury (mTBI) and enduring stressful events resulting in post-traumatic stress disorder (PTSD). A large number of returning service members have been diagnosed with both a history of mTBI and current PTSD. Substantial literature exists on the neuropsychological factors associated with mTBI and PTSD occurring separately; far less research has explored the combined effects of PTSD and mTBI. The current study employed neuropsychological and psychological measures in a sample of 251 OIF/OEF veterans to determine whether participants with a history of mTBI and current PTSD (mTBI+PTSD) have poorer cognitive and psychological outcomes than participants with mTBI only (mTBI-o), PTSD only (PTSD-o), or veteran controls (VC), when groups are comparable on intelligence quotient, education, and age. The mTBI+PTSD group performed more poorly than VC, mTBI-o, and PTSD-o groups on several neuropsychological measures. Effect size comparisons suggest small deleterious effects for mTBI-o on measures of processing speed and visual attention and small effects for PTSD-o on measures of verbal memory, with moderate effects for mTBI+PTSD on the same variables. Additionally, the mTBI+PTSD group was significantly more psychologically distressed than the PTSD-o group, and PTSD-o group was more distressed than VC and mTBI-o groups. These findings suggest that veterans with mTBI+PTSD perform significantly lower on neuropsychological and psychiatric measures than veterans with mTBI-o or PTSD-o. The results also raise the possibility of mild but persisting cognitive changes following mTBI sustained during deployment.

  2. EMDR for post-traumatic stress and other psychological trauma.

    Science.gov (United States)

    Norgate, Kath

    Eye movement desensitisation and reprocessing (EMDR) is a powerful psychotherapy with well-researched benefits for adults and children who are experiencing post-traumatic stress and post-traumatic stress disorder. There is a wealth of research and practice-based evidence demonstrating the effectiveness of EMDR in many differing clinical presentations but the true potential of this extraordinarily beneficial therapeutic approach has not been fully embraced by the mental health nursing profession.

  3. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

    NARCIS (Netherlands)

    Bromet, E J; Atwoli, L; Kawakami, N; Navarro-Mateu, F; Piotrowski, P; King, A J; Aguilar-Gaxiola, S; Alonso, J; Bunting, B; Demyttenaere, K; Florescu, S; de Girolamo, G; Gluzman, S; Haro, J M; de Jonge, P; Karam, E G; Lee, S; Kovess-Masfety, V; Medina-Mora, M E; Mneimneh, Z; Pennell, B-E; Posada-Villa, J; Salmerón, D; Takeshima, T; Kessler, R C

    2016-01-01

    BACKGROUND: Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few

  4. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

    NARCIS (Netherlands)

    Bromet, E J; Atwoli, L; Kawakami, N; Navarro-Mateu, F; Piotrowski, P; King, A J; Aguilar-Gaxiola, S; Alonso, J; Bunting, B; Demyttenaere, K; Florescu, S; de Girolamo, G; Gluzman, S; Haro, J M; de Jonge, P; Karam, E G; Lee, S; Kovess-Masfety, V; Medina-Mora, M E; Mneimneh, Z; Pennell, B-E; Posada-Villa, J; Salmerón, D; Takeshima, T; Kessler, R C

    Background. Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few

  5. Predictive validity of the Trauma Screening Questionnaire in detecting post-traumatic stress disorder in patients with psychotic disorders

    NARCIS (Netherlands)

    de Bont, P.A.J.M.; van den Berg, D.P.G.; van der Vleugel, B.M.; de Roos, C.; de Jongh, A.; van der Gaag, M.; van Minnen, A.

    2015-01-01

    Background Post-traumatic stress disorder (PTSD) is highly prevalent in patients with a psychotic disorder. Because a PTSD diagnosis is often missed in patients with psychosis in routine care, a valid screening instrument could be helpful. Aims To determine the validity of the Trauma Screening Quest

  6. Refugee Children in Sweden: Post-Traumatic Stress Disorder in Iranian Preschool Children Exposed to Organized Violence.

    Science.gov (United States)

    Almqvist, Kjerstin; Brandell-Forsberg, Margareta

    1997-01-01

    Evaluation of the incidence of post-traumatic stress disorder (PTSD) in 50 preschool children from 47 Iranian families living as refugees in Sweden found a rise of PTSD from 2% to 21% in the 42 children with traumatic exposure through war and political persecution. Stability of prevalence was high in follow-up 2 and 2.5 years later. (Author/DB)

  7. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

    NARCIS (Netherlands)

    Bromet, E. J.; Atwoli, L.; Kawakami, N.; Navarro-Mateu, F.; Piotrowski, P.; King, A. J.; Aguilar-Gaxiola, S.; Alonso, J.; Bunting, B.; Demyttenaere, K.; Florescu, S.; de Girolamo, G.; Gluzman, S.; Haro, J. M.; de Jonge, P.; Karam, E. G.; Lee, S.; Kovess-Masfety, V.; Medina-Mora, M. E.; Mneimneh, Z.; Pennell, B. -E.; Posada-Villa, J.; Salmeron, D.; Takeshima, T.; Kessler, R. C.

    2017-01-01

    Background. Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20-40% range in disaster-focused studies but considerably lower (3-5%) in the few

  8. Boosting oxytocin after trauma: Effects of oxytocin on fear neurocircuitry in patients with post-traumatic stress disorder

    NARCIS (Netherlands)

    Koch, S.B.J.

    2016-01-01

    The neuropeptide oxytocin has been suggested as promising pharmacological agent to boost treatment response in post-traumatic stress disorder (PTSD). As first step to investigate the clinical potential of oxytocin in PTSD, a randomized placebo-controlled cross-over fMRI study was conducted in police

  9. Resting state functional connectivity of the anterior cingulate cortex in veterans with and without post-traumatic stress disorder

    NARCIS (Netherlands)

    Kennis, Mitzy; Rademaker, Arthur R.; van Rooij, Sanne J H; Kahn, René S.; Geuze, Elbert

    2015-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that is associated with structural and functional alterations in several brain areas, including the anterior cingulate cortex (ACC). Here, we examine resting state functional connectivity of ACC subdivisions in PTSD, using a seed-based

  10. Post-Traumatic Stress Disorder and Health Risk Behaviors among Afghanistan and Iraq War Veterans Attending College

    Science.gov (United States)

    Widome, Rachel; Kehle, Shannon M.; Carlson, Kathleen F.; Laska, Melissa Nelson; Gulden, Ashley; Lust, Katherine

    2011-01-01

    Objective: To determine if post-traumatic stress disorder (PTSD) is associated with health risk behaviors among Operations Enduring and Iraqi Freedom (OEF/OIF) veterans attending college. Method: Using 2008 Boynton College Student Health Survey data, we tested associations between self-reported PTSD diagnosis and self-reported risk behaviors…

  11. Post Traumatic Stress, Context, and the Lingering Effects of the Hurricane Katrina Disaster among Ethnic Minority Youth

    Science.gov (United States)

    Weems, Carl F.; Taylor, Leslie K.; Cannon, Melinda F.; Marino, Reshelle C.; Romano, Dawn M.; Scott, Brandon G.; Perry, Andre M.; Triplett, Vera

    2010-01-01

    This study examined the stability of post traumatic stress disorder (PTSD) symptoms in a predominantly ethnic minority sample of youth exposed to Hurricane Katrina. Youth (n = 191 grades 4th thru 8th) were screened for exposure to traumatic experiences and PTSD symptoms at 24 months (Time 1) and then again at 30 months (Time 2) post-disaster. PTSD…

  12. Blunted responses to reward in remitted post-traumatic stress disorder.

    Science.gov (United States)

    Kalebasi, Nilufer; Kuelen, Eveline; Schnyder, Ulrich; Schumacher, Sonja; Mueller-Pfeiffer, Christoph; Wilhelm, Frank H; Athilingam, Jegath; Moergeli, Hanspeter; Martin-Soelch, Chantal

    2015-08-01

    Recent evidence suggests blunted responses to rewarding stimuli in patients with post-traumatic stress disorder (PTSD). However, it is not clear whether these alterations in reward processing normalize in remitted PTSD patients. We tested behavioral and physiological responses to monetary reward in a spatial memory task in 13 accident survivors with remitted PTSD, 14 accident survivors who never had PTSD, and 16 nontrauma-exposed subjects. All accident survivors were recruited from two samples of severely physically injured patients, who had participated in previous prospective studies on the incidence of PTSD after accidental injury approximately 10 years ago. Reaction time, accuracy, skin conductance responses, and self-reported mood were assessed during the task. Accident survivors who never had PTSD and nontrauma exposed controls reported significantly higher positive mood in the reinforced versus nonreinforced condition (P factor for the development of PTSD after a traumatic event.

  13. Effects of post-traumatic stress disorder on occipital lobe function and structure.

    Science.gov (United States)

    Chao, Linda L; Lenoci, Maryann; Neylan, Thomas C

    2012-05-09

    Although there is evidence for strong connectivity between the amygdala and the visual cortex and some evidence for reduced occipital lobe gray matter volume in patients with post-traumatic stress disorder (PTSD), few studies have directly examined the effects of PTSD on occipital function. The current study used functional and structural MRI to examine occipital cortex function and structure in male combat veterans with and without PTSD. Left occipital gray matter volume was reduced in PTSD patients relative to the controls and correlated negatively with the severity of PTSD symptoms. Functional activity in the lateral occipital complex to aversive and nonaversive pictures presented in novel and repeated presentations was not altered by PTSD. These findings suggest that PTSD adversely affects occipital lobe volume but not the reactivity of the lateral occipital complex to generally aversive, trauma nonspecific stimuli.

  14. Disturbance in the neural circuitry underlying positive emotional processing in post-traumatic stress disorder (PTSD). An fMRI study.

    Science.gov (United States)

    Jatzko, Alexander; Schmitt, Andrea; Demirakca, Traute; Weimer, Erik; Braus, Dieter F

    2006-03-01

    This study was designed to investigate the circuitry underlying movie-induced positive emotional processing in subjects with chronic PTSD. Ten male subjects with chronic PTSD and ten matched controls were studied. In an fMRI-paradigm a sequence of a wellknown Walt Disney cartoon with positive emotional valence was shown. PTSD subjects showed an increased activation in the right posterior temporal, precentral and superior frontal cortex. Controls recruited more emotion-related regions bilateral in the temporal pole and areas of the left fusiform and parahippocampal gyrus. This pilot study is the first to reveal alterations in the processing of positive emotions in PTSD possibly reflecting a neuronal correlate of the symptom of emotional numbness in PTSD.

  15. Post-traumatic stress symptoms among former child soldiers in Sierra Leone: follow-up study.

    Science.gov (United States)

    Betancourt, Theresa S; Newnham, Elizabeth A; McBain, Ryan; Brennan, Robert T

    2013-09-01

    Former child soldiers are at risk of developing post-traumatic stress disorder (PTSD); however, the trajectory of symptoms has yet to be examined. The risk and protective factors associated with PTSD symptom change among former child soldiers in Sierra Leone were investigated. Data from 243 former child soldiers (mean age 16.6 years, 30% female) were analysed. Self-reported rates of possible PTSD using standard cut-off points declined from 32% to 16% 4 years later (Pchild soldiers despite limited access to care. Family and community support played a vital part in promoting psychological adjustment.

  16. Medically Related Post-traumatic Stress in Children and Adolescents with Congenital Heart Defects

    Science.gov (United States)

    Meentken, Maya G.; van Beynum, Ingrid M.; Legerstee, Jeroen S.; Helbing, Willem A.; Utens, Elisabeth M. W. J.

    2017-01-01

    Children and adolescents with a congenital heart defect (ConHD) frequently undergo painful or frightening medical procedures and hospitalizations. They often need multiple invasive procedures at a very young age and require regular checkups during their entire life. From other pediatric populations, it is known that these kinds of experiences can result in acute stress reactions and even in post-traumatic stress disorder (PTSD) in the long-term. PTSD and also subthreshold PTSD can lead to serious (psychosocial) impairment. However, limited information is available about PTSD in children with ConHD. Therefore, the aim of this review is to provide a summary of the current literature on post-traumatic stress (PTS) in children and adolescents with ConHD describing the prevalence of PTSD and its predictors/correlates. This review indicates that a range of 12–31% of children undergoing cardiac surgery develop PTSD. A range of 12–14% shows elevated post-traumatic stress symptoms (PTSS). These findings are comparable to those of hospitalized children without ConHD. Noteworthy, most studies used varying self-report questionnaires to measure PTSD and only one study used a semistructured interview. Although all studies point in the same direction of elevated PTSD and PTSS, systematic research is necessary to be able to draw firm conclusions. At present, as far as we know, in most clinics treating patients with ConHD, there is no regular screening for PTS in children with ConHD. In the reviewed literature, there is strong consensus that screening for PTSS and (preventive) psychological care for children and adolescents with ConHD is urgently needed. PMID:28243582

  17. Post-Traumatic Stress Disorder and the Military: A Selected Bibliography

    Science.gov (United States)

    2008-03-01

    ProQuest Russell, Mark C. “Treating Combat-Related Stress Disorders : A Multiple Case Study Utilizing Eye Movement Desensitization and Reprocessing ( EMDR ...use, PTSD, and generalized anxiety disorder . http://www.pdhealth.mil/mhsa.asp. U.S. Department of Veterans Affairs, National Center for Post...i POST-TRAUMATIC STRESS DISORDER AND THE MILITARY A Selected Bibliography Compiled by Lori M. Sekela U.S. Army War College Library Carlisle Barracks

  18. DIAGNOSTIC CHALLENGES IN ASSESSING POST-TRAUMATIC STRESS DISORDER.

    Directory of Open Access Journals (Sweden)

    Mariana Arnaudova

    2015-12-01

    Full Text Available Post-traumatic stress disorder (PTSD is one of those psychiatric disorders that are still away from our attention, understanding, assessment and proper management. What could be the reason as by its name and diagnostic criteria an etiological fact is specified, namely a specific traumatic event. In our paper we aim to share and elicit some difficulties that we have met in consulting, diagnostic and management of people, who have suffered a traumatic event. On the base of a review of current psychiatric classifications and ongoing discussions we briefly summarize and discuss important key points. The definition of the event, associated with PTSD is different in DSM-III (introduced for the fist time in a classification of mental disorders, DSM-IV and ICD-10. DSM-IV is less restrictive and includes events that occur more frequently. In DSM-5, PTSD is placed in chapter “Trauma and Stressor-related disorders” and the accent is on the variable clinical characteristics of psychological distress. Emotional reactions to the traumatic event are no longer part of Criterion A. The clinical presentation varies and a number of intrusive psychological and physiological reactions of distress are described. Here comes a problem- the assessment of the trauma itself and the determination of the basic symptoms, when such an event happens. So, the skills to assess the trauma, to determine and competently attribute these symptoms to the specific event and cluster are of great importance. We conclude that a number of risk and prognostic factors should be considered in the process of assessment, diagnosis and management.

  19. Specific symptoms predict suicidal ideation in Vietnam combat veterans with chronic post-traumatic stress disorder.

    Science.gov (United States)

    Bell, Jordan B; Nye, Ella C

    2007-11-01

    Previous research documented the elevated risk of suicide and suicidal ideation among Vietnam veterans with post-traumatic stress disorder (PTSD). The aim of the current study was to examine which Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, PTSD symptom clusters are most associated with suicidal ideation in this population. Fifty Vietnam combat veterans enrolled in treatment for PTSD responded to the Beck Scale for Suicide Ideation and were interviewed with the Clinician-Administered PTSD Scale. In linear regression analysis, it was found that the reexperiencing symptom cluster was significantly associated with suicidal ideation but the other two symptom clusters (avoidance/numbing and increased arousal) were not. Furthermore, scores on a measure of severity of combat exposure were not found to be significantly related to PTSD symptoms or suicidal ideation. The results of this study suggest the importance of reexperiencing symptoms for predicting which individuals with combat-related PTSD are most at risk for suicidal ideation and behavior.

  20. Exposure to workplace bullying and post-traumatic stress disorder symptomology: the role of protective psychological resources.

    Science.gov (United States)

    Spence Laschinger, Heather K; Nosko, Amanda

    2015-03-01

    To examine the relationship between nurses' exposure to workplace bullying and Post-Traumatic Stress Disorder symptomology and the protective role of psychological capital (PsyCap). Workplace bullying has serious organisational and health effects in nursing. Few studies have examined the relation of workplace bullying to serious mental health outcomes, such as Post-Traumatic Stress Disorder. Even fewer have examined the effect of intrapersonal strengths on the health impact of workplace bullying. A survey of 1205 hospital nurses was conducted to test the hypothesized model. Nurses completed standardized measures of bullying, Post-Traumatic Stress Disorder and PsyCap. A moderated regression analysis revealed that more frequent exposure to workplace bullying was significantly related to Post-Traumatic Stress Disorder symptomology regardless of the PsyCap level. That is, PsyCap did not moderate the bullying/PTSD relationship in either group. Bullying exposure and PsyCap were significant independent predictors of Post-Traumatic Stress Disorder symptoms in both groups. Efficacy, a subdimension of PsyCap, moderated the bullying/Post-Traumatic Stress Disorder relationship only among experienced nurses. Workplace bullying appears to be predictive of Post-Traumatic Stress Disorder symptomology, a serious mental health outcome. Workplace bullying is a serious threat to nurses' health and calls for programmes that eliminate bullying and encourage greater levels of positive resources among nurses. © 2013 John Wiley & Sons Ltd.

  1. Post-traumatic stress disorder and cardiovascular disease.

    Science.gov (United States)

    Edmondson, Donald; von Känel, Roland

    2017-04-01

    In this paper, a first in a Series of two, we look at the evidence for an association of post-traumatic stress disorder with incident cardiovascular disease risk and the mechanisms that might cause this association, as well as the prevalence of post-traumatic stress disorder due to cardiovascular disease events and its associated prognostic risk. We discuss research done after the publication of previous relevant systematic reviews, and survey currently funded research from the two most active funders in the field: the National Institutes of Health and the US Veterans Administration. We conclude that post-traumatic stress disorder is a risk factor for incident cardiovascular disease, and a common psychiatric consequence of cardiovascular disease events that might worsen the prognosis of the cardiovascular disease. There are many candidate mechanisms for the link between post-traumatic stress disorder and cardiovascular disease, and several ongoing studies could soon point to the most important behavioural and physiological mechanisms to target in early phase intervention development. Similarly, targets are emerging for individual and environmental interventions that might offset the risk of post-traumatic stress disorder after cardiovascular disease events.

  2. Attachment organization in Arabic-speaking refugees with post traumatic stress disorder.

    Science.gov (United States)

    Riber, Karin

    2016-01-01

    As a part of an ongoing clinical study of refugees with post traumatic stress disorder (PTSD), the primary objective of the current study was to examine and describe the distribution of adult attachment patterns as assessed by the Adult Attachment Interview (AAI) in Arabic-speaking refugees. A total of 43 adult male and female refugees with Iraqi and Palestinian backgrounds completed the AAI. Sixty-seven percent of the sample was classified as Unresolved with respect to loss or trauma and a substantial proportion of insecure attachment representations (14% Secure-Autonomous, 39% Dismissing, 42% Preoccupied, 5% Cannot Classify) was found, in addition to high intake levels of post traumatic stress symptoms and comorbidity. Findings are compared with AAI studies of other PTSD or trauma samples, and the paper elaborates upon the methodological challenges in administering the AAI in a context of simultaneous translation.

  3. Psychogenetics of post-traumatic stress disorder: a short review

    Directory of Open Access Journals (Sweden)

    Ahmed Rady

    2010-11-01

    Full Text Available Ahmed Rady, Adel Elsheshai, Osama Elkholy, Heba Abou el WafaDepartment of Psychiatry, Alexandria University, Alexandria, EgyptAbstract: Post-traumatic stress disorder is a commonly overlooked psychiatric disorder due to the heterogeneity of symptoms that may simulate many other psychiatric disorders. Such heterogeneity of manifestations may be explained by the multifaceted nature of the different neurotransmitters, endocrinologic axis, and their genetic basis, that are implicated in the etiology. Although this disorder has been studied from many different perspectives, its etiology is still enigmatic. This minireview demonstrates, in brief, that different susceptibility genes are associated with post traumatic stress disorder.Keywords: trauma, post traumatic stress disorder, psychogenetic, stress response, neurobiology

  4. Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder

    OpenAIRE

    McGuire TM; Lee CW; Drummond PD

    2014-01-01

    Tracy M McGuire, Christopher W Lee, Peter D Drummond School of Psychology, Murdoch University, Perth, WA, Australia Abstract: Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, ar...

  5. Serum total oxidant and antioxidant status in earthquake survivors with post-traumatic stress disorder.

    Science.gov (United States)

    Ozdemir, Pinar Guzel; Kaplan, İbrahim; Uysal, Cem; Bulut, Mahmut; Atli, Abdullah; Bez, Yasin; Kaya, Mehmet Cemal; Ozdemir, Osman

    2015-06-01

    Oxidative stress has been shown to play an important role in the pathogenesis of post-traumatic stress disorder (PTSD). Although there are some studies on oxidative stress and PTSD, there is no report available on the serum total oxidant and antioxidant status in earthquake survivors with PTSD. Therefore, this study aimed to investigate the serum total oxidant and antioxidant status in earthquake survivors with chronic PTSD. The study group included 45 earthquake survivors with PTSD and 40 earthquake survivors without PTSD. The oxidative status was determined using the total antioxidant status and total oxidant status (TOS) measurements and by calculating the oxidative stress index (OSI). There were no statistically significant differences in the total antioxidant status, TOS, or OSI when comparing individuals with and without PTSD (all, p>0.05). There were no correlations between Clinician-Administered PTSD Scale scores and oxidant and antioxidant stress markers (all, p>0.05). Our results suggest that the total oxidant and antioxidant status may not affect earthquake survivors with PTSD. This is the first study to evaluate the oxidative status in earthquake survivors with PTSD. Further studies are necessary to confirm these findings.

  6. Prevention of Post-Traumatic Stress Disorder After Trauma: Current Evidence and Future Directions.

    Science.gov (United States)

    Qi, Wei; Gevonden, Martin; Shalev, Arieh

    2016-02-01

    Post-traumatic stress disorder (PTSD) is a frequent, tenacious, and disabling consequence of traumatic events. The disorder's identifiable onset and early symptoms provide opportunities for early detection and prevention. Empirical findings and theoretical models have outlined specific risk factors and pathogenic processes leading to PTSD. Controlled studies have shown that theory-driven preventive interventions, such as cognitive behavioral therapy (CBT), or stress hormone-targeted pharmacological interventions, are efficacious in selected samples of survivors. However, the effectiveness of early clinical interventions remains unknown, and results obtained in aggregates (large groups) overlook individual heterogeneity in PTSD pathogenesis. We review current evidence of PTSD prevention and outline the need to improve the disorder's early detection and intervention in individual-specific paths to chronic PTSD.

  7. Psychotrauma and effective treatment of post-traumatic stress disorder in soldiers and peacekeepers

    Directory of Open Access Journals (Sweden)

    Quarcoo David

    2009-07-01

    Full Text Available Abstract Psychotrauma occurs as a result to a traumatic event, which may involve witnessing someone's actual death or personally experiencing serious physical injury, assault, rape and sexual abuse, being held as a hostage, or a threat to physical or psychological integrity. Post-traumatic stress disorder (PTSD is an anxiety disorder and was defined in the past as railway spine, traumatic war neurosis, stress syndrome, shell shock, battle fatigue, combat fatigue, or post-traumatic stress syndrome (PTSS. If untreated, post-traumatic stress disorder can impair relationships of those affected and strain their families and society. Deployed soldiers are especially at a high risk to be affected by PTSD but often receive inadequate treatment. Reviews to date have focused only on a single type of treatment or groups of soldiers from only one country. The aim of the current review was to evaluate characteristics of therapeutic methods used internationally to treat male soldiers' PTSD after peacekeeping operations in South Eastern Europe and the Gulf wars. This systematic literature review returned results pertaining to the symptoms, diagnosis, timing and effectiveness of treatment. Sample groups and controls were relatively small and, therefore, the results lack generalizability. Further research is needed to understand the influence and unique psychological requirements of each specific military operation on the internationally deployed soldiers.

  8. Post-traumatic stress disorder and suicidal behaviour in immigrants to Sweden

    OpenAIRE

    Ferrada-Noli, Marcello

    1996-01-01

    The aim of the investigation was to study definite & undetermined suicides in immigrants toSweden, as well as aspects of suicidal behaviour associated with Post-traumatic stress disorder(PTSD) among immigrants/refugees. We have also inquired in which modality immigrantsuicide victims had been in contact with psychiatric care. Likewise, psychosocial andsocioeconomic factors were studied with respect to differences in the suicide rate betweenimmigrants and native Swedes. The problem of the high...

  9. DUKUNGAN SOSIAL DAN POST-TRAUMATIC STRESS DISORDER PADA REMAJA PENYINTAS GUNUNG MERAPI

    Directory of Open Access Journals (Sweden)

    Fatwa Tentama

    2015-01-01

    Full Text Available Abstract The greatest eruption of the Mount Merapi took place in the past four-years. Various psychological problems were reported since then, one of which was post-traumatic stress disorder (PTSD. The survivors of Mt. Merapi eruption needed social support from the significant others. This study aims to empirically test the correlation between social support and PTSD on adolecescents survivor of Mt. Merapi’s eruption. Thirty junior high school students of SMP Negeri I Turi, Sleman, Yogyakarta, aged 12-15 years participated the study. Two scales were used to collect data: the Post-traumatic Stress Disorder Scale (15 items; α = 0.89 and Social Support Scale (16 items; α = 0.88. The results of product moment correlation analysis of Pearson revealed a negative significant correlation between social support and PTSD (r = -0.42; p = 0.02. This finding indicated that the less social support adolescent has received, the more severe they reported post-traumatic stress disorders.

  10. Acute and post-traumatic stress disorder after spontaneous abortion.

    Science.gov (United States)

    Bowles, S V; James, L C; Solursh, D S; Yancey, M K; Epperly, T D; Folen, R A; Masone, M

    2000-03-15

    When a spontaneous abortion is followed by complicated bereavement, the primary care physician may not consider the diagnosis of acute stress disorder or post-traumatic stress disorder. The major difference between these two conditions is that, in acute stress disorder, symptoms such as dissociation, reliving the trauma, avoiding stimuli associated with the trauma and increased arousal are present for at least two days but not longer than four weeks. When the symptoms persist beyond four weeks, the patient may have post-traumatic stress disorder. The symptoms of distress response after spontaneous abortion include psychologic, physical, cognitive and behavioral effects; however, patients with distress response after spontaneous abortion often do not meet the criteria for acute or post-traumatic stress disorder. After spontaneous abortion, as many as 10 percent of women may have acute stress disorder and up to 1 percent may have post-traumatic stress disorder. Critical incident stress debriefing, which may be administered by trained family physicians or mental health practitioners, may help patients who are having a stress disorder after a spontaneous abortion.

  11. Reduction of prefrontal thickness in military police officers with post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Leonardo Baldaçara

    Full Text Available Abstract Background Brain-imaging studies in post-traumatic stress disorder (PTSD have consistently revealed alterations in brain structure and function and this is correlated to symptomatology. However, few studies have investigated the role of biomarkers in PTSD some specific groups, as police officers. Objective To evaluate prefrontal and limbic volumes, and cortical thickness of police officers exposed to trauma during work who developed post-traumatic stress disorder, resilient matched controls (without PTSD, and compared to healthy civilians. Methods Prefrontal and limbic volumes, and cortical thickness of 12 police officers with PTSD, 12 resilient police officers, and 12 healthy civilians who underwent brain MRI were analyzed. Results Differences in limbic structures volume were not significative after Bonferroni correction. A significant reduction in cortical thickness on right rostral cingulate, right and left middle frontal gyrus, left superior frontal, left lingual, calcarine and cuneus were observed in PTSD group in comparison to controls was observed. Discussion Although preliminary, our results suggested not only the association between cortical thickness and PTSD, but also indicated that patients and controls have anatomical differences.

  12. Trait anxiety mediates the effect of stress exposure on post-traumatic stress disorder and depression risk in cardiac surgery patients

    NARCIS (Netherlands)

    Kok, Lotte; Sep, Milou S; Veldhuijzen, Dieuwke S; Cornelisse, Sandra; Nierich, Arno P; van der Maaten, Joost; Rosseel, Peter M; Hofland, Jan; Dieleman, Jan M; Vinkers, Christiaan H; Joëls, Marian; van Dijk, Diederik; Hillegers, Manon H

    2016-01-01

    BACKGROUND: Post-traumatic stress disorder (PTSD) and depression are common after cardiac surgery. Lifetime stress exposure and personality traits may influence the development of these psychiatric conditions. METHODS: Self-reported rates of PTSD and depression and potential determinants (i.e.,

  13. Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: a review

    Directory of Open Access Journals (Sweden)

    Kar N

    2011-04-01

    Full Text Available Nilamadhab KarDepartment of Psychiatry, Wolverhampton City Primary Care Trust, Wolverhampton, UKBackground: Post-traumatic stress disorder (PTSD is a psychiatric sequel to a stressful event or situation of an exceptionally threatening or catastrophic nature. Cognitive behavioral therapy (CBT has been used in the management of PTSD for many years. This paper reviews the effectiveness of CBT for the treatment of PTSD following various types of trauma, its potential to prevent PTSD, methods used in CBT, and reflects on the mechanisms of action of CBT in PTSD.Methods: Electronic databases, including PubMed, were searched for articles on CBT and PTSD. Manual searches were conducted for cross-references in the relevant journal sites.Results: The current literature reveals robust evidence that CBT is a safe and effective intervention for both acute and chronic PTSD following a range of traumatic experiences in adults, children, and adolescents. However, nonresponse to CBT by PTSD can be as high as 50%, contributed to by various factors, including comorbidity and the nature of the study population. CBT has been validated and used across many cultures, and has been used successfully by community therapists following brief training in individual and group settings. There has been effective use of Internet-based CBT in PTSD. CBT has been found to have a preventive role in some studies, but evidence for definitive recommendations is inadequate. The effect of CBT has been mediated mostly by the change in maladaptive cognitive distortions associated with PTSD. Many studies also report physiological, functional neuroimaging, and electroencephalographic changes correlating with response to CBT.Conclusion: There is scope for further research on implementation of CBT following major disasters, its preventive potential following various traumas, and the neuropsychological mechanisms of action.Keywords: post-traumatic stress disorder, cognitive behavioral therapy

  14. A randomized, controlled pilot study of MDMA (± 3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Oehen, Peter; Traber, Rafael; Widmer, Verena; Schnyder, Ulrich

    2013-01-01

    Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988-1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results. Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups. We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores (p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement (p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two (p = 0.016).

  15. Symptoms intensification of post-traumatic stress in individuals performing the job of a medical rescue worker

    Directory of Open Access Journals (Sweden)

    Ewa Ogłodek

    2011-09-01

    Full Text Available Background: The purpose of the task was the assessment of stress and the intensification of the symptoms of post-traumatic stress disorder (PTSD in the group of medical rescue workers. Material and methods: The research covered 36 individuals, working as medical rescue workers (18 males and 18 females; average age: 40.9. The medical rescue workers were employed in the Hospital Emergency Department. The control group composed of 34 patients (17 males and 17 females; average age: 39.6 the questionnaires were completed by individuals assessing the intensification of post-traumatic stress, namely Mississippi-C PTSD Scale, and assessed the ambience dominant in their workplace. Results: What was observed was significant interdependencies among the intensification of symptoms of post-traumatic stress in case of the interviewed groups of medical rescue workers. Conclusions: What becomes import, is to take preventive action in the field of mental health among medical rescue workers.

  16. Psychosocial predictors of chronic Post-Traumatic Stress Disorder in Sri Lankan tsunami survivors.

    Science.gov (United States)

    Lommen, Miriam J J; Sanders, Angelique J M L; Buck, Nicole; Arntz, Arnoud

    2009-01-01

    This study aimed to determine whether psychological factors associated with Post-Traumatic Stress Disorder (PTSD) identified in Western samples generalize to low Social-Economical-Status (SES) populations in an underdeveloped Asian country. The study included 113 survivors of the 2004-tsunami on the south coast of Sri Lanka, recruited from 4 preschools and 10 villages for displaced persons. With logistic regressions the relations between interview-based PTSD diagnosis and psychological factors were assessed, controlling for putative confounders. Fifteen months post-trauma the prevalence of PTSD was 52.2%. Multivariate analyses indicated that negative interpretation of tsunami-memories was significantly (PPTSD. Of the putative confounders, gender and (non-replaced) lost work equipment were related to current PTSD (PPTSD is quite universal, suggesting that interventions focusing on this factor may be important in treatment of tsunami survivors who are suffering from chronic PTSD.

  17. Brief Report: The Relationship between Post-Traumatic Stress Disorder Symptoms and Overgeneral Autobiographical Memory in Older Adults

    Science.gov (United States)

    Robinson, Sarah R.; Jobson, Laura A.

    2013-01-01

    Objective: The aim of this study was to investigate the relationship between post-traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults. Method: Older adult trauma survivors (N = 23) completed the Autobiographical Memory Test, Posttraumatic Stress Diagnostic Scale, and Addenbrooke's Cognitive…

  18. Brief Report: The Relationship between Post-Traumatic Stress Disorder Symptoms and Overgeneral Autobiographical Memory in Older Adults

    Science.gov (United States)

    Robinson, Sarah R.; Jobson, Laura A.

    2013-01-01

    Objective: The aim of this study was to investigate the relationship between post-traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults. Method: Older adult trauma survivors (N = 23) completed the Autobiographical Memory Test, Posttraumatic Stress Diagnostic Scale, and Addenbrooke's Cognitive…

  19. Chronic pain patients with possible co-morbid post-traumatic stress disorder admitted to multidisciplinary pain rehabilitation

    DEFF Research Database (Denmark)

    Andersen, Tonny Elmose; Andersen, Lou-Ann Christensen; Andersen, Per Grünwald

    2014-01-01

    BACKGROUND: Although post-traumatic stress disorder (PTSD) is a common co-morbidity in chronic pain, little is known about the association between PTSD and pain in the context of chronic pain rehabilitation. OBJECTIVE: The aim of the present study was two-fold: (1) to investigate the association......: A consecutively referred cohort of 194 patients completed a baseline questionnaire at admission covering post-traumatic stress, pain symptoms, physical and mental functioning, as well as self-reported sleep quality and cognitive difficulties. Medication use was calculated from their medical records. A total of 95...... as well as inferior social functioning compared to patients without PTSD. Possible co-morbid PTSD did not result in higher use of opioids or sedatives. Surprisingly, possible co-morbid PTSD at admission was not associated with lower levels of symptom reduction from pre- to post-treatment. CONCLUSIONS...

  20. Comorbidity between post-traumatic stress disorder and borderline personality disorder: a review.

    Science.gov (United States)

    Frías, Álvaro; Palma, Carol

    2015-01-01

    Traditionally, the presence of post-traumatic stress disorder (PTSD) in subjects diagnosed with borderline personality disorder (BPD) has been the object of scant empirical research. The clarification of issues related to the different areas of study for this comorbidity is not only significant from a theoretical point of view but also relevant for clinical practice. The aim of this review is to describe the main theoretical findings and research conclusions about the comorbidity between PTSD and BPD. A literature review was carried out via PubMed and PsycINFO for the period between 1990 and September 2013. The descriptors used were 'post-traumatic stress disorder', 'borderline personality disorder', 'PTSD', 'complex PTSD' and 'BPD'. Epidemiological studies show that the risk of PTSD among BPD subjects is not regularly higher than in subjects with other personality disorders. Furthermore, there is no conclusive evidence about the main aetiopathogenic mechanism of this comorbidity, either of one disorder being a risk factor for the other one or of common underlying variables. Concerning comparative studies, several studies with PTSD-BPD subjects have found a higher severity of psychopathology and psychosocial impairment than in BPD subjects. With regard to nosological status, the main focus of controversy is the validation of 'complex PTSD', a clinical entity which may comprise a subgroup of PTSD-BPD subjects. With regard to treatment, there are preliminary evidences for the efficient treatment of psychopathology in both PTSD and BPD. These findings are remarkable for furthering the understanding of the link between PTSD and BPD and their implications for treatment. The results of this review are discussed, including methodological constraints that hinder external validity and consistency of referred findings. © 2014 S. Karger AG, Basel.

  1. Prevalence of post-traumatic stress disorder in children: the case of the Mbagala bomb blasts in Tanzania.

    Science.gov (United States)

    Messo, Innocent Nasson

    2013-05-01

    In April 2009, military bombs stockpiled in Mbagala, Dar es Salaam, exploded uncontrollably, landing in the neighbourhood killing 26 people, injuring about 600 and destroying 9049 homes. This must have been a terrible experience, with psychological consequences. The purpose of this study was to investigate the prevalence of Post-Traumatic Stress Disorder (PTSD) among the children involved in the bomb blasts. It was hypothesized that children would not exhibit PTSD symptoms, as well as not showing sex differences in exhibiting PTSD symptoms. The study findings show 93% of children bomb survivors had PTSD symptoms, with no sex differences in the PTSD reported.

  2. Temporomandibular joint health status in war veterans with post-traumatic stress disorder

    OpenAIRE

    Mottaghi, Ahmad; Zamani, Elham

    2014-01-01

    Background and Aim: The objective of this study was to determine the prevalence of signs and symptoms of temporomandibular joint dysfunction (TMJD) in the Iran/Iraq war veterans suffering from post-traumatic stress disorder. Materials and Methods: A total of 120 subjects in the age range of 27 to 55 years were included; it included case group (30 war veterans with PTSD) and three control groups (30 patients with PTSD who had not participated in the War, 30 healthy war veterans, and 30 healthy...

  3. Risk factors for developing post-traumatic stress disorder following childbirth

    DEFF Research Database (Denmark)

    Andersen, Louise B; Melvaer, Lisa B; Videbech, Poul

    2012-01-01

    Background. Approximately 1-2% of women suffer from post-traumatic stress disorder (PTSD) postnatally. This review aims to elucidate how women at risk can be identified. Methods. A systematic search of the published literature was carried out using the MEDLINE database (November 2003 to 29(th...... in pregnancy, previous traumatic experiences, and obstetrical emergencies were identified as the most important risk factors. Conclusions. We have identified both strongly associated and non-associated factors that are associated with PTSD following childbirth. While the literature is limited by methodological...

  4. Post traumatic stress disorder among former child soldiers attending ...

    African Journals Online (AJOL)

    ... (LRA) at a rehabilitation school in northern Uganda with a case of mass psychotic ... Methods: Data on post-traumatic stress disorder, depressed mood, physical ... Nearly half of the children (42.2%) reported a positive family history of severe ...

  5. Which symptoms of post-traumatic stress disorder are associated with suicide attempts?

    Science.gov (United States)

    Selaman, Zeynep M H; Chartrand, Hayley K; Bolton, James M; Sareen, Jitender

    2014-03-01

    Individuals with post-traumatic stress disorder are at increased risk for suicide attempts. The present study aimed to determine which of the specific DSM-IV symptoms of post-traumatic stress disorder (PTSD) are independently associated with suicide attempts. Data came from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC). The NESARC has a sample size of N = 34653. The full sample size included in analyses was 2322 individuals with PTSD. Among individuals with lifetime PTSD, after adjusting for sociodemographic factors, as well as any mood, substance, personality, or anxiety disorder (excluding PTSD), increasing numbers of re-experiencing and avoidance symptoms were significantly correlated with suicide attempts. Of the specific symptoms, having physical reactions by reminders of the trauma, being unable to recall some part of it, and having the sense of a foreshortened future, were all associated with suicide attempts. These findings will help extend our understanding of the elevated risk for suicide attempts in individuals with PTSD.

  6. Post-traumatic stress symptoms and post-traumatic growth in 223 childhood cancer survivors: predictive risk factors

    Directory of Open Access Journals (Sweden)

    Marta eTremolada

    2016-02-01

    Full Text Available With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder (PTSD in young adult survivors of childhood cancer ranges from 6.2% to 22%; associated risk factors are young age at the assessment, female gender, low education level and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSS, and to identify the risk factors and the associated post-traumatic growth (PTG index.Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman’s Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients’ mean age at the assessment was 19.33 years (SD = 3.01, 15-25, 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD=4.17. Most (52.5% had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD=4.40.The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4% and sub-clinical PTSS (6-8 symptoms: 11.2%, with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r=0.24 p=0.0001. A hierarchical regression model (R2 = 0.08; F = 1.46; p = 0.05 identified female gender (β = 0.16; p = 0.05 and less perceived social support (β = -0.43; p = 0.05 as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R2 = 0.36; F = 9.1; p = 0.0001, with

  7. The Evolution of Post-Traumatic Stress Disorder following Moderate-to-Severe Traumatic Brain Injury.

    Science.gov (United States)

    Alway, Yvette; Gould, Kate Rachel; McKay, Adam; Johnston, Lisa; Ponsford, Jennie

    2016-05-01

    Increasing evidence indicates that post-traumatic stress disorder (PTSD) may develop following traumatic brain injury (TBI), despite most patients having no conscious memory of their accident. This prospective study examined the frequency, timing of onset, symptom profile, and trajectory of PTSD and its psychiatric comorbidities during the first 4 years following moderate-to-severe TBI. Participants were 85 individuals (78.8% male) with moderate or severe TBI recruited following admission to acute rehabilitation between 2005 and 2010. Using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Disorders (SCID-I), participants were evaluated for pre- and post-injury PTSD soon after injury and reassessed at 6 months, 12 months, 2 years, 3 years, and 4 years post-injury. Over the first 4 years post-injury, 17.6% developed injury-related PTSD, none of whom had PTSD prior to injury. PTSD onset peaked between 6 and 12 months post-injury. The majority of PTSD cases (66.7%) had a delayed-onset, which for a third was preceded by subsyndromal symptoms in the first 6 months post-injury. PTSD frequency increased over the first year post-injury, remained stable during the second year, and gradually declined thereafter. The majority of subjects with PTSD experienced a chronic symptom course and all developed one or more than one comorbid psychiatric disorder, with mood, other anxiety, and substance-use disorders being the most common. Despite event-related amnesia, post-traumatic stress symptoms, including vivid re-experiencing phenomena, may develop following moderate-to-severe TBI. Onset is typically delayed and symptoms may persist for several years post-injury.

  8. Post-traumatic stress disorder in children and adolescents: epidemiology, diagnosis and treatment options.

    Science.gov (United States)

    Donnelly, Craig L; Amaya-Jackson, Lisa

    2002-01-01

    Post-traumatic stress disorder (PTSD) is a common psychiatric condition in childhood and adolescence. Rates vary widely depending upon the type of trauma exposure. Interpersonal traumas, such as rape or physical abuse, are more likely to result in PTSD than exposure to natural or technological disaster. Clinical presentations are exceedingly complex and children with PTSD are at increased risk of having comorbid psychiatric diagnoses. Because of its complexity and frequent occurrence with other disorders, assessment of PTSD necessitates a broad-based evaluation utilizing multiple informations and structured instruments specific to the symptoms of PTSD in youth. Cognitive-behavioral therapy (CBT) is the treatment of first choice. Pharmacological agents for PTSD treatment have received little empirical investigation in childhood. Pharmacological treatment is used to target disabling symptoms of the disorder, which limit psychotherapy or life functioning, by helping children to tolerate working through distressful material in therapy and life. Pharmacological treatment should be based on a stepwise approach utilizing broad spectrum medications such as the selective serotonin reuptake inhibitors as first-line agents. Comorbid conditions should be identified and treated with appropriate medication or psychosocial interventions. Treatment algorithms are provided to guide rational medication strategies for children and adolescents with PTSD, subsyndromal PTSD, and in PTSD that is comorbid with other psychiatric conditions of childhood. Reduction in even one debilitating symptom of PTSD can improve a child's overall functioning across multiple domains.

  9. Post traumatic stress disorder and coping in a sample of adult survivors of the Italian earthquake.

    Science.gov (United States)

    Cofini, V; Carbonelli, A; Cecilia, M R; Binkin, N; di Orio, F

    2015-09-30

    The aim was to investigate the prevalence of post traumatic stress disorder (PTSD) in people who had left their damaged homes and were still living in temporary housing more than a year after the April 2009 L'Aquila (Italy) earthquake. In addition, we evaluated the differences in coping strategies implemented by persons who had and who did not have PTSD. A cross-sectional prevalence study was carried out on a sample of 281 people aged >18 years and living in temporary housing after the earthquake. The questionnaires used include the Davidson Trauma Scale and the Brief Cope. The prevalence of PTSD was 43%. Women and the non-employed were more vulnerable to PTSD, while, age and level of education were not associated with PTSD. Those with PTSD symptoms often employed maladaptive coping strategies for dealing with earthquake and had the highest scores in the domains of denial, venting, behavioral disengagement, self-blame. By contrast, those without PTSD generally had more adaptive coping mechanisms. Adults who were living in temporary housing after the earthquake experienced high rates of PTSD. The difference in coping mechanisms between those who have PTSD and those who do not also suggests that they influence the likeliness of developing PTSD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Attentional and executive functions are differentially affected by post-traumatic stress disorder and trauma.

    Science.gov (United States)

    Flaks, Mariana K; Malta, Stella M; Almeida, Priscila P; Bueno, Orlando F A; Pupo, Mariana C; Andreoli, Sérgio B; Mello, Marcelo F; Lacerda, Acioly L T; Mari, Jair J; Bressan, Rodrigo A

    2014-01-01

    Among the neurocognitive impairments observed in patients with Post-traumatic Stress Disorder (PTSD), attentional and executive dysfunctions appear to correlate with negative effects on education, work, daily life activities, and social relations, as well as the re-experiencing, avoidance, and hyperarousal symptoms of PTSD. However, there is no consensus regarding which aspects of attentional and executive functions are impaired in PTSD patients. Attentional and executive functions were assessed using the digit span (WAIS-III) and spatial span (WMS-III) tests under forward and backward recall conditions, the Stroop Test, and the Wisconsin Card Sorting Test (WCST). Our sample was composed of victims of urban violence who developed PTSD (PTSD+) (n = 81), victims of urban violence who did not develop PTSD (PTSD-) (n = 70), and healthy controls not exposed to trauma (HC) (n = 50). The PTSD+ group had poorer performance on the spatial span forward subtest (p = 0.023; eta(2) = 0.038) and poorer execution time (p = 0.023; eta(2) = 0.042) and accuracy (p = 0.019; eta(2) = 0.044) on the Stroop Test compared to HC. These data suggest that there are few differences between the PTSD+ and HC groups, which are restricted to less complex measures of attentional and executive functional processes (short term capacity, selective attention, processing speed, and inhibitory control) and are related to visual stimuli. Therefore, cognitive impairments directly correlated with the manifestation of PTSD. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. The Mental Disability Military Assessment Tool : A Reliable Tool for Determining Disability in Veterans with Post-traumatic Stress Disorder

    NARCIS (Netherlands)

    Fokkens, Andrea S.; Groothoff, Johan W.; van der Klink, Jac J. L.; Popping, Roel; Stewart, Roy E.; van de Ven, Lex; Brouwer, Sandra; Tuinstra, Jolanda

    2015-01-01

    Purpose An assessment tool was developed to assess disability in veterans who suffer from post-traumatic stress disorder (PTSD) due to a military mission. The objective of this study was to determine the reliability, intra-rater and inter-rater variation of the Mental Disability Military (MDM) asses

  12. Abnormal Hippocampal Morphology in Dissociative Identity Disorder and Post-Traumatic Stress Disorder Correlates with Childhood Trauma and Dissociative Symptoms

    NARCIS (Netherlands)

    Chalavi, Sima; Vissia, Eline M.; Giesen, Mechteld E.; Nijenhuis, Ellert R. S.; Draijer, Nel; Cole, James H.; Dazzan, Paola; Pariante, Carmine M.; Madsen, Sarah K.; Rajagopalan, Priya; Thompson, Paul M.; Toga, Arthur W.; Veltman, Dick J.; Reinders, Antje A. T. S.

    Smaller hippocampal volume has been reported in individuals with post-traumatic stress disorder (PTSD) and dissociative identity disorder (DID), but the regional specificity of hippocampal volume reductions and the association with severity of dissociative symptoms and/or childhood traumatization

  13. What Are Professors Doing in the Classroom That Might Attenuate Learning Issues That Challenge Students with Post Traumatic Stress Disorder?

    Science.gov (United States)

    Force, Marilynn

    2013-01-01

    Many students enter the postsecondary classroom with Post Traumatic Stress Disorder (PTSD), but do not disclose their disability for fear of stigma from the school and the instructors they must face. For the past 7 years, this author has noticed that, when instructional designs incorporate practices that meet the needs and learning processes of…

  14. Brief eclectic psychotherapy v. eye movement desensitisation and reprocessing therapy for post-traumatic stress disorder: randomised controlled trial

    NARCIS (Netherlands)

    Nijdam, M.J.; Gersons, B.P.R.; Reitsma, J.B.; de Jongh, A.; Ollf, M.

    2012-01-01

    Background Trauma-focused cognitive-behavioural therapy (CBT) and eye movement desensitisation and reprocessing therapy (EMDR) are efficacious treatments for post-traumatic stress disorder (PTSD), but few studies have directly compared them using well-powered designs and few have investigated respon

  15. Is EMDR an Effective Treatment for People Diagnosed with Both Intellectual Disability and Post-Traumatic Stress Disorder?

    Science.gov (United States)

    Gilderthorp, Rosanna C.

    2015-01-01

    This study aimed to critically review all studies that have set out to evaluate the use of eye movement desensitization and reprocessing (EMDR) for people diagnosed with both intellectual disability (ID) and post-traumatic stress disorder (PTSD). Searches of the online databases Psych Info, The Cochrane Database of Systematic Reviews, The Cochrane…

  16. Incidental Retrieval of Emotional Contexts in Post-Traumatic Stress Disorder and Depression: An fMRI Study

    Science.gov (United States)

    Whalley, Matthew G.; Rugg, Michael D.; Smith, Adam P. R.; Dolan, Raymond J.; Brewin, Chris R.

    2009-01-01

    In the present study, we used fMRI to assess patients suffering from post-traumatic stress disorder (PTSD) or depression, and trauma-exposed controls, during an episodic memory retrieval task that included non-trauma-related emotional information. In the study phase of the task neutral pictures were presented in emotional or neutral contexts.…

  17. What Are Professors Doing in the Classroom That Might Attenuate Learning Issues That Challenge Students with Post Traumatic Stress Disorder?

    Science.gov (United States)

    Force, Marilynn

    2013-01-01

    Many students enter the postsecondary classroom with Post Traumatic Stress Disorder (PTSD), but do not disclose their disability for fear of stigma from the school and the instructors they must face. For the past 7 years, this author has noticed that, when instructional designs incorporate practices that meet the needs and learning processes of…

  18. Post-traumatic Stress Disorder After Sexual Abuse in Adolescent Girls.

    Science.gov (United States)

    Ashby, Bethany D; Kaul, Paritosh

    2016-12-01

    The sexual assault of girls and women in this country is estimated at approximately 20%. The development of post-traumatic stress disorder (PTSD) after sexual abuse and assault is one of the potential lingering aftereffects. In this article we describe PTSD after sexual abuse and its effect on presenting complaints, such as sexually transmitted infections, contraception, and chronic pain, for the pediatric and adolescent gynecology (PAG) clinician. Treatment approaches, including the use of antidepressants and anxiolytics, as well as evidenced-based psychotherapies, are highlighted. In addition, this article will assist the PAG clinician in identifying trauma-related concerns during clinic visits and will cover specific screening tools to aid in identification of PTSD. A better understanding of PTSD after sexual abuse will allow PAG providers to deliver better care to their patients.

  19. Post-traumatic stress disorder: cognitive hypnotherapy, mindfulness, and acceptance-based treatment approaches.

    Science.gov (United States)

    Lynn, Steven Jay; Malakataris, Anne; Condon, Liam; Maxwell, Reed; Cleere, Colleen

    2012-04-01

    In this article, we describe how cognitive hypnotherapy can be used in conjunction with evidence-based practices for the treatment of post-traumatic stress disorder (PTSD). We review cognitive-behavioral interventions for PTSD, including mindfulness and acceptance-based approaches, and contend that (a) empirical support for the use of hypnosis in treating a variety of conditions is considerable; (b) hypnosis is fundamentally a cognitive-behavioral intervention; (c) psychological interventions with a firm footing in cognitive-behavioral therapy (CBT) are well-suited to treat the symptoms of PTSD; and (d) hypnosis can be a useful adjunct to evidence-based cognitive-behavioral approaches, including mindfulness and acceptance-based interventions, for treating PTSD.

  20. Evidence for the changes of pituitary volumes in patients with post-traumatic stress disorder.

    Science.gov (United States)

    Atmaca, Murad; Ozer, Omer; Korkmaz, Sevda; Taskent, Ismail; Yildirim, Hanefi

    2017-02-28

    In pubertal and postpubertal patients with post-traumatic stress disorder (PTSD), significantly greater pituitary gland volumes have been reported. Moving from this point, in the present study, we aimed to investigate pituitary gland volumes in patients with PTSD and hypothesized that volumes of the gland would be structurally changed. Volumetric magnetic resonance imaging of the pituitary gland was performed among sixteen patients with PTSD and fifteen healthy control subjects. We found that the mean volume of the pituitary gland was statistically significant and smaller than that of healthy subjects (0.69±0.08cm(3) for patient group and 0.83±0.21 for control subjects). Consequently, in the present study, we found that patients with PTSD had smaller pituitary gland volumes than those of healthy controls like other anxiety disorders. It is important to provide support for this finding in future longitudinal investigations. Copyright © 2016. Published by Elsevier B.V.

  1. Insomnia and symptoms of post-traumatic stress disorder among women veterans.

    Science.gov (United States)

    Hughes, Jaime; Jouldjian, Stella; Washington, Donna L; Alessi, Cathy A; Martin, Jennifer L

    2013-01-01

    Women will account for 10% of the Veteran population by 2020, yet there has been little focus on sleep issues among women Veterans. In a descriptive study of 107 women Veterans with insomnia (mean age = 49 years, 44% non-Hispanic white), 55% had probable post traumatic stress disorder (PTSD) (total score ≥33). Probable PTSD was related to more severe self-reported sleep disruption and greater psychological distress. In a regression model, higher PTSD Checklist-Civilian (PCL-C) total score was a significant independent predictor of worse insomnia severity index score while other factors were not. Women Veterans preferred behavioral treatments over pharmacotherapy in general, and efforts to increase the availability of such treatments should be undertaken. Further research is needed to better understand the complex relationship between insomnia and PTSD among women Veterans.

  2. Animal models of post-traumatic stress disorder and recent neurobiological insights.

    Science.gov (United States)

    Whitaker, Annie M; Gilpin, Nicholas W; Edwards, Scott

    2014-09-01

    Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress-induced and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often-observed combination of PTSD and comorbid conditions such as alcohol use disorder. Future studies will continue to refine preclinical PTSD models in hope of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders.

  3. Biological underpinnings of trauma and post-traumatic stress disorder: focusing on genetics and epigenetics.

    Science.gov (United States)

    Ryan, Joanne; Chaudieu, Isabelle; Ancelin, Marie-Laure; Saffery, Richard

    2016-11-01

    Certain individuals are more susceptible to stress and trauma, as well as the physical and mental health consequences following such exposure, including risk for post-traumatic stress disorder (PTSD). This differing vulnerability is likely to be influenced by genetic predisposition and specific characteristics of the stress itself (nature, intensity and duration), as well as epigenetic mechanisms. In this review we provide an overview of research findings in this field. We highlight some of the key genetic risk factors identified for PTSD, and the evidence that epigenetic processes might play a role in the biological response to trauma, as well as being potential biomarkers of PTSD risk. We also discuss important considerations for future research in this area.

  4. Separation from parents during childhood trauma predicts adult attachment security and post-traumatic stress disorder.

    Science.gov (United States)

    Bryant, R A; Creamer, M; O'Donnell, M; Forbes, D; Felmingham, K L; Silove, D; Malhi, G; van Hoof, M; McFarlane, A C; Nickerson, A

    2017-08-01

    Prolonged separation from parental support is a risk factor for psychopathology. This study assessed the impact of brief separation from parents during childhood trauma on adult attachment tendencies and post-traumatic stress. Children (n = 806) exposed to a major Australian bushfire disaster in 1983 and matched controls (n = 725) were assessed in the aftermath of the fires (mean age 7-8 years) via parent reports of trauma exposure and separation from parents during the fires. Participants (n = 500) were subsequently assessed 28 years after initial assessment on the Experiences in Close Relationships scale to assess attachment security, and post-traumatic stress disorder (PTSD) was assessed using the PTSD checklist. Being separated from parents was significantly related to having an avoidant attachment style as an adult (B = -3.69, s.e. = 1.48, β = -0.23, p = 0.013). Avoidant attachment was associated with re-experiencing (B = 0.03, s.e. = 0.01, β = 0.31, p = 0.045), avoidance (B = 0.03, s.e. = 0.01, β = 0.30, p = 0.001) and numbing (B = 0.03, s.e. = 0.01, β = 0.30, p childhood trauma can have long-lasting effects on one's attachment security, and that this can be associated with adult post-traumatic psychopathology.

  5. Post-traumatic stress disorder among people exposed to the Ventotene street disaster in Rome

    Directory of Open Access Journals (Sweden)

    Onofri Antonio

    2008-03-01

    Full Text Available Abstract Objective To test five hypotheses on Post-traumatic stress disorder (PTSD: 1 Is PTSD the most prevalent disorder after trauma? 2 Is the proximity to the disaster related to the risk of PTSD? 3 Is PTSD associated with child mourning or separation, previous stress, or familiarity for psychiatric disorders? 4 Does the exposition to trauma increase substance abuse or somatization? 5 Can episodic trauma cause long-lasting psychiatric morbidity? Methods Clinical assessment of subjects exposed to an explosion in a building caused by a gas-leak. Best estimate clinical diagnoses were made according to DSM-IV-TR criteria. The Zung Depression Rating Scale, the Zung Anxiety Rating Scale, and the Clinician Administered Post Traumatic Stress Disorder Scale were used in the clinical assessment. Statistical analysis was performed by means of t-test with Bonferroni's correction on continuous variables and χ2 or Fisher test on categorical variables. Results PTSD was the most prevalent disorder after trauma, diagnosed in 32 (36.8% subjects. The subjects who had not seen dead or injured people were more likely to receive no psychiatric diagnosis. Civil status, parenthood, death of relatives in the disaster, personal injuries, history of child mourning or separation, of previous stress, as well as familiarity for any psychiatric disorder or substance use disorder were not related with the rate of ascertained psychiatric diagnoses. Nearly two years after trauma, most of patients who had suffered PTSD still met PTSD criteria. Conclusion The 1st and the 5th hypotheses were corroborated, the 3rd and the 4th hypotheses were not confirmed. The 2nd hypothesis was partially confirmed.

  6. Post-Traumatic Stress Disorder in Adolescents in Lebanon as Wars Gained in Ferocity: A Systematic Review

    OpenAIRE

    Khuzama Hijal Shaar

    2013-01-01

    Significance for public health Post traumatic stress disorder (PTSD) in adolescents has been implicated in developmental impairments, mental and scholastic problems, alcohol and drug abuse, and antisocial behavior in its victims among others. Absence of review studies regarding the prevalence of PTSD in adolescents in Lebanon, a country plagued by decades of civil strife and external occupation and invasion, is noted. Such information may reinforce the need to develop national public health p...

  7. Post-traumatic stress disorder associated with life-threatening motor vehicle collisions in the WHO World Mental Health Surveys

    OpenAIRE

    Stein, Dan J; Karam, Elie G.; Shahly, Victoria; Hill, Eric D.; King, Andrew; Petukhova, Maria; Atwoli, Lukoye; Evelyn J Bromet; Florescu, Silvia; Haro, Josep Maria; Hinkov, Hristo; Karam, Aimee; MEDINA-MORA, MARÍA ELENA; Navarro-Mateu, Fernando; Piazza, Marina

    2016-01-01

    Background: Motor vehicle collisions (MVCs) are a substantial contributor to the global burden of disease and lead to subsequent post-traumatic stress disorder (PTSD). However, the relevant literature originates in only a few countries, and much remains unknown about MVC-related PTSD prevalence and predictors. Methods: Data come from the World Mental Health Survey Initiative, a coordinated series of community epidemiological surveys of mental disorders throughout the world. The subset of 13 s...

  8. Post-traumatic stress disorder in adolescents in Lebanon as wars gained in ferocity: a systematic review

    OpenAIRE

    2013-01-01

    Significance for public health Post traumatic stress disorder (PTSD) in adolescents has been implicated in developmental impairments, mental and scholastic problems, alcohol and drug abuse, and antisocial behavior in its victims among others. Absence of review studies regarding the prevalence of PTSD in adolescents in Lebanon, a country plagued by decades of civil strife and external occupation and invasion, is noted. Such information may reinforce the need to develop national public health p...

  9. [Post-traumatic stress disorder in Germany. Results of a nationwide epidemiological study].

    Science.gov (United States)

    Maercker, A; Forstmeier, S; Wagner, B; Glaesmer, H; Brähler, E

    2008-05-01

    In a representative epidemiological study (n=2426) with a broad age range of respondents (14-93 years), prevalence rates of traumatic life events, post-traumatic stress disorder (PTSD), and partial PTSD were estimated. A standardized interview using the trauma checklist of the Composite International Diagnostic Interview and a DSM-IV PTSD symptom checklist (Modified PTSD Symptom Scale) were applied. One-month prevalence rates were 2.3% for DSM-IV PTSD and 2.7% for partial PTSD. There were no gender differences but age-group differences did appear: among persons older than 60, the prevalence of PTSD was 3.4%, whereas the prevalence was estimated at 1.3% among persons aged 14-29 years and 1.9% among those aged 30-59 years. Partial PTSD exhibited the same age distribution, with 3.8% in the elderly, 2.4% in the middle-aged, and 1.3% in young adults. The results correspond with those of other international studies taking war-related consequences for older age groups into account. Our representative study provides the first evidence of higher PTSD prevalence rates among older age groups in the German population, which is assumed to be related to consequences of World War II.

  10. Risk factors predict post-traumatic stress disorder differently in men and women

    Directory of Open Access Journals (Sweden)

    Elklit Ask

    2008-11-01

    Full Text Available Abstract Background About twice as many women as men develop post-traumatic stress disorder (PTSD, even though men as a group are exposed to more traumatic events. Exposure to different trauma types does not sufficiently explain why women are more vulnerable. Methods The present work examines the effect of age, previous trauma, negative affectivity (NA, anxiety, depression, persistent dissociation, and social support on PTSD separately in men and women. Subjects were exposed to either a series of explosions in a firework factory near a residential area or to a high school stabbing incident. Results Some gender differences were found in the predictive power of well known risk factors for PTSD. Anxiety predicted PTSD in men, but not in women, whereas the opposite was found for depression. Dissociation was a better predictor for PTSD in women than in men in the explosion sample but not in the stabbing sample. Initially, NA predicted PTSD better in women than men in the explosion sample, but when compared only to other significant risk factors, it significantly predicted PTSD for both men and women in both studies. Previous traumatic events and age did not significantly predict PTSD in either gender. Conclusion Gender differences in the predictive value of social support on PTSD appear to be very complex, and no clear conclusions can be made based on the two studies included in this article.

  11. Psychiatric Comorbidity in Childhood Post Traumatic Stress Disorder.

    Science.gov (United States)

    Famularo, Richard; And Others

    1996-01-01

    This study of 117 severely abused children found that 35% exhibited evidence of posttraumatic stress disorder (PTSD). Results indicated that PTSD was correlated with attention deficit disorders, anxiety disorders, psychotic disorders, suicidal ideation, and mood disorders. (CR)

  12. Anticonvulsants to treat post-traumatic stress disorder.

    Science.gov (United States)

    Wang, Hee Ryung; Woo, Young Sup; Bahk, Won-Myong

    2014-09-01

    We reviewed the existing literature on the efficacy of anticonvulsants in treating post-traumatic stress disorder. We performed a literature search using PubMed, EMBASE and the Cochrane database on 30 September 2013. Randomized,controlled studies that investigated the efficacy of anticonvulsants for post-traumatic stress disorder were included in this review. Studies with retrospective designs, case reports and case series were excluded. A total of seven studies met the inclusion criteria for this review. Three studies used topiramate with negative findings regarding its efficacy. Two studies used divalproex, both of which failed to show superiority over placebo. One study used lamotrigine, with favourable results, and one study used tiagabine, with negative results. Future long-term studies with larger sample sizes are needed to investigate the clinical utility of anticonvulsants for posttraumatic stress disorder treatment.

  13. Post-Traumatic Stress Disorder: Evidence-Based Research for the Third Millennium

    Directory of Open Access Journals (Sweden)

    Javier Iribarren

    2005-01-01

    Full Text Available The stress that results from traumatic events precipitates a spectrum of psycho-emotional and physiopathological outcomes. Post-traumatic stress disorder (PTSD is a psychiatric disorder that results from the experience or witnessing of traumatic or life-threatening events. PTSD has profound psychobiological correlates, which can impair the person's daily life and be life threatening. In light of current events (e.g. extended combat, terrorism, exposure to certain environmental toxins, a sharp rise in patients with PTSD diagnosis is expected in the next decade. PTSD is a serious public health concern, which compels the search for novel paradigms and theoretical models to deepen the understanding of the condition and to develop new and improved modes of treatment intervention. We review the current knowledge of PTSD and introduce the role of allostasis as a new perspective in fundamental PTSD research. We discuss the domain of evidence-based research in medicine, particularly in the context of complementary medical intervention for patients with PTSD. We present arguments in support of the notion that the future of clinical and translational research in PTSD lies in the systematic evaluation of the research evidence in treatment intervention in order to insure the most effective and efficacious treatment for the benefit of the patient.

  14. A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Furuta Marie

    2012-11-01

    Full Text Available Abstract Background The incidence of severe maternal morbidity is increasing in high-income countries as a consequence, in part, of increased obstetric intervention and increasingly complex medical needs of women who become pregnant. Access to emergency obstetric care means that for the majority of women in these countries, an experience of severe maternal morbidity is unlikely to result in loss of life. However, little is known about the subsequent impact on postnatal psychological health resulting in an evidence gap to support provision of appropriate care for these women. There has recently been increasing recognition that childbirth can be a cause of post-traumatic stress disorder (PTSD. The combination of experiencing a life-threatening complication and its management may culminate in psychological trauma. This systematic review examined the association between women’s experience of severe maternal morbidity during labour, at the time of giving birth or within the first week following birth, and PTSD and its symptoms. Methods Relevant literature was identified through multiple databases, including MEDLINE, PsycINFO, EMBASE, CINAHL, British Nursing Index, Web of Science, Cochrane library and the British Library, using predetermined search strategies. The search terms included "post-traumatic stress disorder", "PTSD", "stress disorders, post-traumatic", "maternal morbidity", “pregnancy complications” “puerperal disorders”, "obstetric labo(ur complication", "postpartum h(aemorrhage", "eclampsia”. Studies identified were categorised according to pre-defined inclusion and exclusion criteria. The quality of included studies was assessed using the relevant CASP appraisal tools. Results Eleven primary studies met review criteria. Evidence of a relationship between severe maternal morbidity and PTSD/PTSD symptoms was inconsistent and findings varied between studies. Nevertheless, there is some evidence that severe pre-eclampsia is a risk

  15. A systematic review of the relationship between severe maternal morbidity and post-traumatic stress disorder.

    Science.gov (United States)

    Furuta, Marie; Sandall, Jane; Bick, Debra

    2012-11-10

    The incidence of severe maternal morbidity is increasing in high-income countries as a consequence, in part, of increased obstetric intervention and increasingly complex medical needs of women who become pregnant. Access to emergency obstetric care means that for the majority of women in these countries, an experience of severe maternal morbidity is unlikely to result in loss of life. However, little is known about the subsequent impact on postnatal psychological health resulting in an evidence gap to support provision of appropriate care for these women. There has recently been increasing recognition that childbirth can be a cause of post-traumatic stress disorder (PTSD). The combination of experiencing a life-threatening complication and its management may culminate in psychological trauma. This systematic review examined the association between women's experience of severe maternal morbidity during labour, at the time of giving birth or within the first week following birth, and PTSD and its symptoms. Relevant literature was identified through multiple databases, including MEDLINE, PsycINFO, EMBASE, CINAHL, British Nursing Index, Web of Science, Cochrane library and the British Library, using predetermined search strategies. The search terms included "post-traumatic stress disorder", "PTSD", "stress disorders, post-traumatic", "maternal morbidity", "pregnancy complications" "puerperal disorders", "obstetric labo(u)r complication", "postpartum h(a)emorrhage", "eclampsia". Studies identified were categorised according to pre-defined inclusion and exclusion criteria. The quality of included studies was assessed using the relevant CASP appraisal tools. Eleven primary studies met review criteria. Evidence of a relationship between severe maternal morbidity and PTSD/PTSD symptoms was inconsistent and findings varied between studies. Nevertheless, there is some evidence that severe pre-eclampsia is a risk factor for PTSD and its symptoms, an association possibly

  16. Complex contribution of combat-related post-traumatic stress disorder to veteran suicide: facing an increasing challenge.

    Science.gov (United States)

    Lee, Elizabeth A D

    2012-04-01

    The purpose of this case study is to present the complex contribution of combat-related post-traumatic stress disorder (PTSD) to suicide and international standards of treatment among veterans deployed to the Middle East. PTSD carries increased physical and psychological health risk in combat soldiers. Internationally, guidelines for PTSD promote cognitive behavior therapies, specifically exposure therapy, as first line treatment; however, implementation varies among countries. Evidence supports the benefit of exposure-based psychotherapy for combat-related PTSD. Commonly prescribed antidepressants and other psychotherapy treatments may not be as beneficial. © 2011 Wiley Periodicals, Inc.

  17. Domestic violence and post-traumatic stress disorder severity for participants of a domestic violence rehabilitation program.

    Science.gov (United States)

    Gerlock, April A

    2004-06-01

    Domestic violence has been a long-standing problem for our nation's active duty and military veterans. The purpose of this article is to describe participants of a domestic violence program, the program design to help lessen attrition, and the completers and noncompleters of the program. There was a significant relationship between post-traumatic stress disorder (PTSD) and domestic violence severity for the sample. PTSD severity was also related to reports of domestic violence in the family of origin. Completers and noncompleters were compared on demographic and violence variables and on nine research measures. Completers were more likely younger than 35 years old, employed, had higher self-ratings of relationship mutuality, lower levels of stress and post-traumatic stress, and were regularly court monitored. The results of a logistic regression significantly predicted completers and noncompleters based on age, relationship mutuality, PTSD, and court-monitored status (model chi2 statistic of 31.08, p = 0.0000).

  18. Secondary psychotic features in refugees diagnosed with post-traumatic stress disorder: a retrospective cohort study.

    Science.gov (United States)

    Nygaard, Mette; Sonne, Charlotte; Carlsson, Jessica

    2017-01-05

    A substantial amount of refugees (10-30%) suffer from Post-Traumatic Stress Disorder (PTSD). In Denmark there are different facilities specialised in psychiatric treatment of trauma-affected refugees. A previously published case report from such a facility in Denmark shows that some patients suffer from secondary psychotic symptoms alongside their PTSD. The aim of this study was to illustrate the characteristics and estimate the prevalence of psychotic features in a clinical population of trauma-affected refugees with PTSD. Psychiatric records from 220 consecutive patients at Competence Centre for Transcultural Psychiatry (CTP) were examined, and all the PTSD patients were divided into two groups; one group with secondary psychotic features (PTSD-SP group) and one without (PTSD group). A categorisation and description of the secondary psychotic features was undertaken. One hundred eighty-one patients were diagnosed with PTSD among which psychotic symptoms were identified in 74 (40.9, 95% CI 33.7-48.1%). The majority of symptoms identified were auditory hallucinations (66.2%) and persecutory delusions (50.0%). There were significantly more patients diagnosed with enduring personality change after catastrophic experience in the PTSD-SP group than in the PTSD group (P = 0.009). Furthermore the PTSD-SP group included significantly more patients exposed to torture (P = 0.001) and imprisonment (P = 0.005). This study provides an estimation of PTSD-SP prevalence in a clinical refugee population with PTSD. The study points to the difficulties distinguishing psychotic features from flashbacks and the authors call for attention to psychotic features in PTSD patients in order to improve documentation and understanding of the disorder.

  19. Disrupted resting-state insular subregions functional connectivity in post-traumatic stress disorder.

    Science.gov (United States)

    Zhang, Youxue; Xie, Bing; Chen, Heng; Li, Meiling; Guo, Xiaonan; Chen, Huafu

    2016-07-01

    Post-traumatic stress disorder (PTSD) is suggested to be a structural and functional abnormality in the insula. The insula, which consists of distinct subregions with various patterns of connectivity, displays complex and diverse functions. However, whether these insular subregions have different patterns of connectivity in PTSD remains unclear. Investigating the abnormal functional connectivity of the insular subregions is crucial to reveal its potential effect on diseases specifically PTSD. This study uses a seed-based method to investigate the altered resting-state functional connectivity of insular subregions in PTSD. We found that patients with PTSD showed reduced functional connectivity compared with healthy controls (HCs) between the left ventral anterior insula and the anterior cingulate cortex. The patients with PTSD also exhibited decreased functional connectivity between the right posterior insula and left inferior parietal lobe, and the postcentral gyrus relative to HCs. These results suggest the involvement of altered functional connectivity of insular subregions in the abnormal regulation of emotion and processing of somatosensory information in patients with PTSD. Such impairments in functional connectivity patterns of the insular subregions may advance our understanding of the pathophysiological basis underlying PTSD.

  20. Prevalence and Determinants of Chronic Post-Traumatic Stress Disorder After Floods.

    Science.gov (United States)

    Chen, Long; Tan, Hongzhuan; Cofie, Reuben; Hu, Shimin; Li, Yan; Zhou, Jia; Yang, Tubao; Tang, Xuemin; Cui, Guanghui; Liu, Aizhong

    2015-10-01

    To explore the prevalence and determinants of chronic post-traumatic stress disorder (PTSD) among flood victims. A cross-sectional survey was carried out in 2014 among individuals who had experienced the 1998 floods and had been diagnosed with PTSD in 1999 in Hunan, China. Cluster sampling was used to select subjects from the areas that had been surveyed in 1999. PTSD was diagnosed according to DSM-IV criteria, social support was measured according to a Social Support Rating Scale, coping style was measured according to a Simplified Coping Style Questionnaire, and personality was measured by use of the revised Eysenck Personality Questionnaire Short Scale for Chinese. Data were collected through face-to-face interviews by use of a structured questionnaire. Multivariate logistic regression analysis was used to reveal the determinants of chronic PTSD. A total of 123 subjects were interviewed, 17 of whom (14.4%) were diagnosed with chronic PTSD. Chronic PTSD was significantly associated with disaster stressors (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.22-2.47), nervousness (OR: 1.09; 95% CI: 1.01-1.17), and social support (OR: 0.85; 95 CI%: 0.74-0.98). Chronic PTSD in flood victims is significantly associated with disaster stressors, nervousness, and social support. These factors may play important roles in identifying persons at high risk of chronic PTSD.

  1. Post-traumatic Stress Disorder Symptoms in a Female Patient Following Repeated Teasing: Treatment with Gabapentin and Lamotrigine and the Possible Role of Sensitization

    OpenAIRE

    Kishimoto, Akira; Goto, Yurie; Hashimoto, Kenji

    2014-01-01

    Post-traumatic stress disorder (PTSD) is a pathological response to trauma characterized by frequent recollections, recurrent nightmares, and flashbacks of the traumatic event(s). To date, the precise mechanisms underlying the development of PTSD remain unknown. Several studies have suggested that antiepileptic drugs, such as gabapentin and lamotrigine, may be effective in the treatment of PTSD symptoms. We report on a 15-year-old Japanese female junior high school student who developed PTSD ...

  2. Predictors of recovery from post-traumatic stress disorder after the dongting lake flood in China: a 13–14 year follow-up study

    OpenAIRE

    Dai, Wenjie; Wang, Jieru; KAMINGA, Atipatsa C; Chen, Long; Tan, Hongzhuan; Lai, Zhiwei; Deng, Jing; Liu, Aizhong

    2016-01-01

    Background Floods are some of the most common and destructive natural disasters in the world, potentially leading to both physical injuries and psychological disorders, including post-traumatic stress disorder (PTSD). PTSD can damage functional capacity and interfere with social functioning. However, little is known about recovery from PTSD after floods. This study used 2013–2014 follow-up data on survivors of the 1998 Dongting Lake flood who were diagnosed with PTSD in 2000 to measure the pr...

  3. The Relationship of Complex Post-traumatic Stress Disorder and Post-traumatic Stress Disorder in a Culturally Distinct, Conflict-Affected Population: A Study among West Papuan Refugees Displaced to Papua New Guinea.

    Science.gov (United States)

    Silove, Derrick; Tay, Alvin Kuowei; Kareth, Moses; Rees, Susan

    2017-01-01

    Controversy continues about the validity of the construct of complex post-traumatic stress disorder (C-PTSD). In particular, questions remain whether C-PTSD can be differentiated from post-traumatic stress disorder (PTSD) and, secondarily, other common mental disorders. The examination of these issues needs to be expanded to populations of diverse cultural backgrounds exposed to prolonged persecution. We undertake such an inquiry among a community sample of West Papuan refugees exposed to extensive persecution and trauma. We interviewed over 300 West Papuan refugees using the Refugee-Mental Health Assessment Package to record symptoms of PTSD, C-PTSD, major depressive disorder (MDD), and complex grief (CG). We used first- and second-order confirmatory factor analysis (CFA) to test aspects of the convergent and discriminant validity of C-PTSD. The CFA analysis supported both a one-factor and two-factor model of PTSD and C-PTSD. Nested model comparison tests provide support for the parsimonious one-factor model solution. A second-order CFA model of PTSD and C-PTSD produced a poor fit. The modified three-factor multi-disorder solution combining a traumatic stress (TS) factor (amalgamating PTSD and C-PTSD), MDD, and CG yielded a good fit only after removing three CG domains (estrangement, yearning, and behavioral change), a model that produced large standardized residuals (>0.20). The most parsimonious model yielded a single TS factor combining symptom domains of C-PTSD and PTSD in this culturally distinct community exposed to extensive persecution and conflict-related trauma. There may be grounds for expanding the scope of psychological treatments for refugees to encompass this wider TS response. Our findings are consistent with theoretical frameworks focusing on the wider TS reaction of refugees exposed to human rights-related traumas of mass conflict, persecution, and displacement.

  4. The Relationship of Complex Post-traumatic Stress Disorder and Post-traumatic Stress Disorder in a Culturally Distinct, Conflict-Affected Population: A Study among West Papuan Refugees Displaced to Papua New Guinea

    Directory of Open Access Journals (Sweden)

    Derrick Silove

    2017-05-01

    Full Text Available BackgroundControversy continues about the validity of the construct of complex post-traumatic stress disorder (C-PTSD. In particular, questions remain whether C-PTSD can be differentiated from post-traumatic stress disorder (PTSD and, secondarily, other common mental disorders. The examination of these issues needs to be expanded to populations of diverse cultural backgrounds exposed to prolonged persecution. We undertake such an inquiry among a community sample of West Papuan refugees exposed to extensive persecution and trauma.MethodsWe interviewed over 300 West Papuan refugees using the Refugee-Mental Health Assessment Package to record symptoms of PTSD, C-PTSD, major depressive disorder (MDD, and complex grief (CG. We used first- and second-order confirmatory factor analysis (CFA to test aspects of the convergent and discriminant validity of C-PTSD.ResultsThe CFA analysis supported both a one-factor and two-factor model of PTSD and C-PTSD. Nested model comparison tests provide support for the parsimonious one-factor model solution. A second-order CFA model of PTSD and C-PTSD produced a poor fit. The modified three-factor multi-disorder solution combining a traumatic stress (TS factor (amalgamating PTSD and C-PTSD, MDD, and CG yielded a good fit only after removing three CG domains (estrangement, yearning, and behavioral change, a model that produced large standardized residuals (>0.20.ConclusionThe most parsimonious model yielded a single TS factor combining symptom domains of C-PTSD and PTSD in this culturally distinct community exposed to extensive persecution and conflict-related trauma. There may be grounds for expanding the scope of psychological treatments for refugees to encompass this wider TS response. Our findings are consistent with theoretical frameworks focusing on the wider TS reaction of refugees exposed to human rights-related traumas of mass conflict, persecution, and displacement.

  5. Post Traumatic Stress Disorder: The Facts

    Science.gov (United States)

    2007-02-22

    the medical professionals used to believe that Soldiers who tend to be emotionally numb after a trauma were showing a healthy response, but now...stress. Some studies have shown that cortisol levels are lower than normal and epinephrine and norepinephrine are higher than normal. 3. When

  6. Post-Traumatic Stress Disorder (PDQ)

    Science.gov (United States)

    ... are helped by methods that teach them to change their behaviors by changing their thinking patterns. Through cognitive behavioral therapy (CBT), patients may be helped to: Understand their symptoms . Learn ways to cope and to manage stress (such as relaxation training ). Become aware of ...

  7. Are happier people less vulnerable to rumination, anxiety, and post-traumatic stress? Evidence from a large scale disaster

    Directory of Open Access Journals (Sweden)

    Cristian Zanon

    2016-01-01

    Full Text Available Abstract The present longitudinal study tested hypotheses about the relationship of subjective well-being and neuroticism with rumination, anxiety, and post-traumatic stress in university students after a large scale disaster. Measures of subjective well-being and personality were obtained two months before the 2013 Santa Maria’s fire. Measures of rumination, PTSD and anxiety were collected five months after the disaster with the same students. The results provide evidence that life satisfaction correlated negatively with rumination, anxiety, and post-traumatic stress. Positive affect presented similar but slightly smaller negative correlations with these variables, while negative affect presented higher correlations with rumination, anxiety, and post-traumatic stress. These findings provide evidence that subjective well-being components may constitute important predictors of psychopathological symptomatology after a disaster and may be helpful to plan clinical interventions.

  8. Women survivors of intimate partner violence and post-traumatic stress disorder: Prediction and prevention

    Directory of Open Access Journals (Sweden)

    DeJonghe E

    2008-01-01

    Full Text Available A considerable body of research has demonstrated that women who are abused by their male romantic partners are at substantially elevated risk for the development of post-traumatic stress disorder (PTSD. This article reviews recent literature regarding intimate partner violence (IPV and resultant PTSD symptoms. The article is intended to be an introduction to the topic rather than an exhaustive review of the extensive literature in this area. Factors that enhance and reduce the risk for PTSD, including social support, coping styles, and types of abusive behavior experienced, are described. In addition, the unique risks associated with IPV for women who have children are discussed. Prevention efforts and treatment are briefly reviewed.

  9. Post-traumatic stress among rescue workers after terror attacks in Norway.

    Science.gov (United States)

    Skogstad, L; Heir, T; Hauff, E; Ekeberg, Ø

    2016-10-01

    On 22 July 2011, Norway was struck by two terror attacks. Seventy-seven people were killed, and many injured. Rescue workers from five occupational groups and unaffiliated volunteers faced death and despair to assist victims. To investigate the level of, and associations between, demographic variables, exposure and work-related variables and post-traumatic stress symptoms (PTSS). A cross-sectional study of general and psychosocial health care personnel, police officers, firefighters, affiliated and unaffiliated volunteers were conducted ~10 months after the terror attacks. The respondents answered a self-reported questionnaire. Post-traumatic stress disorder (PTSD) Checklist - specific (PCL-S) assessed PTSS. There were 1790 participants; response rate was 61%. About 70% of the professional rescue workers had previous work experience with similar tasks or had participated in training or disaster drills. They assessed the rescue work as a success. Firefighters and unaffiliated volunteers reported more perceived threat compared with the other groups. Among the professional personnel, the prevalence of sub-threshold PTSD (PCL 35-49) was 2% and possible PTSD (PCL ≥ 50) 0.3%. The corresponding figures among the unaffiliated volunteers were 24% and 15%, respectively. In the multivariate analysis, female gender (β = 1.7), witnessing injured/dead (β = 2.0), perceived threat (β = 1.1), perceived obstruction in rescue work (β = 1.6), lower degree of previous training (β = -0. 9) and being unaffiliated volunteers (β = 8.3) were significantly associated with PTSS. In the aftermath of a terror attack, professional rescue workers appear to be largely protected from post-traumatic stress reactions, while unaffiliated volunteers seem to be at higher risk. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Traumatic memories, post-traumatic stress disorder and serum cortisol levels in long-term survivors of the acute respiratory distress syndrome

    NARCIS (Netherlands)

    Hauer, Daniela; Weis, Florian; Krauseneck, Till; Vogeser, Michael; Schelling, Gustav; Roozendaal, Benno

    2009-01-01

    Survivors of the acute respiratory distress syndrome (ARDS) often report traumatic memories from the intensive care unit (ICU) and display a high incidence of post-traumatic stress disorder (PTSD). As it is known that subjects with PTSD often show sustained reductions in circulating cortisol concent

  11. Comorbidade entre transtorno de estresse pós-traumático e abuso e dependência de álcool e drogas: uma revisão da literatura Comorbidity of post traumatic stress disorder (PTSD with alcohol and drug abuse and dependency: a literature review

    Directory of Open Access Journals (Sweden)

    Heloisa de Souza Dantas

    2008-01-01

    Full Text Available CONTEXTO: Pesquisas revelam uma alta comorbidade entre o transtorno de estresse pós-traumático (TEPT e o abuso e dependência de álcool e drogas (ADAD. OBJETIVOS: Descrever a natureza da associação entre TEPT e ADAD, as diferenças entre os gêneros feminino e masculino, bem como os principais tratamentos utilizados. MÉTODOS: Pesquisa bibliográfica entre os anos de 1995 e 2007 no PubMed, utilizando os termos "trauma" AND "alcohol", "trauma" AND "substance abuse", "trauma" AND "dependence", "trauma" AND "drugs", "posttraumatic stress" AND "alcohol", posttraumatic stress" AND "substance abuse", "posttraumatic stress" AND "dependence", "posttraumatic stress" AND "drugs". RESULTADOS: As seguintes hipóteses foram identificadas: 1 o abuso de substâncias aumenta os riscos para a ocorrência de TEPT em virtude de estilos de vida que expõem mais o sujeito à ocorrência de traumas e pelo fato de as drogas potencializarem as seqüelas do trauma; 2 o TEPT levaria ao aumento do uso de álcool e drogas acompanhado de possível abuso com o objetivo de aliviar sintomas decorrentes do transtorno. Conclusões: A identificação precoce da comorbidade entre o TEPT e o ADAD é fundamental para o bom prognóstico do paciente, bem como o atendimento adequado às vítimas de situações traumáticas para que sejam minimizadas as chances da ocorrência do TEPT.BACKGROUND: The literature reveals high comorbidity rates between post traumatic stress disorder (PTSD and substance abuse and dependence (SAD. OBJECTIVES: This paper seeks to describe the relationship between the two disorders; the gender differences; and the primary treatments used to reduce PTSD as well as SAD symptoms. METHODS: A review of the literature between 1995 and 2007. A PubMed search was used to find articles with the key words: "trauma" AND "alcohol", "trauma" AND "substance abuse", "trauma" AND "dependence", "trauma" AND "drugs", "post traumatic stress" AND "alcohol", post traumatic

  12. Translating the psychobiology of post-traumatic stress disorder into clinically useful analogy.

    Science.gov (United States)

    Scott, M J; Stradling, S G

    2001-06-01

    Psychological theorizing about post-traumatic stress disorder (PTSD) has developed considerably since early behavioural formulations (Brewin, Dalgleish, & Joseph, 1996; Mowrer, 1960) and there have been parallel developments in biological understanding (Yehuda, 1998). However clinical practice has not been affected by the new psychobiology. It is suggested that it is possible to translate this new understanding into a clinically useful analogy that will help circumvent the difficulties of forming a therapeutic alliance with trauma victims which have been reported (Pitman et al., 1991; Scott & Stradling, 1997).

  13. Comparison of Memory Function and MMPI-2 Profile between Post-traumatic Stress Disorder and Adjustment Disorder after a Traffic Accident.

    Science.gov (United States)

    Bae, Sung-Man; Hyun, Myoung-Ho; Lee, Seung-Hwan

    2014-04-01

    Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD.

  14. Prospective post-traumatic stress disorder symptom trajectories in active duty and separated military personnel.

    Science.gov (United States)

    Porter, Ben; Bonanno, George A; Frasco, Melissa A; Dursa, Erin K; Boyko, Edward J

    2017-01-30

    Post-traumatic stress disorder (PTSD) is a serious mental illness that affects current and former military service members at a disproportionately higher rate than the civilian population. Prior studies have shown that PTSD symptoms follow multiple trajectories in civilians and military personnel. The current study examines whether the trajectories of PTSD symptoms of veterans separated from the military are similar to continuously serving military personnel. The Millennium Cohort Study is a population-based study of military service members that commenced in 2001 with follow-up assessments occurring approximately every 3 years thereafter. PTSD symptoms were assessed at each time point using the PTSD Checklist. Latent growth mixture modeling was used to compare PTSD symptom trajectories between personnel who separated (veterans; n = 5292) and personnel who remained in military service (active duty; n = 16,788). Four distinct classes (resilient, delayed-onset, improving, and elevated-recovering) described PTSD symptoms trajectories in both veterans and active duty personnel. Trajectory shapes were qualitatively similar between active duty and veterans. However, within the resilient, improving, and elevated recovering classes, the shapes were statistically different. Although the low-symptom class was the most common in both groups (veterans: 82%; active duty: 87%), veterans were more likely to be classified in the other three classes (in all cases, p military and civilian life.

  15. Structural brain aberrations associated with the dissociative subtype of post-traumatic stress disorder.

    Science.gov (United States)

    Daniels, J K; Frewen, P; Theberge, J; Lanius, R A

    2016-03-01

    One factor potentially contributing to the heterogeneity of previous results on structural grey matter alterations in adult participants suffering from post-traumatic stress disorder (PTSD) is the varying levels of dissociative symptomatology. The aim of this study was therefore to test whether the recently defined dissociative subtype of PTSD characterized by symptoms of depersonalization and derealization is characterized by specific differences in volumetric brain morphology. Whole-brain MRI data were acquired for 59 patients with PTSD. Voxel-based morphometry was carried out to test for group differences between patients classified as belonging (n = 15) vs. not belonging (n = 44) to the dissociative subtype of PTSD. The correlation between dissociation (depersonalization/derealization) severity and grey matter volume was computed. Patients with PTSD classified as belonging to the dissociative subtype exhibited greater grey matter volume in the right precentral and fusiform gyri as well as less volume in the right inferior temporal gyrus. Greater dissociation severity was associated with greater volume in the right middle frontal gyrus. The results of this first whole-brain investigation of specific grey matter volume in dissociative subtype PTSD indentified structural aberrations in regions subserving the processing and regulation of emotional arousal. These might constitute characteristic biomarkers for the dissociative subtype PTSD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Post-traumatic stress disorder and suicide risk: a systematic review.

    Science.gov (United States)

    Krysinska, Karolina; Lester, David

    2010-01-01

    There is a gap in the literature regarding suicide risk among traumatized individuals with post-traumatic stress disorder (PTSD) and this article aims to systematically review literature on the relationship between PTSD and suicidal behavior and ideation. A meta-analysis of 50 articles that examined the association between PTSD and past and current suicidal ideation and behavior was conducted. There was no evidence for an increased risk of completed suicide in individuals with PTSD. PTSD was associated with an increased incidence of prior attempted suicide and prior and current suicidal ideation. Controlling for other psychiatric disorders (including depression) weakened, but did not eliminate, this association. The evidence indicates that there is an association between PTSD and suicidality with several factors, such as concurrent depression and the pre-trauma psychiatric condition, possibly mediating this relationship. There are significant clinical implications of the reported relationship for suicide risk assessment and therapy, and further studies might help to understand the mediating pathways between PTSD and increased suicide risk.

  17. Intact error monitoring in combat Veterans with post-traumatic stress disorder.

    Science.gov (United States)

    Swick, Diane; Honzel, Nikki; Turken, U

    2015-11-30

    The error-related negativity (ERN) is a neuroelectric signature of performance monitoring during speeded response time tasks. Previous studies indicate that individuals with anxiety disorders show ERN enhancements that correlate with the degree of clinical symptomology. Less is known about the error monitoring system in post-traumatic stress disorder (PTSD). PTSD is characterized by impairments in the regulation of fear and other emotional responses, as well as deficits in maintaining cognitive control. Here, combat Veterans with PTSD were compared to control Veterans in two different versions of the flanker task (n=13 or 14 per group). Replicating and extending previous findings, PTSD patients showed an intact ERN in both experiments. In addition, task performance and error compensation behavior were intact. Finally, ERN amplitude showed no relationship with self-reported PTSD, depression, or post-concussive symptoms. These results suggest that error monitoring represents a relative strength in PTSD that can dissociate from cognitive control functions that are impaired, such as response inhibition and sustained attention. A healthy awareness of errors in external actions could be leveraged to improve interoceptive awareness of emotional state. The results could have positive implications for PTSD treatments that rely on self-monitoring abilities, such as neurofeedback and mindfulness training.

  18. Sleep-disordered breathing in patients with post-traumatic stress disorder.

    Science.gov (United States)

    Jaoude, Philippe; Vermont, Leah N; Porhomayon, Jahan; El-Solh, Ali A

    2015-02-01

    Post-traumatic stress disorder (PTSD) and sleep-disordered breathing (SDB) are shared by many patients. They both affect sleep and the quality of life of affected subjects. A critical review of the literature supports an association between the two disorders in both combat-related and non-combat-related PTSD. The exact mechanism linking PTSD and SDB is not fully understood. A complex interplay between sleep fragmentation and neuroendocrine pathways is suggested. The overlap of symptoms between PTSD and SDB raises diagnostic challenges that may require a novel approach in the methods used to diagnose the coexisting disorders. Similar therapeutic challenges face patients and providers when treating concomitant PTSD and SDB. Although continuous positive airway pressure therapy imparts a mitigating effect on PTSD symptomatology, lack of both acceptance and adherence are common. Future research should focus on ways to improve adherence to continuous positive airway pressure therapy and on the use of alternative therapeutic methods for treating SDB in patients with PTSD.

  19. [Influence of social support and coping style on chronic post-traumatic stress disorder after floods].

    Science.gov (United States)

    Dai, W J; Chen, L; Tan, H Z; Lai, Z W; Hu, S M; Li, Y; Liu, A Z

    2016-02-01

    To explore the long-term prognosis and influence of social support and coping style of patients with post-traumatic stress disorder (PTSD) after suffering from floods. Patients suffered PTSD due to Dongting lake flood in 1998 were selected through cluster random sampling. PTSD scale civilian version (PCL-C) was used to examine and diagnose the participants in this study. PTSD was then evaluated by the social support rating scale (SSRS) and the simple coping style questionnaire (SCSQ). Among all the 120 subjects, 14(11.67%) of them were diagnosed as having PTSD. Compared with the rehabilitation group, scores on subjective support, objective support, total social support and positive coping, total of coping style from the non-rehabilitation group all appeared significant low (Pfloods while disaster experience (OR=1.626, 95%CI: 1.118-2.365) appeared as a risk factor. Chronic PTSD developed after the floods called for attention. Better social support, positive coping style could significantly improve the long-term prognosis of patients with PTSD after the floods.

  20. Perfusion deficits and functional connectivity alterations in patients with post-traumatic stress disorder

    Science.gov (United States)

    Liu, Yang; Li, Baojuan; Zhang, Xi; Zhang, Linchuan; Li, Liang; Lu, Hongbing

    2016-03-01

    To explore the alteration in cerebral blood flow (CBF) and functional connectivity between survivors with recent onset post-traumatic stress disorder (PTSD) and without PTSD, survived from the same coal mine flood disaster. In this study, a processing pipeline using arterial spin labeling (ASL) sequence was proposed. Considering low spatial resolution of ASL sequence, a linear regression method was firstly used to correct the partial volume (PV) effect for better CBF estimation. Then the alterations of CBF between two groups were analyzed using both uncorrected and PV-corrected CBF maps. Based on altered CBF regions detected from the CBF analysis as seed regions, the functional connectivity abnormities in PTSD patients was investigated. The CBF analysis using PV-corrected maps indicates CBF deficits in the bilateral frontal lobe, right superior frontal gyrus and right corpus callosum of PTSD patients, while only right corpus callosum was identified in uncorrected CBF analysis. Furthermore, the regional CBF of the right superior frontal gyrus exhibits significantly negative correlation with the symptom severity in PTSD patients. The resting-state functional connectivity indicates increased connectivity between left frontal lobe and right parietal lobe. These results indicate that PV-corrected CBF exhibits more subtle perfusion changes and may benefit further perfusion and connectivity analysis. The symptom-specific perfusion deficits and aberrant connectivity in above memory-related regions may be putative biomarkers for recent onset PTSD induced by a single prolonged trauma exposure and help predict the severity of PTSD.

  1. Prevalence and Correlates of Post-traumatic Stress Disorder in Adults With Congenital Heart Disease.

    Science.gov (United States)

    Deng, Lisa X; Khan, Abigail May; Drajpuch, David; Fuller, Stephanie; Ludmir, Jonathan; Mascio, Christopher E; Partington, Sara L; Qadeer, Ayesha; Tobin, Lynda; Kovacs, Adrienne H; Kim, Yuli Y

    2016-03-01

    Post-traumatic stress disorder (PTSD) is associated with adverse outcomes and increased mortality in cardiac patients. No studies have examined PTSD in the adult congenital heart disease (ACHD) population. The objectives of this study were to assess the prevalence of self-reported symptoms of PTSD in patients with ACHD and explore potential associated factors. Patients were enrolled from an outpatient ACHD clinic and completed several validated measures including the Impact of Event Scale-Revised, PTSD Checklist-Civilian Version, and the Hospital Anxiety and Depression Scale. Clinical data were abstracted through medical data review. A total of 134 participants (mean age 34.6 ± 10.6; 46% men) were enrolled. Of the 127 participants who completed the Impact of Event Scale-Revised, 14 (11%) met criteria for elevated PTSD symptoms specifically related to their congenital heart disease or treatment. Of the 134 patients who completed PTSD Checklist-Civilian Version, 27 (21%) met criteria for global PTSD symptoms. In univariate analyses, patients with congenital heart disease-specific PTSD had their most recent cardiac surgery at an earlier year (p = 0.008), were less likely to have attended college (p = 0.04), had higher rates of stroke or transient ischemic attack (p = 0.03), and reported greater depressive symptoms on the Hospital Anxiety and Depression Scale (7 vs 2, p PTSD were depressive symptoms (p PTSD is present in 11% to 21% of subjects seen at a tertiary referral center for ACHD. The high prevalence of PTSD in this complex group of patients has important implications for the medical and psychosocial management of this growing population.

  2. The aetiology of post-traumatic stress following childbirth: a meta-analysis and theoretical framework.

    Science.gov (United States)

    Ayers, S; Bond, R; Bertullies, S; Wijma, K

    2016-04-01

    There is evidence that 3.17% of women report post-traumatic stress disorder (PTSD) after childbirth. This meta-analysis synthesizes research on vulnerability and risk factors for birth-related PTSD and refines a diathesis-stress model of its aetiology. Systematic searches were carried out on PsycINFO, PubMed, Scopus and Web of Science using PTSD terms crossed with childbirth terms. Studies were included if they reported primary research that examined factors associated with birth-related PTSD measured at least 1 month after birth. In all, 50 studies (n = 21 429) from 15 countries fulfilled inclusion criteria. Pre-birth vulnerability factors most strongly associated with PTSD were depression in pregnancy (r = 0.51), fear of childbirth (r = 0.41), poor health or complications in pregnancy (r = 0.38), and a history of PTSD (r = 0.39) and counselling for pregnancy or birth (r = 0.32). Risk factors in birth most strongly associated with PTSD were negative subjective birth experiences (r = 0.59), having an operative birth (assisted vaginal or caesarean, r = 0.48), lack of support (r = -0.38) and dissociation (r = 0.32). After birth, PTSD was associated with poor coping and stress (r = 0.30), and was highly co-morbid with depression (r = 0.60). Moderator analyses showed that the effect of poor health or complications in pregnancy was more apparent in high-risk samples. The results of this meta-analysis are used to update a diathesis-stress model of the aetiology of postpartum PTSD and can be used to inform screening, prevention and intervention in maternity care.

  3. Autobiographical Memory for Stressful Events, Traumatic Memory and Post Traumatic Stress Disorder: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Pânila Longhi Lorenzzon

    2014-08-01

    Full Text Available Stressors and traumatic events may contribute in the development of many psychopathologies, especially Post Traumatic Stress Disorder (PTSD. People with this disorder can present significant memory loss, particularly in Autobiographical Memory (AM. This paper aims to present a systematic review of the literature regarding the changes in the Autobiographical Memory in people exposed to potentially traumatic stressors. Therefore a research in the databases PsycINFO, PubMed, Web of Science and Pilots was performed during March 2012. A total of 29 articles were selected. Results demonstrate that people with PTSD present alterations in a larger number of AM components compared to the cases where PTSD did not develop the disorder. In the same way, subjects who were never exposed to trauma did not demonstrate significant AM alterations when compared to the other groups. The results indicate that the changes in AM are primarily associated with PTSD, yet it was not possible to clarify whether such changes are related to the timely development of the disorder or if they are also observed in traumatic memories even in the absence of the disorder.

  4. Directed Forgetting in Post-Traumatic-Stress-Disorder: A study of refugee immigrants in Germany

    Directory of Open Access Journals (Sweden)

    Michaela eBaumann

    2013-08-01

    Full Text Available People with post-traumatic stress disorder (PTSD often suffer from memory disturbances. In particular, previous studies suggest that PTSD patients perform atypically on tests of directed forgetting, which may be mediated by an altered emotional appraisal of the presented material. Also, a special role of dissociative symptoms in traumatized individuals’ memory performance has been suggested. Here, we investigate these issues in traumatized immigrants in Germany. In an item-method directed forgetting task, pictures were presented individually, each followed by an instruction to either remember or forget it. Later, recognition memory was tested for all pictures, regardless of initial instruction. Overall, the PTSD group’s discrimination accuracy was lower than the control group’s, as PTSD participants produced fewer hits and more false alarms, but the groups did not differ in directed forgetting itself. Moreover, the more negatively participants evaluated the stimuli, the less they were able to discriminate old from new items. Participants with higher dissociation scores were particularly poor at recognizing to-be-forgotten items. Results confirm PTSD patients’ general discrimination deficits, but provide no evidence for a distinct directed forgetting pattern in PTSD. Furthermore, data indicate that, in general, more negatively perceived items are discriminated with less accuracy than more positively appraised ones. Results are discussed in the larger context of emotion and stress-related modulations of episodic memory, with particular focus on the role of dissociative symptoms.

  5. “Soldier’s Heart”: A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Harvey B. Pollard

    2016-09-01

    Full Text Available Soldier’s Heart, is an American Civil War term linking post-traumatic stress disorder (PTSD with increased propensity for cardiovascular disease (CVD. We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks.We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1 and Tumor Necrosis Factor alpha (TNFA. We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher’s Exact Test (P= 3*10-54. We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher’s Exact Test (P= 1.8*10-16. Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.

  6. "Soldier's Heart": A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder.

    Science.gov (United States)

    Pollard, Harvey B; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M; Dalgard, Clifton L; Srivastava, Meera; Wilkerson, Matthew D; Stein, Murray B; Ursano, Robert J

    2016-01-01

    "Soldier's Heart," is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test (P = 3 × 10(-54)). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test (P = 1.8 × 10(-16)). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.

  7. “Soldier's Heart”: A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder

    Science.gov (United States)

    Pollard, Harvey B.; Shivakumar, Chittari; Starr, Joshua; Eidelman, Ofer; Jacobowitz, David M.; Dalgard, Clifton L.; Srivastava, Meera; Wilkerson, Matthew D.; Stein, Murray B.; Ursano, Robert J.

    2016-01-01

    “Soldier's Heart,” is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test (P = 3 × 10−54). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test (P = 1.8 × 10−16). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation. PMID:27721742

  8. Differential effects of sertraline in a predator exposure animal model of post-traumatic stress disorder.

    Science.gov (United States)

    Wilson, C Brad; McLaughlin, Leslie D; Ebenezer, Philip J; Nair, Anand R; Dange, Rahul; Harre, Joseph G; Shaak, Thomas L; Diamond, David M; Francis, Joseph

    2014-01-01

    Serotonin (5-HT), norepinephrine (NE), and other neurotransmitters are modulated in post-traumatic stress disorder (PTSD). In addition, pro-inflammatory cytokines (PIC) are elevated during the progression of the disorder. Currently, the only approved pharmacologic treatments for PTSD are the selective-serotonin reuptake inhibitors (SSRI) sertraline and paroxetine, but their efficacy in treating PTSD is marginal at best. In combat-related PTSD, SSRIs are of limited effectiveness. Thus, this study sought to analyze the effects of the SSRI sertraline on inflammation and neurotransmitter modulation via a predator exposure/psychosocial stress animal model of PTSD. We hypothesized that sertraline would diminish inflammatory components and increase 5-HT but might also affect levels of other neurotransmitters, particularly NE. PTSD-like effects were induced in male Sprague-Dawley rats (n = 6/group × 4 groups). The rats were secured in Plexiglas cylinders and placed in a cage with a cat for 1 h on days 1 and 11 of a 31-day stress regimen. PTSD rats were also subjected to psychosocial stress via daily cage cohort changes. At the conclusion of the stress regimen, treatment group animals were injected intraperitoneally (i.p.) with sertraline HCl at 10 mg/kg for 7 consecutive days, while controls received i.p. vehicle. The animals were subsequently sacrificed on day 8. Sertraline attenuated inflammatory markers and normalized 5-HT levels in the central nervous system (CNS). In contrast, sertraline produced elevations in NE in the CNS and systemic circulation of SSRI treated PTSD and control groups. This increase in NE suggests SSRIs produce a heightened noradrenergic response, which might elevate anxiety in a clinical setting.

  9. Differential Effects of Sertraline in a Predator Exposure Animal Model of Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    C. Brad eWilson

    2014-07-01

    Full Text Available Serotonin (5-HT, norepinephrine (NE, and other neurotransmitters are modulated in post-traumatic stress disorder (PTSD. In addition, pro-inflammatory cytokines (PIC are elevated during the progression of the disorder. Currently, the only approved pharmacologic treatments for PTSD are the selective serotonin reuptake inhibitors (SSRI sertraline and paroxetine, but their efficacy in treating PTSD is marginal at best. In combat-related PTSD, SSRIs are of limited effectiveness. Thus, this study sought to analyze the effects of the SSRI sertraline on inflammation and neurotransmitter modulation via a predator exposure/psychosocial stress animal model of PTSD. We hypothesized that sertraline would diminish inflammatory components and increase 5-HT but might also affect levels of other neurotransmitters, particularly NE. PTSD-like effects were induced in male Sprague-Dawley rats (n = 6/group x 4 groups. The rats were secured in Plexiglas cylinders and placed in a cage with a cat for 1 hour on days 1 and 11 of a 31-day stress regimen. PTSD rats were also subjected to psychosocial stress via daily cage cohort changes. At the conclusion of the stress regimen, treatment group animals were injected intraperitoneally (i.p. with sertraline HClNorepinephrine at 10mg/kg for 7 consecutive days, while controls received i.p. vehicle. The animals were subsequently sacrificed on day 8. Sertraline attenuated inflammatory markers and normalized 5-HT levels in the central nervous system (CNS. In contrast, sertraline produced elevations in NE in the CNS and systemic circulation of SSRI treated PTSD and control groups. This increase in norepinephrine suggests SSRIs produce a heightened noradrenergic response, which might elevate anxiety in a clinical setting.

  10. Event-related potential studies of post-traumatic stress disorder: a critical review and synthesis

    Directory of Open Access Journals (Sweden)

    Javanbakht Arash

    2011-10-01

    Full Text Available Abstract Despite the sparseness of the currently available data, there is accumulating evidence of information processing impairment in post-traumatic stress disorder (PTSD. Studies of event-related potentials (ERPs are the main tool in real time examination of information processing. In this paper, we sought to critically review the ERP evidence of information processing abnormalities in patients with PTSD. We also examined the evidence supporting the existence of a relationship between ERP abnormalities and symptom profiles or severity in PTSD patients. An extensive Medline search was performed. Keywords included PTSD or post-traumatic stress disorder, electrophysiology or EEG, electrophysiology, P50, P100, N100, P2, P200, P3, P300, sensory gating, CNV (contingent negative variation and MMN (mismatch negativity. We limited the review to ERP adult human studies with control groups which were reported in the English language. After applying our inclusion-exclusion review criteria, 36 studies were included. Subjects exposed to wide ranges of military and civilian traumas were studied in these reports. Presented stimuli were both auditory and visual. The most widely studied components included P300, P50 gating, N100 and P200. Most of the studies reported increased P300 response to trauma-related stimuli in PTSD patients. A smaller group of studies reported dampening of responses or no change in responses to trauma-related and/or unrelated stimuli. P50 studies were strongly suggestive of impaired gating in patients with PTSD. In conclusion, the majority of reports support evidence of information processing abnormalities in patients with PTSD diagnosis. The predominance of evidence suggests presence of mid-latency and late ERP components differences in PTSD patients in comparison to healthy controls. Heterogeneity of assessment methods used contributes to difficulties in reaching firm conclusions regarding the nature of these differences. We suggest

  11. Post-traumatic stress disorder symptoms may explain poor mental health in patients with fibromyalgia.

    Science.gov (United States)

    Toussaint, Loren L; Whipple, Mary O; Vincent, Ann

    2015-10-20

    Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.

  12. Eyeblink Classical Conditioning and Post Traumatic Stress Disorder – A Model Systems Approach

    Directory of Open Access Journals (Sweden)

    Bernard G Schreurs

    2015-04-01

    Full Text Available Not everyone exposed to trauma suffers flashbacks, bad dreams, numbing, fear, anxiety, sleeplessness, hyper-vigilance, hyperarousal, or an inability to cope, but those who do may suffer from post traumatic stress disorder (PTSD. PTSD is a major physical and mental health problem for military personnel and civilians exposed to trauma. There is still debate about the incidence and prevalence of PTSD especially among the military, but for those who are diagnosed, behavioral therapy and drug treatment strategies have proven to be less than effective. A number of these treatment strategies are based on rodent fear conditioning research and are capable of treating only some of the symptoms because the extinction of fear does not deal with the various forms of hyper-vigilance and hyperarousal experienced by people with PTSD. To help address this problem, we have developed a preclinical eyeblink classical conditioning model of PTSD in which conditioning and hyperarousal can both be extinguished. We review this model and discuss findings showing that unpaired stimulus presentations can be effective in reducing levels of conditioning and hyperarousal even when unconditioned stimulus intensity is reduced to the point where it is barely capable of eliciting a response. These procedures have direct implications for the treatment of PTSD and could be implemented in a virtual reality environment.

  13. Eyeblink classical conditioning and post-traumatic stress disorder - a model systems approach.

    Science.gov (United States)

    Schreurs, Bernard G; Burhans, Lauren B

    2015-01-01

    Not everyone exposed to trauma suffers flashbacks, bad dreams, numbing, fear, anxiety, sleeplessness, hyper-vigilance, hyperarousal, or an inability to cope, but those who do may suffer from post-traumatic stress disorder (PTSD). PTSD is a major physical and mental health problem for military personnel and civilians exposed to trauma. There is still debate about the incidence and prevalence of PTSD especially among the military, but for those who are diagnosed, behavioral therapy and drug treatment strategies have proven to be less than effective. A number of these treatment strategies are based on rodent fear conditioning research and are capable of treating only some of the symptoms because the extinction of fear does not deal with the various forms of hyper-vigilance and hyperarousal experienced by people with PTSD. To help address this problem, we have developed a preclinical eyeblink classical conditioning model of PTSD in which conditioning and hyperarousal can both be extinguished. We review this model and discuss findings showing that unpaired stimulus presentations can be effective in reducing levels of conditioning and hyperarousal even when unconditioned stimulus intensity is reduced to the point where it is barely capable of eliciting a response. These procedures have direct implications for the treatment of PTSD and could be implemented in a virtual reality environment.

  14. Neural activity related to cognitive and emotional empathy in post-traumatic stress disorder.

    Science.gov (United States)

    Mazza, Monica; Tempesta, Daniela; Pino, Maria Chiara; Nigri, Anna; Catalucci, Alessia; Guadagni, Veronica; Gallucci, Massimo; Iaria, Giuseppe; Ferrara, Michele

    2015-04-01

    The aim of this study is to evaluate the empathic ability and its functional brain correlates in post-traumatic stress disorder subjects (PTSD). Seven PTSD subjects and ten healthy controls, all present in the L'Aquila area during the earthquake of the April 2009, underwent fMRI during which they performed a modified version of the Multifaceted Empathy Test. PTSD patients showed impairments in implicit and explicit emotional empathy, but not in cognitive empathy. Brain responses during cognitive empathy showed an increased activation in patients compared to controls in the right medial frontal gyrus and the left inferior frontal gyrus. During implicit emotional empathy responses patients with PTSD, compared to controls, exhibited greater neural activity in the left pallidum and right insula; instead the control group showed an increased activation in right inferior frontal gyrus. Finally, in the explicit emotional empathy responses the PTSD group showed a reduced neural activity in the left insula and the left inferior frontal gyrus. The behavioral deficit limited to the emotional empathy dimension, accompanied by different patterns of activation in empathy related brain structures, represent a first piece of evidence of a dissociation between emotional and cognitive empathy in PTSD patients. The present findings support the idea that empathy is a multidimensional process, with different facets depending on distinct anatomical substrates. Copyright © 2014 Elsevier B.V. All rights reserved.

  15. Post-traumatic stress disorder in a sample of Syrian refugees in Lebanon.

    Science.gov (United States)

    Kazour, Francois; Zahreddine, Nada R; Maragel, Michel G; Almustafa, Mustafa A; Soufia, Michel; Haddad, Ramzi; Richa, Sami

    2017-01-01

    Lebanon is the main hosting country for the Syrian crisis, with more than one million Syrian refugees. The objective of this study was to determine the prevalence of post-traumatic stress disorder (PTSD), and identify its possible predictors, in a sample of Syrian refugees living in camps in Lebanon. We conducted a household survey on Syrian refugees between 18 and 65years old in 6 camps of the Central Bekaa region, using the Mini International Neuropsychiatric Interview (M.I.N.I.) as a diagnostic tool. Among the 452 respondents, we found a lifetime prevalence of PTSD of 35.4%, and a point prevalence of 27.2%. The lifetime prevalence of SUD was 1.99% and the point prevalence 0.66%. Multivariate logistic regression could not identify any predictor of current PTSD among a list of demographic variables, but identified the Syrian hometown as a significant predictor of lifetime PTSD (p=.013), with refugees from Aleppo having significantly more PTSD than those coming from Homs (adjusted OR 2.14, 95% CI [1.28, 3.56], p=.004). PTSD was a real mental health issue in our sample of adult Syrian refugees in Central Bekaa camps, unlike SUD. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Systematic Review on Post-Traumatic Stress Disorder Among Survivors of the Wenchuan Earthquake.

    Science.gov (United States)

    Hong, Chunlan; Efferth, Thomas

    2016-12-01

    Post-traumatic stress disorder (PTSD) widely occurs among victims or witness of disasters. With flashbacks, hyperarousal, and avoidance being the typical symptoms, PTSD became a focus of psychological research. The earthquake in Wenchuan, China, on May 12, 2008, was without precedent in magnitude and aftermath and caused huge damage, which drew scientists' attention to mental health of the survivors. We conducted a systematic overview by collecting published articles from the PubMed database and classifying them into five points: epidemiology, neuropathology, biochemistry, genetics and epigenetics, and treatment. The large body of research during the past 6 years showed that adolescents and adults were among the most studied populations with high prevalence rates for PTSD. Genomic and transcriptomic studies focusing on gene × environment studies as well as epigenetics are still rare, although a few available data showed great potential to better understand the pathophysiology of PTSD as multifactorial disease. Phytotherapy with Chinese herbs and acupuncture are rarely reported as of yet, although the first published data indicated promising therapy effects. Future studies should focus on the following points: (1) The affected populations under observation should be better defined concerning individual risk factor, time of observation, spatial movement, and individual disease courses of patients. (2) The role of social support for prevalence rates of PTSD should be observed in more detail. (3) Efficacy and safety of Chinese medicine should be studied to find potential interventions and effective treatments of PTSD.

  17. Marijuana, expectancies, and post-traumatic stress symptoms: a preliminary investigation.

    Science.gov (United States)

    Earleywine, Mitch; Bolles, Jamie R

    2014-01-01

    Previous work suggests that people might turn to marijuana to alleviate the symptoms of post-traumatic stress disorder (PTSD) and associated distress. Expectancy theories emphasize that the use of drugs correlates with their anticipated effects. The current study examined multivariate links among marijuana use, PTSD symptoms, and expectancies for marijuana-induced changes in those symptoms. Over 650 combat-exposed, male veterans who used marijuana at least once per week completed measures of PTSD symptoms, marijuana expectancies, and marijuana use in an Internet survey. Participants generally expected marijuana to relieve PTSD symptoms, especially those related to intrusions and arousal. Symptoms, expectancies for relief of symptoms, and marijuana consumption correlated significantly. Regressions revealed significant indirect effects of symptoms on use via expectancies, but no significant interactions of expectancies and symptoms. Combat-exposed veterans who use marijuana appear to use more as the magnitude of PTSD symptoms and their expectations of marijuana-induced relief of those symptoms increase. These results emphasize the importance of PTSD treatments in an effort to keep potential negative effects of marijuana to a minimum. They also underscore the import of expectancies in predicting marijuana use.

  18. The role of frontal EEG asymmetry in post-traumatic stress disorder.

    Science.gov (United States)

    Meyer, Thomas; Smeets, Tom; Giesbrecht, Timo; Quaedflieg, Conny W E M; Smulders, Fren T Y; Meijer, Ewout H; Merckelbach, Harald L G J

    2015-05-01

    Frontal alpha asymmetry, a biomarker derived from electroencephalography (EEG) recordings, has often been associated with psychological adjustment, with more left-sided frontal activity predicting approach motivation and lower levels of depression and anxiety. This suggests high relevance to post-traumatic stress disorder (PTSD), a disorder comprising anxiety and dysphoria symptoms. We review this relationship and show that frontal asymmetry can be plausibly linked to neuropsychological abnormalities seen in PTSD. However, surprisingly few studies (k = 8) have directly addressed frontal asymmetry in PTSD, mostly reporting that trait frontal asymmetry has little (if any) predictive value. Meanwhile, preliminary evidence suggest that state-dependent asymmetry during trauma-relevant stimulation distinguishes PTSD patients from resilient individuals. Thus, exploring links between provocation-induced EEG asymmetry and PTSD appears particularly promising. Additionally, we recommend more fine-grained analyses into PTSD symptom clusters in relation to frontal asymmetry. Finally, we highlight hypotheses that may guide future research and help to fully apprehend the practical and theoretical relevance of this biological marker.

  19. Theta, mental flexibility, and post-traumatic stress disorder: connecting in the parietal cortex.

    Directory of Open Access Journals (Sweden)

    Benjamin T Dunkley

    Full Text Available Post-traumatic stress disorder (PTSD is a mental health injury characterised by re-experiencing, avoidance, numbing and hyperarousal. Whilst the aetiology of the disorder is relatively well understood, there is debate about the prevalence of cognitive sequelae that manifest in PTSD. In particular, there are conflicting reports about deficits in executive function and mental flexibility. Even less is known about the neural changes that underlie such deficits. Here, we used magnetoencephalography to study differences in functional connectivity during a mental flexibility task in combat-related PTSD (all males, mean age = 37.4, n = 18 versus a military control (all males, mean age = 33.05, n = 19 group. We observed large-scale increases in theta connectivity in the PTSD group compared to controls. The PTSD group performance was compromised in the more attentionally-demanding task and this was characterised by 'late-stage' theta hyperconnectivity, concentrated in network connections involving right parietal cortex. Furthermore, we observed significant correlations with the connectivity strength in this region with a number of cognitive-behavioural outcomes, including measures of attention, depression and anxiety. These findings suggest atypical coordination of neural synchronisation in large scale networks contributes to deficits in mental flexibility for PTSD populations in timed, attentionally-demanding tasks, and this propensity toward network hyperconnectivity may play a more general role in the cognitive sequelae evident in this disorder.

  20. Associations between body mass index, post-traumatic stress disorder, and child maltreatment in young women.

    Science.gov (United States)

    Duncan, Alexis E; Sartor, Carolyn E; Jonson-Reid, Melissa; Munn-Chernoff, Melissa A; Eschenbacher, Michaela A; Diemer, Elizabeth W; Nelson, Elliot C; Waldron, Mary; Bucholz, Kathleen K; Madden, Pamela A F; Heath, Andrew C

    2015-07-01

    The objective of this study was to examine interrelationships between child maltreatment, post-traumatic stress disorder (PTSD) and body mass index (BMI) in young women. We used multinomial logistic regression models to explore the possibility that PTSD statistically mediates or moderates the association between BMI category and self-reported childhood sexual abuse (CSA), physical abuse (CPA), or neglect among 3,699 young women participating in a population-based twin study. Obese women had the highest prevalence of CSA, CPA, neglect, and PTSD (pchild maltreatment were significantly, positively associated with overweight and obesity in unadjusted models, only CSA was significantly associated with obesity after adjusting for other forms of maltreatment and covariates (OR=2.21, 95% CI: 1.63, 3.00). CSA and neglect, but not CPA, were associated with underweight in unadjusted models; however, after adjusting for other forms of maltreatment and covariates, the associations were no longer statistically significant (OR=1.43, 95% CI: 0.90-2.28 and OR=2.16, 95% CI: 0.90-5.16 for CSA and neglect, respectively). Further adjustment for PTSD generally resulted in modest attenuation of effects across associations of child maltreatment forms with BMI categories, suggesting that PTSD may, at most, be only a weak partial mediator of these associations. Future longitudinal studies are needed to elucidate the mechanisms linking CSA and obesity and to further evaluate the role of PTSD in associations between child maltreatment and obesity.

  1. Brain structure in post-traumatic stress disorder A voxel-based morphometry analysis**

    Institute of Scientific and Technical Information of China (English)

    Liwen Tan; Li Zhang; Rongfeng Qi; Guangming Lu; Lingjiang Li; Jun Liu; Weihui Li

    2013-01-01

    This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, us-ing the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, fol owed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occip-ital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

  2. Brain structure in post-traumatic stress disorder: A voxel-based morphometry analysis.

    Science.gov (United States)

    Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui

    2013-09-15

    This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.

  3. Imagery rescripting and reprocessing therapy after failed prolonged exposure for post-traumatic stress disorder following industrial injury.

    Science.gov (United States)

    Grunert, Brad K; Weis, Jo M; Smucker, Mervin R; Christianson, Heidi F

    2007-12-01

    Prolonged exposure (PE) has been reported to be effective for improving post-traumatic stress symptoms in 60-65% of trauma victims suffering from post-traumatic stress disorder (PTSD). This study examined the results of adding an imagery-based, cognitive restructuring component (imagery rescripting and reprocessing therapy, IRRT) to the treatment of 23 Type I trauma victims suffering from PTSD, all of whom failed to improve with PE alone. With the added treatment component, 18 of 23 clients showed a full recovery from their PTSD symptoms, and no longer met criteria for PTSD after 1-3 sessions of IRRT. It was noteworthy that non-FEAR emotions (e.g., guilt, shame, anger) were found to be predominant for all 23 PE failures examined in this study, suggesting that a simple habituation model (on which PE is based) is not sufficient to address non-FEAR emotions in PTSD. By contrast, IRRT, a cognitive restructuring treatment, was much more effective in PTSD symptom reduction for these clients. It was proposed that more detailed, individualized trauma assessments be conducted for each patient that focus on (1) identifying the predominant trauma-related emotions and cognitions that maintain the PTSD response, and (2) finding the best CBT "treatment fit" for the specific trauma characteristics of each patient.

  4. Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes

    Science.gov (United States)

    Swan, Sarah; Keen, Nadine; Reynolds, Nicola; Onwumere, Juliana

    2017-01-01

    Individuals with severe mental health problems, such as psychosis, are consistently shown to have experienced high levels of past traumatic events. They are also at an increased risk of further traumatisation through victimization events such as crime and assault. The experience of psychosis itself and psychiatric hospitalization have also been recognized to be sufficiently traumatic to lead to the development of post-traumatic stress (PTS) symptoms. Rates of post-traumatic stress disorder (PTSD) are elevated in people with psychosis compared to the general population. The current guidance for the treatment of PTSD is informed by an evidence base predominately limited to populations without co-morbid psychiatric disorders. The systematic review therefore sought to present the current available literature on the use of psychological treatments targeting PTS symptoms in a population with a primary diagnosis of a psychotic disorder. The review aimed to investigate the effect of these interventions on PTS symptoms and also the effect on secondary domains such as psychotic symptoms, affect and functioning. Fifteen studies were identified reporting on cognitive behavior therapy, prolonged exposure, eye movement desensitisation and reprocessing and written emotional disclosure. The review provides preliminary support for the safe use of trauma-focused psychological interventions in groups of people with severe mental health problems. Overall, the interventions were found to be effective in reducing PTS symptoms. Results were mixed with regard to secondary effects on additional domains. Further research including studies employing sufficiently powered methodologically rigorous designs is indicated.

  5. Epigenetic and genetic variation at SKA2 predict suicidal behavior and post-traumatic stress disorder.

    Science.gov (United States)

    Kaminsky, Z; Wilcox, H C; Eaton, W W; Van Eck, K; Kilaru, V; Jovanovic, T; Klengel, T; Bradley, B; Binder, E B; Ressler, K J; Smith, A K

    2015-08-25

    Traumatic stress results in hypothalamic pituitary adrenal (HPA) axis abnormalities and an increased risk to both suicidal behaviors and post-traumatic stress disorder (PTSD). Previous work out of our laboratory identified SKA2 DNA methylation associations with suicidal behavior in the blood and brain of multiple cohorts. Interaction of SKA2 with stress predicted suicidal behavior with ~80% accuracy. SKA2 is hypothesized to reduce the ability to suppress cortisol following stress, which is of potentially high relevance in traumatized populations. Our objective was to investigate the interaction of SKA2 and trauma exposure on HPA axis function, suicide attempt and PTSD. SKA2 DNA methylation at Illumina HM450 probe cg13989295 was assessed for association with suicidal behavior and PTSD metrics in the context of Child Trauma Questionnaire (CTQ) scores in 421 blood and 61 saliva samples from the Grady Trauma Project (GTP) cohort. Dexamethasone suppression test (DST) data were evaluated for a subset of 209 GTP subjects. SKA2 methylation interacted with CTQ scores to predict lifetime suicide attempt in saliva and blood with areas under the receiver operator characteristic curve (AUCs) of 0.76 and 0.73 (95% confidence interval (CI): 0.6-0.92, P = 0.003, and CI: 0.65-0.78, P suicidal behaviors and PTSD through dysregulation of the HPA axis in response to stress.

  6. Association of DHEA, DHEAS, and cortisol with childhood trauma exposure and post-traumatic stress disorder.

    Science.gov (United States)

    Van Voorhees, Elizabeth E; Dennis, Michelle F; Calhoun, Patrick S; Beckham, Jean C

    2014-01-01

    There has been a great deal of interest in the role of the neuroendocrine hormones of the hypothalamic-pituitary-adrenal (HPA) axis in the expression of stress-related psychopathology such as post-traumatic stress disorder (PTSD). This investigation examined the association of PTSD and childhood maltreatment with three key HPA axis hormones: cortisol, dehydroepiandrosterone (DHEA), and dehydroepiandrosterone sulfate (DHEAS). Regression analyses were undertaken on a sample of 43 participants with and 57 participants without PTSD. Results demonstrated that after controlling for age, sex, and PTSD status, exposure to childhood maltreatment was significantly associated with cortisol secretion [F(4,95)=11.68, ΔR(2)=0.11, P=0.0009] and cortisol/DHEA ratio [F(4,95)=6.20, ΔR(2)=0.05, P=0.01]. PTSD status was not associated with any of these neuroendocrine variables. Findings are discussed in the context of the complexity of the relationship of these neuroendocrine variables with trauma exposure and trauma-related psychopathology. It is suggested that DHEA(S) or cortisol/DHEA(S) ratios may not be biomarkers of specific forms of psychopathology per se, but that, instead, the severity and developmental timing of trauma may set the HPA axis in ways that are reflected in interactions among these neuroendocrine hormones. In adulthood, these HPA axis hormones may continue to be dynamically affected by personal and environmental resources.

  7. Context Processing and the Neurobiology of Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Liberzon, Israel; Abelson, James L

    2016-10-05

    Progress in clinical and affective neuroscience is redefining psychiatric illness as symptomatic expression of cellular/molecular dysfunctions in specific brain circuits. Post-traumatic stress disorder (PTSD) has been an exemplar of this progress, with improved understanding of neurobiological systems subserving fear learning, salience detection, and emotion regulation explaining much of its phenomenology and neurobiology. However, many features remain unexplained and a parsimonious model that more fully accounts for symptoms and the core neurobiology remains elusive. Contextual processing is a key modulatory function of hippocampal-prefrontal-thalamic circuitry, allowing organisms to disambiguate cues and derive situation-specific meaning from the world. We propose that dysregulation within this context-processing circuit is at the core of PTSD pathophysiology, accounting for much of its phenomenology and most of its biological findings. Understanding core mechanisms like this, and their underlying neural circuits, will sharpen diagnostic precision and understanding of risk factors, enhancing our ability to develop preventive and "personalized" interventions.

  8. [Diagnostic and clinical aspects of complex post-traumatic stress disorder].

    Science.gov (United States)

    Sack, M

    2004-05-01

    The symptomatology of patients suffering in the aftermath of severe and prolonged traumatization is not entirely covered by the diagnostic criteria of post-traumatic stress disorder (PTSD). Consequently, the concept of complex PTSD was proposed, including symptoms of affective dysregulation, dissociation and somatization, alterations in self-perception, altered relationships with others, and altered systems of meaning. Thereby, a variety of symptoms usually classified as co-morbid disorders are combined in a single etiological model. The whole symptomatology is considered as more or less effective adaptation strategies and not primarily as deficits. This understand-ing of the underlying etiology in subjects with complex traumatization opens perspectives for new psychotherapeutic treatment strategies which have already shown effectiveness in daily practice.

  9. A randomized controlled effectiveness trial of cognitive behavior therapy for post-traumatic stress disorder in terrorist-affected people in Thailand

    OpenAIRE

    Bryant, Richard A.; EKASAWIN, SUPARAT; CHAKRABHAND, SOMCHAI; SUWANMITRI, SOAWALUK; DUANGCHUN, ORAWAN; CHANTALUCKWONG, THANANET

    2011-01-01

    Although cognitive behaviour therapy (CBT) is the treatment of choice for post-traumatic stress disorder (PTSD), there is no evidence of its success with PTSD patients still under direct threat of terrorist attacks. This study reports the first randomized controlled trial of CBT for PTSD terrorist-affected people. Twenty-eight survivors of terrorist attacks in southern Thailand were randomized to 8 sessions of either CBT or treatment as usual (TAU). CBT was modified to accom...

  10. Cortical folding in post-traumatic stress disorder after motor vehicle accidents: Regional differences in gyrification.

    Science.gov (United States)

    Chu, Chun; Xie, Bing; Qiu, Mingguo; Liu, Kaijun; Tan, Liwen; Wu, Yi; Chen, Wei; Zhang, Shaoxiang

    2017-04-01

    Structural and functional magnetic resonance imaging (MRI) studies have revealed evidence of brain abnormalities in post-traumatic stress disorder (PTSD) patients. Cortical complexity and local gyrification index (lGI) reflect potential biological processes associated with normal or abnormal cognitive functioning. In the current study, lGI was used to explore cortical folding in PTSD patients involved in motor vehicle accidents (MVA). MRI brain scans were acquired from 18 PTSD patients who had suffered MVA at least 6 months previously and 18 healthy control subjects. All MRI images were obtained on a 3-T Siemens MRI machine and the cortical folding was analyzed using the workflow provided by software FreeSurfer. A general FreeSurfer's general linear model was used in the group analysis. In addition, correlation analysis was performed between the average of lGI extracted from the significantly different areas and the data for the clinical scale. The PTSD patients had significantly greater Clinician-Administered PTSD Scale scores than the control group. The patients showed significantly reduced lGI in the left lateral orbitofrontal cortex, consistent with findings of previous volumetric studies on PTSD. But there were no significant correlations in the left lateral orbitofrontal cortex between Clinician-Administered PTSD Scale scores and lGI. We suggest that abnormal gyrification in PTSD patients can be an important indicator of neurodevelopment deficits and may indeed be a biological marker for PTSD. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  11. Post-traumatic stress and age variation in amygdala volumes among youth exposed to trauma.

    Science.gov (United States)

    Weems, Carl F; Klabunde, Megan; Russell, Justin D; Reiss, Allan L; Carrión, Victor G

    2015-12-01

    Theoretically, normal developmental variation in amygdala volumes may be altered under conditions of severe stress. The purpose of this article was to examine whether posttraumatic stress moderates the association between age and amygdala volumes in youth exposed to traumatic events who are experiencing symptoms of post-traumatic stress disorder (PTSD). Volumetric imaging was conducted on two groups of youth aged 9-17 years: 28 with exposure to trauma and PTSD symptoms (boys = 15, girls = 13) and 26 matched (age, IQ) comparison youth (Controls; boys = 12, girls = 14). There was a significant group by age interaction in predicting right amygdala volumes. A positive association between age and right amygdala volumes was observed, but only in PTSD youth. These associations with age remained when controlling for IQ, total brain volumes and sex. Moreover, older youth with PTSD symptoms had relatively larger right amygdala volumes than controls. Findings provide evidence that severe stress may influence age-related variation in amygdala volumes. Results further highlight the importance of utilizing age as an interactive variable in pediatric neuroimaging research, in so far as age may act as an important moderator of group differences.

  12. Fiscal and Operational Impacts of Standardizing US Military Resiliency Programs to Minimize Post-Traumatic Stress Disorder

    Science.gov (United States)

    2016-04-01

    separate programs aimed at decreasing the rates of post-traumatic stress disorder (PTSD) and suicide . The purpose of this paper is to evaluate the current...Marine Corps Behavioral Health Information Network Primary focus: Community counseling and suicide prevention Website: http://bhin.usmc-mccs .org... Behavior of Men in Battle. New York: Free Press, 1985. House. Current Status of Suicide Prevention Programs in the Military: Hearing before the

  13. Stress hormones and post-traumatic stress disorder in civilian trauma victims: a longitudinal study. Part II: the adrenergic response.

    Science.gov (United States)

    Videlock, Elizabeth J; Peleg, Tamar; Segman, Ronen; Yehuda, Rachel; Pitman, Roger K; Shalev, Arieh Y

    2008-05-01

    The aim of the study was to prospectively evaluate the association between the occurrence of post-traumatic stress disorder (PTSD) and the adrenergic response to the traumatic event, and additionally, to explore the link between PTSD and the initial norepinephrine:cortisol ratio. Plasma levels and urinary excretion of norepinephrine (NE) were measured in 155 survivors of traumatic events during their admission to a general hospital emergency room (ER) and at 10 d, 1 month and 5 months later. Symptoms of peri-traumatic dissociation, PTSD and depression were assessed in each follow-up session. The Clinician-Administered PTSD Scale (CAPS) conferred a diagnosis of PTSD at 5 months. Trauma survivors with (n=31) and without (n=124) PTSD had similar levels of plasma NE, urinary NE excretion, and NE:cortisol ratio in the ER. Plasma NE levels were lower in subjects with PTSD at 10 d, 1 month, and 5 months. There was a weak but significant positive correlation between plasma levels of NE in the ER and concurrent heart rate, and a negative correlation between NE in the ER and dissociation symptoms. Peripheral levels of NE, shortly after traumatic events, are poor risk indicators of subsequent PTSD among civilian trauma victims. Simplified biological models may not properly capture the complex aetiology of PTSD.

  14. Parental Factors Associated with Child Post-traumatic Stress Following Injury: A Consideration of Intervention Targets

    Directory of Open Access Journals (Sweden)

    Anna E. Wise

    2017-08-01

    Full Text Available Post-traumatic stress disorder (PTSD symptoms are relatively common following pediatric traumatic injury and are related to poor long-term child outcomes. However, due to concerns regarding the efficacy of early child preventive interventions, and difficulty intervening with injured and medicated children soon after the event, it is not feasible to provide early psychological interventions to children exposed to traumatic injury. Parental PTSD symptoms and reactions to the child’s traumatic injury impact child outcomes and provide potential targets for early intervention to reduce child symptom development without involving the child. The authors conducted a review of the literature using Psycinfo and Pubmed research databases (publication years = 1990–2017 and identified 65 published studies relevant to the topic of the review. The present review considers parent factors [parenting styles, parental post-traumatic pathology (PTS, adaptive and maladaptive coping strategies, and communication regarding the traumatic injury] and their impact on child PTS. We focus specifically on factors amenable to intervention. We further review moderators of these relationships (e.g., child age and gender, parent gender and conclude that it is unlikely that a one-size-fits-all approach to treatment will be successful. Rather, it is necessary to consider the age and gender of parent child dyads in designing and providing targeted interventions to families following the traumatic injury of a child.

  15. Client-centred therapy, post-traumatic stress disorder and post-traumatic growth: theoretical perspectives and practical implications.

    Science.gov (United States)

    Joseph, Stephen

    2004-03-01

    In practice it is not unusual for client-centred therapists to work with people who have experienced traumatic events. However, client-centred therapy is not usually considered within texts on traumatic stress and questions have been raised over the appropriateness of client-centred therapy with trauma survivors. The present study shows how, although he was writing well before the introduction of the term 'post-traumatic stress disorder', Carl Rogers provided a theory of therapy and personality that contains an account of threat-related psychological processes largely consistent with contemporary trauma theory. Rogers' theory provides the conceptual underpinnings to the client-centred and experiential ways of working with traumatized people. Furthermore, Rogers' theory provides an understanding of post-traumatic growth processes, and encourages therapists to adopt a more positive psychological perspective to their understanding of how people adjust to traumatic events.

  16. Cognitive behaviour therapy for postnatal post-traumatic stress disorder: case studies.

    Science.gov (United States)

    Ayers, Susan; McKenzie-McHarg, Kirstie; Eagle, Andrew

    2007-09-01

    Background. Approximately 1-2% of women suffer from postnatal post-traumatic stress disorder (PTSD) with wide ranging consequences for these women and their families 1. Appropriate treatment of women who have difficult or traumatic births is not yet established. Evidence in other populations shows that cognitive behavior therapy (CBT) is effective for PTSD and it is therefore the recommended treatment 2. However, a recent review of treatments for postnatal distress concluded that descriptions of postnatal counseling are largely generalized and non-specific, which makes them difficult to assess or replicate 3. Aims and method. The current paper therefore aims to describe the use of CBT interventions to treat postnatal distress, and to illustrate common themes or issues that occur in postnatal PTSD. This paper reports two case studies of women with postnatal PTSD and their treatment using CBT. Conclusions. In these cases, CBT was an effective treatment for postnatal PTSD. A number of implications are explored for the management of pregnancy and labor.

  17. Childhood maltreatment and post-traumatic stress disorder among incarcerated young offenders.

    Science.gov (United States)

    Moore, Elizabeth; Gaskin, Claire; Indig, Devon

    2013-10-01

    Young offenders have a high prevalence of mental illness and a large proportion report experiencing a number of traumatic events during childhood, but there is little research exploring this association. This study describes the prevalence of, and association between, child maltreatment and post-traumatic stress disorder (PTSD) among young offenders. The study uses data collected as part of the 2009 NSW Young People in Custody Health Survey which was conducted in nine juvenile detention centers. This paper reports on findings from the baseline questionnaires and 18-months of re-offending data. The analysis included 291 participants who were assessed for PTSD and child maltreatment. The sample was 88% male, 48% Aboriginal, with an average age of 17 years (range 13-21 years). One in five (20%) participants were diagnosed with PTSD, with females significantly more likely to have PTSD than males (40% vs. 17%, pyoung offenders reported any child abuse or neglect, with females nearly 10 times more likely to report three or more kinds of severe child maltreatment than males. The main correlate for a diagnosis of PTSD was having three or more kinds of severe child maltreatment (OR=6.73, 95% CI: 1.06-42.92). This study provides evidence for the need to comprehensively assess child abuse and neglect among young offenders in order to provide appropriate treatment in custody and post-release.

  18. Post traumatic stress symptoms in the first years of conjugal bereavement

    NARCIS (Netherlands)

    Schut, Henk; de Keijser, Adrianus; van den Bout, Jan; Dijkhuis, Jos

    1990-01-01

    Bereavement is generally regarded as one of the most stressful events one can encounter. Yet, bereavement research and the study of post-traumatic stress seem to be mainly developing along separate lines. Strictly speaking, post-traumatic stress disorder can only occur after encountering events outs

  19. Post-traumatic stress influences local and remote functional connectivity: a resting-state functional magnetic resonance imaging study.

    Science.gov (United States)

    Ke, Jun; Chen, Feng; Qi, Rongfeng; Xu, Qiang; Zhong, Yuan; Chen, Lida; Li, Jianjun; Zhang, Li; Lu, Guangming

    2016-10-08

    Post-traumatic stress disorder (PTSD) is associated with alterations in regional brain activation and remote functional connectivity (FC) in limbic and prefrontal cortex. However, little is known about local FC changes following a traumatic event. Resting-state functional magnetic resonance images were collected for typhoon survivors with (n = 27) and without PTSD (n = 33), and healthy controls (n = 30). Local FC was examined by calculating regional homogeneity (ReHo), and remote FC was investigated between regions showing significant ReHo group differences. The PTSD group showed ReHo changes in multiple regions, including the amygdala, parahippocampal gyrus, and prefrontal cortex relative to both control groups. Compared with healthy controls, typhoon survivors had increased ReHo in the insula/inferior frontal gyrus, middle and dorsal anterior cingulate cortex (MCC/dACC), as well as enhanced negative FC between the MCC/dACC and posterior cingulate cortex (PCC)/precuneus. The typhoon-exposed control group exhibited higher ReHo in the PCC/precuneus than the PTSD and healthy control groups. Furthermore, positive correlations were found between PTSD symptom severity and ReHo in several regions. Post-traumatic stress can influence local and remote FC, irrespective of PTSD diagnosis. Future studies are needed to validate the findings and to determine whether the alterations represent pre-existing or acquired deficits.

  20. Post-traumatic stress disorder in an emergency department population one year after Hurricane Katrina.

    Science.gov (United States)

    Mills, Lisa D; Mills, Trevor J; Macht, Marlow; Levitan, Rachel; De Wulf, Annelies; Afonso, Natasha S

    2012-07-01

    Hurricane Katrina resulted in a significant amount of injury, death, and destruction. To determine the prevalence of, and risk factors for, symptoms of post-traumatic stress disorder (PTSD) in an emergency department (ED) population, 1 year after hurricane Katrina. Survey data including the Primary Care PTSD (PC-PTSD) screening instrument, demographic data, and questions regarding health care needs and personal loss were collected and analyzed. Seven hundred forty-seven subjects completed the survey. The PC-PTSD screen was positive in 38%. In the single variate analysis, there was a correlation with a positive PC-PTSD screen and the following: staying in New Orleans during the storm (odds ratio [OR] 1.73, 95% confidence interval [CI] 1.28-2.34), having material losses (OR 1.64, 95% CI 1.03-2.60), experiencing the death of a loved one (OR 1.96, 95% CI 1.35-1.87), needing health care during the storm (OR 2.01, 95% CI 1.48-2.73), and not having health care needs met during the storm (OR 2.00, 95% CI 1.26-3.18) or after returning to New Orleans (OR 2.29, 95% CI 1.40-3.73). In the multivariate analysis, the death of a loved one (OR 1.87, 95% CI 1.26-2.78), being in New Orleans during the storm (OR 1.69, 95% CI 1.22-2.33), and seeking health care during the storm (OR 1.69, 95% CI 1.22-2.35) were associated with positive PC-PTSD screens. There was a high prevalence of PTSD in this ED population surveyed 1 year after hurricane Katrina. By targeting high-risk patients, disaster relief teams may be able to reduce the impact of PTSD in similar populations. Published by Elsevier Inc.

  1. Advances in epidemiological study of post-traumatic stress disorders in postwar civilian survivors

    Directory of Open Access Journals (Sweden)

    Xiang-yu KONG

    2012-02-01

    Full Text Available Post-traumatic stress disorder (PTSD is a feeling of persecution arising from the exposure to a life-threatening event. PTSD shows three kinds of characteristic symptoms including intrusive, avoidance, and arousal syndromes. Numerous literatures had been published on the study of the PTSD epidemiology. However, research results varied due to different research subjects and evaluation methods used. A big difference exists between the studies on refugees, migrating population, and community population, because these studies are affected by different definitions of war trauma, difference in choice of samples, and application of psychological intervention. Therefore, no exact conclusions have been established on the accurate incidence of PTSD in civilians after having endured war trauma or mental torture. Currently, studies on PSTD are still inadequate. The first reason for this inadequacy is the difference existing between previous study methods. In addition, differences also exist in the statistical results between different research groups; the present study objects are all non-western ethnics or some specific population, thus selective bias existing in samples adopted. Secondly, the majority of the studies had no a control group, thus the results lacking reliability and universality. The third reason is that more attention should be paid to the impact of nationality and cultural background on the study of postwar PTSD. In summary, a large amount of work should be done in the field of PSTD epidemiology in the future. Therefore, it is very important to look for simple tools for screening and measuring PTSD in Chinese population, and investigate the incidence of PTSD after all kinds of traumatic events and its distribution for effectively preventing and treating PTSD.

  2. Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder.

    Science.gov (United States)

    McGuire, Tracy M; Lee, Christopher W; Drummond, Peter D

    2014-01-01

    Post-traumatic stress disorder (PTSD) continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR). EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented.

  3. Nightmare Frequency, Nightmare Distress and the Efficiency of Trauma-Focused Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder

    Science.gov (United States)

    Levrier, Katia; Marchand, Andre; Belleville, Genevieve; Dominic, Beaulieu-Prevost; Guay, Stephane

    2016-01-01

    Background Up to 71% of trauma victims diagnosed with PTSD have frequent nightmares (NM), compared to only 2% to 5% of the general population. Objectives The present study examined whether nightmares before the beginning of cognitive behavior therapy (CBT) for post-traumatic stress disorder (PTSD) could influence overall PTSD symptom reduction for 71 individuals with PTSD and different types of traumatic events. Patients and Methods Participants received a validated CBT of 20 weekly individual sessions. They were evaluated at five measurement times: at pre-treatment, after the third and ninth session, at post-treatment, and at 6 months follow-up. Results The presence of nightmares did not impact overall CBT efficiency. Specific CBT components were efficient in reducing the frequency and distress of nightmares. Conclusions Most participants no longer had PTSD but some still had nightmares. PMID:27800462

  4. Nightmare Frequency, Nightmare Distress and the Efficiency of Trauma-Focused Cognitive Behavioral Therapy for Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Levrier

    2016-05-01

    Full Text Available Background Up to 71% of trauma victims diagnosed with PTSD have frequent nightmares (NM, compared to only 2% to 5% of the general population. Objectives The present study examined whether nightmares before the beginning of cognitive behavior therapy (CBT for post-traumatic stress disorder (PTSD could influence overall PTSD symptom reduction for 71 individuals with PTSD and different types of traumatic events. Patients and Methods Participants received a validated CBT of 20 weekly individual sessions. They were evaluated at five measurement times: at pre-treatment, after the third and ninth session, at post-treatment, and at 6 months follow-up. Results The presence of nightmares did not impact overall CBT efficiency. Specific CBT components were efficient in reducing the frequency and distress of nightmares. Conclusions Most participants no longer had PTSD but some still had nightmares.

  5. Validity of the OSU Post-Traumatic Stress Disorder Scale and the Behavior Assessment System for Children Self-Report of Personality with Child Tornado Survivors

    Science.gov (United States)

    Evans, Linda Garner; Oehler-Stinnett, Judy

    2008-01-01

    Tornadoes and other natural disasters can lead to anxiety and posttraumatic stress disorder (PTSD) in children. This study provides further validity for the Oklahoma State University Post-Traumatic Stress Disorder Scale-Child Form (OSU PTSDS-CF) by comparing it to the Behavior Assessment System for Children Self-Report of Personality (BASC-SRP).…

  6. Prevention of suicidal behavior in adolescents with post-traumatic stress disorder.

    Science.gov (United States)

    Ruby, Eugene; Sher, Leo

    2013-01-01

    Post-traumatic stress disorder (PTSD) is significantly associated with an increased risk for suicidal behavior among adolescents. Suicide is one of the top three causes of adolescent deaths worldwide. Despite the strong relationship between PTSD and suicidal behavior, precise causal pathways linking PTSD to suicide in adolescents remains unclear. A slew of mediating factors and variables commonly present themselves with both suicide and PTSD, including co-morbid psychiatric disorders, exposure to different forms of trauma and stressful life events, core neurobiological changes, and mental, emotional, and physiological states such as hyperarousal, impulsivity, and aggression. Because youth is such a critical stage of development, it is very important that at-risk adolescents are identified and referred for treatment. With many treatment challenges in these populations, effective implementation and use of prevention methods are of increasing importance. The most proven prevention methods include physician education, means restriction, and gatekeeper training. Other strategies that have received empirical support are public education campaigns and implementing guidelines for the media, including those for television, print media, and the Internet.

  7. Complex post-traumatic stress disorder in patients with somatization disorder.

    Science.gov (United States)

    Spitzer, Carsten; Barnow, Sven; Wingenfeld, Katja; Rose, Matthias; Löwe, Bernd; Grabe, Hans Joergen

    2009-01-01

    Given the association between severe childhood trauma, adult somatization and complex post-traumatic stress disorder (cPTSD), the purpose of the present paper was to assess this syndrome and its clinical correlates in patients with somatization disorder (SD). A total of 28 patients (82% women, mean age = 41.7+/-10.1 years) meeting DSM-IV criteria for SD as confirmed by the Structured Clinical Interview for DSM-IV, Axis I were compared to 28 age- and gender-matched patients with major depression, but without a lifetime diagnosis of SD. They completed the Structured Interview for Disorders of Extreme Stress, the Brief Symptom Inventory, the Inventory of Interpersonal Problems-Circumplex Scales, and the SF-36 Health Survey. Compared to the control group, SD patients had higher risks for current and lifetime diagnoses of cPTSD (odds ratio (OR) = 15.0, 95% confidence interval (CI) = 1.76-127.54; and OR = 8.33, 95%CI = 2.04-34.07, respectively). SD subjects with cPTSD had more psychological distress, more interpersonal problems and worse psychosocial functioning than those without the syndrome. The concept of complex PTSD may hold clinical utility when applied to SD patients because it identifies a distinct subgroup characterized by severe psychosocial impairment. The diagnostic and therapeutic implications of the present findings are discussed.

  8. Anxiety sensitivity and post-traumatic stress reactions: Evidence for intrusions and physiological arousal as mediating and moderating mechanisms.

    Science.gov (United States)

    Olatunji, Bunmi O; Fan, Qianqian

    2015-08-01

    A growing body of research has implicated anxiety sensitivity (AS) and its dimensions in the development of post-traumatic stress disorder (PTSD). However, the mechanism(s) that may account for the association between AS and PTSD remains unclear. Using the "trauma film paradigm," which provides a prospective experimental tool for investigating analog intrusion development, the present study examines the extent to which intrusions mediate the association between AS and the development of posttraumatic stress reactions. After completing a measure of AS and state mood, unselected participants (n = 45) viewed a 10 min film of graphic scenes of fatal traffic accidents and then completed a second assessment of state mood. Participants then kept a daily diary to record intrusions about the film for a one-week period. Post-traumatic stress reactions about the film were then assessed after the one-week period. The results showed that general AS and physical and cognitive concerns AS predicted greater post-traumatic stress reactions about the film a week later. Furthermore, the number of intrusions the day after viewing the traumatic film, but not fear and disgust in response to the trauma film, mediated the association between general AS (and AS specifically for physical and cognitive concerns) and post-traumatic stress reactions a week later. Subsequent analysis also showed that physiological arousal during initial exposure to the traumatic film moderated the association between general AS and the number of intrusions reported the day after viewing the film. The implications of these analog findings for conceptualizing the mechanism(s) that may interact to explain the role of AS in the development of PTSD and its effective treatment are discussed.

  9. Stress modulation of drug self-administration: implications for addiction comorbidity with post-traumatic stress disorder.

    Science.gov (United States)

    Logrip, Marian L; Zorrilla, Eric P; Koob, George F

    2012-02-01

    Drug abuse and dependence present significant health burdens for our society, affecting roughly 10% of the population. Stress likely contributes to the development and persistence of drug use; for example, rates of substance dependence are elevated among individuals diagnosed with post-traumatic stress disorder (PTSD). Thus, understanding the interaction between stress and drug use, and associated neuroadaptations, is key for developing therapies to combat substance use disorders. For this purpose, many rodent models of the effects of stress exposure on substance use have been developed; the models can be classified according to three categories of stress exposure: developmental, adult nonsocial, and adult social. The present review addresses preclinical findings on the effect of each type of trauma on responses to and self-administration of drugs of abuse by focusing on a key exemplar for each category. In addition, the potential efficacy of targeting neuropeptide systems that have been implicated in stress responses and stress system neuroadaptation in order to treat comorbid PTSD and substance abuse will be discussed. This article is part of a Special Issue entitled 'Post-Traumatic Stress Disorder'.

  10. Alterations in cognitive flexibility in a rat model of post-traumatic stress disorder.

    Science.gov (United States)

    George, Sophie A; Rodriguez-Santiago, Mariana; Riley, John; Abelson, James L; Floresco, Stan B; Liberzon, Israel

    2015-06-01

    Exposure to stressful or traumatic events is associated with increased vulnerability to post-traumatic stress disorder (PTSD). This vulnerability may be partly mediated by effects of stress on the prefrontal cortex (PFC) and associated circuitry. The PFC mediates critical cognitive functions, including cognitive flexibility, which reflects an organism's ability to adaptively alter behavior in light of changing contingencies. Prior work suggests that chronic or acute stress exerts complex effects on different forms of cognitive flexibility, via actions on the PFC. Similarly, PFC dysfunction is reported in PTSD, as are executive function deficits. Animal models that permit study of the effects of stress/trauma on cognitive flexibility may be useful in illuminating ways in which stress-linked cognitive changes contribute to PTSD. Here, we examined the behavioral effects of a rodent model of PTSD - single prolonged stress (SPS) - on performance of two forms of cognitive flexibility: reversal learning and strategy set-shifting. SPS did not impair acquisition of either a response or visual-cue discrimination but did cause slight impairments in the retrieval of the visual-cue rule. During response discrimination reversal, SPS rats made more perseverative errors. In comparison, during set-shifting from the visual-cue to response discrimination, SPS rats did not show enhanced perseveration, but did display increased never-reinforced errors, indicative of impairment in selecting a novel strategy. These data demonstrate that SPS leads to a complex and intriguing pattern of deficits in flexible responding and suggest that impairments in executive functioning associated with PTSD could, in part, be a neuro-cognitive consequence of trauma exposure.

  11. Randomized controlled trial of cognitive behaviour therapy for comorbid post-traumatic stress disorder and alcohol use disorders.

    Science.gov (United States)

    Sannibale, Claudia; Teesson, Maree; Creamer, Mark; Sitharthan, Thiagarajan; Bryant, Richard A; Sutherland, Kylie; Taylor, Kirsten; Bostock-Matusko, Delphine; Visser, Alicia; Peek-O'Leary, Marie

    2013-08-01

    Aims This study aimed to test the efficacy of integrated cognitive behaviour therapy (CBT) for coexisting post traumatic stress disorder (PTSD) and alcohol use disorders (AUD). Setting Clinics across Sydney, Australia.Design Randomized controlled trial of 12 once-weekly individual sessions of either integrated CBT for PTSD and AUD(integrated therapy, IT; n = 33) or CBT for AUD plus supportive counselling (alcohol-support, AS; n = 29). Blind assessments were conducted at baseline and post-treatment and at 5 [standard deviation (SD) = 2.25] and 9.16(SD = 3.45) months post-treatment. Participants Sixty-two adults with concurrent PTSD and AUD. Measurements Outcomes included changes in alcohol consumption (time-line follow-back), PTSD severity [clinician-administered PTSD scale (CAPS)], alcohol dependence and problems, and depression and anxiety. Findings Reductions in PTSD severity were evident in both groups. IT participants who had received one or more sessions of exposure therapy exhibited a twofold greater rate of clinically significant change in CAPS severity at follow-up than AS participants [IT60%, AS 39%, odds ratio (OR): 2.31, 95% confidence interval (CI): 1.06, 5.01]. AS participants exhibited larger reductions than IT participants in alcohol consumption, dependence and problems within the context of greater treatment from other services during follow-up. Results lend support to a mutually maintaining effect between AUD and PTSD. Conclusions Individuals with severe and complex presentations of coexisting post-traumatic stress disorder(PTSD) and alcohol use disorders (AUD) can derive substantial benefit from cognitive behaviour therapy targeting AUD, with greater benefits associated with exposure for PTSD. Among individuals with dual disorders, these therapies can generate significant, well-maintained treatment effects on PTSD, AUD and psychopathology.

  12. Post-Traumatic Stress Disorder among Cardiac Patients: Prevalence, Risk Factors, and Considerations for Assessment and Treatment

    Directory of Open Access Journals (Sweden)

    Heather Tulloch

    2014-12-01

    Full Text Available There is increasing awareness of the impact of post-traumatic stress disorder (PTSD on physical health, particularly cardiovascular disease. We review the literature on the role of trauma in the development of cardiovascular risk factors and disease, aftermath of a cardiac event, and risk for recurrence in cardiac patients. We explore possible mechanisms to explain these relationships, as well as appropriate assessment and treatment strategies for this population. Our main conclusion is that screening and referral for appropriate treatments are important given the high prevalence rates of PTSD in cardiac populations and the associated impact on morbidity and mortality.

  13. Post-Traumatic Stress, Trauma-Informed Care, and Compassion Fatigue in Psychiatric Hospital Staff: A Correlational Study.

    Science.gov (United States)

    Jacobowitz, William; Moran, Christine; Best, Cheryl; Mensah, Lucy

    2015-01-01

    Assault of staff in psychiatric hospitals is a frequent occurrence, and studies indicate that hospital staff are at risk of developing post-traumatic stress disorder (PTSD). We performed a correlational study with a convenience sample of 172 staff in a psychiatric hospital and compared the rate of traumatic events (TEs), resilience, confidence, and compassion fatigue to PTSD symptoms (PTSS). Regression analyses identified two variables that were unique predictors of PTSS: (1) trauma-informed care (TIC) meeting attendance and (2) burnout symptoms. Severe TEs, age, and compassion satisfaction also contributed to the model. Attention to these factors may help reduce PTSS in psychiatric staff.

  14. How war veterans with post-traumatic stress disorder experience nature-based therapy in a forest therapy garden

    OpenAIRE

    Poulsen, Dorthe Varning

    2015-01-01

    Since 1980 more than 30.000 Danish soldiers have been serving abroad. It is estimated that 5-8 % of them develop post-traumatic stress disorder (PTSD). Medicine and psychological treatment do not always lead to an improvement in the veteran’s condition and there is a need for complementary treatments. The objective of this Ph.D. project was to explore the impact of nature-based therapy (NBT) from the perspective of veterans suffering from PTSD. The thesis consists of two studies: A systematic...

  15. The latent structure of post-traumatic stress disorder among Arabic-speaking refugees receiving psychiatric treatment in Denmark

    DEFF Research Database (Denmark)

    Vindbjerg, Erik; Carlsson, Jessica; Mortensen, Erik Lykke

    2016-01-01

    Background: Refugees are known to have high rates of post-traumatic stress disorder (PTSD). Although recent years have seen an increase in the number of refugees from Arabic speaking countries in the Middle East, no study so far has validated the construct of PTSD in an Arabic speaking sample...... provided sufficient fit indices. However, a combination of excessively small clusters, and a case of mistranslation in the official Arabic translation of the HTQ, rendered results two of the models inadmissible. A post hoc analysis revealed that a simpler factor structure is supported, once local...

  16. Altered amygdala resting-state functional connectivity in post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Christine Anne Rabinak

    2011-11-01

    Full Text Available Post-traumatic stress disorder (PTSD is often characterized by aberrant amygdala activation and functional abnormalities in corticolimbic circuitry, as elucidated by functional neuroimaging. These ‘activation’ studies have primarily relied on tasks designed to induce region-specific, and task-dependent brain responses in limbic (e.g., amygdala and paralimbic brain areas through the use of evocative probes such as personalized traumatic script-driven imagery and other negatively valenced emotional stimuli (e.g., threatening faces, aversive scenes, traumatic cues. It remains unknown if these corticolimbic circuit abnormalities exist at baseline or ‘at rest’, in the absence of fear/anxiety-related provocation and outside the context of task demands. Recently, a new approach to studying functional interconnectivity of brain regions derived from ‘resting state’ scans has elucidated systems-level neural network function that may be obscured by activation tasks and may help inform functional interpretations of brain activation patterns. Little is known about whether altered amygdala connectivity patterns exist at rest in PTSD. Therefore the primary aim of the present experiment was to investigate aberrant amygdala functional connectivity patterns in combat-related PTSD patients during resting state. Seventeen Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF veterans with combat-related PTSD (PTSD group and seventeen combat-exposed OEF/OIF veterans without PTSD (Combat-Exposed Control [CEC] group underwent an 8-minute resting-state functional magnetic resonance imaging scan. Using conventional methods to generate connectivity maps, we extracted the time series from an anatomically-derived amygdala ‘seed’ region and conducted voxel-wise correlation analyses across the entire brain to search for group differences (between PTSD and CEC groups in amygdala functional connectivity, which we hypothesized would localize to the medial

  17. Post-traumatic stress disorder among Syrian refugees in Turkey: a cross-sectional study.

    Science.gov (United States)

    Alpak, Gokay; Unal, Ahmet; Bulbul, Feridun; Sagaltici, Eser; Bez, Yasin; Altindag, Abdurrahman; Dalkilic, Alican; Savas, Haluk A

    2015-03-01

    Refugees have had major challenges to meet their health care needs throughout history especially in war zones and natural disaster times. The health care needs of Syrian refugees have been becoming an increasingly important issue. We aimed to examine the prevalence of post-traumatic stress disorder (PTSD) and explore its relation with various socioeconomic variables among Syrian refugees, who sought asylum in Turkey. This cross-sectional study was conducted in a tent city. Sample size calculation yielded 352 and the participants of the study were determined randomly. Experienced and native Arabic speaking, psychiatrist evaluated the participants. The frequency of PTSD was 33.5%. Through the binary logistic regression analysis, we calculated that the probability of having PTSD among Syrian refugees in our sample was 71%, if they had the following features: with female gender; being diagnosed with psychiatric disorder in the past; having a family history of psychiatric disorder; and experiencing 2 or more traumas. The findings of our study suggest that PTSD among Syrian refugees in Turkey might be an important mental health issue in refugee camps especially among female refugees, who were exposed to 2 or more traumatic events and had a personal or family history of psychiatric disorder.

  18. Post-traumatic stress disorder and suicidal behavior: A narrative review.

    Science.gov (United States)

    Panagioti, Maria; Gooding, Patricia; Tarrier, Nicholas

    2009-08-01

    There is a large literature investigating the underlying mechanisms, risk factors and demographics of suicidal thoughts and behaviors across a number of psychiatric disorders, such as, major depression, anxiety and schizophrenia. However, less research has focused on the relationship between Post-Traumatic Stress Disorder (PTSD) and suicide. There were two broad aims of this review. The first was to assess the extent to which PTSD is associated with suicide, and the second was to determine the effects of co-morbid disorders on this relationship. Overall, there was a clear relationship between PTSD and suicidal thoughts and behaviors irrespective of the type of trauma experienced. Very few studies directly examined whether depression was a mediating factor in the relationships reported. However, where this was investigated, the presence of co-morbid depression appeared to boost the effect of PTSD on suicidality. It was noteworthy that hardly any studies had investigated concepts thought to be key in other domains of research into suicidality, such as, feelings of entrapment, defeat and hopelessness.

  19. Nicotine-Derived Compounds as Therapeutic Tools Against Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Barreto, George E; Yarkov, Alexander; Avila-Rodriguez, Marcos; Aliev, Gjumrakch; Echeverria, Valentina

    2015-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops after experiencing trauma. Actual therapies do not help majority of patients with PTSD. Moreover, extinguished fear memories usually reappear in the individuals when exposed to trauma cues. New drugs to reduce the impact of conditioned cues in eliciting abnormal fear responses are urgently required. Cotinine, the main metabolite of nicotine, decreased anxiety and depressive-like behavior, and enhanced fear extinction in mouse models of PTSD. Cotinine, considered a positive modulator of the α7 nicotinic acetylcholine receptor (α7nAChR), enhances fear extinction in rodents in a manner dependent on the activity of the αnAChRs. Cotinine stimulates signaling pathways downstream of α7nAChR including the protein kinase B (Akt)/glycogen synthase kinase 3β (GSK3β) pathway and the extracellular signal-regulated kinases (ERKs). The stimulation of these factors promotes synaptic plasticity and the extinction of fear. In this review, we discuss the hypothesis that cotinine relieves PTSD symptoms and facilitates fear memory extinction by promoting brain plasticity through the positive modulation of presynaptic nAChRs and its effectors in the brain.

  20. Hippocampal Dysfunction Effects on Context Memory: Possible Etiology for Post-traumatic Stress Disorder

    Science.gov (United States)

    Acheson, Dean T.; Gresack, Jodi E.; Risbrough, Victoria B.

    2011-01-01

    Hippocampal volume reductions and functional impairments are reliable findings in post-traumatic stress disorder (PTSD) imaging studies. However, it is not clear if and how hippocampal dysfunction contributes to the etiology and maintenance of PTSD. Individuals with PTSD are often described as showing fear responses to trauma reminders outside of contexts in which these cues would reasonably predict danger. Animal studies suggest that the hippocampus is required to form and recall associations between contextual stimuli and aversive events. For example, the hippocampus is critical for encoding memories in which a complex configuration of multiple cues is associated with the aversive event. Conversely, the hippocampus is not required for associations with discrete cues. In animal studies, if configural memory is disrupted, learning strategies using discrete cue associations predominate. These data suggest poor hippocampal function could bias the organism towards forming multiple simple cue associations during trauma, thus increasing the chances of fear responses in multiple environments (or contexts) in which these cues may be present. Here we will examine clinical and animal literature to support a theory of hippocampal dysfunction as a primary contributory factor to the etiology of PTSD, and discuss future research required to test these hypotheses. PMID:21596050

  1. Mobbing in Slovenia: Prevalence, Mobbing Victim Characteristics, and the Connection with Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Mumel Damijan

    2015-03-01

    Full Text Available An increasing number of organizations face the problem of mobbing, which represents a serious, widespread problem with numerous consequences for victims, organizations, and society. We also recognize the connection this phenomenon has with the emergence of post-traumatic stress disorder (PTSD. PTSD poses one of the most critical consequences for victims of mobbing, who mostly consist of employees at lower organizational levels. Our research focuses on the prevalence of mobbing in Slovenia, its correlation to PTSD, and some differences in the subjective and objective assessments of being exposed to mobbing. We found that the prevalence of mobbing in Slovenia can be compared to some previous assessments as well as data from other countries. Among the study's participants, 24% could be classified as regular victims of mobbing. For the first time, we link mobbing with PTSD using a Slovenian sample. We also recorded some interesting differences between subjective and objective assessments of mobbing, thereby indicating the importance of subjective conceptualizations of mobbing acts, which should be investigated in greater detail in future research.

  2. Using EMDR to treat post-traumatic stress disorder in a prison setting.

    Science.gov (United States)

    Kitchiner, N J

    2000-01-01

    This article describes the treatment of a young man who developed post-traumatic stress disorder (PTSD) following the sudden unexpected miscarriage of his unborn child. He was diagnosed with this anxiety disorder while serving a term of imprisonment. He was treated with a controversial psychological treatment for PTSD, eye movement desensitisation reprocessing (EMDR) therapy, during one, 1-hour session. After this session, his progress was monitored by a further three follow-up appointments at 1 week, 1 month and 3 months, where the self-report questionnaires were repeated and compared with pre-treatment scores. These demonstrated improvement post-treatment and at a 3-month follow-up session. The discussion arising from the treatment will concentrate on EMDR as an effective treatment for PTSD, particularly within a prison setting. Data from recent research highlight the potential risks of PTSD within a community population and the implications for midwives and nurses who treat and care for traumatized patients are discussed.

  3. POST Traumatic Stress Disorder in Emergency Workers: Risk Factors and Treatment

    Science.gov (United States)

    Argentero, Piergiorgio; Dell'Olivo, Bianca; Setti, Ilaria

    Post traumatic stress disorder (PTSD) are emergent phenomena resulting from exposure to a traumatic event that causes actual or threatened death or injury and produces intense fear, helplessness, or horror. In order to assess the role of different factors contributing to this kind of emergent phenomenon prevalence rates across gender, cultures, and samples exposed to different traumas are examined. Risk factors for PTSD, including pre-existing individual-based factors, features of the traumatic event, and post-trauma interventions are examined as well. Several characteristics of the trauma, related to cognitions, post-trauma social support and therapeutic interventions for PTSD are also considered. Further work is needed in order to analyze the inter-relationships among these factors and underlying mechanisms. The chaotic nature of traumatic processes, the multiple and interactive impacts on traumatic events require a comprehensive perspective aimed at planning effective interventions. Treatment outcome studies recommended the combined use of training and therapies as first-line treatment for PTSD.

  4. Potential of eye movement desensitization and reprocessing therapy in the treatment of post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    McGuire TM

    2014-09-01

    Full Text Available Tracy M McGuire, Christopher W Lee, Peter D Drummond School of Psychology, Murdoch University, Perth, WA, Australia Abstract: Post-traumatic stress disorder (PTSD continues to attract both empirical and clinical interest due to its complex symptom profile and the underlying processes involved. Recently, research attention has been focused on the types of memory processes involved in PTSD and hypothesized neurobiological processes. Complicating this exploration, and the treatment of PTSD, are underlying comorbid disorders, such as depression, anxiety, and substance use disorders. Treatment of PTSD has undergone further reviews with the introduction of eye movement desensitization and reprocessing (EMDR. EMDR has been empirically demonstrated to be as efficacious as other specific PTSD treatments, such as trauma-focused cognitive behavioral therapy. There is emerging evidence that there are different processes underlying these two types of trauma treatment and some evidence that EMDR might have an efficiency advantage. Current research and understanding regarding the processes of EMDR and the future direction of EMDR is presented. Keywords: post-traumatic stress disorder, eye movement desensitization, neurobiological, symptoms, treatment, comorbid

  5. Reliability and Validity of the Korean Version of the Symptom Checklist-Post-Traumatic Stress Disorder Scale.

    Science.gov (United States)

    Chang, Jae Hyeok; Kim, Daeho; Jang, Eonyoung; Park, Joo Eon; Bae, Hwallip; Han, Chang Woo; Kim, Seok Hyeon

    2016-05-01

    The Symptom Checklist - Post-Traumatic Stress Disorder Scale (SCL-PTSD), also known as Crime-Related PTSD Scale has been validated in survivors of interpersonal trauma in the general population. However, the psychometric properties have not been investigated in a clinical setting for patients with PTSD from diverse traumatic events. This study investigates the reliability and validity of the Korean version of the SCL-PTSD among 104 psychiatric outpatients with PTSD, caused by interpersonal (n = 50) or non-interpersonal trauma (n = 54). Self-report data of the SCL-PTSD, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Impact of Events Scale-Revised (IES-R) were gathered. The Korean version of the SCL-PTSD showed excellent internal consistency and moderate-to-good four-week temporal stability in both the interpersonal and non-interpersonal trauma groups. In comparison with other diagnostic groups, the scores of the SCL-PTSD were significantly higher compared to those of adjustment disorder, depression, other anxiety disorders, and schizophrenia, demonstrating its criteria-related validity. Convergent validity was confirmed because the scores of the SCL-PTSD were significantly correlated with BDI, SAI and TAI scores. Concurrent validity was demonstrated by significant correlation with the IES-R score. This study demonstrated the favorable psychometric prosperities of the Korean version of the SCL-PTSD, supporting its use in clinical research and practice.

  6. The effect of flexible cognitive-behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees

    DEFF Research Database (Denmark)

    Buhmann, Caecilie Böck; Nordentoft, Merete; Ekstrøm, Morten

    2016-01-01

    design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months...

  7. The Dose of Exposure and Prevalence Rates of Post Traumatic Stress Disorder in a Sample of Turkish Children Eleven Months After the 1999 Marmara Earthquakes

    Science.gov (United States)

    Bulut, Sefa; Bulut, Solmaz; Tayli, Asli

    2005-01-01

    Since Turkey is a centrally prime earthquake zone, Turkey's children are at risk for developing Post Traumatic Stress Disorder (PTSD) caused by earthquake exposures and threats of anticipated earthquakes. Given the gaps in the literature and the risk to children living in Turkey, the present study was undertaken to investigate the severity and…

  8. How well can post-traumatic stress disorder be predicted from pre-trauma risk factors? An exploratory study in the WHO World Mental Health Surveys

    NARCIS (Netherlands)

    Kessler, Ronald C.; Rose, Sherri; Koenen, Karestan C.; Karam, Elie G.; Stang, Paul E.; Stein, Dan J.; Heeringa, Steven G.; Hill, Eric D.; Liberzon, Israel; McLaughlin, Katie A.; McLean, Samuel A.; Pennell, Beth E.; Petukhova, Maria; Rosellini, Anthony J.; Ruscio, Ayelet M.; Shahly, Victoria; Shalev, Arieh Y.; Silove, Derrick; Zaslavsky, Alan M.; Angermeyer, Matthias C.; Bromet, Evelyn J.; Caldas de Almeida, Jose Miguel; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia E.; Gureje, Oye; Haro, Josep Maria; Hinkov, Hristo; Kawakami, Norito; Kovess-Masfety, Viviane; Lee, Sing; Medina-Mora, Maria Elena; Murphy, Samuel D.; Navarro-Mateu, Fernando; Piazza, Marina; Posada-Villa, Jose; Scott, Kate; Torres, Yolanda; Viana, Maria Carmen

    2014-01-01

    Post-traumatic stress disorder (PTSD) should be one of the most preventable mental disorders, since many people exposed to traumatic experiences (TEs) could be targeted in first response settings in the immediate aftermath of exposure for preventive intervention. However, these interventions are cos

  9. Concurrent and prospective associations of habitual overgeneral memory and prospection with symptoms of depression, general anxiety, obsessive compulsiveness, and post-traumatic stress

    NARCIS (Netherlands)

    Boelen, Paul A.; Huntjens, Rafaele J. C.; van den Hout, Marcel A.

    2014-01-01

    Reduced memory specificity is associated with depression, post-traumatic stress disorder (PTSD), and some other forms of psychopathology. Reduced memory specificity is also associated with reduced specificity of envisioned future events. Research in this area has mostly relied on cue-word methods th

  10. Epigenetic modification of the glucocorticoid receptor gene is linked to traumatic memory and post-traumatic stress disorder risk in genocide survivors

    NARCIS (Netherlands)

    Vukojevic, V.; Kolassa, I.T.; Fastenrath, M.; Gschwind, L.; Spalek, K.; Milnik, A.; Heck, A.; Vogler, C.; Wilker, S.; Demougin, P.; Peter, F.; Atucha, E.; Stetak, A.; Roozendaal, B.; Elbert, T.; Papassotiropoulos, A.; Quervain, D.J. de

    2014-01-01

    Recent evidence suggests that altered expression and epigenetic modification of the glucocorticoid receptor gene (NR3C1) are related to the risk of post-traumatic stress disorder (PTSD). The underlying mechanisms, however, remain unknown. Because glucocorticoid receptor signaling is known to regulat

  11. The Relationship between Childhood Sexual Abuse, Complex Post-Traumatic Stress Disorder and Alexithymia in Two Outpatient Samples: Examination of Women Treated in Community and Institutional Clinics

    Science.gov (United States)

    McLean, Linda M.; Toner, Brenda; Jackson, Jennifer; Desrocher, Mary; Stuckless, Noreen

    2006-01-01

    Relationships between trauma variables, complex post-traumatic stress disorder (complex PTSD), affect dysregulation, dissociation, somatization, and alexithymia were studied in 70 women with early-onset sexual abuse treated in community-based private (n = 25) or clinic outpatient settings (n = 45). Measures were the Toronto Alexithymia Scale-20…

  12. Racial discrimination, post-traumatic stress and prescription drug problems among Aboriginal Canadians.

    Science.gov (United States)

    Currie, Cheryl; Wild, T Cameron; Schopflocher, Donald; Laing, Lory

    2015-06-24

    1) To examine associations between racial discrimination and drug problems among urban-based Aboriginal adults; and 2) to determine whether these associations are best explained by symptoms of psychological stress, distress or post-traumatic stress disorder (PTSD). Data were collected through in-person surveys with a community-based sample of Aboriginal adults (N = 372) living in a mid-sized city in western Canada in 2010. Associations were examined using bootstrapped linear regression models adjusted for confounders, with continuous prescription and illicit drug problem scores as outcomes. Mediation was examined using the cross-products of coefficients method. More than 80% of Aboriginal adults had experienced racial discrimination in the past year, with the majority reporting high levels in that period. Past-year discrimination was a risk factor for PTSD symptoms and prescription drug problems in models adjusted for confounders and other forms of psychological trauma. In mediation models, PTSD symptoms explained the association between discrimination and prescription drug problems; psychological stress and distress did not. PTSD symptoms also explained this association when the covariance between mediators was controlled. The results also indicate that participation in Aboriginal cultural traditions was associated with increased discrimination. Most efforts to address Aboriginal health inequities in Canada have focused on the role Aboriginal people play in these disparities. The current findings combine with others to call for an expanded focus. Non-Aboriginal Canadians may also play a role in the health inequities observed. The findings of this study suggest efforts to reduce discrimination experienced by Aboriginal adults in cities may reduce PTSD symptomology and prescription drug problems in these populations.

  13. POST TRAUMATIC STRESS DISORDER HANDLING THROUGH THE TRAUMA HEALING FOR SCOUT CARE

    Directory of Open Access Journals (Sweden)

    Muhammad Jufri

    2016-12-01

    Full Text Available The purpose of this activity is (1 to improve the knowledge of Scouting Care in Post Traumatic Stress Disordet overcome through Trauma Healing, (2 To improve the technical skills of Trauma Healing. The method used in this activity are: the percentage method, lecture and question and answer, discussion methods, methods of practice. The results of these activities are (1 there is an increased knowledge of participants in following the activities, especially in implementing and applying the theory and practice of PTSD to handling, from the data worksheet that was analyzed contained 94.5% of the questions as an evaluation materials may be answered by the participants. This indicates that the participant understands and is able to apply the techniques of PTSD very well in dealing with post-disaster stress. (2 Participants skillfully PTSD through psychotherapy techniques such as: deepbreating, relaxation techniques, storytelling / story telling, play therapy / role playing and games-games. From a practice several times, through observation through direct observation, illustrating that the participants could perform well in groups or individually

  14. Differences in Intrusive Memory Experiences in Post-traumatic Stress Disorder after Single, Re- and Prolonged Traumatization

    Science.gov (United States)

    Müller, Helge H.; Moeller, Sebastian; Jenderek, Konstanze; Stroebel, Armin; Wiendieck, Kurt; Sperling, Wolfgang

    2016-01-01

    Intrusive memory experiences (IMEs) are a common symptom of post-traumatic stress disorder (PTSD). Sensory perceptions of IMEs in the PTSD context vary substantially. The present research examined 20 patients with a single trauma, 20 re-traumatized patients and 80 Holocaust-traumatized patients who suffered from PTSD. Our results revealed significant differences in IME frequency based on the types of trauma experience. The findings suggest that patients with prolonged (Holocaust) traumata suffered from visual (65%) and combined visual/acoustic intrusive memories (29%), whereas visual memory experiences were most frequent (90%) among single-trauma patients. The trauma experience and the intrusive memory trigger stimulus were interdependent. The type of trauma critically affects the traumatic experience. Future studies should focus on these findings to improve PTSD therapeutic options. PMID:27375541

  15. The latent structure of post-traumatic stress disorder among Arabic-speaking refugees receiving psychiatric treatment in Denmark

    DEFF Research Database (Denmark)

    Vindbjerg, Erik; Carlsson, Jessica; Mortensen, Erik Lykke;

    2016-01-01

    Background: Refugees are known to have high rates of post-traumatic stress disorder (PTSD). Although recent years have seen an increase in the number of refugees from Arabic speaking countries in the Middle East, no study so far has validated the construct of PTSD in an Arabic speaking sample...... of refugees. Methods: Responses to the Harvard Trauma Questionnaire (HTQ) were obtained from 409 Arabic-speaking refugees diagnosed with PTSD and undergoing treatment in Denmark. Confirmatory factor analysis was used to test and compare five alternative models. Results: All four- and five-factor models...... dependence is addressed. Conclusions: Overall, the construct of PTSD is supported in this sample of Arabic-speaking refugees. Apart from pursuing maximum fit, future studies may wish to test simpler, potentially more stable models, which allow a more informative analysis of individual items....

  16. The latent structure of post-traumatic stress disorder among Arabic-speaking refugees receiving psychiatric treatment in Denmark

    DEFF Research Database (Denmark)

    Vindbjerg, Erik; Carlsson, Jessica; Mortensen, Erik Lykke;

    2016-01-01

    Background: Refugees are known to have high rates of post-traumatic stress disorder (PTSD). Although recent years have seen an increase in the number of refugees from Arabic speaking countries in the Middle East, no study so far has validated the construct of PTSD in an Arabic speaking sample...... of refugees. Methods: Responses to the Harvard Trauma Questionnaire (HTQ) were obtained from 409 Arabic-speaking refugees diagnosed with PTSD and undergoing treatment in Denmark. Confirmatory factor analysis was used to test and compare five alternative models. Results: All four- and five-factor models...... dependence is addressed. Conclusions: Overall, the construct of PTSD is supported in this sample of arabic-speaking refugees. Apart from pursuing maximum fit, future studies may wish to test simpler, potentially more stable models, which allow a more informative analysis of individual items....

  17. Psychotic symptoms in post traumatic stress disorder: a case ...

    African Journals Online (AJOL)

    QuickSilver

    2003-05-07

    May 7, 2003 ... Posttraumatic stress disorder (PTSD) is a psychiatric illness for- mally recognized with the .... addition, he received individual and group supportive psycho- therapy similar to .... is needed in this area to clarify which factors contribute to the development of ... Herman,J. Trauma & Recovery. Basic Books:New ...

  18. Prevalence estimates of combat-related post-traumatic stress disorder: critical review.

    Science.gov (United States)

    Richardson, Lisa K; Frueh, B Christopher; Acierno, Ronald

    2010-01-01

    The aim of the present study was to provide a critical review of prevalence estimates of combat-related post-traumatic stress disorder (PTSD) among military personnel and veterans, and of the relevant factors that may account for the variability of estimates within and across cohorts, including methodological and conceptual factors accounting for differences in prevalence rates across nations, conflicts/wars, and studies. MEDLINE and PsycINFO databases were examined for literature on combat-related PTSD. The following terms were used independently and in combinations in this search: PTSD, combat, veterans, military, epidemiology, prevalence. The point prevalence of combat-related PTSD in US military veterans since the Vietnam War ranged from approximately 2% to 17%. Studies of recent conflicts suggest that combat-related PTSD afflicts between 4% and 17% of US Iraq War veterans, but only 3-6% of returning UK Iraq War veterans. Thus, the prevalence range is narrower and tends to have a lower ceiling among combat veterans of non-US Western nations. Variability in prevalence is likely due to differences in sampling strategies; measurement strategies; inclusion and measurement of the DSM-IV clinically significant impairment criterion; timing and latency of assessment and potential for recall bias; and combat experiences. Prevalence rates are also likely affected by issues related to PTSD course, chronicity, and comorbidity; symptom overlap with other psychiatric disorders; and sociopolitical and cultural factors that may vary over time and by nation. The disorder represents a significant and costly illness to veterans, their families, and society as a whole. Further carefully conceptualized research, however, is needed to advance our understanding of disorder prevalence, as well as associated information on course, phenomenology, protective factors, treatment, and economic costs.

  19. Post-Traumatic Stress Disorder: A Neglected Health Concern among Commercial Motor Vehicle Drivers

    Directory of Open Access Journals (Sweden)

    AH Naseri Esfahani

    2013-10-01

    Full Text Available Background: Post-traumatic stress disorder (PTSD is an anxiety disorder that may develop following a trauma. Iranian commercial motor vehicle drivers experience many road traffic accidents during their working life; this may increase the probability for developing PTSD, which in turn may lead to increased human errors as well as decreased work efficiency.Objective: To examine the prevalence of PTSD and its associated factors among a group of Iranian commercial motor vehicle drivers.Methods: In a cross-sectional study, 424 drivers who referred to participate in an annually training program were selected using a simple random sampling technique. They were requested to complete the Persian version of PCL-C and a data collection sheet about their occupational and demographic features.Results: 385 (90.8% of 424 studied drivers completed the study. 265 (68.8% of the drivers had first-grade driving license. The mean±SD on-the-job daily driving was 10.2±2.8 h. 74 of 385 (19.2%; 95% CI: 15.3%–23.2% met the PTSD criteria. Higher age and job experience as a professional driver, and having past history or past familial history of psychiatric disorders, were independent predictors of developing PTSD. The disease was more prevalent among drivers with first-grade driving license.Conclusion: The prevalence of PTSD among Iranian commercial motor vehicle drivers is higher than the figures reported elsewhere. Measures to diagnose of such drivers and to ensure optimum follow-up of victims before return to professional driving should be considered.

  20. Patient-reported outcomes in post-traumatic stress disorder. Part II: focus on pharmacological treatment.

    Science.gov (United States)

    Kapfhammer, Hans-Peter

    2014-06-01

    Post-traumatic stress disorder (PTSD) may be associated with long-lasting psychological suffering, distressing psychosocial disability, markedly reduced health-related quality of life, and increased morbidity and mortality in a subgroup of individuals in the aftermath of serious traumatic events. Both etiopathogenesis and treatment modalities of PTSD are best conceptualized within a biopsychosotial model. Pharmacotherapy may lay claim to a major role in the multimodal treatment approaches. Here we outline two different pharmacotherapeutic trends that aim to modify the encoding, consolidation, and rehearsal of traumatic memory in order to reduce the risk of PTSD immediately after trauma exposure on the one hand, and that endeavor to treat the clinical state of PTSD on the other. The theoretical rationales of both pharmacological strategies are the complex neurobiological underpinnings that characterize traumatic memory organization and clinical PTSD. Meanwhile, promising data from randomized controlled trials have been obtained for both approaches. Empirical evidence may inform clinicians in their clinical efforts for this special group of patients. The efficacy of several classes of drugs that have been investigated within a context of research should be evaluated critically and still have to stand the test of effectiveness in daily clinical practice. From a patient perspective, empirical results may serve as a psychoeducative guideline to what pharmacotherapeutic approaches may realistically achieve, what their risks and benefits are, and what their limits are in contributing to reducing the often major chronic suffering caused by serious traumatic events. Ethical issues have to be considered, particularly in the context of pharmacological strategies projected to prevent PTSD in the aftermath of traumatic exposure.

  1. Racial discrimination, post traumatic stress, and gambling problems among urban Aboriginal adults in Canada.

    Science.gov (United States)

    Currie, Cheryl L; Wild, T Cameron; Schopflocher, Donald P; Laing, Lory; Veugelers, Paul; Parlee, Brenda

    2013-09-01

    Little is known about risk factors for problem gambling (PG) within the rapidly growing urban Aboriginal population in North America. Racial discrimination may be an important risk factor for PG given documented associations between racism and other forms of addictive behaviour. This study examined associations between racial discrimination and problem gambling among urban Aboriginal adults, and the extent to which this link was mediated by post traumatic stress. Data were collected via in-person surveys with a community-based sample of Aboriginal adults living in a mid-sized city in western Canada (N = 381) in 2010. Results indicate more than 80 % of respondents experienced discrimination due to Aboriginal race in the past year, with the majority reporting high levels of racism in that time period. Past year racial discrimination was a risk factor for 12-month problem gambling, gambling to escape, and post traumatic stress disorder (PTSD) symptoms in bootstrapped regression models adjusted for confounders and other forms of social trauma. Elevated PTSD symptoms among those experiencing high levels of racism partially explained the association between racism and the use of gambling to escape in statistical models. These findings are the first to suggest racial discrimination may be an important social determinant of problem gambling for Aboriginal peoples. Gambling may be a coping response that some Aboriginal adults use to escape the negative emotions associated with racist experiences. Results support the development of policies to reduce racism directed at Aboriginal peoples in urban areas, and enhanced services to help Aboriginal peoples cope with racist events.

  2. The effects of music relaxation and muscle relaxation techniques on sleep quality and emotional measures among individuals with post-traumatic stress disorder

    OpenAIRE

    Ilana Kremer; Naomi Ziv; Zahi Arnon; Boaz Bloch; Limor Vadas; Iris Haimov

    2012-01-01

    The aim of the present study was to examine the effects of music and muscle relaxation techniques on sleep quality and emotional measures in individuals with Post-traumatic stress disorder (PTSD). Thirteen PTSD patients, who had no other major psychiatric, sleep, or neurological disorders, participated in the study. The study comprised one 7-day, running-in, no-treatment period, followed by two 7-day experimental periods. The treatments were either music relaxation or muscle relaxation techni...

  3. Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder.

    Science.gov (United States)

    Lipinska, Malgorzata; Timol, Ridwana; Kaminer, Debra; Thomas, Kevin G F

    2014-06-01

    Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder.

  4. Influence of post-traumatic stress disorder on neuroinflammation and cell proliferation in a rat model of traumatic brain injury.

    Directory of Open Access Journals (Sweden)

    Sandra A Acosta

    Full Text Available Long-term consequences of traumatic brain injury (TBI are closely associated with the development of severe psychiatric disorders, such as post-traumatic stress disorder (PTSD, yet preclinical studies on pathological changes after combined TBI with PTSD are lacking. In the present in vivo study, we assessed chronic neuroinflammation, neuronal cell loss, cell proliferation and neuronal differentiation in specific brain regions of adult Sprague-Dawley male rats following controlled cortical impact model of moderate TBI with or without exposure to PTSD. Eight weeks post-TBI, stereology-based histological analyses revealed no significant differences between sham and PTSD alone treatment across all brain regions examined, whereas significant exacerbation of OX6-positive activated microglial cells in the striatum, thalamus, and cerebral peduncle, but not cerebellum, in animals that received TBI alone and combined TBI-PTSD compared with PTSD alone and sham treatment. Additional immunohistochemical results revealed a significant loss of CA3 pyramidal neurons in the hippocampus of TBI alone and TBI-PTSD compared to PTSD alone and sham treatment. Further examination of neurogenic niches revealed a significant downregulation of Ki67-positive proliferating cells, but not DCX-positive neuronally migrating cells in the neurogenic subgranular zone and subventricular zone for both TBI alone and TBI-PTSD compared to PTSD alone and sham treatment. Comparisons of levels of neuroinflammation and neurogenesis between TBI alone and TBI+PTSD revealed that PTSD did not exacerbate the neuropathological hallmarks of TBI. These results indicate a progressive deterioration of the TBI brain, which, under the conditions of the present approach, was not intensified by PTSD, at least within our time window and within the examined areas of the brain. Although the PTSD manipulation employed here did not exacerbate the pathological effects of TBI, the observed long

  5. The prevalence of long-term post-traumatic stress symptoms among adolescents after the tsunami in Aceh.

    Science.gov (United States)

    Agustini, E N; Asniar, I; Matsuo, H

    2011-08-01

    The aim of this study was to identify long-term post-traumatic stress disorder (PTSD) symptoms in Aceh 4.5 years after the tsunami and to examine whether certain factors affected the severity of PTSD symptoms among adolescents. The PTSD symptoms of 482 adolescents aged 11 to 19 years were assessed according to the Child Post-Traumatic Stress Reaction Index (CPTSD-RI). The severity of the disaster was identified by the Traumatic Exposure Severity Scale (TESS). Of the adolescents who completed the questionnaire, 54 (11.2%), 124 (25.7%), 196 (40.7%), 103 (21.4%) and 5 (1%), respectively, reported none, mild, moderate, severe and very severe symptoms on CPTSD-RI. Gender, loss of parents, somatic response and support level were significantly associated with the total score on CPTSD-RI (P PTSD, ranging from very severe to moderate, could persist for a long time after the tsunami and be affected by gender, loss of parents, somatic response, support level and severity of the disaster.

  6. Preventing post traumatic stress disorder in accident and emergency nursing. A review of the literature.

    Science.gov (United States)

    Cudmore, J

    1996-01-01

    Nurses working in Accident and Emergency may be susceptible to post-traumatic stress disorder (Rentoul and Ravenscroft 1993, Scott and Stradling 1994). The literature suggests that defusing immediately following a resuscitation may help to reduce abnormal stress reactions (Mitchell, 1988; Wright, 1992, 1993). Critical incident stress debriefing is recommended following critical incidents to help prevent emergency personnel developing post-traumatic stress disorder (Jimmerson, 1988; Mitchell, 1983, 1988; Parkinson, 1995).

  7. Study of post traumatic stress disorder among inhabitants of ancient Οlympia exposed to 2007 fire

    Directory of Open Access Journals (Sweden)

    Gritzani I.

    2013-07-01

    Full Text Available Introduction: Post Traumatic Stress Disorder (PTSD is the most often studied and most frequent and debilitating psychological disturbance that occurs after natural disasters. The aim of this study was to investigate the role of fire on post traumatic stress, psychopathology and hostility among individuals who had been exposed to, and to evaluate the differences of the above psychological parameters, in contrast to those who had not experienced.Material and Method: 174 healthy individuals participated to the present study. Subjects were classified into two groups- inhabitants of ancient Olympia exposed to fire disaster and not being exposed in fire residents of Nauplio- based on their personal statements. The first group constituted of 83 individuals who reported being exposed to the fire, while the other group constituted of 91 individuals who reported not being exposed to such a traumatic experience. The questionnaire PTSD Checklist Civilian Version (PCL (Weathers, Litz, Huska & Keane, 1994, the questionnaire (SCL-90 (Derogatis, 1977 and the questionnaire (HDHQ(Caine et al. 1967 were used to gather the data. Results: Higher levels of post traumatic stress and a tendency to develop a extrapunitiveness hostile attitude were observed among participants who had reported being exposed to fire natural disaster. Psychopathology in those participants was not proved, apart from the depression subscale. Demographic factors such as middle age and female gender seemed to be correlated with PTSD, psychopathology and hostility after fire. Conclusion: Findings illustrated the multidimensional nature of natural disasters. Longitudinal studies are needed to examine the range of factors associated with the development and/or persistence of PTSD or related disorders from the chronic phase of psychological reactivity.

  8. Impact of coping styles on post-traumatic stress disorder and depressive symptoms among pregnant women exposed to Hurricane Katrina.

    Science.gov (United States)

    Oni, Olurinde; Harville, Emily W; Xiong, Xu; Buekens, Pierre

    2012-01-01

    Experiencing natural disasters such as hurricanes is associated with post-traumatic stress disorder (PTSD) and depression. We examined the role played by perceived stress and coping styles in explaining and modifying this association among pregnant women exposed to Hurricane Katrina. The study comprised 192 women (133 from New Orleans and 59 from Baton Rouge) who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane. Women were interviewed regarding their hurricane experience, perceived stress, and mental health outcomes. Coping styles was assessed using the Brief COPE, PTSD symptoms using the Post-Traumatic Checklist, and depressive symptoms using the Edinburgh Depression Scale. Multivariable regression models were run to determine the effects of coping styles on mental health and the interactions among coping styles, hurricane experience, and perceived stress on mental health. Apart from the positive reframing and humor coping styles, all coping styles correlated positively with PTSD or depression (p hurricane experience. Coping styles are potential moderators of the effects of stress on mental health of pregnant women.

  9. Charles Darwin's (1809-1882) illness - the role of post-traumatic stress disorder.

    Science.gov (United States)

    Heyse-Moore, Louis

    2016-09-15

    During most of his adult life, in counterpoint to his fame in describing the theory of evolution, Charles Darwin was chronically ill. He consulted many doctors with only limited and temporary success. His symptoms were many and varied. His doctors favoured dyspepsia or suppressed gout as the diagnosis. The Water Cure was only effective initially. Many diagnoses have been proposed by physicians since then. Perhaps he suffered from post-traumatic stress disorder (PTSD), not instead of but as well as other physical problems. His symptoms match with criteria for PTSD. Traumatic episodes from his life are considered in this paper: his mother's painful, sudden death from an acute abdominal event when he was eight; his reaction to seeing operations without anaesthetic; the deaths of three of his children, including his beloved daughter, Annie, aged ten; and being overwhelmed by his chronic, unrelenting symptoms. Trauma had not been conceptualised as a diagnosis in Darwin's time. Rather, hysteria and, in war, irritable heart were names given to what is now called PTSD.

  10. Treatment of post-traumatic stress disorder in patients with severe mental illness: a review.

    Science.gov (United States)

    Mabey, Linda; van Servellen, Gwen

    2014-02-01

    Although the prevalence of post-traumatic stress disorder (PTSD) is high among those with severe mental illness, little is known about the use of interventions to lessen the burden of PTSD in this population. Currently, there are limited data about safe and effective interventions to treat these individuals. This systematic published work review presents the scientific published work reporting studies of psychological treatment approaches for individuals with comorbid PTSD and severe mental illness. A secondary aim of this study was to identify the specific models implemented and tested, and their impact upon patient outcomes. A review of the published work from January 2001 through January 2012 of English-language publications retrieved from the Cumulative Index of Nursing and Allied Health Literature (CINAHL), MEDLINE, and the American Psychological Association generated abstracts (PsycINFO) databases was conducted. Six studies met the inclusion criteria for the review. The treatment programs described were cognitive-behavioural therapy, psychoeducation, exposure-based cognitive-behavioural therapy, and eye movement desensitization and reprocessing. Evidence of the effectiveness of these programs is examined. Data to support the use of these interventions are limited, indicating the need for further research and efficacy trials. Future areas of research and implications for nursing are discussed.

  11. Psychological resilience is associated with more intact social functioning in veterans with post-traumatic stress disorder and depression.

    Science.gov (United States)

    Wingo, Aliza P; Briscione, Maria; Norrholm, Seth D; Jovanovic, Tanja; McCullough, S Ashley; Skelton, Kelly; Bradley, Bekh

    2017-03-01

    Patients with depression or post-traumatic stress disorder (PTSD), common sequelae among individuals exposed to stressful or traumatic events, often report impairment in social functioning. Resilience is a multidimensional construct that enables adaptive coping with life adversity. Relationship between resilience and social functioning among veterans with depression and PTSD is not entirely clear and is the focus of this report. Resilience was assessed in 264 veterans using the Connor-Davidson Resilience Scale, PTSD with the PTSD Symptom Scale, depression with the Beck Depression Inventory, and social functioning with the Short Form Health Survey. Higher resilience was associated with more intact social functioning after PTSD and depression severity, childhood maltreatment, physical health, gender, education, marital status, and employment were simultaneously adjusted for. Childhood maltreatment, gender, marital status, education, and employment did not predict social functioning; however, greater severity of PTSD, depression, or physical health problems was each significantly associated with more impaired social functioning. Our findings suggest that higher resilience was associated with more intact social functioning regardless of the severity of PTSD and depression. Given the importance of social functioning in depression and/or PTSD recovery, studies are needed to examine if enhancing resilience presents a complementary approach to alleviating impaired social functioning.

  12. Post-traumatic stress disorder in somatic disease: lessons from critically ill patients.

    Science.gov (United States)

    Schelling, Gustav

    2008-01-01

    Post-traumatic stress disorder (PTSD) is a well-recognized complication of severe illness. PTSD has been described in patients after multiple trauma, burns, or myocardial infarction with a particularly high incidence in survivors of acute pulmonary failure (Acute Respiratory Distress Syndrome) or septic shock. Many patients with evidence of PTSD after critical illness have been treated in intensive care units (ICUs). Studies in long-term survivors of ICU treatment demonstrated a clear and vivid recall of different categories of traumatic memory such as nightmares, anxiety, respiratory distress, or pain with little or no recall of factual events. A high number of these traumatic memories from the ICU has been shown to be a significant risk factor for the later development of PTSD in long-term survivors. In addition, patients in the ICU are often treated with stress hormones like epinephrine, norepinephrine, or cortisol. The number of the above-mentioned categories of traumatic memory increased with the totally administered dosages of catecholamines and cortisol, and the evaluation of these categories at different time points after discharge from the ICU showed better memory consolidation with higher dosages of stress hormones administered. Conversely, the prolonged administration of beta-adrenergic antagonists during the recovery phase after cardiac surgery resulted in a lower number of traumatic memories and a lower incidence of stress symptoms at 6 months after surgery. Findings with regard to the administration of the stress hormone cortisol were more complex, however. Several studies from our group have demonstrated that the administration of stress doses of cortisol to critically ill patients resulted in a significant reduction of PTSD symptoms measured after recovery without influencing the number of categories of traumatic memory. This can possibly be explained by a cortisol-induced temporary impairment in traumatic memory retrieval that has previously been

  13. Post-traumatic stress disorder in the military veteran.

    Science.gov (United States)

    Friedman, M J; Schnurr, P P; McDonagh-Coyle, A

    1994-06-01

    1. Military personnel exposed to war-zone trauma are at risk for developing PTSD. Those at greatest risk are those exposed to the highest levels of war-zone stress, those wounded in action, those incarcerated as prisoners of war, and those who manifest acute war-zone reactions, such as CSR. 2. In addition to problems directly attributable to PTSD symptoms per se, individuals with this disorder frequently suffer from other comorbid psychiatric disorders, such as depression, other anxiety disorders, and alcohol or substance abuse/dependence. The resulting constellation of psychiatric symptoms frequently impairs marital, vocational, and social function. 3. The likelihood of developing chronic PTSD depends on premilitary and postmilitary factors in addition to features of the trauma itself. Premilitary factors include negative environmental factors in childhood, economic deprivation, family psychiatric history, age of entry into the military, premilitary educational attainment, and personality characteristics. Postmilitary factors include social support and the veteran's coping skills. 4. Among American military personnel, there are three populations at risk for unique problems that may amplify the psychological impact of war-zone stress. They are women whose war-zone experiences may be complicated by sexual assault and harassment; nonwhite ethnic minority individuals whose premilitary, postmilitary, and military experience is affected by the many manifestations of racism; and those with war-related physical disabilities, whose PTSD and medical problems often exacerbate each other. 5. The longitudinal course of PTSD is quite variable. Some trauma survivors may achieve complete recovery, whereas others may develop a persistent mental disorder in which they are severely and chronically incapacitated. Other patterns include delayed, chronic, and intermittent PTSD. 6. Theoretically primary preventive measures might include prevention of war or screening out vulnerable

  14. Depressive, anxiety and post-traumatic stress disorders at six years after occupational injuries.

    Science.gov (United States)

    Chin, Wei-Shan; Shiao, Judith Shu-Chu; Liao, Shih-Cheng; Kuo, Chun-Ya; Chen, Chih-Chieh; Guo, Yue Leon

    2017-01-02

    The aim of this study is to determine the prevalence rates of depressive, anxiety and PTSDs, and the risk factors for psychological symptoms at 6 years after occupational injury. This longitudinal study followed workers who were occupationally injured in 2009. Psychological symptoms and return to work were assessed at 3 and 12 months after injury. Injured workers who had completed the initial questionnaire survey at 3 or 12 months after injury were recruited. A self-administered questionnaire was mailed to the participants. For workers with high Brief Symptom Rating Scale and Post-traumatic Symptom Checklist scores, an in-depth psychiatric evaluation was performed using the Mini-international Neuropsychiatric Interview. A total of 570 workers completed the questionnaire (response rate, 28.7%). Among them, 243 (42.6%) had high psychological symptom scores and were invited for a phone interview; 135 (55.6%) completed the interview. The estimated rates of major depression and post-traumatic stress disorder (PTSD)/partial PTSD were 9.2 and 7.2%, respectively, and both these rates were higher at 6 years after injury than at 12 months after injury (2.0 and 5.1%). After adjustment for family and social factors, the risk factors for high psychological scores were length of hospitalization immediately after injury, affected physical appearance, repeated occupational injuries, unemployment, and number of quit jobs after the injury. At 6 years after occupational injury, the re-emergence of psychiatric disorders was observed. Relevant factors for poor psychological health were severity of injury and instability of work. Periodic monitoring of psychological and physical health and economic stability are warranted.

  15. [BEHAVIORAL, PHYSIOLOGICAL AND MORPHOLOGICAL CHARACTERISTICS ASSOCIATED WITH POST-TRAUMATIC RESPONSE TO CONTINUOUS EXPOSURE VERSUS ALTERNATE EXPOSURE IN AN ANIMAL MODEL OF POST-TRAUMATIC STRESS DISORDER].

    Science.gov (United States)

    Ostfeld, Ishay; Kaplan, Zeev; Cohen, Hagit

    2016-12-01

    The aim of this study was to approximate these conditions in an animal model of post-traumatic stress disorder (PTSD). More specifically, the neurobiological basis of these conditions, focusing on stress-related behavioral changes, HPA-axis and morphological were evaluated. The intention was to employ this well-validated, reproducible and reliable model for PTSD, to elicit data which will provide some guidance in the planning of a prospective study involving military personal. Combat personnel are exposed to significant stress and hardship, both physical and emotional, during their service and especially during active combat. Military forces are increasingly involved in conflicts involving nonmilitary or paramilitary adversaries in which they are exposed not to battles but to sporadic events, in what has come to be labeled "low intensity conflict". "Low intensity conflict" refers to a level of hostilities or use of military power that falls short of a full scale conventional or general war. These are characterized by brief periods of extreme stress and tangible danger interspersed by prolonged periods of siege. Whereas the potentially traumatizing effect of battle conditions is well documented, the risks of the sporadic highly stressful nature of "low intensity conflict" have not been studied. Furthermore, in recent years, soldiers commonly receive "relaxation periods" before re-engaging in battle. This new policy may possibly contradict the traditional treatment principles, focusing on "proximity" and "continuity" to the battlefield and its effects have not been studied. Continuous and sporadic stresses, representing battlefield conditions, were induced in a validated rat animalmodel for PTSD and behavioral changes, hormonal levels and brain morphology were evaluated. Behavioral response, hormonal levels and brain morphological changes suggest that PTSD-like reactions were significantly higher in rats exposed to continuous stress compared to those exposed to

  16. Post-traumatic stress disorder symptom burden and gender each affect generalization in a reward- and punishment-learning task.

    Science.gov (United States)

    Radell, Milen L; Beck, Kevin D; Gilbertson, Mark W; Myers, Catherine E

    2017-01-01

    Post-traumatic stress disorder (PTSD) can develop following exposure to a traumatic event. Re-experiencing, which includes intrusive memories or flashbacks of the trauma, is a core symptom cluster of PTSD. From an associative learning perspective, this cluster may be attributed to cues associated with the trauma, which have come to elicit symptoms in a variety of situations encountered in daily life due to a tendency to overgeneralize. Consistent with this, prior studies have indicated that both individuals with clinically diagnosed with PTSD, and those with self-reported symptoms who may not meet full diagnostic criteria, show changes in generalization. Building on prior research, the current study examined whether PTSD symptom burden, but also gender, veteran status, and combat experience-all associated with PTSD vulnerability-modulate learning and generalization in a computer-based task. Participants were presented with stimulus compounds consisting of a foreground and background that could be predictive of reward, punishment or no outcome. Learning was followed by a generalization test where these components were recombined to form novel configurations. An interaction between PTSD symptom burden and gender was found where females with more severe PTSD symptoms showed no evidence of sensitivity to the background. This result is consistent with increased generalization, and may indicate a decrease in the ability to process cue configurations leading to re-experiencing in a variety of situations. Further work is indicated to help elucidate the cognitive processes driving gender differences that may confer vulnerability to PTSD.

  17. Post-traumatic stress disorder symptom burden and gender each affect generalization in a reward- and punishment-learning task

    Science.gov (United States)

    Beck, Kevin D.; Gilbertson, Mark W.; Myers, Catherine E.

    2017-01-01

    Post-traumatic stress disorder (PTSD) can develop following exposure to a traumatic event. Re-experiencing, which includes intrusive memories or flashbacks of the trauma, is a core symptom cluster of PTSD. From an associative learning perspective, this cluster may be attributed to cues associated with the trauma, which have come to elicit symptoms in a variety of situations encountered in daily life due to a tendency to overgeneralize. Consistent with this, prior studies have indicated that both individuals with clinically diagnosed with PTSD, and those with self-reported symptoms who may not meet full diagnostic criteria, show changes in generalization. Building on prior research, the current study examined whether PTSD symptom burden, but also gender, veteran status, and combat experience–all associated with PTSD vulnerability–modulate learning and generalization in a computer-based task. Participants were presented with stimulus compounds consisting of a foreground and background that could be predictive of reward, punishment or no outcome. Learning was followed by a generalization test where these components were recombined to form novel configurations. An interaction between PTSD symptom burden and gender was found where females with more severe PTSD symptoms showed no evidence of sensitivity to the background. This result is consistent with increased generalization, and may indicate a decrease in the ability to process cue configurations leading to re-experiencing in a variety of situations. Further work is indicated to help elucidate the cognitive processes driving gender differences that may confer vulnerability to PTSD. PMID:28196108

  18. Accelerated resolution therapy: an innovative mental health intervention to treat post-traumatic stress disorder.

    Science.gov (United States)

    Finnegan, Alan; Kip, K; Hernandez, D; McGhee, S; Rosenzweig, L; Hynes, C; Thomas, M

    2016-04-01

    Post-traumatic stress disorder (PTSD) is a disabling trauma and stress-related disorder that may occur after a person experiences a traumatic event, and evokes a combination of intrusion and avoidance symptoms, negative alterations in cognitions and mood, and alterations in arousal and reactivity. Accelerated resolution therapy (ART) is an emerging psychotherapy that provides fast and lasting resolution for mental health problems such as PTSD. ART has been shown to achieve a positive result in one to five sessions, typically over a 2-week period, and requires no homework, skills practice or repeated exposure to targeted events. Initial research, including one randomised control trial, has demonstrated that ART interventions can significantly reduce symptoms of psychological trauma in both civilians and US service members and veterans. These results suggest that ART be considered as either a primary treatment option or for refractory PTSD in those with a suboptimal response to endorsed first-line therapies. Conservative estimates indicate substantial potential cost savings in PTSD treatment. Despite the need for more definitive clinical trials, there is increasing interest in ART in the USA, including in the US Army. The growing positive empirical evidence is compelling, and there appears to be sufficient evidence to warrant UK researchers undertaking ART research. The armed forces offer the potential for comparative international trials. However, equally important are veterans, emergency services personnel and those subjected to violence. ART appears to also have application in other conditions, including depression, anxiety disorders, and alcohol or drug misuse. ART can potentially help personnel traumatised by the unique challenges of war and conflict zones by providing brief psychotherapy in a readily accessible and culturally competent manner. ART facilitates the provision of interventions and resolutions in theatre, thus enhancing forces' fighting capability.

  19. Post-traumatic stress disorder and opioid use disorder: A narrative review of conceptual models.

    Science.gov (United States)

    Danovitch, Itai

    2016-01-01

    Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.

  20. Cancer-Related Post-traumatic Stress (PDQ®)—Patient Version

    Science.gov (United States)

    Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

  1. Cancer-Related Post-traumatic Stress (PDQ®)—Health Professional Version

    Science.gov (United States)

    Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.

  2. Post traumatic stress disorder: undiagnosed cases in a tertiary ...

    African Journals Online (AJOL)

    subjects with PTSD were more likely to use cannabis. Conclusions: PTSD ... psychological interventions aimed at preventing PTSD have been ineffective, trauma ... cognitive restructuring has been successful in the treatment of this disorder.10 ...

  3. Self-inflicted burns in patients with chronic combat-related post-traumatic stress disorder.

    Science.gov (United States)

    Bras, Marijana; Loncar, Zoran; Boban, Maja; Gregurek, Rudolf; Brajković, Lovorka; Tomicić, Hrvoje; Muljacić, Ante; Micković, Vlatko; Kalenić, Barbara

    2007-12-01

    This study examined self-inflicted burns in case series of four patients with chronic combat-related post-traumatic stress disorder (PTSD). Those patients were hospitalized in the Burn Unit of the University Hospital of Traumatology in Zagreb because of severe burns and had a premorbid psychiatric history of PTSD. Demographic data and information regarding the circumstances surrounding the incident, burn severity, treatment and outcomes of these patients were collected. The authors have analyzed possible impacts of the sensationalistic way in which media present cases of self-inflicted burning that induce other, new cases of this suicide type, known in the literature as "Werther's syndrome". The importance of multidisciplinary approach in the treatment of burn patients is stressed with emphasis on the important role of liaison psychiatrist in treating these patients. It is necessary to educate media people to avoid sensational reporting on this kind of events. Continuous psychiatric treatment of vulnerable individuals could be useful in prevention of self-inflicted burns.

  4. Limbic brain responses in mothers with post-traumatic stress disorder and comorbid dissociation to video clips of their children.

    Science.gov (United States)

    Moser, Dominik Andreas; Aue, Tatjana; Wang, Zhishun; Rusconi Serpa, Sandra; Favez, Nicolas; Peterson, Bradley Scott; Schechter, Daniel Scott

    2013-09-01

    Maternal dissociative symptoms which can be comorbid with interpersonal violence-related post-traumatic stress disorder (IPV-PTSD) have been linked to decreased sensitivity and responsiveness to children's emotional communication. This study examined the influence of dissociation on neural activation independently of IPV-PTSD symptom severity when mothers watch video-stimuli of their children during stressful and non-stressful mother-child interactions. Based on previous observations in related fields, we hypothesized that more severe comorbid dissociation in IPV-PTSD would be associated with lower limbic system activation and greater neural activity in regions of the emotion regulation circuit such as the medial prefrontal cortex and dorsolateral prefrontal cortex (dlPFC). Twenty mothers (of children aged 12-42 months), with and without IPV-PTSD watched epochs showing their child during separation and play while undergoing functional magnetic resonance imaging (fMRI). Multiple regression indicated that when mothers diagnosed with IPV-PTSD watched their children during separation compared to play, dissociative symptom severity was indeed linked to lowered activation within the limbic system, while greater IPV-PTSD symptom severity was associated with heightened limbic activity. Concerning emotion regulation areas, there was activation associated to dissociation in the right dlPFC. Our results are likely a neural correlate of affected mothers' reduced capacity for sensitive responsiveness to their young child following exposure to interpersonal stress, situations that are common in day-to-day parenting.

  5. Tsunami-affected Scandinavian tourists: disaster exposure and post-traumatic stress symptoms

    DEFF Research Database (Denmark)

    Heir, Trond; Rosendal, Susanne; Bergh-Johannesson, Kerstin

    2011-01-01

    Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies.......Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies....

  6. A systematic review of treatments for post-traumatic stress disorder among refugees and asylum-seekers.

    Science.gov (United States)

    Crumlish, Niall; O'Rourke, Killian

    2010-04-01

    Recent years have seen a consensus emerge on the treatment of post-traumatic stress disorder (PTSD) in the general population. No such consensus exists for refugees, although the rate of PTSD among refugees is 10 times that of the general population. We conducted a systematic review of randomized controlled trial of treatment of PTSD among refugees and asylum-seekers. We rated trials with a risk of bias table and drew conclusions about the evidence for individual therapies. Ten randomized, controlled trials (n = 528) met our search criteria. Trials were small, and allocation concealment and blinding were inadequate. No treatment was firmly supported, but there was evidence for narrative exposure therapy and cognitive-behavioral therapy. Future trials should evaluate interventions that are developed within refugees' cultures, based on a local understanding of trauma and psychological distress.

  7. Post-traumatic stress disorder in adolescents in Lebanon as wars gained in ferocity: a systematic review.

    Science.gov (United States)

    Shaar, Khuzama Hijal

    2013-09-02

    Significance for public healthPost traumatic stress disorder (PTSD) in adolescents has been implicated in developmental impairments, mental and scholastic problems, alcohol and drug abuse, and antisocial behavior in its victims among others. Absence of review studies regarding the prevalence of PTSD in adolescents in Lebanon, a country plagued by decades of civil strife and external occupation and invasion, is noted. Such information may reinforce the need to develop national public health policies to identify PTSD in children and adolescents, provide them with counseling and treatment, and formulate prevention strategies to protect vulnerable youth from devastations of war.For decades, Lebanon was war-torn by civil strife, and occupation and invasion by neighboring countries. In time, these wars have escalated in intensity from sniping, barricading streets and random shelling of residential quarters to the use of rockets, aerial bombing, and heavy artillery. Adverse mental health effects are noted in times of war with post traumatic stress disorder (PTSD) as a main outcome. The aim of this study was to carry out a systematic review of published studies documenting the prevalence of PTSD in the adolescent population of Lebanon, to investigate the increase in these rates with the escalation of war intensity, and to examine PTSD determinants. A search strategy was developed for online databases (PubMed and Google Scholar) between inception to the first week of January 2013. Search terms used were PTSD, adolescents and Lebanon. Eleven studies reporting PTSD in adolescents met the inclusion criteria for a total number of 5965 adolescents. Prevalence rates of PTSD ranged from 8.5% to 14.7% for the civil war, 3.7% for adolescents with sensory disabilities, 21.6% for the Grapes of Wrath War, and 15.4% to 35.0% for the 2006 July War. Some increase in PTSD rates in time is noted. Type of trauma such as bereavement, injury, house destruction, and economic problems, low self

  8. Severe war trauma and post-traumatic stress disorder in adolescents with sensory impairments: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Khuzama Hijal Shaar

    2013-04-01

    Full Text Available A paucity of studies of the psychological status of adolescents with sensory impairments in political conflict areas is noted. This study was set up to examine the exposure of adolescents with sensory impairments (ASIs to severe war trauma and development of post-traumatic stress disorder (PTSD as compared to their able-bodied peers (ABPs. It also answers the question whether their impairments have made them more resilient in facing traumatic events. A cross-sectional study of all ASIs attending special schools in three administrative districts in Lebanon (n=166 as well as a group of 166 age and sex-matched ABPs from neighboring schools was conducted. The Post Traumatic Stress Reaction Checklist for children (PTSRC was used to assess exposure to severe trauma, PTSD and their determinants. ASIs reported a lower exposure to severe traumatic events (24.1% as compared to their ABPs (69.9%, and risk factors for their exposure were an older age group, a fatherless family, and severe visual impairment. Prevalence rates for PTSD were similar in the two study groups (17.5% and 16.4%. Younger ASIs were at a significantly higher risk of developing PTSD. Lower exposure to trauma among ASIs points to the more sheltered life that they lead. Given the same exposure as ABPs, similar rates of PTSD are noted among the two study groups. This may indicate that having a sensory impairment may protect from PTSD due to decreased exposure to severe trauma and not due to increased resilience of subjects.

  9. Long-Term Maternal Stress and Post-traumatic Stress Symptoms Related to Developmental Outcome of Extremely Premature Infants.

    Science.gov (United States)

    Zerach, Gadi; Elsayag, Adi; Shefer, Shahar; Gabis, Lidia

    2015-08-01

    In this study, we examined the relations between the severity of developmental outcomes of extremely low birth weight (ELBW) children and their mothers' stress and post-traumatic stress disorder (PTSD) symptoms, 4-16 years after birth. Israeli mothers (N = 78) of a cohort of extremely premature infants (24-27 weeks) born 4-16 years earlier were asked to report about the medical and developmental condition of their child and their current perceived stress and PTSD symptoms. Results show that mothers of ELBW children with normal development reported the lowest perceived stress compared with mothers of ELBW children with developmental difficulties. We also found that 25.6% of the mothers had the potential to suffer from PTSD following the birth of an ELBW child. Furthermore, the severity of prematurity developmental outcomes made a significant contribution to mothers' perceived stress. To sum, mothers of ELBW infants' perceived stress is related to their children's severity of prematurity developmental outcomes, 4-16 years after birth. Clinical implications of these findings are discussed.

  10. Post-traumatic Stress Symptoms and Post-traumatic Growth in 223 Childhood Cancer Survivors: Predictive Risk Factors.

    Science.gov (United States)

    Tremolada, Marta; Bonichini, Sabrina; Basso, Giuseppe; Pillon, Marta

    2016-01-01

    With modern therapies and supportive care, survival rates of childhood cancer have increased considerably. However, there are long-term psychological sequelae of these treatments that may not manifest until pediatric survivors are into adulthood. The prevalence of post-traumatic stress disorder in young adult survivors of childhood cancer ranges from 6.2 to 22%; associated risk factors are young age at the assessment, female gender, low education level, and some disease-related factors. The aim of this study was to investigate, in adolescent and young adult (AYA) survivors of childhood cancer, the incidence and severity of post-traumatic stress symptoms (PTSSs), and to identify the risk factors and the associated post-traumatic growth (PTG) index. Participants were 223 AYA cancer survivors recruited during follow-up visits in the Oncohematology Clinic of the Department of Child and Woman's Health, University of Padua. Data were collected from self-report questionnaires on PTSS incidence, PTG mean score, perceived social support, and medical and socio-demographic factors. Ex-patients' mean age at the assessment was 19.33 years (SD = 3.01, 15-25), 123 males and 100 females, with a mean of years off-therapy of 9.64 (SD = 4.17). Most (52.5%) had survived an hematological disorder and 47.5% a solid tumor when they were aged, on average, 8.02 years (SD = 4.40). The main results indicated a moderate presence of clinical (≥9 symptoms: 9.4%) and sub-clinical PTSS (6-8 symptoms: 11.2%), with the avoidance criterion most often encountered. Re-experience symptoms and PTG mean score were significantly associated (r = 0.24; p = 0.0001). A hierarchical regression model (R (2) = 0.08; F = 1.46; p = 0.05) identified female gender (β = 0.16; p = 0.05) and less perceived social support (β = -0.43; p = 0.05) as risk factors to developing PTSS. Another hierarchical regression model assessed the possible predictors of the PTG total score (R (2) = 0.36; F = 9.1; p = 0.0001), with

  11. Stress-induced enhancement of fear conditioning activates the amygdalar cholecystokinin system in a rat model of post-traumatic stress disorder.

    Science.gov (United States)

    Feng, Ting; Yang, Shengchang; Wen, Di; Sun, Qiming; Li, Yingmin; Ma, Chunling; Cong, Bin

    2014-10-01

    Post-traumatic stress disorder (PTSD), a debilitating psychiatric disease characterized by invasive and persistent fear memories-induced stressful experience, is associated with numerous changes in neuroendocrine function. Here, we investigated whether PTSD-like symptoms are associated with changes in the cholecystokinin (CCK) system in the basolateral amygdala. We developed an animal model of PTSD using multiple foot shocks at 1.1 mA. The resulting conditioned fear response was severe (>80% freezing) and maintained for at least 28 days. The stress-associated neurotransmitters norepinephrine, dopamine, and corticotrophin-releasing hormone were elevated at 1 day after foot shock. CCK immunoreactivity and extracellular concentration as well as the expression of CCK receptors (CCK1R, CCK2R) increased progressively for 28 days following foot shock. Taken together, these results suggest that stress-induced activation of the CCK system in the BLA, which may contribute toward the development of PTSD-like symptoms.

  12. Executive Dysfunctions: The role in Attention Deficit Hyperactivity and Post-traumatic Stress neuropsychiatric disorders

    Directory of Open Access Journals (Sweden)

    Lía Martínez

    2016-08-01

    Full Text Available Executive functions (EFs is an umbrella term for various cognitive processes controlled by a complex neural activity, which allow the production of different types of behaviors seeking to achieve specific objectives, one of them being inhibitory control. There is a wide consensus that clinical and behavioral alterations associated with EF, such as inhibitory control, are present in various neuropsychiatric disorders. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and the psychopathological processes associated with Attention Deficit Hyperactivity Disorder (ADHD and Post-traumatic Stress Disorder (PTSD. A revision on the role of frontal-subcortical neural circuits and their presumable abnormal functioning and the high frequency of neuropsychiatric symptoms could explain the difficulties with putting effector mechanisms into action, giving individuals the necessary tools to act efficiently in their environment. Although neuronal substrate data about ADHD and PTSD has been reported in the literature, it is isolated. Therefore, this review highlights the overlapping of neural substrates in the symptomatology of ADHD and PTSD disorders concerning EFs, especially in the inhibitory component. Thus, the changes related to impaired EF that accompany disorders like ADHD and PTSD could be explained by disturbances that have a direct or indirect impact on the functioning of these loops. Initially, the theoretical model of EF according to current neuropsychology will be presented, focusing on the inhibitory component. In a second stage, this component will be analyzed for each of the disorders of interest, considering the clinical aspects, the etiology and the neurobiological basis. Additionally, commonalities between the two neuropsychiatric conditions will be taken into consideration from the perspectives of cognitive and emotional inhibition. Finally, the

  13. Executive Dysfunctions: The Role in Attention Deficit Hyperactivity and Post-traumatic Stress Neuropsychiatric Disorders

    Science.gov (United States)

    Martínez, Lía; Prada, Edward; Satler, Corina; Tavares, Maria C. H.; Tomaz, Carlos

    2016-01-01

    Executive functions (EFs) is an umbrella term for various cognitive processes controlled by a complex neural activity, which allow the production of different types of behaviors seeking to achieve specific objectives, one of them being inhibitory control. There is a wide consensus that clinical and behavioral alterations associated with EF, such as inhibitory control, are present in various neuropsychiatric disorders. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and the psychopathological processes associated with attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). A revision on the role of frontal-subcortical neural circuits and their presumable abnormal functioning and the high frequency of neuropsychiatric symptoms could explain the difficulties with putting effector mechanisms into action, giving individuals the necessary tools to act efficiently in their environment. Although, neuronal substrate data about ADHD and PTSD has been reported in the literature, it is isolated. Therefore, this review highlights the overlapping of neural substrates in the symptomatology of ADHD and PTSD disorders concerning EFs, especially in the inhibitory component. Thus, the changes related to impaired EF that accompany disorders like ADHD and PTSD could be explained by disturbances that have a direct or indirect impact on the functioning of these loops. Initially, the theoretical model of EF according to current neuropsychology will be presented, focusing on the inhibitory component. In a second stage, this component will be analyzed for each of the disorders of interest, considering the clinical aspects, the etiology and the neurobiological basis. Additionally, commonalities between the two neuropsychiatric conditions will be taken into consideration from the perspectives of cognitive and emotional inhibition. Finally, the implications and future

  14. Glucocorticoids for the treatment of post-traumatic stress disorder and phobias: a novel therapeutic approach.

    Science.gov (United States)

    de Quervain, Dominique J-F; Margraf, Jürgen

    2008-04-07

    Post-traumatic stress disorder (PTSD) and phobias belong to the most common anxiety disorders and to the most common psychiatric illnesses in general. In both disorders, aversive memories are thought to play an important role in the pathogenesis and symptomatology. Previously, we have reported that elevated glucocorticoid levels inhibit memory retrieval in animals and healthy humans. We therefore hypothesized that the administration of glucocorticoids might also inhibit the retrieval of aversive memory, thereby reducing symptoms in patients with PTSD and phobias. In recent clinical studies, we found first evidence to support this hypothesis. In patients with PTSD, low-dose cortisol treatment for one month reduced symptoms of traumatic memories without causing adverse side effects. Furthermore, we found evidence for a prolonged effect of the cortisol treatment. Persistent retrieval and reconsolidation of traumatic memories is a process that keeps these memories vivid and thereby the disorder alive. By inhibiting memory retrieval, cortisol may weaken the traumatic memory trace, and thus reduce symptoms even beyond the treatment period. In patients with social phobia, we found that a single oral administration of cortisone 1 h before a socio-evaluative stressor significantly reduced self-reported fear during the anticipation-, exposure-, and recovery phase of the stressor. In subjects with spider phobia, repeated oral administration of cortisol 1 h before exposure to a spider photograph induced a progressive reduction of stimulus-induced fear. This effect was maintained when subjects were exposed to the stimulus again two days after the last cortisol administration, indicating that cortisol facilitated the extinction of phobic fear. In conclusion, by a common mechanism of reducing the retrieval of aversive memories, glucocorticoids may be suited for the treatment of PTSD as well as phobias. More studies are needed to further evaluate the therapeutic efficacy of

  15. Post-traumatic stress disorder in older adults: a systematic review of the psychotherapy treatment literature.

    Science.gov (United States)

    Dinnen, Stephanie; Simiola, Vanessa; Cook, Joan M

    2015-01-01

    Older adults represent the fastest growing segment of the US and industrialized populations. However, older adults have generally not been included in randomized clinical trials of psychotherapy for post-traumatic stress disorder (PTSD). This review examined reports of psychological treatment for trauma-related problems, primarily PTSD, in studies with samples of at least 50% adults aged 55 and older using standardized measures. A systematic review of the literature was conducted on psychotherapy for PTSD with older adults using PubMed, Medline, PsychInfo, CINAHL, PILOTS, and Google Scholar. A total of 42 studies were retrieved for full review; 22 were excluded because they did not provide at least one outcome measure or results were not reported by age in the case of mixed-age samples. Of the 20 studies that met review criteria, there were: 13 case studies or series, three uncontrolled pilot studies, two randomized clinical trials, one non-randomized concurrent control study and one post hoc effectiveness study. Significant methodological limitations in the current older adult PTSD treatment outcome literature were found reducing its internal validity and generalizability, including non-randomized research designs, lack of comparison conditions and small sample sizes. Select evidence-based interventions validated in younger and middle-aged populations appear acceptable and efficacious with older adults. There are few treatment studies on subsets of the older adult population including cultural and ethnic minorities, women, the oldest old (over 85), and those who are cognitively impaired. Implications for clinical practice and future research directions are discussed.

  16. Executive Dysfunctions: The Role in Attention Deficit Hyperactivity and Post-traumatic Stress Neuropsychiatric Disorders.

    Science.gov (United States)

    Martínez, Lía; Prada, Edward; Satler, Corina; Tavares, Maria C H; Tomaz, Carlos

    2016-01-01

    Executive functions (EFs) is an umbrella term for various cognitive processes controlled by a complex neural activity, which allow the production of different types of behaviors seeking to achieve specific objectives, one of them being inhibitory control. There is a wide consensus that clinical and behavioral alterations associated with EF, such as inhibitory control, are present in various neuropsychiatric disorders. This paper reviews the research literature on the relationship between executive dysfunction, frontal-subcortical neural circuit changes, and the psychopathological processes associated with attention deficit hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD). A revision on the role of frontal-subcortical neural circuits and their presumable abnormal functioning and the high frequency of neuropsychiatric symptoms could explain the difficulties with putting effector mechanisms into action, giving individuals the necessary tools to act efficiently in their environment. Although, neuronal substrate data about ADHD and PTSD has been reported in the literature, it is isolated. Therefore, this review highlights the overlapping of neural substrates in the symptomatology of ADHD and PTSD disorders concerning EFs, especially in the inhibitory component. Thus, the changes related to impaired EF that accompany disorders like ADHD and PTSD could be explained by disturbances that have a direct or indirect impact on the functioning of these loops. Initially, the theoretical model of EF according to current neuropsychology will be presented, focusing on the inhibitory component. In a second stage, this component will be analyzed for each of the disorders of interest, considering the clinical aspects, the etiology and the neurobiological basis. Additionally, commonalities between the two neuropsychiatric conditions will be taken into consideration from the perspectives of cognitive and emotional inhibition. Finally, the implications and future

  17. The Neuropsychological Profile of Comorbid Post-Traumatic Stress Disorder in Adult ADHD.

    Science.gov (United States)

    Antshel, Kevin M; Biederman, Joseph; Spencer, Thomas J; Faraone, Stephen V

    2016-12-01

    ADHD and post-traumatic stress disorder (PTSD) are often comorbid yet despite the increased comorbidity between the two disorders, to our knowledge, no data have been published regarding the neuropsychological profile of adults with comorbid ADHD and PTSD. Likewise, previous empirical studies of the neuropsychology of PTSD did not control for ADHD status. We sought to fill this gap in the literature and to assess the extent to which neuropsychological test performance predicted psychosocial functioning, and perceived quality of life. Participants were 201 adults with ADHD attending an outpatient mental health clinic between 1998 and 2003 and 123 controls without ADHD. Participants completed a large battery of self-report measures and psychological tests. Diagnoses were made using data obtained from structured psychiatric interviews (i.e., Structured Clinical Interview for DSM-IV, Schedule for Affective Disorders and Schizophrenia for School-Age Children Epidemiologic Version). Differences emerged between control participants and participants with ADHD on multiple neuropsychological tests. Across all tests, control participants outperformed participants with ADHD. Differences between the two ADHD groups emerged on seven psychological subtests including multiple Wechsler Adult Intelligence Scale-Third edition and Rey-Osterrieth Complex Figure Test measures. These test differences did not account for self-reported quality of life differences between groups. The comorbidity with PTSD in adults with ADHD is associated with weaker cognitive performance on several tasks that appear related to spatial/perceptual abilities and fluency. Neuropsychological test performances may share variance with the quality of life variables yet are not mediators of the quality of life ratings. © The Author(s) 2014.

  18. Dexmedetomidine alleviates anxiety-like behaviors and cognitive impairments in a rat model of post-traumatic stress disorder.

    Science.gov (United States)

    Ji, Mu-Huo; Jia, Min; Zhang, Ming-Qiang; Liu, Wen-Xue; Xie, Zhong-Cong; Wang, Zhong-Yun; Yang, Jian-Jun

    2014-10-03

    Post-traumatic stress disorder (PTSD) is a psychiatric disease that has substantial health implications, including high rates of health morbidity and mortality, as well as increased health-related costs. Although many pharmacological agents have proven the effects on the development of PTSD, current pharmacotherapies typically only produce partial improvement of PTSD symptoms. Dexmedetomidine is a selective, short-acting α2-adrenoceptor agonist, which has anxiolytic, sedative, and analgesic effects. We therefore hypothesized that dexmedetomidine possesses the ability to prevent the development of PTSD and alleviate its symptoms. By using the rat model of PTSD induced by five electric foot shocks followed by three weekly exposures to situational reminders, we showed that the stressed rats displayed pronounced anxiety-like behaviors and cognitive impairments compared to the controls. Notably, repeated administration of 20μg/kg dexmedetomidine showed impaired fear conditioning memory, decreased anxiety-like behaviors, and improved spatial cognitive impairments compared to the vehicle-treated stressed rats. These data suggest that dexmedetomidine may exert preventive and protective effects against anxiety-like behaviors and cognitive impairments in the rats with PTSD after repeated administration. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Blast Exposure Induces Post-Traumatic Stress Disorder-Related Traits in a Rat Model of Mild Traumatic Brain Injury

    OpenAIRE

    Elder, Gregory A; Dorr, Nathan P.; De Gasperi, Rita; Gama Sosa, Miguel A.; Shaughness, Michael C.; Maudlin-Jeronimo, Eric; Hall, Aaron A; McCarron, Richard M.; Ahlers, Stephen T

    2012-01-01

    Blast related traumatic brain injury (TBI) has been a major cause of injury in the wars in Iraq and Afghanistan. A striking feature of the mild TBI (mTBI) cases has been the prominent association with post-traumatic stress disorder (PTSD). However, because of the overlapping symptoms, distinction between the two disorders has been difficult. We studied a rat model of mTBI in which adult male rats were exposed to repetitive blast injury while under anesthesia. Blast exposure induced a variety ...

  20. Cloud storage based mobile assessment facility for patients with post-traumatic stress disorder using integrated signal processing algorithm

    Science.gov (United States)

    Balbin, Jessie R.; Pinugu, Jasmine Nadja J.; Basco, Abigail Joy S.; Cabanada, Myla B.; Gonzales, Patrisha Melrose V.; Marasigan, Juan Carlos C.

    2017-06-01

    The research aims to build a tool in assessing patients for post-traumatic stress disorder or PTSD. The parameters used are heart rate, skin conductivity, and facial gestures. Facial gestures are recorded using OpenFace, an open-source face recognition program that uses facial action units in to track facial movements. Heart rate and skin conductivity is measured through sensors operated using Raspberry Pi. Results are stored in a database for easy and quick access. Databases to be used are uploaded to a cloud platform so that doctors have direct access to the data. This research aims to analyze these parameters and give accurate assessment of the patient.

  1. Reviewing Frankl's Will to meaning and its implications for psychotherapy dealing with post-traumatic stress disorder.

    Science.gov (United States)

    Chung, M C

    1995-01-01

    Recent research has shown that people who have gone through war experiences in one way or the other tend to manifest reactions classified as post-traumatic stress disorder. Viktor Frankl, the founder of logotherapy, manifested PTSD reactions when he was in a concentration camp. This paper attempts to sketch how he lived through his traumatic experiences by relying on the principle of Will to Meaning as his survival mechanism. Two implications will be outlined derived from this principle for psychotherapies dealing with disaster survivors.

  2. Effectiveness of trauma-focused treatment for patients with psychosis with and without the dissociative subtype of post-traumatic stress disorder.

    Science.gov (United States)

    van Minnen, A; van der Vleugel, B M; van den Berg, D P G; de Bont, P A J M; de Roos, C; van der Gaag, M; de Jongh, A

    2016-10-01

    This study presents secondary analyses of a recently published trial in which post-traumatic stress disorder (PTSD) patients with psychosis (n = 108) underwent 8 sessions of trauma-focused treatment, either prolonged exposure (PE) or eye movement desensitisation and reprocessing (EMDR) therapy. 24.1% fulfilled the criteria for the dissociative subtype, a newly introduced PTSD subtype in DSM-5. Treatment outcome was compared for patients with and without the dissociative subtype of PTSD. Patients with the dissociative subtype of PTSD showed large reductions in clinician-administered PTSD scale (CAPS) score, comparable with patients without the dissociative subtype of PTSD. It is concluded that even in a population with severe mental illness, patients with the dissociative subtype of PTSD do benefit from trauma-focused treatments without a pre-phase of emotion regulation skill training and should not be excluded from these treatments. © The Royal College of Psychiatrists 2016.

  3. REM Desensitization as a New Therapeutic Method for Post- Traumatic Stress Disorder: A Randomized Controlled Trial

    Directory of Open Access Journals (Sweden)

    Khodabakhsh Ahmadi

    2016-05-01

    Full Text Available Aim: to evaluate potential efficacy of a new therapeutic approach in posttraumatic stress disorder in comparison with eye movement desensitization and reprocessing (EMDR, a standard treatment approach and controls. Methods: the study was designed using a randomized controlled trial methodology. Participants were recruited from military servicemen aged between 25 to 50 years who were admitting hospitals of Bushehr, Iran, with the final diagnosis of PTSD. Finally 33 male patients were devided into three subgroups: G1: EMDR; G2: REM Desensitization; and group 3: controls who received no therapy. Mississippi Scale for Posttraumatic Stress Disorder, Pittsburgh Sleep Quality Index (PSQI and a 37 item death anxiety questionnaire were used for measures. Results: multiple comparisons showed that intrusive thoughts were significantly more likely to improve with REM Desensitization versus EMDR (P=0.03, while depression was more responsive to EMDR (p=0.03. Among the Pittsburgh scale for the quality of sleep items, sleep quality (p=0.02, sleep duration (p=0.001, and total sleep quality score (p=0.002 were significantly more likely to improve in the REM Desensitization group. Change in the absolute death anxiety scores was not different between subgroups excepting EMDR versus control group (p=0.05. Conclusion: REM, desensitization, the new therapeutic approach to PTSD is a highly effective strategy, even more than EMDR, the standard treatment, in most of the evaluated subjects, with special emphasis on sleep symptoms, and also in the management of intrusive thoughts. Depression is the only factor in which, REM Desensitization was significantly less likely to represent a superior therapeutic effect than EMDR. Key words: post traumatic stress disorder (PTSD, eye movement desensitization and reprocessing, new treatment.

  4. Sex differentials in the risk factors of post traumatic stress disorder among tsunami survivors in Tamil Nadu, India.

    Science.gov (United States)

    T T, Pyari; T K, Sundari Ravindran

    2016-10-01

    This study assessed if pre disaster, with-in disaster and post disaster factors predicted Post Traumatic Stress Disorder (PTSD) differently, among men and women survivors of the 2004 Southeast Asian tsunami in Kanyakumari district, Tamil Nadu, India. PTSD was identified using a validated tool, Impact of Events Scale-Revised (IES-R) among the participants in a cross-sectional community based survey (n=485). Case control analysis of 299 subjects was done to determine the predictors of PTSD. The odds of having PTSD were 6.35 times higher in women than men. Higher odds for PTSD was seen among women who were married, aged over 40, belonged to low socioeconomic status and resided in heavily damaged areas. Protective odds for PTSD was found among women who had received more than three times of counseling services whereas men were not at risk if they were free from fear of recurrence of tsunami, when adjusted for other variables. Women were vulnerable to PTSD because of their socially constructed roles. It is important to consider gender based vulnerabilities while designing interventions to combat mental health problems among disaster affected communities. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Psycho-social and Mental Variables and Post-Traumatic Stress Disorder in Traffic Accident Survivors in Northern Iran.

    Science.gov (United States)

    Khodadadi-Hassankiadeh, Naema; Dehghan-Nayeri, Nahid; Shahsavari, Hooman; Yousefzadeh-Chabok, Shahrokh; Haghani, Hamid

    2017-07-01

    To assess the psycho-social and mental variables associated with post-traumatic stress disorder (PTSD) in a series of Iranian patients. A total of 528 eligible accident survivors in pre-sampling of a randomized controlled trial targeting PTSD were included in this cross-sectional study. Psycho-social characteristics associated to PTSD were explored in these survivors in an outpatient clinic. They completed the questionnaires via interview between six weeks to six months after accident. Data collection tools were PSS (DSM-V version) for PTSD and BDI-II for depression and a researcher-made questionnaire for psycho-social variables. There was a significant association between PTSD and the following variables; family communication, current depression, return to work, history of death of relatives, witnessed the death, length of amnesia, hospitalization, injured situation, and accident severity. Multivariate logistic regression indicated that some variables were associated with PTSD such as accident severity, (paccident and poor family communication who do not return to work. Thus, routine assessment of PTSD, depression and psycho-social variables after traffic accidents must be taken into account.

  6. Longitudinal study of probable post-traumatic stress disorder in firefighters exposed to the World Trade Center disaster.

    Science.gov (United States)

    Berninger, Amy; Webber, Mayris P; Niles, Justin K; Gustave, Jackson; Lee, Roy; Cohen, Hillel W; Kelly, Kerry; Corrigan, Malachy; Prezant, David J

    2010-12-01

    Symptoms of post-traumatic stress disorder (PTSD) have been reported even years after the terrorist attacks of September 11, 2001 (9/11). We used screening tools to assess the prevalence of probable PTSD in 9/11-exposed firefighters at two time points, within 6 months of 9/11 (baseline) and 3-4 years post-disaster (follow-up). Five thousand six hundred fifty-six individuals completed assessments at both times. 15.5% reported probable PTSD post-9/11, 8.6% at baseline and 11.1% at follow-up, on average 2.9 (SD 0.5) years later. Analyses revealed that nearly half of all probable PTSD occurred as delayed onset (absent baseline, present follow-up). Compared with the resilient group (no probable PTSD at either time), probable PTSD at baseline, and delayed onset at follow-up were each associated with concomitant functional impairment (OR 19.5 and 18.9), respectively. Similar percentages of firefighters met criteria for baseline and delayed onset probable PTSD at follow-up, years later. Both were associated with substantial functional impairment. Early risk identification could provide opportunities for mental health interventions before symptoms compromise work and social relationships.

  7. The role of parenting behaviors in childhood post-traumatic stress disorder: A meta-analytic review.

    Science.gov (United States)

    Williamson, Victoria; Creswell, Cathy; Fearon, Pasco; Hiller, Rachel M; Walker, Jennifer; Halligan, Sarah L

    2017-04-01

    Studies that have examined the association between parenting behaviors and childhood post-traumatic stress disorder (PTSD) have yielded mixed findings. To clarify the role of parenting in childhood PTSD we conducted a systematic review and meta-analysis of 14 studies that investigated the association between parenting and youth PTSD symptoms (total n=4010). Negative parenting behaviors (e.g. overprotection, hostility) accounted for 5.3% of the variance in childhood PTSD symptoms. Positive parenting behaviors (e.g. warmth, support) account for 2.0% of variance. The negative and positive parenting and child PTSD symptom associations did not statistically differ in magnitude. Moderator analyses indicated that methodological factors and trauma variables may affect the association between parenting and child PTSD. Most studies relied upon questionnaire measures of general parenting style, and studies were predominantly cross-sectional with weaker evidence found in longitudinal studies. Given the small number of high quality studies available, only provisional recommendations about the role of parenting in childhood PTSD are made. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Regional cerebral glucose metabolism differentiates danger- and non-danger-based traumas in post-traumatic stress disorder.

    Science.gov (United States)

    Ramage, Amy E; Litz, Brett T; Resick, Patricia A; Woolsey, Mary D; Dondanville, Katherine A; Young-McCaughan, Stacey; Borah, Adam M; Borah, Elisa V; Peterson, Alan L; Fox, Peter T

    2016-02-01

    Post-traumatic stress disorder (PTSD) is presumably the result of life threats and conditioned fear. However, the neurobiology of fear fails to explain the impact of traumas that do not entail threats. Neuronal function, assessed as glucose metabolism with (18)fluoro-deoxyglucose positron emission tomography, was contrasted in active duty, treatment-seeking US Army Soldiers with PTSD endorsing either danger- (n = 19) or non-danger-based (n = 26) traumas, and was compared with soldiers without PTSD (Combat Controls, n = 26) and Civilian Controls (n = 24). Prior meta-analyses of regions associated with fear or trauma script imagery in PTSD were used to compare glucose metabolism across groups. Danger-based traumas were associated with higher metabolism in the right amygdala than the control groups, while non-danger-based traumas associated with heightened precuneus metabolism relative to the danger group. In the danger group, PTSD severity was associated with higher metabolism in precuneus and dorsal anterior cingulate and lower metabolism in left amygdala (R(2 )= 0.61). In the non-danger group, PTSD symptom severity was associated with higher precuneus metabolism and lower right amygdala metabolism (R(2 )= 0.64). These findings suggest a biological basis to consider subtyping PTSD according to the nature of the traumatic context.

  9. Qualitative Inquiry Explores Health-Related Quality of Life of Female Veterans With Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Haun, Jolie N; Duffy, Allyson; Lind, Jason D; Kisala, Pamela; Luther, Stephen L

    2016-11-01

    As the number of female veterans increases, health care systems must be prepared to meet the individualized needs of this population. To date, published data on health-related quality of life (HRQOL) of veterans with post-traumatic stress disorder (PTSD) focus on quantitative data and primarily represent the male population. The purpose of this study was to qualitatively explore the impact of PTSD on female veterans' HRQOL. A descriptive qualitative study used focus groups and demographic surveys to achieve data collection in a sample of veterans with PTSD. This report focuses on the analysis of a sample of 12 females to explore PTSD HRQOL experiences unique to female veterans. Female veterans reported several areas in which their HRQOL was impacted adversely in social participation, physical, cognitive, and emotional aspects of their lives. Issues with self-medication and substance abuse were also reported by participants. Female participants' perceptions about Veterans Health Administration were also discussed, highlighting unmet needs when receiving care for PTSD. These data provide unique insights from the perspective of female veterans with PTSD about their HRQOL and receiving care within the Veterans Health Administration health care system. These data can inform future research to better address the needs of female veterans living with PTSD.

  10. Prevalence and significant determinants of post-traumatic stress disorder in a large sample of patients with multiple sclerosis.

    Science.gov (United States)

    Ostacoli, Luca; Carletto, Sara; Borghi, Martina; Cavallo, Marco; Rocci, Emanuela; Zuffranieri, Marco; Malucchi, Simona; Bertolotto, Antonio; Zennaro, Alessandro; Furlan, Pier Maria; Picci, Rocco Luigi

    2013-06-01

    Chronic and life-threatening neurodegenerative diseases may be associated with post-traumatic stress disorder (PTSD). Therefore, the current study was an investigation of the prevalence of PTSD in multiple sclerosis (MS) patients, and identification of significant determinants of PTSD. Two hundred thirty-two MS patients were consecutively recruited and screened for the presence of PTSD with the Impact of Event Scale-Revised, corroborated by the Structured Clinical Interview for DSM-IV. Furthermore, participants were administered the Hospital Anxiety and Depression Scale and the Fatigue Severity Scale. Twelve patients (12/232, i.e. 5.17 %) were diagnosed as suffering from PTSD. Levels of education, anxiety and depression were significant determinants of the presence of PTSD. The role played by the levels of education, anxiety and depression in determining the presence of PTSD has been discussed. Further research on the psychological features of neurodegenerative diseases is urgently needed in order to plan appropriate treatments and improve patients' quality of life.

  11. Altered regional homogeneity in post-traumatic stress disorder: a resting-state functional magnetic resonance imaging study

    Institute of Scientific and Technical Information of China (English)

    Yan Yin; Baoci Shan; Qiyong Gong; Lingjiang Li; Changfeng Jin; Lisa T.Eyler; Hua Jin; Xiaolei Hu; Lian Duan; Huirong Zheng; Bo Feng; Xuanyin Huang

    2012-01-01

    Objective Little is known about the brain systems that contribute to vulnerability to post-traumatic stress disorder (PTSD).Comparison of the resting-state patterns of intrinsic functional synchronization,as measured by functional magnetic resonance imaging (fMRI),between groups with and without PTSD following a traumatic event can help identify the neural mechanisms of the disorder and targets for intervention.Methods Fifty-four PTSD patients and 72 matched traumatized subjects who experienced the 2008 Sichuan earthquake were imaged with blood oxygen level-dependent (BOLD) fMRI and analyzed using the measure of regional homogeneity (ReHo) during the resting state.Results PTSD patients presented enhanced ReHo in the left inferior parietal lobule and right superior frontal gyrus,and reduced ReHo in the right middle temporal gyrus and lingual gyrus,relative to traumatized individuals without PTSD.Conclusion Our findings showed that abnormal brain activity exists under resting conditions in PTSD patients who had been exposed to a major earthquake.Alterations in the local functional connectivity of cortical regions are likely to contribute to the neural mechanisms underlying PTSD.

  12. Characterising intra- and inter-intrinsic network synchrony in combat-related post-traumatic stress disorder.

    Science.gov (United States)

    Dunkley, Benjamin T; Doesburg, Sam M; Jetly, Rakesh; Sedge, Paul A; Pang, Elizabeth W; Taylor, Margot J

    2015-11-30

    Soldiers with post-traumatic stress disorder (PTSD) exhibit elevated gamma-band synchrony in left fronto-temporal cortex, and connectivity measures in these regions correlate with comorbidities and PTSD severity, which suggests increased gamma synchrony is related to symptomology. However, little is known about the role of intrinsic, phase-synchronised networks in the disorder. Using magnetoencephalography (MEG), we characterised spectral connectivity in the default-mode, salience, visual, and attention networks during resting-state in a PTSD population and a trauma-exposed control group. Intrinsic network connectivity was examined in canonical frequency bands. We observed increased inter-network synchronisation in the PTSD group compared with controls in the gamma (30-80 Hz) and high-gamma range (80-150 Hz). Analyses of connectivity and symptomology revealed that PTSD severity was positively associated with beta synchrony in the ventral-attention-to-salience networks, and gamma synchrony within the salience network, but also negatively correlated with beta synchrony within the visual network. These novel results show that frequency-specific, network-level atypicalities may reflect trauma-related alterations of ongoing functional connectivity, and correlations of beta synchrony in attentional-to-salience and visual networks with PTSD severity suggest complicated network interactions mediate symptoms. These results contribute to accumulating evidence that PTSD is a complicated network-based disorder expressed as altered neural interactions.

  13. Efficacy of Lamotrigin in Treatment of Avoidance / Numbing in Post-traumatic Stress Disorders

    Directory of Open Access Journals (Sweden)

    S Amanat

    2006-10-01

    Introduction & Objective: Post-traumatic stress disorder (PTSD is a chronic illness which is difficult to treat yet, it is a common disorder which is associated with significant morbidity and mortality. The hypothesis that exposure to traumatic events may sensitize or kindle limbic nuclei has led to efforts to treat PTSD with anticonvulsants based on the kindling hypothesis. This double–blind clinical trial assesses clinical response to lamotrigine as a potential treatment. Materials & Methods: Thirty patients with PTSD were randomly assigned in a double – blind design. They were treated for 3 months with lamotrigine (N=15, 150-500 mg/day as odd-on or placebo (N=15. The patients were measured in the first visit and at the end of 3 months by clinician administration. PTSD scales (CAPS paired t-test, and Friedman and Will Coxon were used for data analysis. Results: The mean score of frequency of PTSD criteria in Lamotrigine group in the first visit was 10.1±2.2 and in placebo group was 12.75 ±2.24. The mean score of these criteria in lamotrigin group after treatment period was 9±2.5 and for placebo group was 12.45±2.7. The analysis of these sores showed a significant difference in Lamotrigine group and a non significant difference in placebo group. The mean score of Intensity of PTSD criteria in Lamotrigine group in first visit was 9.4±1.2 and in placebo group was 9.1±1.9. The mean score of these criteria in Lamotrigine group after treatment group was 8.4±2 and for placebo group was 9.1±2. The analysis of these scores showed a significant difference in lamotrigine group and a non-significant difference in placebo group. In placebo group, the analysis of mean sores of all intensity and frequency of criteria before and after taking placebo showed a non-significant difference. In Lamotrigine group, the analysis of mean scores of intensity and frequency of criteria such as avoidance of thoughts or feelings, avoidances of activities, place, people, inability

  14. Frequency of trauma exposure and Post-Traumatic Stress Disorder in Italy: analysis from the World Mental Health Survey Initiative.

    Science.gov (United States)

    Carmassi, Claudia; Dell'Osso, Liliana; Manni, Corrado; Candini, Valentina; Dagani, Jessica; Iozzino, Laura; Koenen, Karestan C; de Girolamo, Giovanni

    2014-12-01

    Epidemiological studies have examined the relative importance of Traumatic Events (TEs) in accounting for the societal burden of post-traumatic stress disorder (PTSD). However, most studies used the worst trauma experienced, which can lead to an overestimation of the conditional risk of PTSD. Although a number of epidemiological surveys on PTSD have been carried out in the United States, only a few studies in limited sample have been conducted in Italy. This study, carried out in the framework of the World Mental Health Survey Initiative, is a cross-sectional household survey of a representative sample of the Italian adult population. Lifetime prevalence of TEs and 12-month prevalence of PTSD were evaluated using the Composite International Diagnostic Interview (CIDI). Reports of PTSD associated with randomly selected TEs were weighted by the individual-level probabilities of TE selection to generate estimates of population-level PTSD risk associated with each TE. Network events was the most commonly reported class of TEs (29.4%). War events had the highest conditional risk of PTSD (12.2%). The TEs that contributed most to societal PTSD burden were unexpected death of a loved one (24.1%) and having seen atrocities (18.2%). Being female was related to high risk of PTSD after experiencing a TE. Exposure to network events is commonly reported among Italian adults, but two TEs are responsible for the highest burden associated with PTSD: the unexpected death of someone close and sexual assault. These results can help designing public health interventions to reduce the societal PTSD burden.

  15. Post-traumatic stress disorder associated with natural and human-made disasters in the World Mental Health Surveys

    Science.gov (United States)

    Bromet, E. J.; Atwoli, L.; Kawakami, N.; Navarro-Mateu, F.; Piotrowski, P.; King, A. J.; Aguilar-Gaxiola, S.; Alonso, J.; Bunting, B.; Demyttenaere, K.; Florescu, S.; de Girolamo, G.; Gluzman, S.; Haro, J. M.; de Jonge, P.; Karam, E. G.; Lee, S.; Kovess-Masfety, V.; Medina-Mora, M. E.; Mneimneh, Z.; Pennell, B.-E.; Posada-Villa, J.; Salmerón, D.; Takeshima, T.; Kessler, R. C.

    2017-01-01

    Background Research on post-traumatic stress disorder (PTSD) following natural and human-made disasters has been undertaken for more than three decades. Although PTSD prevalence estimates vary widely, most are in the 20–40% range in disaster-focused studies but considerably lower (3–5%) in the few general population epidemiological surveys that evaluated disaster-related PTSD as part of a broader clinical assessment. The World Mental Health (WMH) Surveys provide an opportunity to examine disaster-related PTSD in representative general population surveys across a much wider range of sites than in previous studies. Method Although disaster-related PTSD was evaluated in 18 WMH surveys, only six in high-income countries had enough respondents for a risk factor analysis. Predictors considered were socio-demographics, disaster characteristics, and pre-disaster vulnerability factors (childhood family adversities, prior traumatic experiences, and prior mental disorders). Results Disaster-related PTSD prevalence was 0.0–3.8% among adult (ages 18+) WMH respondents and was significantly related to high education, serious injury or death of someone close, forced displacement from home, and pre-existing vulnerabilities (prior childhood family adversities, other traumas, and mental disorders). Of PTSD cases 44.5% were among the 5% of respondents classified by the model as having highest PTSD risk. Conclusion Disaster-related PTSD is uncommon in high-income WMH countries. Risk factors are consistent with prior research: severity of exposure, history of prior stress exposure, and pre-existing mental disorders. The high concentration of PTSD among respondents with high predicted risk in our model supports the focus of screening assessments that identify disaster survivors most in need of preventive interventions. PMID:27573281

  16. Post-traumatic stress disorder, depression and generalised anxiety disorder in adolescents after a natural disaster: a study of comorbidity

    Directory of Open Access Journals (Sweden)

    Bastia Binaya

    2006-07-01

    Full Text Available Abstract Background Information on mental health sequel in adolescents following natural disasters from developing countries is scant. Method Around one year after a super-cyclone, proportion of adolescents exhibiting post-traumatic psychiatric symptoms, prevalence of post-traumatic stress disorder (PTSD, major depression and generalized anxiety disorder, comorbidity and impairment of performance in school were studied in Orissa, India. Mini International Neuropsychiatric Interview for children and adolescents was used for evaluation and diagnosis. The criteria for diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders – IV. Results Post-disaster psychiatric presentation in adolescents was a conglomeration of PTSD, depression and anxiety symptoms. The prevalences of PTSD, major depressive disorder and generalised anxiety disorder were 26.9%, 17.6% and 12.0% respectively. Proportion of adolescents with any diagnosis was 37.9%. Comorbidity was found in 39.0% of adolescents with a psychiatric diagnosis. Adolescents from middle socioeconomic status were more affected. There were gender differences in the presentation of the symptoms rather than on the prevalence of diagnoses. Prolonged periods of helplessness and lack of adequate post-disaster psychological support were perceived as probable influencing factors, as well as the severity of the disaster. Conclusion The findings of the study highlight the continuing need for identification and intervention for post-disaster psychiatric morbidities in adolescent victims in developing countries.

  17. Quality of life in Croatian Homeland war (1991-1995 veterans who suffer from post-traumatic stress disorder and chronic pain

    Directory of Open Access Journals (Sweden)

    Đorđević Veljko

    2011-07-01

    Full Text Available Abstract Background The aim of this study was to investigate the quality of life in Croatian homeland war veterans who suffer from post-traumatic stress disorder and chronic low back pain (LBP. Methods A total of 369 participants were included, classified in four study groups: those with post-traumatic stress disorder (PTSD; N = 59, those with both PTSD and lower back pain (PTSD+LBP; N = 80, those with isolated LBP (N = 95 and controls (N = 135. WHOQOL-BREF survey was used in the estimation of quality of life. The data were analysed using statistical methods and hierarchical clustering. Results The results indicated a general pattern of lowering quality of life in participants with both psychological (PTSD and physical (LBP burden. The average overall quality of life was 2.82 ± 1.14 for the PTSD+LBP group, 3.29 ± 1.28 for the PTSD group, 4.04 ± 1.25 for the LBP group and 4.48 ± 0.80 for the controls (notably, all the pair-wise comparisons were significantly different at the level of P Conclusions The results of this study reiterate strong impact of PTSD on quality of life, which is additionally reduced if the patient also suffers from LBP. PTSD remains a substantial problem in Croatia, nearly two decades after the beginning of the 1991-1996 Homeland war.

  18. Gender Differences in the Relationship between Maladaptive Behaviors and Post-Traumatic Stress Disorder. A Study on 900 L' Aquila 2009 Earthquake Survivors.

    Science.gov (United States)

    Dell'osso, Liliana; Carmassi, Claudia; Stratta, Paolo; Massimetti, Gabriele; Akiskal, Kareen K; Akiskal, Hagop S; Maremmani, Icro; Rossi, Alessandro

    2012-01-01

    Post-traumatic stress disorder (PTSD) represents one of the most frequently psychiatric sequelae to earthquake exposure. Increasing evidence suggests the onset of maladaptive behaviors among veterans and adolescents with PTSD, with specific gender differences emerging in the latter. Aims of the present study were to investigate the relationships between maladaptive behaviors and PTSD in earthquake survivors, besides the gender differences in the type and prevalence of maladaptive behaviors and their association with PTSD. 900 residents of the town of L'Aquila who experienced the earthquake of April 6th 2009 (Richter Magnitude 6.3) were assessed by means of the Trauma and Loss Spectrum-Self Report (TALS-SR). Significantly higher maladaptive behavior prevalence rates were found among subjects with PTSD. A statistically significant association was found between male gender and the presence of at least one maladaptive behavior among PTSD survivors. Further, among survivors with PTSD significant correlations emerged between maladaptive coping and symptoms of re-experiencing, avoidance and numbing, and arousal in women, while only between maladaptive coping and avoidance and numbing in men. Our results show high rates of maladaptive behaviors among earthquake survivors with PTSD suggesting a greater severity among men. Interestingly, post-traumatic stress symptomatology appears to be a better correlate of these behaviors among women than among men, suggesting the need for further studies based on a gender approach.

  19. Gender Differences in the Relationship between Maladaptive Behaviors and Post-Traumatic Stress Disorder. A Study on 900 L’ Aquila 2009 Earthquake Survivors

    Science.gov (United States)

    Dell’Osso, Liliana; Carmassi, Claudia; Stratta, Paolo; Massimetti, Gabriele; Akiskal, Kareen K.; Akiskal, Hagop S.; Maremmani, Icro; Rossi, Alessandro

    2013-01-01

    Background: Post-traumatic stress disorder (PTSD) represents one of the most frequently psychiatric sequelae to earthquake exposure. Increasing evidence suggests the onset of maladaptive behaviors among veterans and adolescents with PTSD, with specific gender differences emerging in the latter. Aims of the present study were to investigate the relationships between maladaptive behaviors and PTSD in earthquake survivors, besides the gender differences in the type and prevalence of maladaptive behaviors and their association with PTSD. Methods: 900 residents of the town of L’Aquila who experienced the earthquake of April 6th 2009 (Richter Magnitude 6.3) were assessed by means of the Trauma and Loss Spectrum-Self Report (TALS-SR). Results: Significantly higher maladaptive behavior prevalence rates were found among subjects with PTSD. A statistically significant association was found between male gender and the presence of at least one maladaptive behavior among PTSD survivors. Further, among survivors with PTSD significant correlations emerged between maladaptive coping and symptoms of re-experiencing, avoidance and numbing, and arousal in women, while only between maladaptive coping and avoidance and numbing in men. Conclusions: Our results show high rates of maladaptive behaviors among earthquake survivors with PTSD suggesting a greater severity among men. Interestingly, post-traumatic stress symptomatology appears to be a better correlate of these behaviors among women than among men, suggesting the need for further studies based on a gender approach. PMID:23293608

  20. Bodily symptoms in patients with post traumatic stress disorder: A comparative study of traumatized refugees, Danish war veterans, and healthy controls

    DEFF Research Database (Denmark)

    Bentholm, Anette Lisbeth; Nyboe, Lene; Gyllensten, Amanda Lundvik

    2017-01-01

    Background: Post traumatic stress disorder (PTSD) is associated with increased general health symptoms and patients suffer from numerous bodily complaints such as increased pain, increased muscular tension, and restricted breathing. Methods and material: This study applied the Body Awareness...... Movement Quality and Experience scale (BAS MQ-E) in assessing and comparing bodily symptoms, including movement function, in traumatized refugees (N Z 14) and Danish war veterans with PTSD (N Z 19) and healthy controls (N Z 20). Results: Patients with PTSD had significantly poorer stability, balance...

  1. Post-traumatic stress disorder after car accidents.

    Science.gov (United States)

    Kuch, K; Swinson, R P; Kirby, M

    1985-10-01

    Survivors of car crashes often suffer from a post-traumatic fear of driving, generalized anxiety and depression. Unremitting pains are also common. As part of a pilot study 30 referred subjects were exposed to imagery of driving and accidents. Seventy-seven percent were phobic of driving. Fifty-three percent responded with increased anxiety to the imagery. Twelve treatment referrals received exposure therapy and six improved markedly. An additional four improved when a Benzodiazepine was added temporarily. Four out of eight subjects lost their unremitting pains along with their fears. When guided imagery evoked intense anxiety this seemed to predict a favourable outcome. A resumption of pleasure trips was a reliable criterion of recovery. The frequency of phobic symptomatology and it's importance to the understanding and management of post-traumatic anxiety states is discussed.

  2. Valproic acid effects in the hippocampus and prefrontal cortex in an animal model of post-traumatic stress disorder.

    Science.gov (United States)

    Wilson, C Brad; McLaughlin, Leslie D; Ebenezer, Philip J; Nair, Anand R; Francis, Joseph

    2014-07-15

    Reactive oxygen species (ROS) and pro-inflammatory cytokines (PIC) are upregulated in post-traumatic stress disorder (PTSD). Histone deacetylase inhibitors (HDACi) modify genetic transcription and can diminish ROS and PIC escalation. They can also modulate levels of neurotransmitters such as catecholamines and serotonin (5-HT). Thus, this study sought to analyze the effects of the HDACi valproic acid (VA) on oxidative stress, inflammation, and neurotransmitter modulation via a predator exposure/psychosocial stress animal model of PTSD. PTSD-like effects were induced in male Sprague-Dawley rats (n=6/group×4 groups). The rats were secured in Plexiglas cylinders and placed in a cage with a cat for 1h on days 1, 11, and 40 of a 40-day stress regimen. PTSD rats were also subjected to psychosocial stress via daily cage cohort changes. At the conclusion of the stress regimen, the treatment group (PTSD+VA) and control group (Control+VA) rats were given VA in their drinking water for 30 days. The rats were then euthanized and their brains were dissected to remove the hippocampus and prefrontal cortex (PFC). Whole blood was collected to assess systemic oxidative stress. ROS and PIC mRNA and protein elevation in the PTSD group were normalized with VA. Anxiety decreased in this group via improved performance on the elevated plus-maze (EPM). No changes were attributed to VA in the control group, and no improvements were noted in the vehicle groups. Results indicate VA can attenuate oxidative stress and inflammation, enhance fear extinction, and correct neurotransmitter aberrancies in a rat model of PTSD. Copyright © 2014. Published by Elsevier B.V.

  3. Parent and Child Agreement for Acute Stress Disorder, Post-Traumatic Stress Disorder and Other Psychopathology in a Prospective Study of Children and Adolescents Exposed to Single-Event Trauma

    Science.gov (United States)

    Meiser-Stedman, Richard; Smith, Patrick; Glucksman, Edward; Yule, William; Dalgleish, Tim

    2007-01-01

    Examining parent-child agreement for Acute Stress Disorder (ASD) and Post-Traumatic Stress Disorder (PTSD) in children and adolescents is essential for informing the assessment of trauma-exposed children, yet no studies have examined this relationship using appropriate statistical techniques. Parent-child agreement for these disorders was examined…

  4. [Prospective study of post-traumatic stress in victims of terrorist attacks].

    Science.gov (United States)

    Jehel, L; Duchet, C; Paterniti, S; Consoli, S M; Guelfi, J D

    2001-01-01

    In 1995-96 several terrorist attacks struck Paris. After that, the French government decided to optimize the service claimed to treat psychological repercussions of attacks victims. For this reason we need to better understand the psychopathology developing after these traumatic events in order to adjust the various steps of the treatment. In December 1996, a terrorist attack occurred in a Paris subway. Medical and medico-psychological teams intervened immediately on the site to help victims. Among 115 victims, 4 persons died and 35 were seriously injured. The aim of our study was to evaluate the psychological impact among a population of terrorist attacks victims by a prospective study and to identify predictive factors of posttraumatic stress disorder (PTSD). We evaluated PTSD rates at 6 and 18 months, the relationship between coping style and PTSD, and whether PTSD increased health care utilization. Two follow up evaluations were performed in the 6th and 7th month respectively, by means of self-questionnaires sent by mail. Among 115 victims of the bombing attack occurred in December 1996, the 111 survivors were asked to participate to the study. The subjects who accepted and could use French questionnaires were considered eligible for the inclusion: the main criteria of the Watson's PTSD Inventory for the specific post-traumatic symptoms were used; the Goldberg's General Health Questionnaire was used to measure the general psychopathology; to identify coping styles we used the questionnaire "Ways of Coping Check List" of Vitaliano at 6 months and the "Coping Inventory for Stressful Situations (CISS)" by Endler at 18 months; a small questionnaire was proposed to evaluate injuries, hospitalization and specific treatment immediately or after the event. Among 70 subjects who accepted to participate, 56 (33 females) could be evaluated at 6 months and 32 (14 females) subjects at 18th months. The mean age at 6 months was 38.4 years: 41% of participants met PTSD

  5. Post-Traumatic Stress Disorder among School Age Palestinian Children

    Science.gov (United States)

    Khamis, Vivian

    2005-01-01

    Objectives: This study was designed to assess the prevalence of PTSD among Palestinian school-age children. Variables that distinguish PTSD and non-PTSD children were examined, including child characteristics, socioeconomic status, family environment, and parental style of influence. Method: Participants were 1,000 children aged 12 to 16 years.…

  6. Mechanisms of developing post-traumatic stress disorder: new targets for drug development and other potential interventions.

    Science.gov (United States)

    Wimalawansa, Sunil J

    2014-01-01

    The post-traumatic stress disorder (PTSD) is defined as a severe anxiety disorder that develops after exposure to an event with actual, threatened, or perceived death or serious injury, or a threat to the physical integrity of oneself or others that results in significant psychological trauma. Moreover, the ability of people to handle acute severe stress experiences varies among individuals. Depending on the underlying personality and resiliency, therefore, PTSD can occur in individuals exposed to exceedingly stressful incidences or those who have encountered seemingly less overwhelming stressors. In addition to severe stressful exposure, multiple other factors including genetic susceptibility; past experiences; cultural, spiritual, and personal beliefs; bullying and harassments; and lack of support at the workplace, social, and home environement may contribute to the development of PTSD. Author investigated multiple potential mechanisms for the development and sustenance of PTSD based on the recent literature and his own experiences and insight. Based on this search, author indicates that among other pathological and biochemical abnormalities, hormonal aberrations are most likely key mechanisms initiating and the maintenance of the PTSD. These pathophysiological neuro-hormonal changes instigate maladaptive learning processes caused by sustained high levels of anxiety and fear, through a hypo-responsive hypothalamic-pituitary axis and hyper-responsive catecholamine system (persistently elevated blood norepinephrine levels and lower than appropriate glucocorticoid levels). In addition to having inappropriately low serum cortisol levels and high epinephrine and norepinephrine levels, patients with PTSD also have mitochondrial dysfunctions and other hormonal abnormalities. Based on these data, author concluded that these pathological, biochemical and sustained neurohormonal abnormalities are likely to influence the structural brain changes, particularly in the

  7. Type D personality and post-traumatic stress disorder symptoms among intensive care unit nurses: The mediating effect of resilience.

    Science.gov (United States)

    Cho, Geum-Jin; Kang, Jiyeon

    2017-01-01

    The purpose of this study was to investigate the relationship between Type D personality and post-traumatic stress disorder (PTSD) symptoms of intensive care unit (ICU) nurses and to determine the mediating effect of resilience on this relationship. A cross-sectional survey was performed with 179 ICU nurses from 7 hospitals in Gyeong-Nam province, South Korea. The Type D personality, resilience, and PTSD symptoms of subjects were measured using a self-report questionnaire. The mediating effect was analyzed by a series of hierarchical multiple regressions. A total of 38.6% of the study participants turned out to have Type D personality. The Type D personality was positively correlated with PTSD symptoms, and negatively correlated with resilience. There was a negative correlation between resilience and PTSD symptoms. The indirect effect of Type D personality on PTSD symptoms via resilience (β = .51, p personality and PTSD symptoms of ICU nurses. Further studies need to be done to develop interventions for enhancing resilience in ICU nurses.

  8. Clinical and personality characteristics associated with post traumatic stress disorder in problem and pathological gamblers recruited from the community.

    Science.gov (United States)

    Ledgerwood, David M; Milosevic, Aleks

    2015-06-01

    Problem and pathological gamblers (PPGs) are more likely than the general population to experience co-occurring psychiatric problems. However, the problem gambling literature has largely overlooked the importance of trauma and post-traumatic stress disorder (PTSD) as a prevalent co-occurring condition among PPGs. This study examined clinical differences between PPGs with and without a history of co-occurring PTSD. Lifetime PPGs (N = 150) recruited from community sources completed clinical assessments including measures of problem gambling severity, co-occurring psychiatric conditions, gambling motivations and personality traits. Over 19% of the participants met criteria for a lifetime diagnosis of PTSD. Those presenting with PTSD histories were more likely to be women, and were more likely to have lifetime substance use disorder (abuse and/or dependence) and substance dependence, lifetime major depressive disorder, current dysthymic disorder, and lifetime and current anxiety disorder. Those with lifetime PTSD also were more likely to use gambling as a way to cope with negative emotions and experienced greater negative emotionality. Few PPGs (16%) had ever sought treatment for their gambling problems. PTSD is a prevalent condition among individuals with lifetime PPG recruited from the community, and is associated with greater psychiatric co-morbidity among these populations. More research is needed to further understand the relationship between gambling and trauma, and better outreach is needed to encourage these individuals to seek treatment.

  9. A meta-analysis of risk factors for post-traumatic stress disorder in children and adolescents.

    Science.gov (United States)

    Trickey, David; Siddaway, Andy P; Meiser-Stedman, Richard; Serpell, Lucy; Field, Andy P

    2012-03-01

    Post-traumatic stress disorder (PTSD) is a complex and chronic disorder that causes substantial distress and interferes with social and educational functioning. Consequently, identifying the risk factors that make a child more likely to experience traumatic distress is of academic, clinical and social importance. This meta-analysis estimated the population effect sizes of 25 potential risk factors for PTSD in children and adolescents aged 6-18 years across 64 studies (N=32,238). Medium to large effect sizes were shown for many factors relating to subjective experience of the event and post-trauma variables (low social support, peri-trauma fear, perceived life threat, social withdrawal, comorbid psychological problem, poor family functioning, distraction, PTSD at time 1, and thought suppression); whereas pre-trauma variables and more objective measures of the assumed severity of the event generated small to medium effect sizes. This indicates that subjective peri-trauma factors and post-event factors are likely to have a major role in determining whether a child develops PTSD following exposure to a traumatic event. Such factors could potentially be assessed following a potentially traumatic event in order to screen for those most vulnerable to developing PTSD and target treatment efforts accordingly. The findings support the cognitive model of PTSD as a way of understanding its development and guiding interventions to reduce symptoms. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Virtual reality, real emotions: a novel analogue for the assessment of risk factors of post-traumatic stress disorder.

    Science.gov (United States)

    Dibbets, Pauline; Schulte-Ostermann, Michel A

    2015-01-01

    Most people are exposed to a violent or life-threatening situation during their lives, but only a minority develops post-traumatic stress disorder (PTSD). Experimental studies are necessary to assess risk factors, such as imagery ability, for the development of PTSD. Up to now the trauma film paradigm (TFP) has functioned as an analogue for PTSD. This paradigm is known to induce involuntary intrusions, a core symptom of PTSD. Though useful, the film paradigm has a drawback, the participant remains an "outsider" and does not immerse in the film scenes. The aim of the present study was to develop a fitting virtual reality (VR) analogue for PTSD and to assess risk factors for the development of PTSD-symptoms, such as intrusions. To this end a novel VR paradigm was compared to the traditional TFP. Both the VR and TFP elicited a negative mood and induction-related intrusions. More immersion was observed in the VR paradigm compared to the TFP. The results of the risk factors were mixed; more imagery ability coincided with a higher intrusion frequency, but also with less distressing intrusions. The results, implications and suggestions for future research are discussed.

  11. Virtual reality, real emotions: a novel analogue for the assessment of risk factors of post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Pauline eDibbets

    2015-05-01

    Full Text Available Most people are exposed to a violent or life-threatening situation during their lives, but only a minority develops post-traumatic stress disorder (PTSD. Experimental studies are necessary to assess risk factors, such as imagery ability, for the development of PTSD. Up to now the trauma film paradigm has functioned as an analogue for PTSD. This paradigm is known to induce involuntary intrusions, a core symptom of PTSD. Though useful, the film paradigm has a drawback, the participant remains an ‘outsider’ and does not immerse in the film scenes. The aim of the present study was to develop a fitting virtual reality (VR analogue for PTSD and to assess risk factors for the development of PTSD-symptoms, such as intrusions. To this end a novel VR paradigm was compared to the traditional trauma film paradigm (TFP. Both the VR and TFP elicited a negative mood and induction-related intrusions. More immersion was observed in the VR paradigm compared to the TFP. The results of the risk factors were mixed; more imagery ability coincided with a higher intrusion frequency, but also with less distressing intrusions. The results, implications and suggestions for future research are discussed.

  12. Psychiatric comorbidity of chronic daily headache: focus on traumatic experiences in childhood, post-traumatic stress disorder and suicidality.

    Science.gov (United States)

    Juang, Kai Dih; Yang, Chin-Yi

    2014-04-01

    The fifth edition of the Diagnostic and Statistic Manual (DSM-5) reclassified some mental disorders recently. Post-traumatic stress disorder (PTSD) is in a new section termed "trauma- and stressor-related disorder". Community-based studies have shown that PTSD is associated with a notably high suicidal risk. In addition to previous findings of comorbidity between chronic daily headache (CDH) and both depressive disorders and anxiety disorders, recent data suggest that frequency of childhood maltreatment, PTSD, and suicidality are also increased in CDH. CDH patients with migraine aura are especially at risk of suicidal ideation. Research suggests that migraine attack, aura, frequency, and chronicity may all be related to serotonergic dysfunction. Vulnerability to PTSD and suicidality are also linked to brain serotonin function, including polymorphisms in the serotonin transporter gene (5-HTTLPR). In the present review, we focus on recent advances in knowledge of traumatic experiences in childhood, PTSD, and suicidality in relation to migraine and CDH. We hypothesize that vulnerability to PTSD is associated with migraine attack, migraine aura, and CDH. We further postulate that these associations may explain some of the elevated suicidal risks among patients with migraine, migraine aura, and/or CDH. Field studies are required to support these hypotheses.

  13. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy.

    Science.gov (United States)

    Hauer, Beatrijs J A; Wessel, Ineke; Engelhard, Iris M; Peeters, Louis L; Dalgleish, Tim

    2009-07-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So far, no reported studies have tested the predictive value of memory specificity at the onset of a potentially traumatic situation. Therefore the aim of the present study was to investigate whether prenatal memory specificity would predict post-traumatic stress after complicated pregnancy. The results demonstrate that women who retrieved fewer specific memories with a pregnancy-related content to positive cues during pregnancy (i.e., directly after hospitalisation) reported more post-traumatic stress 6 weeks after giving birth. This relationship remained significant after controlling for variables that were related to both baseline autobiographical memory specificity and later post-traumatic stress. A similar pattern was found for depression symptomatology, even when somatic symptoms were excluded from the analyses. Taken together, these data suggest that the relationship of memory specificity with later depression can be generalised to post-traumatic stress symptoms.

  14. [Post-Traumatic Stress Disorder among Incomers in Remire-Montjoly Prison, French Guiana].

    Science.gov (United States)

    Arnal, Romain; Ayhan, Gülen; Pinganaud, Éric; Basurko, Célia; Jehel, Louis

    Despite the recent interest in psychiatric illness in prison, the psychopathology of the Remire-Montjoly prison population remains largely unknown. Subject to significant population movements, French Guiana and its prison houses a very mixed population in which recent history has left a strong mark (earthquake in Haïti, civil war in Suriname, violence related to gold mining population and drug trafficking). These negative life events appear as potential vectors of psychological trauma. Additionally, strong links have been established in the literature between post-traumatic stress disorder (PTSD) and many other psychiatric disorders, including suicidal behavior and addictions. Under these conditions, we felt it essential to focus on the identification of PTSD in this sensitive population.Through adapted reception interviews, we tried to identify the PTSD, to describe by means of socio-demographic factors the studied population and to detect psychiatric comorbidities. The screening tool was the M.I.N.I. 5.0, which identifies 17 psychiatric disorders including the PTSD, based on the DSM IV definition. The target population was the prison incomers, agreeing to participate in the study, aged more than 18 years old and imprisoned between 18 January 2013 and 31 December 2013. To this date, 549 inmates were included in the study.The main result of this study was a prevalence of PTSD of 17% for incomers in detention. We found that the PTSD+ population is more likely to be female (15% against 7% p = 0.0246), which is consistent with the literature data. The M.I.N.I. 5.0 showed a higher prevalence of psychiatric disorders in the PTSD+ group. This association was confirmed in several types of pathology like mood disorders including: major depressive episode and manic or hypomanic episode, suicidal risk, some anxiety disorders including: panic disorder, obsessive-compulsive disorder and generalized anxiety disorder. Strong association was found for current major depressive

  15. Gender differences in the relationship between maladaptive behaviours and post-traumatic stress disorder. A study on 900 L’Aquila 2009 earthquake survivors.

    Directory of Open Access Journals (Sweden)

    Liliana eDell'Osso

    2013-01-01

    Full Text Available Background: Post-traumatic stress disorder (PTSD represents one of the most frequently psychiatric sequelae to earthquake exposure. Increasing evidence suggests the onset of maladaptive behaviors among veterans and adolescents with PTSD, with specific gender differences emerging in the latter. Aims of the present study were to investigate the relationships between maladaptive behaviours and PTSD in earthquake survivors, besides the gender differences in the type and prevalence of maladaptive behaviours and their association with PTSD. Methods: 900 residents of the town of L’Aquila who experienced the earthquake of April 6th 2009 (Richter Magnitude 6.3 were assessed by means of the Trauma and Loss Spectrum Self Report (TALS-SR.Results: Significantly higher maladaptive behaviour prevalence rates were found among subjects with PTSD. A statistically significant association was found between male gender and the presence of at least one maladaptive behaviour among PTSD survivors. In the latter, significant correlations emerged between maladaptive coping and symptoms of re-experiencing, avoidance and numbing and arousal in women, while only between maladaptive coping and avoidance and numbing in men. Conclusions: Our results show high rates of maladaptive behaviours among earthquake survivors with PTSD suggesting a greater severity among men. Interestingly, post-traumatic stress symptomatology appears to be a better correlate of these behaviours among women than among men, suggesting the need for further studies based on a gender approach.

  16. A model linking uncertainty, post-traumatic stress, and health behaviors in childhood cancer survivors.

    Science.gov (United States)

    Lee, Ya-Ling; Gau, Bih-Shya; Hsu, Wen-Ming; Chang, Hsiu-Hao

    2009-01-01

    To consolidate the literature and provide a model to explain the links among uncertainty, post-traumatic stress syndrome, and health behaviors in adolescent and young adult childhood cancer survivors. A systemic review of related literature and theory was used for the proposed model. The literature pertaining to the Uncertainty in Illness Theory, childhood cancer late effects, post-traumatic stress, and health behaviors was reviewed and critiqued from three data sets from 1979-2007: MEDLINE, PsycInfo, and CINAHL. Key words used for the search were uncertainty and post-traumatic stress as well as health behaviors, including smoking, alcohol use, unsafe sex, sunscreen use, and physical inactivity. Childhood cancer survivors living with chronic uncertainty may develop a new view of life and, as a result, adopt more health-promotion behaviors and engage in less health-risk behaviors. However, survivors living with chronic uncertainty may generate symptoms similar to post-traumatic stress disorder and, therefore, adopt fewer health-promotion behaviors and engage in more health-risk behaviors. The uncertainty that pervades the childhood cancer experience can lead to the development of symptoms that resemble those of post-traumatic stress. The symptoms can interfere with the adoption of healthy lifestyle behaviors and avoidance of health-risk behaviors. The theoretically derived model outlined in this article can be used to guide clinical interventions and additional research into the health behaviors of childhood cancer survivors.

  17. Pharmacotherapy of post-traumatic stress disorder: a family practitioners guide to management of the disease.

    Science.gov (United States)

    Katzman, Martin A; Struzik, Lukasz; Vivian, Lisa L; Vermani, Monica; McBride, Joanna C

    2005-01-01

    Post-traumatic stress disorder is a difficult to treat, yet common disorder, which is associated with significant morbidity, mortality and societal burden. Comprehensive management of post-traumatic stress disorder must include both psychotherapeutic and pharmacologic components. The current evidence-based pharmacologic management approaches to post-traumatic stress disorder, suggests that first-line treatments for monotherapy are the selective serotonin reuptake inhibitors, sertraline, paroxetine and fluoxetine. Other potential options include other monotherapies including venlafaxine, mirtazapine, tricyclic antidepressants, monoamine oxidase inhibitors, as well as adjunctive usage of atypical antipsychotics, lamotrigine, trazadone and a number of adrenergic agents. A trial of therapy should be at least 8 weeks and continue for at the very least 12 months, but is likely to be much longer. In light of the risks of untreated post-traumatic stress disorder (e.g., suicide and impaired psychosocial functioning), therapy may need to be continued for 2 years or more. Pharmacologic therapy instituted at the time of acute psychologic trauma shows promise for the prevention of post-traumatic stress disorder in the future and warrants further study.

  18. Post-traumatic Stress Symptoms among Iranian Parents of Children during Cancer Treatment.

    Science.gov (United States)

    Iranmanesh, Sedigheh; Shamsi, Ala; Dehghan, Mahlegha

    2015-04-01

    Support of parents of children with cancer requires healthcare personnel to be knowledgeable about the prevalence of post-traumatic stress symptoms among Iranian parents of children with cancer. This study was conducted to fulfill this aim in the South-East of Iran. Using the Impact of Event Scale -Revised, for parents of children with cancer, 200 parents in two hospitals supervised by Kerman University of Medical Sciences, were assessed. The total mean score of post-traumatic stress symptoms was 41.70. Among all categories of the Impact of Event Scale -Revised, the highest mean belonged to the category of 'intrusion' 16.03 (SD  =  6.24) and the lowest one belonged to the category of 'hyperarousal' 10.68 (SD  =  4.58). Based on the results, mothers had higher post-traumatic stress symptoms compared with fathers (p post-traumatic stress symptoms among mothers was 2.49 times more than that among fathers (p  =  0.01). There was no association between sociodemographic data and post-traumatic stress symptoms. More research is needed to elucidate the Iranian parents' experience of having children with cancer.

  19. Dissociation and memory fragmentation in post-traumatic stress disorder: an evaluation of the dissociative encoding hypothesis.

    Science.gov (United States)

    Bedard-Gilligan, Michele; Zoellner, Lori A

    2012-01-01

    Several prominent theories of post-traumatic stress disorder (PTSD) posit that peritraumatic dissociation results in insufficient encoding of the trauma memory and that persistent dissociation prevents memory elaboration, resulting in memory fragmentation and PTSD. In this review we summarise the empirical literature on peritraumatic and trait dissociation and trauma narrative fragmentation as measured by meta-memory and rater/objective coding. Across 16 studies to date, the association between dissociation and fragmentation was most prominent when examining peritraumatic dissociation and patient's own ratings of memory fragmentation. This relationship did not hold when examining trait dissociation or rater-coded or computer-generated measures of fragmentation. Thus initial evidence points more towards a strong self-reported association between constructs that is not supported on more objective fragmentation coding. Measurement overlap, construct ambiguity, and exclusion of potential confounds may underlie lack of a strong association between dissociation and objective-rated fragmentation.

  20. Effects of interactions between post-traumatic stress disorder with brain-derived neurotrophic factor gene Val66 Met polymorphism on serum lipid profiles in adolescents%PTSD 与 BDN F基因 Val66Met 多态性相互作用对青少年血脂的影响

    Institute of Scientific and Technical Information of China (English)

    樊梅; 李蓉晖; 胡敏珊; 方定志

    2015-01-01

    To test our hypothesis that the interplay may occur between post-traumatic stress disorder (PTSD) and brain-derived neurotrophic factor (BDNF) gene BDNF Val66Met polymorphism and affect serum lipid profiles .Chinese high school students were enrolled after the 2008 Wenchuan earthquake .The PTSD checklist-civilian version (PCL-C) was used to measure the symp-toms of PTSD .Body mass index (BMI) and waist-hip ratio (WHR) were calculated .Serum levels of total cholesterol (TC) ,tri-glyceride (TG) ,low-density lipoprotein cholesterol (LDL-C) ,high-density lipoprotein cholesterol (HDL-C) and glucose were tested by routine methods . BDNF Val66Met polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and verified by DNA sequencing .The results show that the male PTSD subjects have higher TG than male subjects without PTSD in the V al/V al homozygotes .Compared with the Met allele carriers ,V al/V al homozygotes have higher TG in the males with PTSD .The female PTSD subjects have higher BMI than the female subjects without PTSD in the Met allele carriers .The results suggest that the changes of lipid profiles induced by interactions of PTSD and BDNF V al66Met polymorphism are different in adolescents with different gender .These findings will provide new insights into further exploration of factors influencing lipid profiles and the mechanism ,and precision medicine and personalized prevention of dysli-poproteinemia and cardiovascular diseases .%为验证“创伤后应激障碍(post-traumatic stress disorder ,PTSD)和脑源性神经营养因子(brain derived neurotrophic fac-tor ,BDNF)基因 BDNFVal66Met多态性之间存在相互作用并影响血脂及相关指标”的新假设,以2008年汶川地震灾区高中学生为研究对象,采用PTSD检查量表平民版(PTSD checklist-civilian version ,PCL-C)评估PTSD症状,常规体格检查并计算体质指数(body mass index

  1. Common genetic and environmental contributions to post-traumatic stress disorder and alcohol dependence in young women

    Science.gov (United States)

    Sartor, C. E.; McCutcheon, V. V.; Pommer, N. E.; Nelson, E. C.; Grant, J. D.; Duncan, A. E.; Waldron, M.; Bucholz, K. K.; Madden, P. A. F.; Heath, A. C.

    2012-01-01

    Background The few genetically informative studies to examine post-traumatic stress disorder (PTSD) and alcohol dependence (AD), all of which are based on a male veteran sample, suggest that the co-morbidity between PTSD and AD may be attributable in part to overlapping genetic influences, but this issue has yet to be addressed in females. Method Data were derived from an all-female twin sample (n=3768) ranging in age from 18 to 29 years. A trivariate genetic model that included trauma exposure as a separate phenotype was fitted to estimate genetic and environmental contributions to PTSD and the degree to which they overlap with those that contribute to AD, after accounting for potential confounding effects of heritable influences on trauma exposure. Results Additive genetic influences (A) accounted for 72 % of the variance in PTSD ; individual-specific environmental (E) factors accounted for the remainder. An AE model also provided the best fit for AD, for which heritability was estimated to be 71 %. The genetic correlation between PTSD and AD was 0.54. Conclusions The heritability estimate for PTSD in our sample is higher than estimates reported in earlier studies based almost exclusively on an all-male sample in which combat exposure was the precipitating traumatic event. However, our findings are consistent with the absence of evidence for shared environmental influences on PTSD and, most importantly, the substantial overlap in genetic influences on PTSD and AD reported in these investigations. Additional research addressing potential distinctions by gender in the relative contributions of genetic and environmental influences on PTSD is merited. PMID:21054919

  2. Initiation of pharmacotherapy for post-traumatic stress disorder among veterans from Iraq and Afghanistan: a dimensional, symptom cluster approach

    Science.gov (United States)

    Rosenheck, Robert; Mohamed, Somaia; Pietrzak, Robert; Hoff, Rani

    2016-01-01

    Background The pharmacological treatment of post-traumatic stress disorder (PTSD) is extremely challenging, as no specific agent has been developed exclusively to treat this disorder. Thus, there are growing concerns among the public, providers and consumers associated with its use as the efficacy of some agents is still in question. Aims We applied a dimensional and symptom cluster-based approach to better understand how the heterogeneous phenotypic presentation of PTSD may relate to the initiation of pharmacotherapy for PTSD initial episode. Method US veterans who served in the conflicts in Iraq and Afghanistan and received an initial PTSD diagnosis at the US Veterans Health Administration between 2008 and 2011 were included in this study. Veterans were followed for 365 days from initial PTSD diagnosis to identify initiation for antidepressants, anxiolytics/sedatives/hypnotics, antipsychotics and prazosin. Multivariable analyses were used to assess the relationship between the severity of unique PTSD symptom clusters and receiving prescriptions from each medication class, as well as the time from diagnosis to first prescription. Results Increased severity of emotional numbing symptoms was independently associated with the prescription of antidepressants, and they were prescribed after a substantially shorter period of time than other medications. Anxiolytics/sedatives/hypnotics prescription was associated with heightened re-experiencing symptoms and sleep difficulties. Antipsychotics were associated with elevated re-experiencing and numbing symptoms and prazosin with reported nightmares. Conclusions Prescribing practices for military-related PTSD appear to follow US VA/DoD clinical guidelines. Results of this study suggest that a novel dimensional and symptom cluster-based approach to classifying the phenotypic presentation of military-related PTSD symptoms may help inform prescribing patterns for PTSD. Declaration of interest None. Copyright and usage © The

  3. Trauma type affects recognition of Post-Traumatic Stress Disorder among online respondents in the UK and Ireland.

    Science.gov (United States)

    Merritt, Christopher J; Tharp, Ian J; Furnham, Adrian

    2014-08-01

    Mental Health Literacy (MHL) predicts help-seeking for mental health difficulties. Public surveys show high recognition of Post-Traumatic Stress Disorder (PTSD) in relation to military contexts, but this has not been investigated with other sources of trauma. A self-selecting sample of 2960 participants from UK and Ireland completed an online survey. Participants viewed one of three vignettes that described either a male or female character experiencing identical PTSD symptoms, that differed only by trauma source (military combat, industrial accident, sexual assault). Participants were asked to state i) whether a mental health problem was being experienced, ii) what it was, and iii) what help should be sought. Trauma type was a key predictor of classification as a mental health problem, correct identification of PTSD, and help-seeking suggestions. For participants shown the military scenario the odds of recognising PTSD were 5.2 times higher than for those shown the sexual assault vignette, and 2.2 times higher than for those shown the accident scenario. Age (younger), gender (female), education (university), and personal mental health experience were additional significant predictors of higher recognition of PTSD. Reasons for failing to recognise a mental health problem/PTSD were not explored. The online convenience sampling method may limit generalisability of results. Recognition of PTSD is significantly affected by trauma source. The data confirmed the pervasive association with military combat and suggest under-recognition of PTSD from other traumas, particularly sexual assault. Awareness campaigns may aim to increase MHL of PTSD from diverse trauma sources. Copyright © 2014 Elsevier B.V. All rights reserved.

  4. More vulnerability of left than right hippocampal damage in right-handed patients with post-traumatic stress disorder.

    Science.gov (United States)

    Shu, Xi-Ji; Xue, Li; Liu, Wei; Chen, Fu-Yin; Zhu, Cheng; Sun, Xiao-Hai; Wang, Xiao-Ping; Liu, Zhong-Cun; Zhao, Hu

    2013-06-30

    Previous studies have shown hippocampal abnormalities in people with post-traumatic stress disorder (PTSD), but findings of diminished volume in shortages in the hippocampus have been inconsistent. In this study, we investigated changes in hippocampal volume and neuronal metabolites in right-handed PTSD patients to determine their possible relationship(s) with PTSD severity. We performed a case-control study of 11 right-handed PTSD patients and 11 healthy controls using magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy ((1)H MRS). Hippocampal volume and metabolite ratios of N-acetylaspartate (NAA) to creatine (Cr) (NAA/Cr) and choline compounds (Cho) to Cr (Cho/Cr) were calculated. The severity of PTSD was evaluated by the Clinician-Administered PTSD Scale (CAPS). Significantly decreased left and total normalized hippocampal volumes were found in PTSD patients compared with controls (6.6% for the left hippocampus, 5.5% for total hippocampus). Also, the bilateral hippocampal NAA/Cr ratio of PTSD patients was significantly reduced compared with controls. The volume of the left hippocampus was negatively correlated to the CAPS total and CPAS-C scores. The left hippocampal NAA/Cr ratio was negatively correlated to the CAPS-total, CAPS-B, CAPS-C, and CAPS-D scores. The CAPS total and the CAPS-B scores were positively correlated to the Cho/Cr ratio of the right hippocampus. Our results indicate that hippocampal dysfunction is asymmetric in right-handed PTSD patients, with the left side affected more than the right.

  5. Post-traumatic stress disorder in adolescents in Lebanon as wars gained in ferocity: a systematic review

    Directory of Open Access Journals (Sweden)

    Khuzama Hijal Shaar

    2013-09-01

    Full Text Available For decades, Lebanon was war-torn by civil strife, and occupation and invasion by neighboring countries. In time, these wars have escalated in intensity from sniping, barricading streets and random shelling of residential quarters to the use of rockets, aerial bombing, and heavy artillery. Adverse mental health effects are noted in times of war with post traumatic stress disorder (PTSD as a main outcome. The aim of this study was to carry out a systematic review of published studies documenting the prevalence of PTSD in the adolescent population of Lebanon, to investigate the increase in these rates with the escalation of war intensity, and to examine PTSD determinants. A search strategy was developed for online databases (PubMed and Google Scholar between inception to the first week of January 2013. Search terms used were PTSD, adolescents and Lebanon. Eleven studies reporting PTSD in adolescents met the inclusion criteria for a total number of 5965 adolescents. Prevalence rates of PTSD ranged from 8.5% to 14.7% for the civil war, 3.7% for adolescents with sensory disabilities, 21.6% for the Grapes of Wrath War, and 15.4% to 35.0% for the 2006 July War. Some increase in PTSD rates in time is noted. Type of trauma such as bereavement, injury, house destruction, and economic problems, low self efficacy and scholastic impairment were related to PTSD. These findings may help in the development of public health policies for PTSD prevention and treatment for the protection of adolescents from war atrocities and their consequences.

  6. Dissecting the Roles of Brain Injury and Combat-Related Stress in Post-Traumatic Headache

    Science.gov (United States)

    2015-10-01

    AD______________ AWARD NUMBER: W81XWH-14-1-0366 TITLE: Dissecting the Roles of Brain Injury and Combat-Related Stress in Post-Traumatic...Dissecting the Roles of Brain Injury and Combat-Related Stress in Post- Traumatic Headache 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-14-1-0366 5c...geared to either or both. The goal of this proposal is to determine the respective roles of traumatic brain injury and combat-related stress in

  7. The military's approach to traumatic brain injury and post-traumatic stress disorder

    Science.gov (United States)

    Ling, Geoffrey S. F.; Grimes, Jamie; Ecklund, James M.

    2014-06-01

    Traumatic brain injury (TBI) and Post Traumatic Stress Disorder (PTSD) are common conditions. In Iraq and Afghanistan, explosive blast related TBI became prominent among US service members but the vast majority of TBI was still due to typical causes such as falls and sporting events. PTS has long been a focus of the US military mental health providers. Combat Stress Teams have been integral to forward deployed units since the beginning of the Global War on Terror. Military medical management of disease and injury follows standard of care clinical practice guidelines (CPG) established by civilian counterparts. However, when civilian CPGs do not exist or are not applicable to the military environment, new practice standards are created. Such is the case for mild TBI. In 2009, the VA-DoD CPG for management of mild TBI/concussion was published and a system-wide clinical care program for mild TBI/concussion was introduced. This was the first large scale effort on an entire medical care system to address all severities of TBI in a comprehensive organized way. In 2010, the VA-DoD CPG for management of PTSD was published. Nevertheless, both TBI and PTS are still incompletely understood. Investment in terms of money and effort has been committed by the DoD to their study. The Defense and Veterans Brain Injury Center, National Intrepid Center of Excellence and the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury are prominent examples of this effort. These are just beginnings, a work in progress ready to leverage advances made scientifically and always striving to provide the very best care to its military beneficiaries.

  8. the prevalence of post-traumatic stress disorder among sexually ...

    African Journals Online (AJOL)

    2013-10-10

    Oct 10, 2013 ... assault, and parent-child relationships. These findings are ... Many PTSD studies suggest that PTSD is one of the ... MATERIALS AND METHODS. Study site: This ... was found to need treatment were attended to in liaison to ...

  9. Longitudinal changes of telomere length and epigenetic age related to traumatic stress and post-traumatic stress disorder.

    Science.gov (United States)

    Boks, Marco P; van Mierlo, Hans C; Rutten, Bart P F; Radstake, Timothy R D J; De Witte, Lot; Geuze, Elbert; Horvath, Steve; Schalkwyk, Leonard C; Vinkers, Christiaan H; Broen, Jasper C A; Vermetten, Eric

    2015-01-01

    Several studies have reported an association between traumatic stress and telomere length suggesting that traumatic stress has an impact on ageing at the cellular level. A newly derived tool provides an additional means to investigate cellular ageing by estimating epigenetic age based on DNA methylation profiles. We therefore hypothesise that in a longitudinal study of traumatic stress both indicators of cellular ageing will show increased ageing. We expect that particularly in individuals that developed symptoms of post-traumatic stress disorder (PTSD) increases in these ageing parameters would stand out. From an existing longitudinal cohort study, ninety-six male soldiers were selected based on trauma exposure and the presence of symptoms of PTSD. All military personnel were deployed in a combat zone in Afghanistan and assessed before and 6 months after deployment. The Self-Rating Inventory for PTSD was used to measure the presence of PTSD symptoms, while exposure to combat trauma during deployment was measured with a 19-item deployment experiences checklist. These groups did not differ for age, gender, alcohol consumption, cigarette smoking, military rank, length, weight, or medication use. In DNA from whole blood telomere length was measured and DNA methylation levels were assessed using the Illumina 450K DNA methylation arrays. Epigenetic ageing was estimated using the DNAm age estimator procedure. The association of trauma with telomere length was in the expected direction but not significant (B=-10.2, p=0.52). However, contrary to our expectations, development of PTSD symptoms was associated with the reverse process, telomere lengthening (B=1.91, p=0.018). In concordance, trauma significantly accelerated epigenetic ageing (B=1.97, p=0.032) and similar to the findings in telomeres, development of PTSD symptoms was inversely associated with epigenetic ageing (B=-0.10, p=0.044). Blood cell count, medication and premorbid early life trauma exposure did not

  10. Controlled Low-Pressure Blast-Wave Exposure Causes Distinct Behavioral and Morphological Responses Modelling Mild Traumatic Brain Injury, Post-Traumatic Stress Disorder, and Comorbid Mild Traumatic Brain Injury-Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Zuckerman, Amitai; Ram, Omri; Ifergane, Gal; Matar, Michael A; Sagi, Ram; Ostfeld, Ishay; Hoffman, Jay R; Kaplan, Zeev; Sadot, Oren; Cohen, Hagit

    2017-01-01

    The intense focus in the clinical literature on the mental and neurocognitive sequelae of explosive blast-wave exposure, especially when comorbid with post-traumatic stress-related disorders (PTSD) is justified, and warrants the design of translationally valid animal studies to provide valid complementary basic data. We employed a controlled experimental blast-wave paradigm in which unanesthetized animals were exposed to visual, auditory, olfactory, and tactile effects of an explosive blast-wave produced by exploding a thin copper wire. By combining cognitive-behavioral paradigms and ex vivo brain MRI to assess mild traumatic brain injury (mTBI) phenotype with a validated behavioral model for PTSD, complemented by morphological assessments, this study sought to examine our ability to evaluate the biobehavioral effects of low-intensity blast overpressure on rats, in a translationally valid manner. There were no significant differences between blast- and sham-exposed rats on motor coordination and strength, or sensory function. Whereas most male rats exposed to the blast-wave displayed normal behavioral and cognitive responses, 23.6% of the rats displayed a significant retardation of spatial learning acquisition, fulfilling criteria for mTBI-like responses. In addition, 5.4% of the blast-exposed animals displayed an extreme response in the behavioral tasks used to define PTSD-like criteria, whereas 10.9% of the rats developed both long-lasting and progressively worsening behavioral and cognitive "symptoms," suggesting comorbid PTSD-mTBI-like behavioral and cognitive response patterns. Neither group displayed changes on MRI. Exposure to experimental blast-wave elicited distinct behavioral and morphological responses modelling mTBI-like, PTSD-like, and comorbid mTBI-PTSD-like responses. This experimental animal model can be a useful tool for elucidating neurobiological mechanisms underlying the effects of blast-wave-induced mTBI and PTSD and comorbid mTBI-PTSD.

  11. Does abortion increase women's risk for post-traumatic stress? Findings from a prospective longitudinal cohort study.

    Science.gov (United States)

    Biggs, M Antonia; Rowland, Brenly; McCulloch, Charles E; Foster, Diana G

    2016-02-01

    To prospectively assess women's risk for post-traumatic stress disorder (PTSD) and of experiencing post-traumatic stress symptoms (PTSS) over 4 ears after seeking an abortion, and to assess whether symptoms are attributed to the pregnancy, abortion or birth, or other events in women's lives. Prospective longitudinal cohort study which followed women from approximately 1 week after receiving or being denied an abortion (baseline), then every 6 months for 4 years (9 interview waves). 30 abortion facilities located throughout the USA. Among 956 women presenting for abortion care, some of whom received an abortion and some of whom were denied due to advanced gestational age; 863 women are included in the longitudinal analyses. PTSS and PTSD risk were measured using the Primary Care PTSD Screen (PC-PTSD). Index pregnancy-related PTSS was measured by coding the event(s) described by women as the cause of their symptoms. We used unadjusted and adjusted logistic mixed-effects regression analyses to assess whether PTSS, PTSD risk and pregnancy-related PTSS trajectories of women obtaining abortions differed from those who were denied one. At baseline, 39% of participants reported any PTSS and 16% reported three or more symptoms. Among women with symptoms 1-week post-abortion seeking (n=338), 30% said their symptoms were due to experiences of sexual, physical or emotional abuse or violence; 20% attributed their symptoms to non-violent relationship issues; and 19% said they were due to the index pregnancy. Baseline levels of PTSS, PTSD risk and pregnancy-related PTSS outcomes did not differ significantly between women who received and women who were denied an abortion. PTSS, PTSD risk and pregnancy-related PTSS declined over time for all study groups. Women who received an abortion were at no higher risk of PTSD than women denied an abortion. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Epigenetic modification of hippocampal Bdnf DNA in adult rats in an animal model of post-traumatic stress disorder.

    Science.gov (United States)

    Roth, Tania L; Zoladz, Phillip R; Sweatt, J David; Diamond, David M

    2011-07-01

    Epigenetic alterations of the brain-derived neurotrophic factor (Bdnf) gene have been linked with memory, stress, and neuropsychiatric disorders. Here we examined whether there was a link between an established rat model of post-traumatic stress disorder (PTSD) and Bdnf DNA methylation. Adult male Sprague-Dawley rats were given psychosocial stress composed of two acute cat exposures in conjunction with 31 days of daily social instability. These manipulations have been shown previously to produce physiological and behavioral sequelae in rats that are comparable to symptoms observed in traumatized people with PTSD. We then assessed Bdnf DNA methylation patterns (at exon IV) and gene expression. We have found here that the psychosocial stress regimen significantly increased Bdnf DNA methylation in the dorsal hippocampus, with the most robust hypermethylation detected in the dorsal CA1 subregion. Conversely, the psychosocial stress regimen significantly decreased methylation in the ventral hippocampus (CA3). No changes in Bdnf DNA methylation were detected in the medial prefrontal cortex or basolateral amygdala. In addition, there were decreased levels of Bdnf mRNA in both the dorsal and ventral CA1. These results provide evidence that traumatic stress occurring in adulthood can induce CNS gene methylation, and specifically, support the hypothesis that epigenetic marking of the Bdnf gene may underlie hippocampal dysfunction in response to traumatic stress. Furthermore, this work provides support for the speculative notion that altered hippocampal Bdnf DNA methylation is a cellular mechanism underlying the persistent cognitive deficits which are prominent features of the pathophysiology of PTSD.

  13. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief

    Institute of Scientific and Technical Information of China (English)

    Junhua Huang; Qunying Liu; Jinliang Li; Xuejiang Li; Jin You; Liang Zhang; Changfu Tian; Rongsheng Luan

    2013-01-01

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12th, 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate sta-tistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in mul-tivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the oc-currence of post-traumatic stress disorder was the result of the interaction of multiple factors.

  14. Post-traumatic stress disorder status in a rescue group after the Wenchuan earthquake relief.

    Science.gov (United States)

    Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng

    2013-07-15

    Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12(th), 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors.

  15. Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia

    Directory of Open Access Journals (Sweden)

    Cohen Judith A

    2011-09-01

    Full Text Available Abstract Background Sexual violence against children is a major global health and human rights problem. In order to address this issue there needs to be a better understanding of the issue and the consequences. One major challenge in accomplishing this goal has been a lack of validated child mental health assessments in low-resource countries where the prevalence of sexual violence is high. This paper presents results from a validation study of a trauma-focused mental health assessment tool - the UCLA Post-traumatic Stress Disorder - Reaction Index (PTSD-RI in Zambia. Methods The PTSD-RI was adapted through the addition of locally relevant items and validated using local responses to three cross-cultural criterion validity questions. Reliability of the symptoms scale was assessed using Cronbach alpha analyses. Discriminant validity was assessed comparing mean scale scores of cases and non-cases. Concurrent validity was assessed comparing mean scale scores to a traumatic experience index. Sensitivity and specificity analyses were run using receiver operating curves. Results Analysis of data from 352 youth attending a clinic specializing in sexual abuse showed that this adapted PTSD-RI demonstrated good reliability, with Cronbach alpha scores greater than .90 on all the evaluated scales. The symptom scales were able to statistically significantly discriminate between locally identified cases and non-cases, and higher symptom scale scores were associated with increased numbers of trauma exposures which is an indication of concurrent validity. Sensitivity and specificity analyses resulted in an adequate area under the curve, indicating that this tool was appropriate for case definition. Conclusions This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect

  16. An App a Day Keeps the Doctor Away: Guided Education and Training via Smartphones in Subthreshold Post Traumatic Stress Disorder.

    Science.gov (United States)

    Roy, Michael J; Costanzo, Michelle E; Highland, Krista B; Olsen, Cara; Clayborne, Denece; Law, Wendy

    2017-08-01

    Post traumatic stress disorder (PTSD) symptoms are common in military service members (SMs), but stigma can impede treatment initiation. Smartphone applications (apps) are available anywhere, anytime, with the potential to both mitigate the impact of stigma and reduce PTSD symptom severity. We provided 144 SMs or family members, with subthreshold PTSD symptoms (PTSD Checklist [PCL] scores of 28-49), with apps promoting psychoeducation, social engagement, and relaxation and randomized them to 6 weeks of resilience enhancement (brief cognitive-behavioral session, followed by daily text messages directing app use) or a control group (daily text messages of inspirational quotes). Participants (54 percent males, 87 percent SMs) in both groups reported reductions in PTSD, anxiety, and depression symptoms during the 6-week intervention, which were sustained at 3 months, but exhibited partial rebound at 6-12 months. Our preliminary results suggest that app use, with or without specific direction, feasibly and effectively reduces symptom severity. Future studies should consider a longer intervention, enhanced compliance tracking, or boosters to sustain benefits.

  17. Probable Post Traumatic Stress Disorder in Kenya and Its Associated Risk Factors: A Cross-Sectional Household Survey.

    Science.gov (United States)

    Jenkins, Rachel; Othieno, Caleb; Omollo, Raymond; Ongeri, Linnet; Sifuna, Peter; Mboroki, James Kingora; Kiima, David; Ogutu, Bernhards

    2015-10-26

    This study aimed to assess the prevalence of probable post-traumatic stress disorder (PTSD), and its associated risk factors in a general household population in Kenya. Data were drawn from a cross-sectional household survey of mental disorders and their associated risk factors. The participants received a structured epidemiological assessment of common mental disorders, and symptoms of PTSD, accompanied by additional sections on socio-demographic data, life events, social networks, social supports, disability/activities of daily living, quality of life, use of health services, and service use. The study found that 48% had experienced a severe trauma, and an overall prevalence rate of 10.6% of probable PTSD, defined as a score of six or more on the trauma screening questionnaire (TSQ). The conditional probability of PTSD was 0.26. Risk factors include being female, single, self-employed, having experienced recent life events, having a common mental disorder (CMD)and living in an institution before age 16. The study indicates that probable PTSD is prevalent in this rural area of Kenya. The findings are relevant for the training of front line health workers, their support and supervision, for health management information systems, and for mental health promotion in state boarding schools.

  18. Probable Post Traumatic Stress Disorder in Kenya and Its Associated Risk Factors: A Cross-Sectional Household Survey

    Directory of Open Access Journals (Sweden)

    Rachel Jenkins

    2015-10-01

    Full Text Available This study aimed to assess the prevalence of probable post-traumatic stress disorder (PTSD, and its associated risk factors in a general household population in Kenya. Data were drawn from a cross-sectional household survey of mental disorders and their associated risk factors. The participants received a structured epidemiological assessment of common mental disorders, and symptoms of PTSD, accompanied by additional sections on socio-demographic data, life events, social networks, social supports, disability/activities of daily living, quality of life, use of health services, and service use. The study found that 48% had experienced a severe trauma, and an overall prevalence rate of 10.6% of probable PTSD, defined as a score of six or more on the trauma screening questionnaire (TSQ. The conditional probability of PTSD was 0.26. Risk factors include being female, single, self-employed, having experienced recent life events, having a common mental disorder (CMDand living in an institution before age 16. The study indicates that probable PTSD is prevalent in this rural area of Kenya. The findings are relevant for the training of front line health workers, their support and supervision, for health management information systems, and for mental health promotion in state boarding schools.

  19. A meta-analytic investigation of the impact of mindfulness-based interventions on post traumatic stress.

    Science.gov (United States)

    Hopwood, Tanya L; Schutte, Nicola S

    2017-08-04

    A number of studies have investigated the impact of mindfulness-based interventions on symptoms of post-traumatic stress (PTSD) compared to control conditions. The current meta-analysis consolidated findings from 18 studies reporting results for 21 samples of participants. Across studies, mindfulness-based treatments compared to control conditions were effective in ameliorating symptoms of PTSD, with Hedges' g=-0.44. Hedges' g was -0.59 for comparison of mindfulness-based interventions to waitlist control conditions. Changes in mindfulness may underpin the effect of mindfulness-based interventions on PTSD symptoms and thus the meta-analysis examined findings regarding increases in mindfulness. The 12 studies that assessed mindfulness found that the interventions significantly increased mindfulness, Hedges' g=0.52. Moderator analyses indicated that interventions with longer mindfulness training were more efficacious in reducing symptoms of PTSD. Across studies, gender, age, veteran status, or length of time between the intervention and assessment of PTSD symptoms did not moderate the impact of mindfulness-based interventions. The results provide a foundation for future research directions and have implications for work with those impacted by trauma. Copyright © 2017. Published by Elsevier Ltd.

  20. Psychiatric Hospital Workers' Exposure to Disturbing Patient Behavior and Its Relation to Post-Traumatic Stress Disorder Symptoms.

    Science.gov (United States)

    Hilton, N Zoe; Ham, Elke; Dretzkat, Alecia

    2017-09-01

    Background About 10% of health-care workers experience post-traumatic stress disorder (PTSD); the rate is higher among workers exposed to aggression. Objective We extended this research by examining PTSD and exposure to violence and other disturbing patient behaviors, among nursing and other staff on inpatient psychiatric units (forensic and nonforensic). Method Surveys were completed online or in person by 219 respondents (30% response rate). Participants indicated which disturbing behaviors they had been exposed to and ranked the worst three behaviors in each of three categories: most unpleasant to work with, most disruptive to patient care, and most upsetting. Most ( n = 192) also completed the PTSD Checklist (PCL). Results All but two participants reported exposure to at least one disturbing behavior and ranked violence, feces smearing, and screaming constantly as the worst experiences overall. On the PCL, 24% scored above the cut off for probable PTSD. Nursing staff had the highest scores, with no difference between nursing staff on forensic versus nonforensic units. PCL score showed a small positive correlation with the number of disturbing behaviors experienced. Conclusion PTSD symptoms are common among psychiatric hospital workers, not only nursing staff. Future research using clinical assessment, longitudinal designs, and measurement of nonviolent disturbing behaviors is recommended.

  1. Association of post-traumatic stress disorder and work performance: A survey from an emergency medical service, Karachi, Pakistan.

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    Kerai, Salima; Pasha, Omrana; Khan, Uzma; Islam, Muhammad; Asad, Nargis; Razzak, Junaid

    2017-01-01

    The purpose of the study was to explore the association between post-traumatic stress disorder (PTSD) and work performance of emergency medical services personnel in Karachi, Pakistan. Emergency medical service personnel were screened for potential PTSD using Impact of Event Scale-Revised (IES-R). Work performance was assessed on the basis of five variables: number of late arrivals to work, number of days absent, number of days sick, adherence to protocol, and patient satisfaction over a period of 3 months. In order to model outcomes like the number of late arrivals to work, days absent and days late, negative binomial regression was applied, whereas logistic regression was applied for adherence to protocol and linear for patient satisfaction scores. Mean scores of PTSD were 24.0±12.2. No association was found between PTSD and work performance measures: number of late arrivals to work (RRadj 0.99; 0.98-1.00), days absent (RRadj 0.98; 0.96-0.99), days sick (RRadj 0.99; 0.98-1.00), adherence to protocol (ORadj 1.01; 0.99-1.04) and patient satisfaction (β 0.001%-0.03%) after adjusting for years of formal schooling, living status, coping mechanism, social support, working hours, years of experience and anxiety or depression. No statistically significant association was found between PTSD and work performance amongst EMS personnel in Karachi, Pakistan.

  2. Quality of life in Croatian Homeland war (1991-1995) veterans who suffer from post-traumatic stress disorder and chronic pain.

    Science.gov (United States)

    Braš, Marijana; Milunović, Vibor; Boban, Maja; Brajković, Lovorka; Benković, Vanesa; Dorđević, Veljko; Polašek, Ozren

    2011-07-29

    The aim of this study was to investigate the quality of life in Croatian homeland war veterans who suffer from post-traumatic stress disorder and chronic low back pain (LBP). A total of 369 participants were included, classified in four study groups: those with post-traumatic stress disorder (PTSD; N = 59), those with both PTSD and lower back pain (PTSD+LBP; N = 80), those with isolated LBP (N = 95) and controls (N = 135). WHOQOL-BREF survey was used in the estimation of quality of life. The data were analysed using statistical methods and hierarchical clustering. The results indicated a general pattern of lowering quality of life in participants with both psychological (PTSD) and physical (LBP) burden. The average overall quality of life was 2.82 ± 1.14 for the PTSD+LBP group, 3.29 ± 1.28 for the PTSD group, 4.04 ± 1.25 for the LBP group and 4.48 ± 0.80 for the controls (notably, all the pair-wise comparisons were significantly different at the level of P PTSD and 37.1% in PTSD+LBP, suggesting strong synergistic effect of PTSD and LBP. The analysis also identified several clusters of participants with different pattern of quality of life related outcomes, reflecting the complex nature of this indicator. The results of this study reiterate strong impact of PTSD on quality of life, which is additionally reduced if the patient also suffers from LBP. PTSD remains a substantial problem in Croatia, nearly two decades after the beginning of the 1991-1996 Homeland war.

  3. Post-traumatic stress and world assumptions: the effects of religious coping.

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    Zukerman, Gil; Korn, Liat

    2014-12-01

    Religiosity has been shown to moderate the negative effects of traumatic event experiences. The current study was designed to examine the relationship between post-traumatic stress (PTS) following traumatic event exposure; world assumptions defined as basic cognitive schemas regarding the world; and self and religious coping conceptualized as drawing on religious beliefs and practices for understanding and dealing with life stressors. This study examined 777 Israeli undergraduate students who completed several questionnaires which sampled individual world assumptions and religious coping in addition to measuring PTS, as manifested by the PTSD check list. Results indicate that positive religious coping was significantly associated with more positive world assumptions, while negative religious coping was significantly associated with more negative world assumptions. Additionally, negative world assumptions were significantly associated with more avoidance symptoms, while reporting higher rates of traumatic event exposure was significantly associated with more hyper-arousal. These findings suggest that religious-related cognitive schemas directly affect world assumptions by creating protective shields that may prevent the negative effects of confronting an extreme negative experience.

  4. Management of traumatic events: influence of emotion-centered coping strategies on the occurrence of dissociation and post-traumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Georges Brousse

    2011-03-01

    Full Text Available Georges Brousse1,2, Benjamin Arnaud1, Jordane Durand Roger1, Julie Geneste1, Delphine Bourguet1, Frederic Zaplana1, Olivier Blanc1, Jeannot Schmidt1,2, Louis Jehel31CHU Clermont Ferrand, Unité Urgences Psychiatriques, 28 place Henri Dunant BP 69, 63003 Clermont-Ferrand Cedex 01, France; 2Univ Clermont 1, UFR médecine, Clermont-Ferrand, F63001 France; 3Hopital Tenon (CHU APHP 4 rue de la Chine 75020, France, INSERM U669Abstract: Our aim was to assess the influence of the coping strategies employed for the management of traumatic events on the occurrence of dissociation and traumatic disorders. We carried out a 1-year retrospective study of the cognitive management of a traumatic event in 18 subjects involved in the same road vehicle accident. The diagnosis of post-traumatic stress disorder (PTSD was made for 33.3% of the participants. The participants with a PTSD diagnosis 1 year after the event used emotion-centered strategies during the event more often than did those with no PTSD, P < 0.02. In the year after the traumatic event, our results show a strong link between the intensity of PTSD and the severity of the post-traumatic symptoms like dissociation (P = 0.032 and the use of emotion-centered strategies (P = 0.004. Moreover, the participants who presented Peritraumatic Dissociative Experiences Questionnaire scores above 15 made greater use of emotion-centered coping strategies than did those who did not show dissociation, P < 0.04. Our results confirm that the cognitive management of traumatic events may play an essential role in the development of a state of post-traumatic stress in the aftermath of a violent event.Keywords: trauma, coping, emotions, peritraumatic dissociation, post-traumatic stress disorder

  5. Virtual reality exposure therapy for post-traumatic stress disorder and other anxiety disorders.

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    Gerardi, Maryrose; Cukor, Judith; Difede, Joann; Rizzo, Albert; Rothbaum, Barbara Olasov

    2010-08-01

    Anxiety disorders, including phobias and post-traumatic stress disorder, are common and disabling disorders that often involve avoidance behavior. Cognitive-behavioral treatments, specifically imaginal and in vivo forms of exposure therapy, have been accepted and successful forms of treatment for these disorders. Virtual reality exposure therapy, an alternative to more traditional exposure-based therapies, involves immersion in a computer-generated virtual environment that minimizes avoidance and facilitates emotional processing. In this article, we review evidence on the application of virtual reality exposure therapy to the treatment of specific phobias and post-traumatic stress disorder and discuss its advantages and cautions.

  6. An Alternative Approach to the Effects of Multiple Traumas: Complex Post-Traumatic Stress Disorder.

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    Taycan, Okan; Yildirim, Ahmet

    2015-09-01

    Exposure to multiple traumatic events, particularly in childhood, has been shown to result in more complex symptoms than those seen after exposure to a single traumatic event. In case of overlooking the link between trauma and psychopathology, patients with multiple traumatic experiences receive a variety of different diagnoses that are unable to completely cover the clinical picture. Misdiagnoses of genuine cases inevitably lead to mistreatment. A diagnosis of complex post-traumatic stress disorder has been proposed to cover the emerging psychopathology in survivors of multiple traumas. This present report aimed to discuss the construct and to increase the awareness of complex post-traumatic stress disorder diagnosis among mental health professionals.

  7. Impact of Monochorionicity and Twin to Twin Transfusion Syndrome on Prenatal Attachment, Post Traumatic Stress Disorder, Anxiety and Depressive Symptoms.

    Science.gov (United States)

    Beauquier-Maccotta, Berengere; Chalouhi, Gihad E; Picquet, Anne-Laure; Carrier, Aude; Bussières, Laurence; Golse, Bernard; Ville, Yves

    2016-01-01

    Monochronioric (MC) twin pregnancies are considered as high-risk pregnancies with potential complications requiring in-utero interventions. We aimed to assess prenatal attachment, anxiety, post-traumatic stress disorder (PTSD) and depressive symptoms in MC pregnancies complicated with Twin-To-Twin-transfusion syndrome (TTTS) in comparison to uncomplicated monochorionic (UMC) and dichorionic pregnancies (DC). Auto-questionnaires were filled out at diagnosis of TTTS and at successive milestones. Prenatal attachment, PTSD, anxiety and perinatal depression were evaluated respectively by the Prenatal Attachment Inventory (PAI) completed for each twin, the Post-traumatic Checklist Scale (PCLS), the State-Trait Anxiety Inventory (STAI) and the Edinburgh Perinatal Depression Scale (EPDS). There was no significant difference in the PAI scores between the two twins. In the DC and UMC groups, PAI scores increased throughout pregnancy, whilst it didn't for TTTS group. TTTS and DC had a similar prenatal attachment while MC mothers expressed a significantly higher attachment to their fetuses and expressed it earlier. At the announcement of TTTS, 72% of the patients present a score over the threshold at the EPDS Scale, with a higher score for TTTS than for DC (p = 0.005), and UMC (p = 0.007) at the same GA. 30% of mothers in TTTS group have PTSD during pregnancy. 50% of TTTS- patients present an anxiety score over the threshold (STAI-Scale), with a score significantly higher in TTTS than in UMC (pPTSD, high level of anxiety and an alteration of the prenatal attachment. These results should guide the psychological support provided to these patients.

  8. Efficacy of stellate ganglion block in the treatment of anxiety symptoms from combat-related post-traumatic stress disorder: a case series.

    Science.gov (United States)

    Alino, Justin; Kosatka, Donald; McLean, Brian; Hirsch, Kenneth

    2013-04-01

    Report the efficacious use of stellate ganglion blocks (SGBs) in treating the anxiety symptoms of four patients diagnosed with combat-related post-traumatic stress disorder (PTSD) and discuss possible mechanisms of action to explain these findings. Successful treatment of PTSD with SGB has been demonstrated and reported previously at Walter Reed Army Medical Center. An identical protocol was used at Tripler Army Medical Center to treat four service members diagnosed with combat-related PTSD. All patients reported received an SGB on the right side at the level of C6. The patient's PTSD symptoms were evaluated using the Post-traumatic Stress Disorder Checklist (PCL). This checklist was distributed one day before treatment and again the day following treatment. The patients were also given the PCL at subsequent follow-up visits to quantify sustained benefit. SGB showed acute benefit for the symptoms of PTSD by markedly reduced PCL scores after the procedure. Benefits were also sustained during close outpatient follow-up. Selective blockade of the right stellate ganglion at C6 is a minimally invasive procedure with an excellent safety profile that may provide sustained relief of PTSD symptoms. The procedure may also provide benefit for those who are resistant to psychotropic intervention. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  9. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So

  10. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  11. The Effect of Post Traumatic Stress Disorder on Military Leadership: An Historical Perspective

    Science.gov (United States)

    2011-05-19

    Post Traumatic Stress Disorder and Operations Enduring Freedom and Iraqi Freedom: Progress in the Time of Controversy,” Clinical Psychology Review 29...Posttraumatic Stress Disorder and Operating Enduring Freedom and Iraqi Freedom: Progress in a Time of Controversy.” Clinical Psychology Review 29

  12. Prepartum autobiographical memory specificity predicts post-traumatic stress symptoms following complicated pregnancy

    NARCIS (Netherlands)

    Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim

    2009-01-01

    Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So fa

  13. Auditory verbal hallucinations in schizophrenia and post-traumatic stress disorder: common phenomenology, common cause, common interventions?

    Directory of Open Access Journals (Sweden)

    Simon eMccarthy-Jones

    2015-07-01

    Full Text Available Auditory verbal hallucinations (AVH: ‘hearing voices’ are found in both schizophrenia and post-traumatic stress disorder (PTSD. In this paper we first demonstrate that AVH in these two diagnoses share a qualitatively similar phenomenology. We then show that the presence of AVH in schizophrenia is often associated with earlier exposure to traumatic/emotionally overwhelming events, as it is by definition in PTSD. We next argue that the content of AVH relates to earlier traumatic events in a similar way in both PTSD and schizophrenia, most commonly having direct or indirect thematic links to emotionally overwhelming events, rather than being direct re-experiencing. We then propose, following cognitive models of PTSD, that the reconstructive nature of memory may be able to account for the nature of these associations between trauma and AVH content, as may threat-hypervigilance and the individual’s personal goals. We conclude that a notable subset of people diagnosed with schizophrenia with AVH are having phenomenologically and aetiologically identical experiences to PTSD patients who hear voices. As such we propose that the iron curtain between AVH in PTSD (often termed ‘dissociative AVH’ and AVH in schizophrenia (so-called ‘psychotic AVH’ needs to be torn down, as these are often the same experience. One implication of this is that these trauma-related AVH require a common trans-diagnostic treatment strategy. Whilst antipsychotics are already increasingly being used to treat AVH in PTSD, we argue for the centrality of trauma-based interventions for trauma-based AVH in both PTSD and in people diagnosed with schizophrenia.

  14. Change in regional cerebral function in l'aquila earthquake survivors with post-traumatic stress disorder: preliminary findings.

    Science.gov (United States)

    Catalucci, A; Mazza, M; Fasano, F; Ciutti, E; Anselmi, M; Roncone, R; Di Salle, F; Gallucci, M

    2011-03-29

    Subjects with post-traumatic stress disorder (PTSD) present a diminished or blunted emotional response, sometimes called "emotional numbing" (EN), that constitutes one of the central symptoms in PTSD. Symptoms of EN include diminished interest in activities, feeling detached or estranged from others, and restricted range of affect (American Psychiatric Association, 2000). The present work studied the emotional components in individuals with PTSD with the principal aim of investigating subjects' functional alteration in the limbic regions, insula and frontal cortex during an emotional task compared with healthy subjects. Ten subjects with PTSD (survivors of the 6.3 magnitude earthquake of April 6, 2009 in L'Aquila) and ten healthy controls underwent fMRI. PTSD was diagnosed according to DSM-IV-R (APA 2000). All subjects underwent fMRI while viewing content-neutral and emotional stimuli. Data analysis revealed that PTSD subjects had significantly greater cerebral activation in particular in the right anterior insula and in bilateral inferior frontal gyrus. Our data suggest that there is a change in the activation of brain areas responsible for emotional processing in patients with PTSD and are consistent with previous findings demonstrating hyperactivation in frontolimbic structures during emotional tasks. Our study suggests that close personal experience may be critical in engaging the neural mechanisms underlying the emotional modulation of memory. Our findings provide evidence that significant alterations in brain function, similar in many ways to those observed in PTSD, can be seen shortly after major traumatic experiences, highlighting the need for early evaluation and intervention for trauma survivors.

  15. Biologic correlates to the development of post-traumatic stress disorder in female victims of intimate partner violence: implications for practice.

    Science.gov (United States)

    Scott-Tilley, Donna; Tilton, Abigail; Sandel, Mark

    2010-01-01

    The purpose of this article is to discuss the current literature about the risk of post-traumatic stress disorder (PTSD) in victims of intimate partner violence (IPV). PTSD is a complex and serious syndrome with emotional symptoms, psychiatric symptoms, and physical consequences. PTSD is associated with impaired immune function, obesity, increased risk of diabetes, increased severity of premenstrual syndrome symptoms, depression, suicide, and increased likelihood of re-abuse. Female victims of IPV develop PTSD and related consequences at a rate of 74-92%, compared to 6-13% in non-abused women. Advanced practice nurses (APNs) are likely to see one or both of these problems in their practices. The vague, nonspecific symptoms can present challenges to APNs. Biologic correlates are identified to help the APNs identify those most at risk of developing PTSD. Treatment options are discussed.

  16. Longitudinal assessment of sleep disordered breathing in Vietnam veterans with post-traumatic stress disorder

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    Yesavage JA

    2014-10-01

    Full Text Available Jerome A Yesavage,1,2 Lisa M Kinoshita,1,2 Art Noda,2 Laura C Lazzeroni,2 Jennifer Kaci Fairchild,1,2 Leah Friedman,1,2 Gundeep Sekhon,1,2 Stephanie Thompson,1,2 Jauhtai Cheng,1,2 Jamie M Zeitzer1,2 1Department of Veterans Affairs Health Care System, Palo Alto, CA, USA; 2Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA Purpose: Previous work has demonstrated the relatively high prevalence of risk factors for cognitive impairment, such as sleep disordered breathing (SDB and obesity, in Vietnam War era veterans with post-traumatic stress disorder (PTSD. No data are currently available on the longitudinal stability of SDB as a risk factor for cognitive decline in that population, which this study now reports. Methods: Sample consisted of 48 veterans of the Vietnam War with PTSD who completed longitudinal sleep assessments over a 3-year period. The primary outcome measure, the Apnea-Hypopnea Index (AHI indicator, was determined during standard overnight polysomnography. Body mass index (BMI was calculated using standard measurements. Measures of cognitive function tapped auditory verbal memory as measured by the Rey Auditory Verbal Learning Test and executive functioning as measured by the Color-Word Interference Test of the Delis–Kaplan Executive Function System battery. Statistical analyses included mixed effects modeling. Results: In this sample, AHI increased significantly by 2.19 points per year (β=2.19; P<0.005. AHI worsened over the 3-year period, increasing from a mean of 18.7±15.7 to 24.7±17.4 points. Neither BMI nor cognition showed significant change over the 3-year period. Conclusion: SDB worsened in a group of veterans of the Vietnam War with PTSD over a 3-year period. The worsening of SDB over time suggests the need for appropriate countermeasures in populations at risk for progression of the condition. Keywords: SDB, PTSD, sleep apnea, BMI, obesity, cognition

  17. Psycho-trauma, psychosocial adjustment and symptomatic Post-traumatic stress disorder among internally displaced persons in Kaduna, Northwestern Nigeria

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    Taiwo Lateef Sheikh

    2014-09-01

    Full Text Available Background In April 2011, a post election violent conflict in Northern Nigeria led to resettlement of internally displaced persons (IDPs in a camp in Kaduna, the worst affected state. We set out to determine prevalence and socio-demographic factors associated with post-traumatic stress disorder (PTSD among IDPs. We also determined types of psycho-trauma experienced by the IDPs and their psychosocial adjustment.MethodsCross-sectional systematic random sampling was used to select 258 adults IDPs. We used Harvard trauma questionnaire to diagnose symptomatic PTSD, composite international diagnostic interview for diagnosis of depression, and communal trauma event inventory to determine exposure to psycho-trauma. We assessed social adjustment using social provision scale. Multiple logistic regression was used to determine independent predictors of PTSD. Results Of the 258 IDPs, 109 (42.2% had a diagnosis of PTSD, 204 (79.1% had poor living conditions, and only12 (4.7% had poor social provision. The most frequent psycho-traumas were destruction of personal property (96.1%, been evacuated from their town (96% and witnessing violence (88%. More than half (58% of IDPs had experienced 11 – 15 of the 19 traumatic events. Independent predictors of PTSD among respondents were, having a CIDI diagnosis of depression (Adjusted Odd Ratio [AOR]3.5, 95% CI 1.7 – 7.5; p= 0.001 and witnessing death of a family member ( 3.7, 1.2 – 11.5; p=0.0259.ConclusionWe concluded that exposure to psycho-trauma among IDPs in Kaduna led to post conflict PTSD. Death of a family member and co-morbid depression were independent predictors of PTSD among IDPs. Though their living condition was poor, the IDPs had good psychosocial adjustment. We recommended a structured psychosocial intervention among the IDP targeted at improving living condition and dealing with the psychological consequences of psycho-trauma.Key words Post traumatic stress disorder, psychosocial adjustment

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

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    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.

  19. Predicting post-traumatic stress and health anxiety following a venous thrombotic embolism.

    Science.gov (United States)

    Bennett, Paul; Patterson, Katie; Noble, Simon

    2016-05-01

    This research identified psychosocial factors associated with post-traumatic stress and health anxiety following a venous thrombotic embolism. In all, 158 participants, largely registered with a venous thrombotic embolism information website (Lifeblood: The Thrombosis Charity), completed an online survey. Post-traumatic symptom scores were linked to health threat, and not moderated by perceived control over risk for further venous thrombotic embolism. Health anxiety was associated with continuing symptoms and a negative emotional response to the venous thrombotic embolism. There is a need to intervene to reduce both short- and long-term distress in this population, ideally using a stepped-care model.

  20. [Sleep disturbances and spatial memory deficits in post-traumatic stress disorder: the case of L'Aquila (Central Italy)].

    Science.gov (United States)

    Ferrara, Michele; Mazza, Monica; Curcio, Giuseppe; Iaria, Giuseppe; De Gennaro, Luigi; Tempesta, Daniela

    2016-01-01

    Altered sleep is a common and central symptom of post-traumatic stress disorder (PTSD). In fact, sleep disturbances are included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for PTSD. However, it has been hypothesized that sleep disturbances are crucially involved in the aetiology of PTSD, rather than being solely a symptom arising secondarily from this disorder. Therefore, knowing the long-term effects of a trauma can be essential to establish the need of specific interventions for the prevention and treatment of mental disorders that may persist years after a traumatic experience. In one study we showed, for the first time, that even after a period of two years people exposed to a catastrophic disaster such as the L'Aquila earthquake continue to suffer from a reduced sleep quality. Moreover, we observed that sleep quality scores decreased as a function of the proximity to the epicentre, suggesting that the psychological effects of an earthquake may be pervasive and long-lasting. It has been widely shown that disruption of sleep by acute stress may lead to deterioration in memory processing. In fact, in a recent study we observed alterations in spatial memory in PTSD subjects. Our findings indicated that PTSD is accompanied by an impressive deficit in forming a cognitive map of the environment, as well as in sleep-dependent memory consolidation. The fact that this deterioration was correlated to the subjective sleep disturbances in our PTSD group demonstrates the existence of an intimate relationship between sleep, memory consolidation, and stress.

  1. Autobiographical integration of trauma memories and repressive coping predict post-traumatic stress symptoms in undergraduate students.

    Science.gov (United States)

    Smeets, Tom; Giesbrecht, Timo; Raymaekers, Linsey; Shaw, Julia; Merckelbach, Harald

    2010-01-01

    What differentiates those who are able to adapt well to adverse life events (i.e., persons who are resilient) from those who are not (e.g., persons who develop post-traumatic stress symptoms)? Previous work suggests that enhanced autobiographical integration of trauma memories is associated with more severe post-traumatic stress symptoms. Extending this line of work, the present study looked at whether the integration of trauma memories, repressive coping and cognitive reactivity are related to post-traumatic stress symptomatology following negative life events among otherwise healthy young adults (N = 213). Results show that while enhanced integration of trauma memories and high levels of dissociation are related to elevated levels of post-traumatic stress, people who generally engage in repressive coping report fewer post-traumatic stress symptoms. Copyright (c) 2009 John Wiley & Sons, Ltd.

  2. Psychobiology of the acute stress response and its relationship to the psychobiology of post-traumatic stress disorder.

    Science.gov (United States)

    Marshall, Randall D; Garakani, Amir

    2002-06-01

    PTSD that distinguishes the disorder from a simple trauma-induced phobia. The bed nucleus of the stria terminalis (BNST) is specifically implicated from preclinical research in the mediation of context-dependent cues [1]. Treatments that result in down-regulation of the BNST are therefore of particular interest in therapeutic models of prevention after trauma. The fact that a number of vulnerability factors associated with increased risk for developing PTSD are also likely to be biologically based (e.g., a genetic component, prior psychiatric history, prior family of history of psychiatric disorder), provides further evidence in support of a role for psychobiological factors in producing PTSD. Nevertheless, the considerable overlap on these measures between those who will develop PTSD, and those who eventually recover spontaneously, belies any attempt to identify any single or pathognomonic biological marker for risk. For now, the standard of care in predicting level of symptomatology and prognosis in the acute setting continues to be based on careful, informed, serial assessments of symptoms and functioning. Because the capacity to learn from and adapt to adverse conditions are essential to the survival of any species, understanding the neurobiological pathways that mediate learning from traumatic experiences in an adaptive way is as important as understanding the etiology of PTSD and other trauma-related maladaptive consequences. Biological models that trace the causal cascade of post-traumatic events in the brain and neuroendocrine systems may offer a multiplicity of possibilities for intervention. It is well established that conditioned responses are robust and persistent. Moreover, the primary mechanism of habituation is overlearning rather than extinction. Interventions that promote overlearning may therefore prove to be the most powerful and efficient preventative treatments. The therapeutics literature supports this hypothesis, in that brief psychosocial

  3. A rat model of post-traumatic stress disorder reproduces the hippocampal deficits seen in the human syndrome

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    Sonal eGoswami

    2012-06-01

    Full Text Available Despite recent progress, the causes and pathophysiology of post-traumatic stress disorder (PTSD remain poorly understood, partly because of ethical limitations inherent to human studies. One approach to circumvent this obstacle is to study PTSD in a valid animal model of the human syndrome. In one such model, extreme and long-lasting behavioral manifestations of anxiety develop in a subset of Lewis rats after exposure to an intense predatory threat that mimics the type of life-and-death situation known to precipitate PTSD in humans. This study aimed to assess whether the hippocampus-associated deficits observed in the human syndrome are reproduced in this rodent model. Prior to predatory threat, different groups of rats were each tested on one of three object recognition memory tasks that varied in the types of contextual clues (i.e. that require the hippocampus or not the rats could use to identify novel items. After task completion, the rats were subjected to predatory threat and, one week later, tested on the elevated plus maze. Based on their exploratory behavior in the plus maze, rats were then classified as resilient or PTSD-like and their performance on the pre-threat object recognition tasks compared. The performance of PTSD-like rats was inferior to that of resilient rats but only when subjects relied on an allocentric frame of reference to identify novel items, a process thought to be critically dependent on the hippocampus. Therefore, these results suggest that even prior to trauma, PTSD-like rats show a deficit in hippocampal-dependent functions, as reported in twin studies of human PTSD.

  4. Social capital and chronic post-traumatic stress disorder among survivors of the 2007 earthquake in Pisco, Peru.

    Science.gov (United States)

    Flores, Elaine C; Carnero, Andres M; Bayer, Angela M

    2014-01-01

    This study aimed to evaluate the association between chronic Post-Traumatic Stress Disorder (PTSD) and both structural and cognitive social capital in adult survivors of the 2007 earthquake in Pisco, Peru. Cognitive social capital measures trust, sense of belonging and interpersonal relationships in the community and structural social capital measures group membership, support from community groups and individuals, and involvement in citizenship activities. We conducted a population-based cross-sectional study in five counties in Pisco, selecting 1012 adults through complex, multi-stage random sampling. All participants completed socio-demographic questions and validated Spanish-language versions of the Adapted Social Capital Assessment Tool (SASCAT) and the civilian PTSD checklist (PCL-C). After performing descriptive and bivariate analyses, we carried out prevalence ratio (PR) regression. The overall prevalence of chronic PTSD was 15.9% (95% CI: 12.3, 19.8), much higher than anticipated based on existing evidence. Cognitive social capital was found to be negatively associated with chronic PTSD, while no significant association was found for structural social capital. Specifically, those with high cognitive social capital had an almost two times lower prevalence of chronic PTSD (PR = 1.83, 95% CI: 1.50, 2.22) compared with those with low cognitive social capital. No independent association between structural social capital and chronic PTSD was found (PR = 1.44, 95% CI: 0.70, 2.97). In conclusion, cognitive social capital, but not structural social capital, has a protective influence on the occurrence of chronic PTSD in survivors of natural disasters. These results may have public health implications. For example, pre- and post-disaster community-based interventions that catalyze and foster dimensions of cognitive social capital may aid in ameliorating the effect of earthquakes and other natural disasters on populations with high vulnerability to such events

  5. Predictors of birth-related post-traumatic stress symptoms: secondary analysis of a cohort study.

    Science.gov (United States)

    Furuta, Marie; Sandall, Jane; Cooper, Derek; Bick, Debra

    2016-12-01

    This study aimed to identify factors associated with birth-related post-traumatic stress symptoms during the early postnatal period. Secondary analysis was conducted using data from a prospective cohort study of 1824 women who gave birth in one large hospital in England. Post-traumatic stress symptoms were measured by the Impact of Event Scale at 6 to 8 weeks postpartum. Zero-inflated negative binomial regression models were developed for analyses. Results showed that post-traumatic stress symptoms were more frequently observed in black women and in women who had a higher pre-pregnancy BMI compared to those with a lower BMI. Women who have a history of mental illness as well as those who gave birth before arriving at the hospital, underwent an emergency caesarean section or experienced severe maternal morbidity or neonatal complications also showed symptoms. Women's perceived control during labour and birth significantly reduced the effects of some risk factors. A higher level of perceived social support during the postnatal period also reduced the risk of post-traumatic stress symptoms. From the perspective of clinical practice, improving women's sense of control during labour and birth appears to be important, as does providing social support following the birth.

  6. Post-Traumatic Stress Disorder and Quality of Life in Sexually Abused Australian Children

    Science.gov (United States)

    Gospodarevskaya, Elena

    2013-01-01

    The study used publicly available data on post-traumatic stress disorder in a sample of the Australian population with a history of sexual abuse to demonstrate how this evidence can inform economic analyses. The 2007 Australian Mental Health Survey revealed that 8.3% of 993 adolescents experienced childhood sexual abuse, of which 40.2% were…

  7. Post Traumatic Stress Disorder: A Diagnosis for Youth from Violent, Impoverished Communities

    Science.gov (United States)

    Bertram, Rosalyn M.; Dartt, Jennifer L.

    2009-01-01

    We examine the historical development and use of the diagnosis of post-traumatic stress disorder that has been primarily applied to war veterans. We explore how study of this population and refinement of this diagnosis were influenced by changing paradigms and the emergence of new theory. From this context, we then explore similarities and…

  8. The Relationship between Peer Victimization and Post-Traumatic Stress Symptomatology in a Rural Sample

    Science.gov (United States)

    Crosby, James W.; Oehler, Judy; Capaccioli, Kristen

    2010-01-01

    Peer victimization (PV) has been associated with a number of negative psychological sequelae. Few studies, however, have examined the relationship between PV and the symptomatology of post-traumatic stress disorder, and no studies to date have examined this relationship in a rural sample. Adapted versions of the SEQ-SR and the TSCC were used to…

  9. Classroom Strategies for Teaching Veterans with Post-Traumatic Stress Disorder and Traumatic Brain Injury

    Science.gov (United States)

    Sinski, Jennifer Blevins

    2012-01-01

    Postsecondary institutions currently face the largest influx of veteran students since World War II. As the number of veteran students who may experience learning problems caused by Post-Traumatic Stress Disorder and/or Traumatic Brain Injury continues to rise, the need for instructional strategies that address their needs increases. Educators may…

  10. Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

    Science.gov (United States)

    de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

    2011-07-01

    This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

  11. The Root Cause of Post Traumatic and Development Stress Disorders

    Science.gov (United States)

    2012-10-01

    of these brains, we have documented hypermethylation at 355 methylation sites in the medial orbitofrontal cortex in PTSD brains, compared to 25...response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing...and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information

  12. Families' perceptions of veterans' distress due to post-traumatic stress disorder-related symptoms at the end of life.

    Science.gov (United States)

    Alici, Yesne; Smith, Dawn; Lu, Hien L; Bailey, Amos; Shreve, Scott; Rosenfeld, Kenneth; Ritchie, Christine; Casarett, David J

    2010-03-01

    To define the frequency of post-traumatic stress disorder (PTSD)-related symptoms among veterans who are near the end of life and to describe the impact that these symptoms have on patients and their families. Patients had received inpatient or outpatient care from a participating VA facility in the last month of life, and one family member per patient was selected using predefined eligibility criteria. Family members then completed a telephone survey, The Family Assessment of Treatment at End-of-Life, which assessed their perceptions of the quality of the care that the patients and they themselves received during the patients' last month of life. Seventeen percent of patients (89 of 524) were reported to have had PTSD-related symptoms in the last month of life. PTSD-related symptoms caused discomfort less often than pain did (mean frequency score 1.79 vs. 1.93; Wilcoxon sign rank test, PFamily members of patients with PTSD-related symptoms reported less satisfaction overall with the care the patient received (mean score 48 vs. 62; rank sum test, Pfamilies' perceptions of the quality of care that the veteran received. (c) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  13. Blast exposure induces post-traumatic stress disorder-related traits in a rat model of mild traumatic brain injury.

    Science.gov (United States)

    Elder, Gregory A; Dorr, Nathan P; De Gasperi, Rita; Gama Sosa, Miguel A; Shaughness, Michael C; Maudlin-Jeronimo, Eric; Hall, Aaron A; McCarron, Richard M; Ahlers, Stephen T

    2012-11-01

    Blast related traumatic brain injury (TBI) has been a major cause of injury in the wars in Iraq and Afghanistan. A striking feature of the mild TBI (mTBI) cases has been the prominent association with post-traumatic stress disorder (PTSD). However, because of the overlapping symptoms, distinction between the two disorders has been difficult. We studied a rat model of mTBI in which adult male rats were exposed to repetitive blast injury while under anesthesia. Blast exposure induced a variety of PTSD-related behavioral traits that were present many months after the blast exposure, including increased anxiety, enhanced contextual fear conditioning, and an altered response in a predator scent assay. We also found elevation in the amygdala of the protein stathmin 1, which is known to influence the generation of fear responses. Because the blast overpressure injuries occurred while animals were under general anesthesia, our results suggest that a blast-related mTBI exposure can, in the absence of any psychological stressor, induce PTSD-related traits that are chronic and persistent. These studies have implications for understanding the relationship of PTSD to mTBI in the population of veterans returning from the wars in Iraq and Afghanistan.

  14. Case report and theoretical description of accelerated resolution therapy (ART) for military-related post-traumatic stress disorder.

    Science.gov (United States)

    Kip, Kevin E; Shuman, Amy; Hernandez, Diego F; Diamond, David M; Rosenzweig, Laney

    2014-01-01

    This article describes a new, brief exposure-based psychotherapy known as Accelerated Resolution Therapy (ART) that is currently being evaluated as a treatment for combat-related post-traumatic stress disorder (PTSD). We describe a case report of an Army veteran with combat-related PTSD who was treated with 2 sessions of ART and experienced significant clinical improvement. We then discuss the theoretical basis and major components of the ART protocol, including use of lateral left-right eye movements, and differentiate ART with evidence-based psychotherapies currently endorsed by the Department of Defense and Veterans Administration. The number of military personnel who have served in the wars in Iraq and Afghanistan and are afflicted with PTSD is likely in the hundreds of thousands. The ART protocol, which is delivered in 2 to 5 sessions and without homework, uses the psychotherapeutic practices of imaginal exposure and imagery rescripting (IR) facilitated through sets of eye movements. In addition to its brevity, a novel component of ART is use of IR to "replace" negative imagery (and other sensations) with positive imagery. This theoretical description of ART and single case report provide a rationale for future formal evaluation of ART for treatment of military-related PTSD. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  15. Extinction learning in childhood anxiety disorders, obsessive compulsive disorder and post-traumatic stress disorder: implications for treatment.

    Science.gov (United States)

    McGuire, Joseph F; Orr, Scott P; Essoe, Joey K-Y; McCracken, James T; Storch, Eric A; Piacentini, John

    2016-10-01

    Threat conditioning and extinction play an important role in anxiety disorders, obsessive compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Although these conditions commonly affect children, threat conditioning and extinction have been primarily studied in adults. However, differences in phenomenology and neural architecture prohibit the generalization of adult findings to youth. A comprehensive literature search using PubMed and PsycInfo was conducted to identify studies that have used differential conditioning tasks to examine threat acquisition and extinction in youth. The information obtained from this review helps to clarify the influence of these processes on the etiology and treatment of youth with OCD, PTSD and other anxiety disorders. Thirty studies of threat conditioning and extinction were identified Expert commentary: Youth with anxiety disorders, OCD, and PTSD have largely comparable threat acquisition relative to unaffected controls, with some distinctions noted for youth with PTSD or youth who have suffered maltreatment. However, impaired extinction was consistently observed across youth with these disorders and appears to be consistent with deficiencies in inhibitory learning. Incorporating strategies to improve inhibitory learning may improve extinction learning within extinction-based treatments like cognitive behavioral therapy (CBT). Strategies to improve inhibitory learning in CBT are discussed.

  16. Hurricane Katrina experience and the risk of post-traumatic stress disorder and depression among pregnant women.

    Science.gov (United States)

    Xiong, Xu; Harville, Emily W; Mattison, Donald R; Elkind-Hirsch, Karen; Pridjian, Gabriella; Buekens, Pierre

    2010-01-01

    Little is known about the effects of disaster exposure and intensity on the development of mental disorders among pregnant women. The aim of this study was to examine the effect of exposure to Hurricane Katrina on mental health in pregnant women. Prospective cohort epidemiological study. Tertiary hospitals in New Orleans and Baton Rouge, U.S.A. Women who were pregnant during Hurricane Katrina or became pregnant immediately after the hurricane. Post-traumatic stress disorder (PTSD) and depression. The frequency of PTSD was higher in women with high hurricane exposure (13.8 percent) than women without high hurricane exposure (1.3 percent), with an adjusted odds ratio (aOR) of 16.8 (95% confidence interval: 2.6-106.6) after adjustment for maternal race, age, education, smoking and alcohol use, family income, parity, and other confounders. The frequency of depression was higher in women with high hurricane exposure (32.3 percent) than women without high hurricane exposure (12.3 percent), with an aOR of 3.3 (1.6-7.1). Moreover, the risk of PTSD and depression increased with an increasing number of severe experiences of the hurricane. Pregnant women who had severe hurricane experiences were at a significantly increased risk for PTSD and depression. This information should be useful for screening pregnant women who are at higher risk of developing mental disorders after a disaster.

  17. Distinctiveness of symptoms of prolonged grief, depression, and post-traumatic stress in bereaved children and adolescents.

    Science.gov (United States)

    Spuij, Mariken; Reitz, Ellen; Prinzie, Peter; Stikkelbroek, Yvonne; de Roos, Carlijn; Boelen, Paul A

    2012-12-01

    Studies among adults have shown that symptoms of prolonged grief disorder (PGD) are distinct from those of bereavement-related depression and post-traumatic stress-disorder (PTSD). This study was an attempt to replicate this finding in two distinct samples of bereaved children (N = 197; aged 8-12 years) and adolescents (N = 135; 13-18 years), confronted with the death of a parent, sibling or other close relative. Using confirmatory factor analyses, we compared the fit of a one-factor model with the fit of a three-factor model in which symptoms formed three distinct, correlated factors. In both samples, findings showed that the model in which symptoms of PGD, depression, and PTSD loaded on separate factors was superior to a one-factor model and displayed excellent model fit. Summed scores on the PGD, depression, and PTSD items were significantly associated with functional impairment, attesting to the concurrent validity of the PGD, depression, and PTSD factors. The current findings complement prior evidence from adult samples that PGD is a distinct syndrome and suggest that PGD symptoms should be addressed in the assessment and treatment of bereaved children and adolescent seeking help following their loss.

  18. Gray Matter Alterations in Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, and Social Anxiety Disorder.

    Science.gov (United States)

    Cheng, Bochao; Huang, Xiaoqi; Li, Shiguang; Hu, Xinyu; Luo, Ya; Wang, Xiuli; Yang, Xun; Qiu, Changjian; Yang, Yanchun; Zhang, Wei; Bi, Feng; Roberts, Neil; Gong, Qiyong

    2015-01-01

    Post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and social anxiety disorder (SAD) all bear the core symptom of anxiety and are separately classified in the new DSM-5 system. The aim of the present study is to obtain evidence for neuroanatomical difference for these disorders. We applied voxel-based morphometry (VBM) with Diffeomorphic Anatomical Registration Through Exponentiated Lie to compare gray matter volume (GMV) in magnetic resonance images obtained for 30 patients with PTSD, 29 patients with OCD, 20 patients with SAD, and 30 healthy controls. GMV across all four groups differed in left hypothalamus and left inferior parietal lobule and post hoc analyses revealed that this difference is primarily due to reduced GMV in the PTSD group relative to the other groups. Further analysis revealed that the PTSD group also showed reduced GMV in frontal lobe, temporal lobe, and cerebellum compared to the OCD group, and reduced GMV in frontal lobes bilaterally compared to SAD group. A significant negative correlation with anxiety symptoms is observed for GMV in left hypothalamus in three disorder groups. We have thus found evidence for brain structure differences that in future could provide biomarkers to potentially support classification of these disorders using MRI.

  19. Grey matter alterations in post-traumatic stress disorder, obsessive–compulsive disorder and social anxiety disorder

    Directory of Open Access Journals (Sweden)

    Bochao eCheng

    2015-08-01

    Full Text Available Post-traumatic stress disorder (PTSD, obsessive-compulsive disorder (OCD and social anxiety disorder (SAD all bear the core symptom of anxiety and are separately classified in the new DSM-5 system. The aim of the present study is to obtain evidence for neuroanatomical difference for these disorders. We applied voxel-based morphometry (VBM with Diffeomorphic Anatomic Registration Through Exponentiated Lie (DARTEL to compare grey matter volume (GMV in Magnetic Resonance (MR images obtained for thirty patients with PTSD, twenty nine patients with OCD, twenty patients with SAD and thirty healthy controls. GMV across all four groups differed in left hypothalamus and left inferior parietal lobule and post hoc analyses revealed that this difference is primarily due to reduced GMV in the PTSD group relative to the other groups. Further analysis revealed that the PTSD group also showed reduced GMV in frontal lobe, temporal lobe and cerebellum compared to the OCD group, and reduced GMV in frontal lobes bilaterally compared to SAD group. A significant negative correlation with anxiety symptoms is observed for GMV in left hypothalamus in three disorder groups. We have thus found evidence for brain structure differences that in future could provide biomarkers to potentially support classification of these disorders using MRI.

  20. Does pediatric post-traumatic stress disorder alter the brain? Systematic review and meta-analysis of structural and functional magnetic resonance imaging studies.

    Science.gov (United States)

    Milani, Ana Carolina C; Hoffmann, Elis V; Fossaluza, Victor; Jackowski, Andrea P; Mello, Marcelo F

    2017-03-01

    Several studies have recently demonstrated that the volumes of specific brain regions are reduced in children and adolescents with post-traumatic stress disorder (PTSD) compared with those of healthy controls. Our study investigated the potential association between early traumatic experiences and altered brain regions and functions. We conducted a systematic review of the scientific literature regarding functional magnetic resonance imaging and a meta-analysis of structural magnetic resonance imaging studies that investigated cerebral region volumes in pediatric patients with PTSD. We searched for articles from 2000 to 2014 in the PsycINFO, PubMed, Medline, Lilacs, and ISI (Web of Knowledge) databases. All data regarding the amygdala, hippocampus, corpus callosum, brain, and intracranial volumes that fit the inclusion criteria were extracted and combined in a meta-analysis that assessed differences between groups. The meta-analysis found reduced total corpus callosum areas and reduced total cerebral and intracranial volumes in the patients with PTSD. The total hippocampus (left and right hippocampus) and gray matter volumes of the amygdala and frontal lobe were also reduced, but these differences were not significant. The functional studies revealed differences in brain region activation in response to stimuli in the post-traumatic stress symptoms/PTSD group. Our results confirmed that the pediatric patients with PTSD exhibited structural and functional brain abnormalities and that some of the abnormalities occurred in different brain regions than those observed in adults. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.

  1. Identification and Referral of Patients at Risk for Post-traumatic Stress Disorder: A Literature Review and Retrospective Analysis.

    Science.gov (United States)

    Bolduc, Aaron; Hwang, Brice; Hogan, Christopher; Bhalla, Varun K; Nesmith, Elizabeth; Medeiros, Regina; Alexander, Cassie; Holsten, Steven B

    2015-09-01

    Post-traumatic stress disorder (PTSD) is a well-established psychological disorder after severe traumatic injury but remains poorly recognized. Recent changes in the "Resources for Optimal Care of the Injured Trauma Patient 2014" stress the need for comprehensive screening and referral for PTSD and depression after injury. Our purpose was to review the current PTSD literature and perform a retrospective chart review to evaluate screening at our institution. We hypothesized a lack of documentation and thus referral of these patients to mental health professionals. We performed a literature review of 43 publications of risk factors for PTSD in the civilian adult population followed by a retrospective review. Records were analyzed for basic demographics, risk factors found in the literature, and referrals to mental health providers. Risk factors included amputation, dissociative symptoms, female gender, history of mental health disorder, and peri-traumatic emotionality. Traumatic amputation status and gender were recorded in all patients. History of mental health disorder was present in 11.5 per cent patients, absent in 80.75 per cent, and not recorded in 7.75 per cent with an overall documentation of 91.75 per cent. Dissociative symptoms and peri-traumatic emotionality were recorded in 0.5 per cent and 1.0 per cent of patients, respectively. Only 13 patients of 400 (3.25%) were referred to mental health professionals. Despite extensive evidence and literature supporting risk factors for the development of PTSD, identification and treatment at our level 1 trauma center is lacking. There is a need for consistent screening among trauma centers to identify PTSD risk factors and protocols for risk reduction and referrals for patients at risk.

  2. Symptoms of psychological distress and post-traumatic stress disorder in United States Air Force "drone" operators.

    Science.gov (United States)

    Chappelle, Wayne L; McDonald, Kent D; Prince, Lillian; Goodman, Tanya; Ray-Sannerud, Bobbie N; Thompson, William

    2014-08-01

    The goal of this study is to repeat a survey administered in 2010 to assess for changes in mental health among United States Air Force aircrew operating Predator/Reaper remotely piloted aircraft, also commonly referred to as "drones." Participants were assessed for self-reported sources of occupational stress, levels of clinical distress using the Outcome Questionnaire-45.2, and symptoms of post-traumatic stress disorder (PTSD) using the PTSD Checklist-Military Version. A total of 1,094 aircrew responded to the web-based survey composed of the commercially available standardized instruments mentioned above. The survey also contained nonstandardized items asking participants to report the main sources of their occupational stress, as well as questions addressing demographics and work-related characteristics. The estimated response rate to the survey was 49%. Study results reveal the most problematic self-reported stressors are operational: low manning, extra duties/administrative tasks, rotating shift work, and long hours. The results also reveal 10.72% of operators self-reported experiencing high levels of distress and 1.57% reported high levels of PTSD symptomology. The results are lower than findings from the 2010 survey and from soldiers returning from Iraq and Afghanistan. Implications of the study and recommendations for United States Air Force line leadership and mental health providers are discussed.

  3. A treatment development study of a cognitive and mindfulness-based therapy for adolescents with co-occurring post-traumatic stress and substance use disorder.

    Science.gov (United States)

    Fortuna, Lisa R; Porche, Michelle V; Padilla, Auralyd

    2017-08-16

    Substance use is common among adolescents with post-traumatic stress disorder (PTSD). We aimed to develop and study an integrated treatment for adolescents with co-occurring disorders. This is a therapy development and open pilot trial study of a manualized therapy for adolescents with post-traumatic stress, depression, and substance use that uses a combination of cognitive therapy (CT) and mindfulness. Descriptive statistics and paired sample t-tests were calculated to assess for changes in PTSD symptoms, depression, and substance use frequency from baseline to end of treatment using standardized measures and validated by urine drug screens. We also examined for safety, predictors of clinical outcomes, and treatment retention. Thirty-seven adolescents participated in the study; 62% were study completers as defined by retention for at least 6 weeks of treatment. There were significant improvements in PTSD and depression symptoms from baseline to end of treatment, reflecting medium effect sizes, and which was associated with changes in trauma-associated cognitions. There was a reduction in cannabis use, which was the most commonly used substance. Preliminary results suggest feasibility, safety, and potential clinical effectiveness of an integrated therapy for adolescents with PTSD, depression, and substance use. Retention was comparable to other therapy clinical trial studies of adolescents despite the high risk for poor treatment retention and poor clinical outcomes among adolescents with PTSD and co-occurring disorders. We discuss the rationale for continued research of this mindfulness-based CT for adolescents with co-occurring disorders. Adolescents with co-occurring PTSD and substance use achieved meaningful improvement in PTSD and depression symptom severity after receiving a CT and mindfulness dual diagnosis approach. An integrated manualized therapy for dual diagnosis shows promise for reducing cannabis use in adolescents with PTSD. Changes in trauma

  4. High Prevalence of Post-Traumatic Stress Symptoms in Relation to Social Factors in Affected Population One Year after the Fukushima Nuclear Disaster.

    Directory of Open Access Journals (Sweden)

    Takuya Tsujiuchi

    Full Text Available This study investigated post-traumatic stress symptoms in relation to the population affected by the Fukushima Nuclear Disaster, one year after the disaster. Additionally, we investigated social factors, such as forced displacement, which we hypothesize contributed to the high prevalence of post-traumatic stress. Finally, we report of written narratives that were collected from the impacted population.Using the Impact of Event Scale-Revised (IES-R, questionnaires were sent to 2,011 households of those displaced from Fukushima prefecture living temporarily in Saitama prefecture. Of the 490 replies; 350 met the criteria for inclusion in the study. Multiple logistic regression analysis was performed to examine several characteristics and variables of social factors as predictors of probable post-traumatic stress disorder, PTSD.The mean score of IES-R was 36.15±21.55, with 59.4% having scores of 30 or higher, thus indicating a probable PTSD. No significant differences in percentages of high-risk subjects were found among sex, age, evacuation area, housing damages, tsunami affected, family split-up, and acquaintance support. By the result of multiple logistic regression analysis, the significant predictors of probable PTSD were chronic physical diseases (OR = 1.97, chronic mental diseases (OR = 6.25, worries about livelihood (OR = 2.27, lost jobs (OR = 1.71, lost social ties (OR = 2.27, and concerns about compensation (OR = 3.74.Although there are limitations in assuming a diagnosis of PTSD based on self-report IES-R, our findings indicate that there was a high-risk of PTSD strongly related to the nuclear disaster and its consequent evacuation and displacement. Therefore, recovery efforts must focus not only on medical and psychological treatment alone, but also on social and economic issues related to the displacement, as well.

  5. Treating Post-traumatic Stress Disorder in patients with Multiple Sclerosis: a randomized controlled trial comparing the efficacy of Eye Movement Desensitization and Reprocessing and Relaxation Therapy.

    Directory of Open Access Journals (Sweden)

    Sara eCarletto

    2016-04-01

    Full Text Available Objective: Multiple Sclerosis (MS is a demyelinating autoimmune disease that imposes a significant emotional burden with heavy psychosocial consequences. Several studies have investigated the association between MS and mental disorders such as depression and anxiety, and recently researchers have focused also on Post-traumatic Stress Disorder (PTSD. This is the first study that investigates the usefulness of proposing a treatment for PTSD to patients with MS. Methods: A randomized controlled trial with patients with MS diagnosed with PTSD comparing Eye Movement Desensitization and Reprocessing (EMDR; n = 20 and Relaxation Therapy (RT; n = 22. The primary outcome measure was the proportion of participants that no longer meet PTSD diagnosis as measured with Clinician Administered PTSD Scale six-months after the treatment.Results: The majority of patients were able to overcome their PTSD diagnosis after only 10 therapy sessions. EMDR treatment appears to be more effective than RT in reducing the proportion of patients with MS suffering from PTSD. Both treatments are effective in reducing PTSD severity, anxiety symptoms and to improve Quality of Life (QoL. Conclusions: Although our results can only be considered preliminary, this study suggests that it is essential that PTSD symptoms are detected and that brief and cost-effective interventions to reduce PTSD and associated psychological symptoms are offered to patients, in order to help them to reduce the psychological burden associated with their neurological condition.Trail registration: NCT01743664, https://clinicaltrials.gov/ct2/show/NCT01743664

  6. Emerging Generation of Post-Traumatic Stress Disorder Victims

    Science.gov (United States)

    2011-02-02

    of the warmth of a family’s love, they are perplexed by the troubling images that play out in their minds.3 The family and society tries to...served in an Army where mission accomplishment is emphasized more than interpersonal relationships.6 They have contributed to the mission, but at...of PTSD to emerge as the Soldiers are exposed to these horrors daily. Reality is the hard and sometimes cold heart that houses the moral man or

  7. Feasibility, qualitative findings and satisfaction of a brief Tai Chi mind–body programme for veterans with post-traumatic stress symptoms

    Science.gov (United States)

    Niles, Barbara L; Mori, DeAnna L; Polizzi, Craig P; Pless Kaiser, Anica; Ledoux, Annie M; Wang, Chenchen

    2016-01-01

    Objective To examine feasibility, qualitative feedback and satisfaction associated with a 4-session introduction to Tai Chi for veterans with post-traumatic stress symptoms. Design We observed and reported recruitment and retention rates, participant characteristics, adherence, and satisfaction across 2 cohorts. We also examined qualitative feedback provided by questionnaires, focus groups and individual interviews. Main outcome measures Rates of recruitment and retention, focus group and individual feedback interviews, self-reported satisfaction. Participants 17 veterans with post-traumatic stress symptoms. Results Almost 90% (17/19) of those eligible following the telephone screen enrolled in the programme. Three-quarters (76.4%) of the participants attended at least 3 of the 4 Tai Chi sessions. Qualitative data analysis revealed themes indicating favourable impressions of the Tai Chi sessions. In addition, participants reported feeling very engaged during the sessions, and found Tai Chi to be helpful for managing distressing symptoms (ie, intrusive thoughts, concentration difficulties, physiological arousal). Participants also reported high satisfaction: 93.8% endorsed being very or mostly satisfied with the programme. All participants (100%) indicated that they would like to participate in future Tai Chi programmes and would recommend it to a friend. Conclusions Tai Chi appears to be feasible and safe for veterans with symptoms of post-traumatic stress disorder (PTSD), is perceived to be beneficial and is associated with high rates of satisfaction. This study highlights the need for future investigation of Tai Chi as a novel intervention to address symptoms of PTSD. PMID:27899398

  8. Sex differences in objective measures of sleep in post-traumatic stress disorder and healthy control subjects.

    Science.gov (United States)

    Richards, Anne; Metzler, Thomas J; Ruoff, Leslie M; Inslicht, Sabra S; Rao, Madhu; Talbot, Lisa S; Neylan, Thomas C

    2013-12-01

    A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82)  = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82)  = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82)  = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82)  = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82)  = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post-traumatic

  9. Common biochemical defects linkage between post-traumatic stress disorders, mild traumatic brain injury (TBI) and penetrating TBI.

    Science.gov (United States)

    Prasad, Kedar N; Bondy, Stephen C

    2015-03-02

    Post-traumatic stress disorder (PTSD) is a complex mental disorder with psychological and emotional components, caused by exposure to single or repeated extreme traumatic events found in war, terrorist attacks, natural or man-caused disasters, and by violent personal assaults and accidents. Mild traumatic brain injury (TBI) occurs when the brain is violently rocked back and forth within the skull following a blow to the head or neck as in contact sports, or when in close proximity to a blast pressure wave following detonation of explosives in the battlefield. Penetrating TBI occurs when an object penetrates the skull and damages the brain, and is caused by vehicle crashes, gunshot wound to the head, and exposure to solid fragments in the proximity of explosions, and other combat-related head injuries. Despite clinical studies and improved understanding of the mechanisms of cellular damage, prevention and treatment strategies for patients with PTSD and TBI remain unsatisfactory. To develop an improved plan for treating and impeding progression of PTSD and TBI, it is important to identify underlying biochemical changes that may play key role in the initiation and progression of these disorders. This review identifies three common biochemical events, namely oxidative stress, chronic inflammation and excitotoxicity that participate in the initiation and progression of these conditions. While these features are separately discussed, in many instances, they overlap. This review also addresses the goal of developing novel treatments and drug regimens, aimed at combating this triad of events common to, and underlying, injury to the brain.

  10. Ginsenoside Rb1 rescues anxiety-like responses in a rat model of post-traumatic stress disorder.

    Science.gov (United States)

    Lee, Bombi; Sur, Bongjun; Cho, Seong-Guk; Yeom, Mijung; Shim, Insop; Lee, Hyejung; Hahm, Dae-Hyun

    2016-04-01

    Single prolonged stress (SPS), a rat model of post-traumatic stress disorder (PTSD), induces alterations in the hypothalamic-pituitary-adrenal axis. Korean red ginseng, whose major active component is ginsenoside Rb1 (GRb1), is one of the widely used traditional anxiolytics. However, the efficacy of GRb1 in alleviating PTSD-associated anxiety-like abnormalities has not been investigated. The present study used several behavioral tests to examine the effects of GRb1 on symptoms of anxiety in rats after SPS exposure and on the central noradrenergic system. Male Sprague-Dawley rats received GRb1 (10 or 30 mg/kg, i.p., once daily) during 14 days of SPS. Daily GRb1 (30 mg/kg) administration significantly increased the number and duration of open-arm visits in the elevated plus maze (EPM) test, reduced the anxiety index, increased the risk assessment, reduced grooming behaviors in the EPM test, and increased the total number of line crossings of an open field after SPS. The higher dose of GRb1 also blocked SPS-induced decreases in hypothalamic neuropeptide Y expression, increases in locus coeruleus tyrosine hydroxylase expression, and decreases in hippocampal mRNA expression of brain-derived neurotrophic factor. These findings suggest that GRb1 has anxiolytic-like effects on both behavioral and biochemical symptoms similar to those observed in patients with PTSD.

  11. Neuroimmunoendocrine interactions in post-traumatic stress disorder: focus on long-term implications of childhood maltreatment.

    Science.gov (United States)

    Wieck, Andréa; Grassi-Oliveira, Rodrigo; Hartmann do Prado, Carine; Teixeira, Antonio L; Bauer, Moisés E

    2014-01-01

    Childhood maltreatment has been linked to enhanced vulnerability to psychiatric pathologies in adult life, including post-traumatic stress disorder (PTSD). Previous works have reported cogent neuroendocrine and immune changes related to adult traumatic events (war survivors, refugees, etc.), but little information is known regarding the impact of early-life stress (ELS) in adult physiology. Here, we review the neuroendocrine and immunological changes commonly observed in PTSD, focusing on the long-term implications of ELS. Childhood maltreatment may lead to altered glucocorticoid (GC) secretion, resulting in hypo- or hypercortisolemia, and reciprocal changes in peripheral leukocyte sensitivity to GC. It is believed that these neuroendocrine changes are correlated with the immune imbalance phenomenon (low-grade inflammation), characterized by increased plasma levels of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) and C-reactive protein. Changes in peripheral lymphocyte subsets are also documented, such as a reduction in regulatory T cells and an expansion of activated T cells. The excess of circulating cytokines may thus interfere with key brain neurotransmitter pathways involved in depression and enhanced risk to cardiovascular, respiratory, gastrointestinal, inflammatory and autoimmune diseases. Recent gene-environment and epigenetic findings have indicated potential molecular mechanisms linking ELS, neuroendocrine and immunity in PTSD. © 2014 S. Karger AG, Basel.

  12. Aberrant EEG functional connectivity and EEG power spectra in resting state post-traumatic stress disorder: a sLORETA study.

    Science.gov (United States)

    Imperatori, Claudio; Farina, Benedetto; Quintiliani, Maria Isabella; Onofri, Antonio; Castelli Gattinara, Paola; Lepore, Marta; Gnoni, Valentina; Mazzucchi, Edoardo; Contardi, Anna; Della Marca, Giacomo

    2014-10-01

    The aim of the present study was to explore the modifications of EEG power spectra and EEG connectivity of resting state (RS) condition in patients with post-traumatic stress disorder (PTSD). Seventeen patients and seventeen healthy subjects matched for age and gender were enrolled. EEG was recorded during 5min of RS. EEG analysis was conducted by means of the standardized Low Resolution Electric Tomography software (sLORETA). In power spectra analysis PTSD patients showed a widespread increase of theta activity (4.5-7.5Hz) in parietal lobes (Brodmann Area, BA 7, 4, 5, 40) and in frontal lobes (BA 6). In the connectivity analysis PTSD patients also showed increase of alpha connectivity (8-12.5Hz) between the cortical areas explored by Pz-P4 electrode. Our results could reflect the alteration of memory systems and emotional processing consistently altered in PTSD patients.

  13. Pilot study of the effects of mixed light touch manual therapies on active duty soldiers with chronic post-traumatic stress disorder and injury to the head.

    Science.gov (United States)

    Davis, Lauren; Hanson, Brenda; Gilliam, Sara

    2016-01-01

    This pilot study was designed to examine the effects of mixed Light Touch Manual Therapies (LTMT) on headache, anxiety and other symptoms suffered by active duty United States service members experiencing chronic Post-Traumatic Stress Disorder (PTSD). Ten service members diagnosed with PTSD and having a self-reported injury to the head acquired at least two years prior, were provided with two hour-long sessions of mixed LTMT given a week apart. Data to assess the immediate and durable effects were gathered before and after the LTMT sessions. Results indicate that headache, anxiety, and pain interference were significantly reduced during the course of the pilot study. This suggests that mixed LTMT may be helpful in reducing some of the symptoms of PTSD and injury to the head. Further studies will be needed to determine if LTMT is an effective non-pharmacological treatment for headache, anxiety or other problems associated with PTSD or injury to the head.

  14. Post-traumatic stress symptoms in Guillain-Barré syndrome patients after prolonged mechanical ventilation in ICU: a preliminary report.

    Science.gov (United States)

    Le Guennec, Loïc; Brisset, Marion; Viala, Karine; Essardy, Fatiha; Maisonobe, Thierry; Rohaut, Benjamin; Demeret, Sophie; Bolgert, Francis; Weiss, Nicolas

    2014-09-01

    Thirty percent of Guillain-Barré syndrome (GBS) patients require mechanical ventilation (MV) in intensive care unit (ICU). Post-traumatic stress disorder (PTSD) is found in ICU survivors, and the traumatic aspects of intubation and MV have been previously reported as risk factors for PTSD after ICU. Our objective was to determine long-term PTSD or post-traumatic stress symptoms (PTSS) in GBS patients after prolonged MV in ICU. We assessed GBS patients who had MV for more than 2 months. PTSD was assessed using Horowitz Impact of Event Scale (IES), IES-Revisited (IES-R), and the Post-traumatic CheckList Scale; functional outcome using Rankin and Barthel scales; quality of life (QoL) using Nottingham Health Profile (NHP) and 36-Item Short Form Health Survey (SF-36) and depression using Hospital Anxiety and Depression Scale (HAD) and Beck questionnaire. Thirteen patients could be identified and analyzed. They had only mild disability. They were neither anxious nor depressed with an anxiety HAD at 5 (4-11.5), a depression HAD at 1 (0-3.5) and a Beck at 1 (0-5). QoL was mildly decreased in our population with a NHP at 78.5 (12.8-178.8) and mild decreased SF-36. Compared with the French population, the SF-36 sub-categories were, however, not statistically different. Twenty-two percentage of our 13 patients had PTSD and PTSS with a Horowitz IES at 12 (2-29), and an IES-R at 16 (2-34.5). Although severe GBS patients requiring prolonged MV had good functional recovery and no difference in QoL, they had a high incidence of PTSS.

  15. Post-traumatic stress disorder and occupational characteristics of police officers in Republic of Korea: a cross-sectional study

    Science.gov (United States)

    Kim, Inah; Won, Jong-Uk; Roh, Jaehoon

    2016-01-01

    Objective South Korean police officers have a greater workload compared to their counterparts in advanced countries. However, few studies have evaluated the occupational challenges that South Korean police officers face. Therefore, this study aimed to evaluate the police officer's job characteristics and risk of post-traumatic stress disorder (PTSD) among South Korean police officers. Design Cross-sectional study. Setting Police officers in South Korea. Participants 3817 police officers with a traumatic event over a 1-year period. Main outcome measures Officers with a response to the Impact of Event Scale (revised Korean version) score of ≥26 were classified as high risk, and we evaluated their age, sex, department and rank, as well as the frequency and type of traumatic events that they experienced. Results Among the respondents, 41.11% were classified as having a high risk of PTSD. From the perspective of the rank, Inspector group (46.0%) and Assistant Inspector group (42.7%) show the highest frequencies of PTSD. From the perspective of their working division, Intelligence and National Security Division (43.6%) show the highest frequency, followed by the Police Precinct (43.5%) and the Traffic Affairs Management Department (43.3%). It is shown that working in different departments was associated with the prevalence of PTSD (p=0.004). Conclusions The high-risk classification was observed in 41.11% of all officers who had experienced traumatic events, and this frequency is greater than that for other specialised occupations (eg, firefighters). Therefore, we conclude that groups with an elevated proportion of high-risk respondents should be a priority for PTSD treatment, which may help increase its therapeutic effect and improve the awareness of PTSD among South Korean police officers. PMID:26951212

  16. Incidence and risk factors for post-traumatic stress disorder in a population affected by a severe flood.

    Science.gov (United States)

    Fontalba-Navas, A; Lucas-Borja, M E; Gil-Aguilar, V; Arrebola, J P; Pena-Andreu, J M; Perez, J

    2017-03-01

    We aimed to study the risk of developing post-traumatic stress disorder (PTSD) symptoms in people who resided in an affected area by an extremely severe flood, and sociodemographic risk factors associated with this condition. A geographic information system (GIS) was used to distribute the rainfall data. A case-control study was developed to study the relationship between PTSD and sociodemographic risk factors. To delineate the areas affected by the flood and the intensity of this rainfall in comparison with historical hydrological data, we employed geographical information systems (GIS). Then, we recruited a representative sample of the affected population and another population sample that lived at the time of this disaster in adjacent geographical areas that were not affected. Both groups were randomly selected in primary care practices, from December 1st 2012 to January 31st 2013. All participants, 70 from the affected areas and 91 from the non-affected, filled a sociodemographic questionnaire and the trauma questionnaire (TQ) to identify and rate PTSD symptoms. Our GIS analysis confirmed that the amount of precipitation in 2012 in the areas affected by the flood was exceptionally high compared with historical average rainfall data (461l per square metre vs 265). Individuals who resided in the affected areas at the time of the flood were at much higher risk of developing PTSD symptoms (OR: 8.18; 95% CI: 3.99-17.59) than those living in adjacent, non-affected localities. Among the sociodemographic variables included in this study, only material and financial losses were strongly associated with the onset of PTSD (P floods may suffer an increase of PTSD symptoms in the following months. This finding, along with the importance of material losses as a predictor for such disorder, may help develop effective plans to minimize the negative impact of these natural disasters on public health. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights

  17. 创伤后应激障碍对儿童大脑发育的影响%The Effect of Post-traumatic Stress Disorder on Development of Brain in Child

    Institute of Scientific and Technical Information of China (English)

    刘媛; 伍亚民

    2014-01-01

    After going through post-traumatic stress disorder, it may take more severe injury to the physiology and psychology in child because of their special characteristic during growth and development. But the mechanism of post-traumatic stress disorder (PTSD) in child is not clear completely. The pathogenesy of PTSD in child and its inlfuence on the development of brain were reviewed in this manuscript.%儿童由于其特殊的生长与发育特点,在经历创伤后应激障碍(PTSD)时对其身心的影响更加严重,但有关儿童(PTSD)的发生、发展机制尚不完全清楚。因此,文中就儿童PTSD发病特点及其对脑发育的影响进行综述。

  18. BusWorld: designing a virtual environment for post-traumatic stress disorder in Israel: a protocol.

    Science.gov (United States)

    Josman, Naomi; Somer, Eli; Reisberg, Ayelet; Weiss, Patrice L Tamar; Garcia-Palacios, Azucena; Hoffman, Hunter

    2006-04-01

    A number of carefully controlled studies have documented the effectiveness of traditional imaginal exposure for the treatment of post-traumatic stress disorder (PTSD). Virtual reality (VR) exposure therapy is based on a similar logic but rather than self-generating imagery, patients wear a VR helmet and go into a three-dimensional (3-D) computer generated virtual world to help them gain access to their memory of the traumatic event. Recent preliminary research has shown that some patients who fail to respond to traditional therapy benefit from virtual reality exposure therapy, presumably because VR helps the patient become emotionally engaged while recollecting/recounting/re-interpreting/emotionally processing what happened during the traumatic event. The present paper presents a brief overview of a new VR World we developed to provide virtual reality therapy for terrorist bus bombing victims in Israel, and a brief description of our research protocol and measures (for details, see www.vrpain.com).

  19. 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...

  20. A diagnostic dilemma between psychosis and post-traumatic stress disorder: a case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Coentre Ricardo

    2011-03-01

    Full Text Available Abstract Introduction Post-traumatic stress disorder is defined as a mental disorder that arises from the experience of traumatic life events. Research has shown a high incidence of co-morbidity between post-traumatic stress disorder and psychosis. Case presentation We report the case of a 32-year-old black African woman with a history of both post-traumatic stress disorder and psychosis. Two years ago she presented to mental health services with auditory and visual hallucinations, persecutory delusions, suicidal ideation, recurring nightmares, hyper-arousal, and initial and middle insomnia. She was prescribed trifluoperazine (5 mg/day and began cognitive-behavioral therapy for psychosis. Her psychotic symptoms gradually resolved over a period of three weeks; however, she continues to experience ongoing symptoms of post-traumatic stress disorder. In our case report, we review both the diagnostic and treatment issues regarding post-traumatic stress disorder with psychotic symptoms. Conclusions There are many factors responsible for the symptoms that occur in response to a traumatic event, including cognitive, affective and environmental factors. These factors may predispose both to the development of post-traumatic stress disorder and/or psychotic disorders. The independent diagnosis of post-traumatic stress disorder with psychotic features remains an open issue. A psychological formulation is essential regarding the appropriate treatment in a clinical setting.

  1. Altered blood oxygen level-dependent signal variability in chronic post-traumatic stress disorder during symptom provocation

    Directory of Open Access Journals (Sweden)

    Ke J

    2015-07-01

    Full Text Available Jun Ke,1,* Li Zhang,2,* Rongfeng Qi,1,* Qiang Xu,1 Weihui Li,2 Cailan Hou,3 Yuan Zhong,1 Zhiqiang Zhang,1 Zhong He,4 Lingjiang Li,2,5 Guangming Lu11Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, 2Mental Health Institute, the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, 3Guangdong Academy of Medical Science, Guangdong General Hospital, Guangdong Mental Health Center, Guangzhou, 4Department of Radiology of the Second Xiangya Hospital, Central South University, Changsha, 5Shenzhen Kangning Hospital of Guangdong Province, Shenzhen, People’s Republic of China*These authors contributed equally to this workBackground: Recent research suggests that variability in brain signal provides important information about brain function in health and disease. However, it is unknown whether blood oxygen level-dependent (BOLD signal variability is altered in post-traumatic stress disorder (PTSD. We aimed to identify the BOLD signal variability changes of PTSD patients during symptom provocation and compare the brain patterns of BOLD signal variability with those of brain activation.Methods: Twelve PTSD patients and 14 age-matched controls, who all experienced a mining accident, underwent clinical assessment as well as fMRI scanning while viewing trauma-related and neutral pictures. BOLD signal variability and brain activation were respectively examined with standard deviation (SD and general linear model analysis, and compared between the PTSD and control groups. Multiple regression analyses were conducted to explore the association between PTSD symptom severity and these two brain measures across all subjects as well as in the PTSD group.Results: PTSD patients showed increased activation in the middle occipital gyrus compared with controls, and an inverse correlation was found between PTSD

  2. Sleep disturbances and post-traumatic stress disorder; a perpetual circle?

    NARCIS (Netherlands)

    van Liempt, S.

    2012-01-01

    Background: Sleep facilitates the consolidation of fear extinction memory. Disrupted sleep has been proposed as a vulnerability factor for the development of posttraumatic stress disorder (PTSD). Moreover, nightmares and insomnia are hallmark symptoms of PTSD, possibly interfering with fear extincti

  3. Post-traumatic stress disorder in children and adolescents one year after a super-cyclone in Orissa, India: exploring cross-cultural validity and vulnerability factors

    Directory of Open Access Journals (Sweden)

    Pattanaik Pratiti

    2007-02-01

    Full Text Available Abstract Background It has been asserted that psychological responses to disasters in children and adolescents vary widely across cultures, but this has rarely been investigated. The objectives of the study were to clinically evaluate the construct of traumatic stress symptoms and disorder in children and adolescents after a super-cyclone in Orissa, India; to find out the prevalence at one year; compare the effect in high and low exposure areas and study the factors associated with it. Methods Clinical examination of children and adolescents (n = 447 was done, supplemented by a symptoms checklist based on International Classification of Mental and Behavioural Disorders, Diagnostic Criteria for Research and a semi-structured questionnaire for disaster related experiences. Results A majority of children had post-traumatic symptoms. Post-traumatic stress disorder (PTSD was present in 30.6% (95% confidence interval: 26.4 to 34.9, and an additional 13.6% had sub-syndromal PTSD. Parents or teachers reported mental health concerns in 7.2% subjects, who were a minor proportion (12.8% of subjects with any syndromal diagnosis (n = 196. Significantly more (43.7% children in high exposure areas had PTSD than that (11.2% in low exposure areas (p Conclusion Following natural disaster PTSD is a valid clinical construct in children and adolescents in Indian set up; and though highly prevalent it may be missed without clinical screening. Its manifestation and associated factors resembled those in other cultures.

  4. Lessons from the 2004 Asian tsunami: epidemiological and nosological debates in the diagnosis of post-traumatic stress disorder in non-Western post-disaster communities.

    Science.gov (United States)

    Rajkumar, A P; Mohan, T S P; Tharyan, P

    2013-03-01

    The nosological validity of post-traumatic stress disorder (PTSD) remains controversial in non-Western communities. After natural disasters, epidemiological studies often overlook these conceptual debates and assess post-traumatic stress symptoms (PTSS) by short screening instruments. Such PTSS estimates are reported as inflated prevalence rates of PTSD in post-disaster settings. To discuss the prevalence and determinants of PTSS within the context of pertinent epidemiological and nosological debates. We assessed PTSS and grief symptoms of 643 survivors from five Indian villages struck by the Asian tsunami using the Impact of Events Scale - Revised and Complicated Grief Assessment Scale. We adopted a case control design and employed complex sample multiple logistic regression statistics to study the determinants of PTSS. The prevalence of PTSS was 15.1% (95% CI 12.3%-17.9%). PTSS was significantly associated with traumatic grief, female gender, physical injury, death of children and financial losses, but not with functional disability (p = .91). Although PTSS were common in this population, elevating them to a psychiatric construct of PTSD is questionable, when functional impairment and avoidance behaviours were absent. Grief reactions, socio-economic burden, and poor support systems contribute towards PTSS. We highlight the important issues regarding the nosological validity and epidemiology of PTSD in non-Western communities.

  5. Memory control in post-traumatic stress disorder: evidence from item method directed forgetting in civil war victims in Northern Uganda.

    Science.gov (United States)

    Zwissler, B; Hauswald, A; Koessler, S; Ertl, V; Pfeiffer, A; Wöhrmann, C; Winkler, N; Kissler, J

    2012-06-01

    Traumatized individuals and particularly post-traumatic stress disorder (PTSD) patients are characterized by memory disturbances that suggest altered memory control. The present study investigated the issue using an item method, directed forgetting (DF) paradigm in 51 civil war victims in Uganda. All participants had been exposed to severe traumatic stress and 26 additionally suffered from PTSD. In an item cued, DF paradigm photographs were presented, each followed by an instruction to either remember or forget it. A recognition test for all initially presented photographs and thematically similar distracters followed. DF patterns were compared between the non-PTSD and the PTSD groups. Post-experimental ratings of picture valence and arousal were collected and correlated with DF. Results revealed DF, that is, reduced recognition for 'to-be-forgotten' items in the non-PTSD but not in the PTSD group. Moreover, in the non-PTSD, but not in the PTSD group, false alarms were reduced for 'to-be-remembered' items. Finally, DF was reduced in those participants who rated the pictures as more arousing, the PTSD group giving, on average, higher arousal ratings. Data indicate that DF is reduced in PTSD and that the reduction is related to stimulus arousal. Furthermore, individuals with PTSD are characterized by a more global encoding style than individuals without PTSD, reflected in a higher false alarm rate. In sum, traumatized individuals with (but not without) PTSD are impaired in their ability to selectively control episodic memory encoding. This impairment may contribute to clinical features of the disorder such as intrusions and flashbacks.

  6. Acute and chronic plasma metabolomic and liver transcriptomic stress effects in a mouse model with features of post-traumatic stress disorder.

    Science.gov (United States)

    Gautam, Aarti; D'Arpa, Peter; Donohue, Duncan E; Muhie, Seid; Chakraborty, Nabarun; Luke, Brian T; Grapov, Dmitry; Carroll, Erica E; Meyerhoff, James L; Hammamieh, Rasha; Jett, Marti

    2015-01-01

    Acute responses to intense stressors can give rise to post-traumatic stress disorder (PTSD). PTSD diagnostic criteria include trauma exposure history and self-reported symptoms. Individuals who meet PTSD diagnostic criteria often meet criteria for additional psychiatric diagnoses. Biomarkers promise to contribute to reliable phenotypes of PTSD and comorbidities by linking biological system alterations to behavioral symptoms. Here we have analyzed unbiased plasma metabolomics and other stress effects in a mouse model with behavioral features of PTSD. In this model, C57BL/6 mice are repeatedly exposed to a trained aggressor mouse (albino SJL) using a modified, resident-intruder, social defeat paradigm. Our recent studies using this model found that aggressor-exposed mice exhibited acute stress effects including