WorldWideScience

Sample records for stable elevated ptsd

  1. The Implication of Combat Stress and PTSD Trajectories in Metabolic Syndrome and Elevated C-Reactive Protein Levels: A Longitudinal Study.

    Science.gov (United States)

    Solomon, Zahava; Levin, Yafit; Assayag, Einor Ben; Furman, Orit; Shenhar-Tsarfaty, Shani; Berliner, Shlomo; Ohry, Avi

    This study sheds light on the importance of long-term follow-up of trauma survivors, posttraumatic stress disorder (PTSD) trajectories, and early detection of health risk factors in trauma survivors. The present study prospectively assessed the following over 23 years: (1) the association of psychological and physiologic stress during captivity with elevated C-reactive protein (CRP) levels and metabolic syndrome (MetS), which includes hypertension; elevated levels of insulin, triglycerides, and fasting glucose; decreased levels of high-density lipoprotein cholesterol; and obesity and (2) the implication of PTSD trajectories in elevated CRP levels and MetS. Measurements were taken in 1991, 2003, 2008, and 2015. Participants were 116 Israeli combat veterans of the 1973 Yom Kippur War (of these, 101 were former prisoners of war [ex-POWs] and 15 were comparable controls). The medical assessments relevant for this study were body mass index, fasting blood glucose levels, and diabetes, blood pressure or a diagnosis of hypertension, high-density lipoprotein cholesterol and triglyceride levels, and medication intake. In addition, the PTSD Inventory was used to assess PTSD symptoms and trajectories over time according to DSM-IV-TR PTSD criteria. Captivity-in particular, the captivity stressors of weight loss, physical suffering, psychological suffering, and humiliation-was implicated in both elevated CRP levels and MetS, significantly so with elevated CRP levels (P = .01, R² = 0.33). Captivity-induced PTSD, in particular chronic and delayed PTSD trajectories, was associated with elevated CRP levels and MetS, significantly so for MetS (P = .05). Monitoring inflammation using markers like CRP level in trauma survivors can be beneficial, particularly if PTSD is chronic or delayed. Clinicians treating trauma survivors should raise awareness of the importance of such measures in light of long-term health vulnerabilities. © Copyright 2017 Physicians Postgraduate Press, Inc.

  2. Insight among people with severe mental illness, co-occurring PTSD and elevated psychotic symptoms: Correlates and relationship to treatment participation.

    Science.gov (United States)

    Yanos, Philip T; Vayshenker, Beth; Pleskach, Pavel; Mueser, Kim T

    2016-07-01

    There is a dearth of research on what factors are predictive of insight among people with severe mental illness and co-occurring PTSD. Data were drawn from 146 participants with severe mental illness, co-occurring PTSD and elevated psychotic symptoms participating in a randomized controlled trial comparing two interventions for PTSD among people with severe mental illness. We examined the clinical and demographic correlates of insight at baseline, the relationship between baseline insight and treatment participation, the relationship between treatment participation and post-treatment insight, and the relationship between change in insight and change in other clinical variables. Impaired insight was relatively common, with roughly half the sample demonstrating mild or moderate impairment at baseline. Baseline insight was associated with fewer psychotic and disorganized symptoms, and greater emotional discomfort and PTSD knowledge, but was not associated with negative symptoms, PTSD symptoms, depression/anxiety, or treatment participation. Participation in PTSD treatment was associated with increased insight at post-treatment. Improved insight was associated with improvements in disorganization and negative symptoms, but not with knowledge of PTSD or positive symptoms. The findings suggest that engagement in treatment that includes educating people about PTSD may lead to improvements in insight and related improvements in other psychiatric symptoms. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Care » PTSD: National Center for PTSD » Public » Videos PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" ( ...

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ...

  5. Endocannabinoid concentrations in hair are associated with PTSD symptom severity.

    Science.gov (United States)

    Wilker, Sarah; Pfeiffer, Anett; Elbert, Thomas; Ovuga, Emilio; Karabatsiakis, Alexander; Krumbholz, Aniko; Thieme, Detlef; Schelling, Gustav; Kolassa, Iris-Tatjana

    2016-05-01

    The endocannabinoid system has been implicated in the regulation of the stress response, fear memory formation, and inflammatory processes. Posttraumatic stress disorder (PTSD) can result from exposure to extreme stress and is characterized by strong, associative memories for the traumatic events experienced. Furthermore, an elevated physical disease risk has been observed in PTSD, likely to be mediated by inflammatory processes. Therefore, altered endocannabinoid regulation can be expected in individuals with PTSD. However, attempts to assess PTSD-associated differences in the endocannabinoid system from human blood samples have provided inconsistent results, possibly due to fluctuating levels of endocannabinoids. In hair, these neuromodulators are accumulated over time and thus give access to a more stable and reliable assessment. We therefore investigated PTSD-associated differences in hair concentrations of endocannabinoids (N-acyl-ethanolamides palmitoylethanolamide [PEA], oleoylethanolamide [OEA] and stearoylethanolamide [SEA]) in 38 rebel war survivors from Northern Uganda suffering from PTSD and N=38 healthy rebel war survivors without current and lifetime PTSD. PTSD diagnosis and symptom severity were assessed in structured clinical interviews employing the Posttraumatic Diagnostic Scale (PDS). A significant group difference was observed for OEA, with PTSD patients showing reduced hair concentrations. Regression analyses further revealed strong negative relationships between all investigated N-acyl-ethanolamides and symptom severity of PTSD. The observed reductions in endocannabinoids might account for the increased inflammatory state as well as for the failure to extinguish fear memories observed in PTSD. Our findings add to the accumulating evidence suggesting the endocannabinoid system as a target for pharmacological enhancement of exposure-based psychotherapy for PTSD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Toll Free Numbers Homeless Veterans Chat VA » Health Care » PTSD: National Center for PTSD » Public » Videos PTSD: National Center for ... About Us: National Center for PTSD The National Center for PTSD does not provide direct clinical care, individual referrals or benefits information. For help please ...

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Locations Contact Us FAQs Ask a Question Toll Free Numbers ... it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site Map Content Inventory Accessibility ... Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health Care Veterans Health Administration ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ... Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... for PTSD What We Do Mission and Overview Goals and Objectives Looking Ahead Annual Reports Research Initiatives Education Initiatives ... Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health ...

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ... Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers VA Providers and ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... with VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en ... for PTSD" (21.2 MB) Close Video Help Problems viewing videos in pop up windows? See our ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Apps Videos Web Links PTSD Site Search For Professionals Professional Section Home PTSD Overview Types of Trauma Trauma ... Watch our whiteboard video for clinicians in the Professional Section: Prescribing for PTSD, Know Your Options . × What ...

  15. Elevational Dependence of Catchment-scale Evapotranspiration Partitioning as Revealed by Water Stable Isotopes

    Science.gov (United States)

    Yamanaka, T.; Sato, R.

    2017-12-01

    Transpiration (T) through plants (i.e., green water) does not induce isotopic fractionation, although evaporation (E) from soils and water surfaces do. Therefore, water stable isotopes offer a powerful tool to partition evapotranspiration (ET) components. We attempted to evaluate catchment-scale T/ET for five mountainous catchments in the central Japan, using river water isotopes and isotope maps of precipitation and soil water as well as climatic and radar precipitation maps. The estimated T/ET ranged from 56% to 79% (ET not including interception loss), and negatively correlated with mean elevation of the catchments (r = -0.88). This is due to decreasing transpiration (-82 mm/yr per 100 m) and slightly increasing evaporation (8 mm/yr per 100 m) with increasing elevation. Another estimation scheme using isotope data only showed a positive correlation between elevation and E/P*, where P* is effective precipitation defined by gross precipitation minus interception. Because the forest coverage within the catchments has positive correlation with catchment-mean-elevation, both decrease in transpiration and increase in soil evaporation seem to reflect structural change in forests (e.g., dense to sparse) along elevation and thus temperature gradients. Applying the space-for-time substitution, our results indicates that global warming will increase transpiration (and thus carbon intake) at mid-latitude mountainous landscapes.

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Options . × What is PTSD? Right Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here to download "PTSD Treatment: Know Your Options" (29.5 MB) ...

  17. Plasma levels of myeloperoxidase are not elevated in patients with stable coronary artery disease.

    Science.gov (United States)

    Kubala, Lukas; Lu, Guijing; Baldus, Stephan; Berglund, Lars; Eiserich, Jason P

    2008-08-01

    Plasma and serum levels of myeloperoxidase (MPO), a redox-active hemoprotein released by polymorphonuclear neutrophils (PMN) upon activation, is now recognized as a powerful prognostic determinant of myocardial infarction in patients suffering acute coronary syndromes. However, there is limited information on whether systemic MPO levels are also elevated and of discriminating value in patients with stable coronary artery disease (CAD) representing different ethnic groups. Plasma levels of MPO and traditional CAD risk factors were quantified in African American and Caucasian patients (n=557) undergoing elective coronary angiography. MPO levels did not differ significantly between patients with or without CAD [421 pM (321, 533) vs. 412 pM (326, 500), p>0.05]. MPO levels were similar across ethnicity and gender, and correlated positively with CRP and fibrinogen levels (r=0.132, p=0.002 and r=0.106, p=0.011, respectively). In conclusion, plasma MPO levels were not elevated in patients with stable CAD, suggesting that systemic release of MPO is not a characteristic feature of asymptomatic CAD.

  18. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Vet Prescriptions Refills Schedule a VA Appointment Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & ... Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) ...

  19. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens ... Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For ...

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Guide Purpose and Scope Find Assessment Measures Instrument Authority List Research and Biology Research on PTSD Biology ... to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Treatment: Know Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based Treatment: What ...

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based ...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Performance VA Plans, Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget Submission Recovery ... to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here ...

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Site Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health ... Clinical Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries (VALNET) ...

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - Exposure - Experience (TEE) Tournament Wheelchair Games Winter Sports Clinic ... Exposure EMDR for PTSD Medications for PTSD ...

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Guide Purpose and Scope Find Assessment Measures Instrument Authority List Research and Biology Research on PTSD Biology ... Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Common Problems Family and Friends PTSD and Communities Paginas en Espanol Apps, Videos and More Mobile Apps Videos Web Links PTSD Site Search For Professionals Professional Section ...

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Treatment: Know Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based ...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Performance VA Plans, Budget, & Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget Submission Recovery ... and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment ... Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment Self- ... Home PTSD Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment ...

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Overview PTSD Basics Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse ... Treatment Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... PTSD Consultation For Specific Providers VA Providers and Staff Disaster Responders Medical Doctors Community Providers and Clergy ... Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Treatment: Know Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Disasters Is it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get ... other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures ...

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... PTSD Research Quarterly Publications Search Using the PILOTS Database What is PILOTS? Quick Search Tips Modify Your ... stress. Search Pilots Search PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign up ...

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Question Toll Free Numbers Homeless Veterans Chat VA » Health Care » ... with VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en ...

  18. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Financial Report (AFR) Budget Submission Recovery Act Resources Business Congressional Affairs Jobs Benefits Booklet Data & Statistics VA ... Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation More Health ...

  19. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here to download " ... for PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to ...

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... map [a-z] More VA More VA Health Health Care Information A-Z Health Topic Finder My Health ... FAQs Ask a Question Toll Free Numbers VA » Health Care » PTSD: National Center for PTSD » Public » Videos PTSD: ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... a-z] More VA More VA Health Health Care Information A-Z Health Topic Finder My Health ... Ask a Question Toll Free Numbers VA » Health Care » PTSD: National Center for PTSD » Public » Videos PTSD: ...

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... and Security Updating of Web Site Web Site Policies Important Links Linking Policies Small Business POC Subscribe PTSD Awareness PTSD Consultation ... Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 Contact ...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Overview PTSD Basics Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and ... Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment ... Adults Working with Families PTSD Consultation ...

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Professional Section: Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What ... PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to download " ...

  5. PTSD: National Center for PTSD

    Medline Plus

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

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Section Home PTSD Overview PTSD Basics Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? ... Combat Veterans & their Families Readjustment Counseling (Vet Centers) War Related Illness & Injury Study Center Homeless Veterans Returning ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Biology Research on PTSD Biology of PTSD Find Materials by Type List of Materials By Type Assessments Continuing Education Handouts Manuals Mobile ... the Media AboutFace Media Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site ...

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... a-z] More VA More VA Health Health Care Information A-Z Health Topic Finder My Health ... Toll Free Numbers Homeless Veterans Chat VA » Health Care » PTSD: National Center for PTSD » Public » Videos PTSD: ...

  9. Stable Isotope Systematics in Grasshopper Assemblages Along an Elevation Gradient, Colorado

    Science.gov (United States)

    Kohn, M. J.; Evans, S.; Dean, J.; Nufio, C.

    2012-12-01

    Insects comprise over three quarters of all animal species, yet studies of body water isotopic composition are limited to only the cockroach, the hoverfly, and chironomid flies. These studies suggest that oxygen and hydrogen isotopic compositions in body water are primarily controlled by dietary water sources, with modification from respiratory and metabolic processes. In particular, outward diffusion of isotopically depleted water vapor through insect spiracles at low humidity enriches residual body water in 18O and 2H (D). Stable isotope compositions (δ18O and δD) also respond to gradients in elevation and humidity, but these influences remain poorly understood. In this study, we measured grasshopper body water and local vegetation isotopic compositions along an elevation gradient in Colorado to evaluate three hypotheses: 1) Insect body water isotopic composition is directly related to food source water composition 2) Water vapor transport alters body water isotopic compositions relative to original diet sources, and 3) Elevation gradients influence isotopic compositions in insect body water. Thirty-five species of grasshopper were collected from 14 locations in Colorado grasslands, ranging in elevation from 450 to 800 meters (n=131). Body water was distilled from previously frozen grasshopper specimens using a vacuum extraction line, furnaces (90 °C), and liquid nitrogen traps. Water samples were then analyzed for δ18O and δD on an LGR Liquid Water Isotope Analyzer, housed in the Department of Geosciences, Boise State University. Grasshopper body water isotopic compositions show wide variation, with values ranging between -76.64‰ to +42.82‰ in δD and -3.06‰ to +26.78‰ in δ18O. Precipitation δ18O values over the entire Earth excluding the poles vary by approximately 30‰, comparable to the total range measured in our single study area. Most grasshopper values deviate from the global meteoric water line relating δ18O and δD in precipitation

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act Benefits General Benefits Information Disability Compensation Pension GI Bill ® Vocational Rehabilitation & Employment ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation Spinal Cord Injury ...

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Treatments See All Conditions & Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Overview PTSD Basics Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and ... Service Members Rural Veterans Seniors & Aging Veterans Volunteers Women ... in the Workplace VA for Vets Performance Based Interviewing Clinical Trainees ( ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close ... Help Problems viewing videos in pop up windows? See our alternate video page. For information on video formats, and to download an appropriate ...

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Help with VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas ... Contact Us: ncptsd@va.gov Also see: VA Mental Health Connect with us return to top ... Department of Veterans Affairs | 810 Vermont Avenue, NW Washington DC 20420 Last updated February 13, 2018

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... for PTSD Right Click here to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close ... viewing videos in pop up windows? See our alternate video page. For information on video formats, and to download an appropriate ...

  18. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Us FAQs Ask a Question Toll Free Numbers Homeless Veterans Chat VA » Health Care » PTSD: National Center for PTSD » Public » Videos ... Employment Center Returning Service Members Vocational Rehabilitation & Employment Homeless ... Benefits Administration National Cemetery Administration U.S. ...

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

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2014-09-01

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

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

    Science.gov (United States)

    Cloitre, Marylène; Garvert, Donn W; Weiss, Brandon; Carlson, Eve B; Bryant, Richard A

    2014-01-01

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

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to download "Evidence-based Treatment: What Does It Mean?" (22.7 MB) ...

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option ( ... to download "Cognitive Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It ...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... a VA Appointment Conditions & Treatments See All Conditions & Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation ...

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and ... Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult ...

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request ... of Materials By Type Assessments Continuing Education Handouts Manuals Mobile Apps Publications Toolkits Videos Web Links Advanced ...

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research ... Search Tips Modify Your Search How to Obtain Articles Alerts User Guide Purpose and Scope Find Assessment ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic Training - ... Overview PTSD Basics Return from War Specific to Women Types of Trauma War Terrorism Violence and Abuse ...

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries (VALNET) VA ... Search Where to Get Help PTSD Coach Online Tools to help you manage stress. Search Pilots Search ...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... 1. Please switch auto forms mode to off. 2. Hit enter to expand a main menu option ( ... Problems Family and Friends PTSD and Communities Paginas en Espanol Apps, Videos and More Mobile Apps Videos ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Adults Working with Families PTSD Consultation For Specific Providers VA Providers and Staff Disaster Responders Medical Doctors Community Providers and Clergy Co-Occurring Conditions Continuing Education Publications ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... a VA Appointment Conditions & Treatments See All Conditions & Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures ...

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research ( ... you are in crisis or having thoughts of suicide, visit VeteransCrisisLine.net for more resources. Close this ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Health PTSD Public Health Veterans Access, Choice & Accountability Act Benefits General Benefits Information Disability Compensation Pension GI ... VACI) Agency Financial Report (AFR) Budget Submission Recovery Act Resources Business Congressional Affairs Jobs Benefits Booklet Data & ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Community Providers and Clergy Co-Occurring Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Benefits Booklet Data & Statistics VA Open Data VA App Store National Resource Directory Grants Management Services Veterans ... and Friends PTSD and Communities Paginas en Espanol Apps, Videos and More Mobile Apps Videos Web Links ...

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Community Providers and Clergy Co-Occurring Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research ...

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What is ... Advisory Boards History and Achievements Divisions and Staff Leadership Divisions Executive Behavioral Science Clinical Neurosciences Dissemination & Training ...

  18. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries (VALNET) VA Software Documentation Library ( ... PTSD Coach Online Tools to help you manage stress. Search Pilots Search PILOTS *, the largest citation database ...

  19. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult ... Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma ...

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... War Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment ... Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol Apps, Videos ... Health Benefits Home Apply for VA Care Apply Online Application Process Veteran Eligibility Active Duty Families of ...

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Prescriptions Refills Schedule a VA Appointment Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act ... See All Conditions & Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military ...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Education Handouts Manuals Mobile Apps Publications Toolkits Videos Web Links Advanced Search About Us National Center for PTSD What We Do Mission and Overview Goals and Objectives ...

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Travel Nurses Get Job Help Vets in the Workplace VA for Vets Performance Based Interviewing Clinical Trainees ( ... PTSD Coach Online Tools to help you manage stress. Search Pilots Search PILOTS *, the largest citation database ...

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Performance VA Center for Innovation (VACI) Agency Financial Report (AFR) Budget Submission Recovery Act Resources Business Congressional ... Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD ...

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Advanced Search Where to Get Help PTSD Coach Online Tools to help you manage stress. Search Pilots ... Prescriptions My Health e Vet eBenefits Life Insurance Online Applications VA Forms State and Local Resources Strat ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Prescriptions Refills Schedule a VA Appointment Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability ... See All Conditions & Treatments (A-Z) Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse ...

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures ... DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request Form List of All Measures Treatment Treatment ...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Your Options" (29.5 MB) Close × Cognitive Processing Therapy for PTSD Right Click here to download "Cognitive ... Employment Homeless Veterans Women Veterans Minority Veterans Plain Language Surviving Spouses & Dependents Adaptive Sports Program ADMINISTRATION Veterans ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol Apps, Videos ... This section is for Veterans, General Public, Family, & Friends Videos Whiteboard Videos This section includes five educational ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request Form List ...

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Espanol Apps, Videos and More Mobile Apps Videos Web Links PTSD Site Search For Professionals Professional Section ... Education Handouts Manuals Mobile Apps Publications Toolkits Videos Web Links Advanced Search About Us National Center for ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... By Type Assessments Continuing Education Handouts Manuals Mobile Apps Publications Toolkits Videos Web Links Advanced Search About Us National Center for PTSD What We Do Mission and Overview Goals and Objectives ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... VHA Forms & Publications Quality & Safety Quality of Care Ethics VA/DOD Clinical Practice Guidelines Access and Quality ... Watch our whiteboard video for clinicians in the Professional Section: Prescribing for PTSD, Know Your Options . × What ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What ...

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Hepatitis HIV Mental Health Mental Health Home Suicide Prevention Substance Abuse Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation Spinal Cord Injury Telehealth Womens Health Issues ... / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & ...

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol Apps, Videos and More Mobile ... VA Providers and Staff Disaster Responders Medical Doctors Community Providers and Clergy Co-Occurring Conditions Continuing Education ...

  18. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... VA for Vets Performance Based Interviewing Clinical Trainees (Academic Affiliations) Employees & Contractors Talent Management System (TMS) VA ... PTSD Coach Online Tools to help you manage stress. Search Pilots Search PILOTS *, the largest citation database ...

  19. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 ... Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers ...

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Communities Paginas en Espanol Apps, Videos and More Mobile Apps Videos Web Links PTSD Site Search For Professionals ... Materials By Type Assessments Continuing Education Handouts Manuals Mobile Apps Publications Toolkits Videos Web Links Advanced Search About ...

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Basics Disaster and Terrorism Military Trauma Violence & other Trauma Assessment Assessment Overview Adult Interviews Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens ...

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Specific Providers VA Providers and Staff Disaster Responders Medical Doctors Community Providers and Clergy Co-Occurring Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s Trauma Update PTSD Research ...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Processing Therapy for PTSD" (22.2 MB) Close × Evidence-based Treatment: What Does It Mean? Right Click here to download "Evidence-based Treatment: What Does It Mean?" (22.7 ...

  4. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... PTSD Awareness About the Website Site Map Content Inventory Accessibility Privacy and Security Updating of Web Site ... Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen ...

  5. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act Benefits General Benefits Information Disability Compensation Pension ... Grants Management Services Veterans Service Organizations Office of Accountability & Whistleblower ... Rights & Protections Transparency Media Room ...

  6. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... a VA Appointment Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act Benefits General Benefits ... Quitting Smoking Vaccines & Immunizations Flu Vaccination Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers ...

  7. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... the bottom of the page. Share this page Search PTSD Site Choose Section Enter Term and Search ... Coach Online Tools to help you manage stress. Search Pilots Search PILOTS *, the largest citation database on ...

  8. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... PTSD Screens Trauma Exposure Measures Assessment Request Form List of All Measures Treatment Treatment Overview Early Intervention ... and Clergy Co-Occurring Conditions Continuing Education Publications List of Center Publications Articles by Center Staff Clinician’s ...

  9. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Available Press & Promotion Contacts for the Media AboutFace Media Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site Map Content Inventory Accessibility ...

  10. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... The National Center for PTSD does not provide direct clinical care, individual referrals or benefits information. For ... Minority Veterans Plain Language Surviving Spouses & Dependents Adaptive Sports Program ADMINISTRATION Veterans Health Administration Veterans Benefits Administration ...

  11. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... e Vet Prescriptions Refills Schedule a VA Appointment Crisis Prevention Mental Health PTSD Public Health Veterans Access, ... Connect with us return to top CONNECT Veterans Crisis Line: 1-800-273-8255 (Press 1) Social ...

  12. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Health Benefits Home Apply for VA Care Apply Online Application Process Veteran Eligibility Active Duty Families of ... Advanced Search Where to Get Help PTSD Coach Online Tools to help you manage stress. Search Pilots ...

  13. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... with VA Health Care Jobs (VA Careers) Travel Nurses Get Job Help Vets in the Workplace VA ... The following short animated videos use hand-drawn images to help you learn about PTSD and effective ...

  14. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... All Measures Treatment Treatment Overview Early Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families ... Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site Map Content Inventory Accessibility ...

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Communities Paginas en Espanol Apps, Videos and More Mobile Apps Videos Web Links PTSD Site Search For ... Materials By Type Assessments Continuing Education Handouts Manuals Mobile Apps Publications Toolkits Videos Web Links Advanced Search ...

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Awareness PTSD Consultation More Health Care Veterans Health Administration Health Benefits Health Benefits Home Apply for VA ... Plain Language Surviving Spouses & Dependents Adaptive Sports Program ADMINISTRATION Veterans Health Administration Veterans Benefits Administration National Cemetery ...

  17. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... a VA Appointment Crisis Prevention Mental Health PTSD Public Health Veterans Access, Choice & Accountability Act Benefits General ... Protections Transparency Media Room Inside the Media Room Public Affairs News Releases Speeches Videos Publications National Observances ...

  18. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... PTSD Coach Online Tools to help you manage stress. Search Pilots Search PILOTS *, the largest citation database ... Health Care Prescriptions My Health e Vet eBenefits Life Insurance Online Applications VA Forms State and Local ...

  19. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Affiliations) Employees & Contractors Talent Management System (TMS) VA Learning University (VALU) SimLearn Libraries (VALNET) VA Software Documentation ... Advanced Search Where to Get Help PTSD Coach Online Tools to help you manage stress. Search Pilots ...

  20. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival Golden Age Games Summer Sports Clinic ... Kit Logos and Badges Materials for Printing PTSD Awareness About the Website Site Map Content Inventory Accessibility ...

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

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2013-05-01

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

  2. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Intervention Veterans Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers VA Providers and Staff Disaster Responders Medical Doctors Community Providers and Clergy Co-Occurring Conditions Continuing Education Publications List of Center ...

  3. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Care, Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 Contact Us: ncptsd@va.gov Also see: VA Mental Health Connect with us return to top ... Notices Privacy FOIA Regulations Web Policies No FEAR Act Whistleblower Rights & Protections Site ...

  4. Long-term stable vertical bone regeneration after sinus floor elevation and simultaneous implant placement with and without grafting.

    Science.gov (United States)

    Verdugo, Fernando; Uribarri, Agurne; Laksmana, Theresia; D'addona, Antonio

    2017-12-01

    Less invasive surgical approaches to regenerate bone intra-sinus and allow long-term functional implant stability are needed. To evaluate long-term vertical bone regeneration after sinus floor elevation and simultaneous implant placement with and without bone grafting. Vertical bone gains (VBG) post-sinus elevation, with and without grafting, were evaluated in thirty individuals presenting an average residual bone height (RBH) of 4.2 mm using a standardized digital technique. Measurements were taken preoperatively, and at an average of 64.6 months follow-up. Clinically, peri-implant tissues were assessed for pocket formation and presence of inflammation to evaluate established success criteria. Overall, RBH averaged 4.2 ± 1.1 mm (range: 1.8-5.8) and VBG 7.7 ± 1.6 mm (range: 6.0-12.9). Mean difference of 7.6 mm between vertical bone heights (VBH) at augmented implants sites and initial RBH, 11.8 versus 4.2 mm, (P implant site. Long-term follow-ups average 64.6 months (range: 36-144) and all implants met the success criteria. VBG ≥ 7 mm were 7.3 times more likely to develop on grafted sites (OR = 7.3, P = 0.02, CI95%: 1.2-46.2). None to negligible amounts of grafting material are required to regenerate substantial amounts of autogenous bone into atrophic sinus cavities after simultaneous implant placement. The regenerated VBH seems stable for functional implant stability long-term. Implant success rates were 100% at an average of 64.6 months. © 2017 Wiley Periodicals, Inc.

  5. First observations of elevated ducts associated with intermittent turbulence in the stable boundary layer over Bosten Lake, China

    Science.gov (United States)

    Sun, Zheng; Ning, Hui; Song, Shihui; Yan, Dongmei

    2016-10-01

    Nocturnal radiative cooling is a main driver for atmospheric duct formation. Within this atmospheric process, the impacts of intermittent turbulence on ducting have seldom been studied. In this paper, we reported two confusing ducting events observed in the early morning in August 2014 over Bosten Lake, China, when a stable boundary layer (SBL) still survived, by using tethered high-resolution GPS radiosondes. Elevated ducts with strong humidity inversions were observed during the balloon ascents but were absent during observations made upon the balloon descents several minutes later. This phenomenon was initially hypothesized to be attributable to turbulence motions in the SBL, and the connection between the turbulence event and the radar duct was examined by the statistical Thorpe method. Turbulence patches were detected from the ascent profiles but not from the descent profiles. The possible reasons for the duct formation and elimination were discussed in detail. The turbulent transport of moisture in the SBL and the advection due to airflows coming from the lake are the most probable reasons for duct formation. In one case, the downward transport of moisture by turbulence mixing within a Kelvin-Helmholtz billow at the top of the low-level jet resulted in duct elimination. In another case, the passage of density currents originating from the lake may have caused the elimination of the duct. Few studies have attempted to associate intermittent turbulence with radar ducts; thus, this work represents a pioneering study into the connection between turbulent events and atmospheric ducts in a SBL.

  6. Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents

    DEFF Research Database (Denmark)

    Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe

    2015-01-01

    ,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST...

  7. Skin autofluorescence is elevated in patients with stable coronary artery disease and is associated with serum levels of neopterin and the soluble receptor for advanced glycation end products

    NARCIS (Netherlands)

    Mulder, Douwe J.; van Haelst, Paul L.; Gross, Sascha; de Leeuw, Karina; Bijzet, Johannes; Graaff, Reindert; Gans, Rijk O.; Zijlstra, Felix; Smit, Andries J.

    Aims: To investigate whether skin autofluorescence (AF), a non-invasive marker for advanced glycation end products (AGEs), is elevated in stable coronary artery disease (sCAD) and to investigate its relationship with serum levels of the soluble receptor for AGEs (sRAGE), neopterin and C-reactive

  8. How Common Is PTSD?

    Science.gov (United States)

    ... version located in the "Professional" section of our website: Epidemiology of PTSD . Date this content was last updated is at the bottom of the page. ... PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign ...

  9. PTSD: Prevention Focused

    Science.gov (United States)

    2013-04-18

    PTSD development.76 Trauma seems to rest in the brain’s noradrenaline system, making people prone to adrenaline surges after the traumatic event.77 In...one study it was found that PTSD sufferers had abnormally high levels of adrenaline and noradrenaline in their bodies. In another study, PTSD

  10. Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation

    Directory of Open Access Journals (Sweden)

    Ivanović Miloš

    2013-01-01

    Full Text Available Introduction. Rupture of vulnerable atherosclerotic plaques is the cause of most acute coronary syndromes (ACS. Postmortem studies which compared stable coronary lesions and atherosclerotic plaques in patients who have died because of ACS indicated high lipid-core content as one of the major determinants of plaque vulnerability. Objective. Our primary goal was to assess the potential relations of plaque composition determined by IVUS-VH (Intravascular Ultrasound - Virtual Histology in patients with stable angina and subjects in acute phase of ACS without ST segment elevation. Methods. The study comprised of 40 patients who underwent preintervention IVUS examination. Tissue maps were reconstructed from radio frequency data using IVUS-VH software. Results. We analyzed 53 lesions in 40 patients. Stable angina was diagnosed in 24 patients (29 lesions, while acute phase of ACS without ST elevation was diagnosed in 16 patients (24 lesions. In the patients in acute phase of ACS without ST segment elevation IVUS-VH examination showed a significantly larger area of the necrotic core at the site of minimal lumen area and a larger mean of the necrotic core volume in the entire lesion comparing to stable angina subjects (1.84±0.90 mm2 vs. 0.96±0.69 mm2; p<0.001 and 20.94±15.79 mm3 vs. 11.54±14.15 mm3; p<0.05 respectively. Conclusion. IVUS-VH detected that the necrotic core was significantly larger in atherosclerotic lesions in patients in acute phase of ACS without ST elevation comparing to the stable angina subjects and that it could be considered as a marker of plaque vulnerability.

  11. Tonic immobility differentiates stress responses in PTSD.

    Science.gov (United States)

    Fragkaki, Iro; Stins, John; Roelofs, Karin; Jongedijk, Ruud A; Hagenaars, Muriel A

    2016-11-01

    Tonic immobility (TI) is a state of physical immobility associated with extreme stress and the development of posttraumatic stress disorder (PTSD). However, it is unknown whether TI is associated with a distinct actual stress response, i.e., objective immobility measured by a stabilometric platform. This study made a first step in exploring this as well as differences in body sway responses between PTSD patients and healthy controls. We hypothesized that PTSD would be related to increased body sway under stress, whereas TI would be related to decreased body sway under stress. Eye closure was selected as a PTSD-relevant stress induction procedure. Body sway and heart rate (HR) were measured in 12 PTSD patients and 12 healthy controls in four conditions: (1) maintaining a stable stance with eyes open, (2) with eyes closed, (3) during a mental arithmetic task with eyes open, and (4) with eyes closed. As predicted, PTSD patients showed increased body sway from eyes open to eyes closed compared to controls and this effect was eliminated by executing the arithmetic task. Most importantly, retrospective self-reported TI was associated with lower body sway increases in PTSD and higher body sway decreases in controls from eyes-open to eyes-closed conditions. These preliminary findings suggest that eye closure has a different effect on PTSD patients than controls and that high self-reported TI might indicate a distinct stress response pattern, i.e., a proneness for immobility. It may be relevant to take such individual differences in stress-response into account in PTSD treatment.

  12. The dissociative post-traumatic stress disorder (PTSD) subtype: A treatment outcome cohort study in veterans with PTSD.

    Science.gov (United States)

    Haagen, Joris F G; van Rijn, Allison; Knipscheer, Jeroen W; van der Aa, Niels; Kleber, Rolf J

    2018-01-07

    Dissociation is a prevalent phenomenon among veterans with post-traumatic stress disorder (PTSD) that may interfere with the effectiveness of treatment. This study aimed to replicate findings of a dissociative PTSD subtype, to identify corresponding patterns in coping style, symptom type, and symptom severity, and to investigate its impact on post-traumatic symptom improvement. Latent profile analysis (LPA) was applied to baseline data from 330 predominantly (97%) male treatment-seeking veterans (mean age 39.5 years) with a probable PTSD. Multinomial logistic models were used to identify predictors of dissociative PTSD. Eighty veterans with PTSD that commenced with psychotherapy were invited for a follow-up measure after 6 months. The majority (n = 64, 80% response rate) completed the follow-up measure. Changes in post-traumatic stress between baseline and follow-up were explored as a continuous distal outcome. Latent profile analysis revealed four distinct patient profiles: 'low' (12.9%), 'moderate' (33.2%), 'severe' (45.1%), and 'dissociative' (8.8%) PTSD. The dissociative PTSD profile was characterized by more severe pathology levels, though not post-traumatic reactions symptom severity. Veterans with dissociative PTSD benefitted equally from PTSD treatment as veterans with non-dissociative PTSD with similar symptom severity. Within a sample of veterans with PTSD, a subsample of severely dissociative veterans was identified, characterized by elevated severity levels on pathology dimensions. The dissociative PTSD subtype did not negatively impact PTSD treatment. The present findings confirmed the existence of a distinct subgroup veterans that fit the description of dissociative PTSD. Patients with dissociative PTSD subtype symptoms uniquely differed from patients with non-dissociative PTSD in the severity of several psychopathology dimensions. Dissociative and non-dissociative PTSD patients with similar post-traumatic severity levels showed similar levels of

  13. The impact of long-term elevated CO2 on C and N retention in stable SOM pools

    NARCIS (Netherlands)

    Graaff, de M.A.; Kessel, van C.; Six, J.

    2008-01-01

    Elevated atmospheric CO2 frequently increases plant production and concomitant soil C inputs, which may cause additional soil C sequestration. However, whether the increase in plant production and additional soil C sequestration under elevated CO2 can be sustained in the long-term is unclear. One

  14. Why are tropical mountain passes "low" for some species? Genetic and stable-isotope tests for differentiation, migration and expansion in elevational generalist songbirds.

    Science.gov (United States)

    Gadek, Chauncey R; Newsome, Seth D; Beckman, Elizabeth J; Chavez, Andrea N; Galen, Spencer C; Bautista, Emil; Witt, Christopher C

    2017-11-06

    gradient, potentially concurrent with Holocene anthropogenic habitat conversion for agriculture. In different ways, each species defies the tendency for tropical birds to have long-term stable distributions and sedentary habits. We conclude that tropical elevational generalism is rare due to evolutionary instability. © 2017 The Authors. Journal of Animal Ecology © 2017 British Ecological Society.

  15. Prevalence and prognostic significance of incidental cardiac troponin T elevation in ambulatory patients with stable coronary artery disease: Data from The Heart and Soul Study

    Science.gov (United States)

    Hsieh, Bill P. C.; Rogers, Adam M.; Na, Beeya; Wu, Alan H. B.; Schiller, Nelson B.; Whooley, Mary A.

    2009-01-01

    Background The significance of troponin elevation and clinical utility of troponin testing in ambulatory patients with coronary artery disease (CAD) have not been examined. We sought to investigate the prevalence and prognostic value of cardiac troponin T (cTnT) elevation in a population with stable CAD. Methods We studied 987 patients with stable CAD enrolled in the Heart & Soul study who had plasma cTnT measurements before performing exercise treadmill testing. Results Of the studied population, 58 patients or 6.2% had detectable cTnT levels, ≥0.01 ng/mL (0.01–0.72 ng/mL). During a mean follow-up period of 4.3 (0.1–6.5) years, 58.6% of participants with detectable cTnT had cardiovascular events compared with 22.5% of those without detectable cTnT (hazard ratio [HR] 3.8, 95% CI 2.6–5.4, P <.001). This association remained strong after adjustment for traditional risk factors and C-reactive protein (HR 2.0, 95% CI 1.3–3.1, P = .002). However, after further adjustment for N-terminal pro–B-type natriuretic peptide and echocardiographic parameters of left ventricular function, cTnT elevation was not an independent predictor of cardiovascular events (HR 1.3, 95% CI, 0.8–2.3, P = .28). Conclusions In ambulatory patients with stable CAD, the prevalence of cTnT elevation was 6.2%. Cardiac troponin T elevation detected using the conventional troponin assay was associated with increased risk of adverse cardiovascular outcomes, but its prognostic value was not incremental over N-terminal pro–B-type natriuretic peptide and echocardiographic evidence of cardiac abnormalities. PMID:19781430

  16. PTSD-8: A Short PTSD Inventory.

    Science.gov (United States)

    Hansen, Maj; Andersen, Tonny Elmose; Armour, Cherie; Elklit, Ask; Palic, Sabina; Mackrill, Thomas

    2010-09-28

    Traumatic events pose great challenges on mental health services in scarcity of specialist trauma clinicians and services. Simple short screening instruments for detecting adverse psychological responses are needed. Several brief screening instruments have been developed. However, some are limited, especially in relation to reflecting the posttraumatic stress disorder (PTSD) diagnosis. Recently, several studies have challenged pre-existing ideas about PTSD's latent structure. Factor analytic research currently supports two four factor models. One particular model contains a dysphoria factor which has been associated with depression and anxiety. The symptoms in this factor have been hailed as less specific to PTSD. The scope of this article is therefore to present a short screening instrument, based on this research; Posttraumatic Stress Disorder (PTSD) - 8 items. The PTSD-8 is shown to have good psychometric properties in three independent samples of whiplash patients (n=1710), rape victims (n=305), and disaster victims (n=516). Good test-rest reliability is also shown in a pilot study of young adults from families with alcohol problems (n=56).

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

    Directory of Open Access Journals (Sweden)

    Kristina J. Korte

    2017-01-01

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

  18. Assessing the structure and meaningfulness of the dissociative subtype of PTSD.

    Science.gov (United States)

    Ross, Jana; Baník, Gabriel; Dědová, Mária; Mikulášková, Gabriela; Armour, Cherie

    2018-01-01

    Studies conducted in the USA, Canada and Denmark have supported the existence of the dissociative PTSD subtype, characterized primarily by symptoms of depersonalization and derealization. The current study aimed to examine the dissociative PTSD subtype in an Eastern European, predominantly female (83.16%) sample, using an extended set of dissociative symptoms. A latent profile analysis was applied to the PTSD and dissociation data from 689 trauma-exposed university students from Slovakia. Four latent profiles of varying PTSD and dissociation symptomatology were uncovered. They were named non-symptomatic, moderate PTSD, high PTSD and dissociative PTSD. The dissociative PTSD profile showed elevations on depersonalization and derealization, but also the alternative dissociative indicators of gaps in awareness and memory, sensory misperceptions and cognitive and behavioural re-experiencing. The core PTSD symptoms of 'memory impairment' and 'reckless or self-destructive behaviour' were also significantly elevated in the dissociative PTSD profile. Moreover, anxiety and anger predicted membership in the dissociative PTSD profile. The results provide support for the proposal that the dissociative PTSD subtype can be characterized by a variety of dissociative symptoms.

  19. Biomarkers for PTSD

    Science.gov (United States)

    2014-07-01

    networks18. B. Support Vector machine. C. regional texture /complexity measures combined with Random Forrest data mining algorithm19. The performance of...voxel level. PTSD pos had clusters of voxels with decreased FA in the region of the posterior corona radiata. However, these abnormalities became non...classifier by integrating the information from the DTI. Multivariate approach to PTSD diagnosis using regional texture /complexity (Dr. Schuff) Goal: We aim

  20. Neurobiological basis of PTSD

    International Nuclear Information System (INIS)

    Yamasue, Hidenori; Kasai, Kiyoto

    2006-01-01

    This review describes posttraumatic stress disorder (PTSD) from the aspect that it is one of precious neurobiological models where the stress caused by an outer environmental factor affects the livings afterwards. Also described are the actual imaging investigations of PTSD in people encountered the sarin subway terrorism in Tokyo (1995). High resolution MRI has revealed the decreased volume of hippocampus in PTSD patients in recent years. In victims of the terrorism above, authors have found that the volume of anterior cingulate cortical (ACC) gray matter is reduced in voxel-based MRI morphometry and the reduction is well correlated with PTSD severity and lower P300 amplitude. PET and fMRI have shown the hyperactivity of amygdala and hypoactivity of medial prefrontal region around ACC in PTSD. Findings in conditioned animal studies have indicated the importance of ACC neuronal cell activation for fear extinction, where, in humans, fMRI has revealed the cooperation between amygdala and ACC. At present, genetic factors like serotonin transporter polymorphism, environmental ones at infantile stage and their interactive activity are subject to investigation and discussion. Imaging studies will contribute to the clinical diagnosis, treatment and intervention of PTSD. (T.I)

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

    Directory of Open Access Journals (Sweden)

    Sharon Dekel

    2017-05-01

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

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

    Science.gov (United States)

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

    2014-08-01

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

  3. Comparison of long-term mortality after percutaneous coronary intervention in patients treated for acute ST-elevation myocardial infarction versus those with unstable and stable angina pectoris.

    Science.gov (United States)

    Hirsch, Alexander; Verouden, Niels J W; Koch, Karel T; Baan, Jan; Henriques, José P S; Piek, Jan J; Rohling, Wim J; van der Schaaf, Rene J; Tijssen, Jan G P; Vis, Marije M; de Winter, Robbert J

    2009-08-01

    Data remain limited regarding the comparative long-term mortality across the spectrum of patients with different indications for percutaneous coronary intervention (PCI). We evaluated early and late mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI compared with early and late mortality in patients undergoing PCI for unstable angina (UA) or non-STEMI (NSTEMI) and stable angina. A total of 10,549 consecutive patients undergoing PCI from 1997 to 2005 at a single institution were followed up prospectively (median 3.2 years, interquartile range 1.5 to 5.6) to assess all-cause mortality. The indication for PCI was STEMI in 28%, UA/NSTEMI in 32%, and stable angina in 40%. The mortality rate at 6 years was 18.9% in patients with STEMI, 16.2% in patients with UA/NSTEMI, and 11.7% in those with stable angina. During the initial 6 months, patients with STEMI had an increased risk of death compared with patients with UA/NSTEMI (relative risk [RR] 3.09, 95% confidence interval [CI] 2.46 to 3.89) and stable angina (RR 5.82, 95% CI 4.45 to 7.62). However, between 6 months and 6 years, mortality accrued at an almost similar rate among patients with STEMI and those with stable angina (RR 1.06, 95% CI 0.86 to 1.32) and mortality was greatest in patients with UA/NSTEMI (UA/NSTEMI vs stable angina: RR 1.33, 95% CI 1.11 to 1.58; STEMI vs UA/NSTEMI: RR 0.80, 95% CI 0.65 to 0.99). In conclusion, we have demonstrated that the inferior survival rates in patients with STEMI after primary PCI are mainly attributed to greater mortality in the first months after the event. These observations highlight that new adjunctive therapeutic strategies should aim at mortality reduction in the first months after primary PCI.

  4. Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction)

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Jensen, Lisette Okkels; Thayssen, Per

    2011-01-01

    ,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7.......08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008...

  5. Assessing PTSD in the military

    DEFF Research Database (Denmark)

    Karstoft, Karen-Inge; Andersen, Søren B.; Nielsen, Anni Brit Sternhagen

    2017-01-01

    Since 1998, soldiers deployed to war zones with the Danish Defense (≈31,000) have been invited to fill out a questionnaire on post-mission reactions. This provides a unique data source for studying the psychological toll of war. Here, we validate a measure of PTSD-symptoms from the questionnaire...... including symptoms of PTSD (PRIM-PTSD). They also filled out a validated measure of PTSD-symptoms in DSM-IV, the PTSD-checklist (PCL). We tested reliability of PRIM-PTSD by estimating Cronbach's alpha, and tested validity by correlating items, clusters, and overall scale with corresponding items in the PCL....... Furthermore, we conducted two confirmatory factor analytic models to test the factor structure of PRIM-PTSD, and tested measurement invariance of the selected model. Finally, we established a screening and a clinical cutoff score by application of ROC analysis. We found high internal consistency of the PRIM-PTSD...

  6. PTSD in Children and Teens

    Science.gov (United States)

    ... version, located in the "Professional" section of our website: PTSD in Children and Adolescents . Date this content was last updated is at the bottom of the ... PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign ...

  7. Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents.

    Science.gov (United States)

    Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe; Aquino, Melissa; Stone, Gregg W; Sartori, Samantha; Steg, Philippe Gabriel; Wijns, William; Smits, Pieter C; Jeger, Raban V; Leon, Martin B; Windecker, Stephan; Serruys, Patrick W; Morice, Marie-Claude; Camenzind, Edoardo; Weisz, Giora; Kandzari, David; Dangas, George D; Mastoris, Ioannis; Von Birgelen, Clemens; Galatius, Soren; Kimura, Takeshi; Mikhail, Ghada; Itchhaporia, Dipti; Mehta, Laxmi; Ortega, Rebecca; Kim, Hyo-Soo; Valgimigli, Marco; Kastrati, Adnan; Chieffo, Alaide; Mehran, Roxana

    2015-09-15

    The long-term risk associated with different coronary artery disease (CAD) presentations in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is poorly characterized. We pooled patient-level data for women enrolled in 26 randomized clinical trials. Of 11,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST-segment-elevation myocardial infarction (STEMI) as clinical presentation. A stepwise increase in 3-year crude cumulative mortality was observed in the transition from SAP to STEMI (4.9% vs 6.1% vs 9.4%; p <0.01). Conversely, no differences in crude mortality rates were observed between 1 and 3 years across clinical presentations. After multivariable adjustment, STEMI was independently associated with greater risk of 3-year mortality (hazard ratio [HR] 3.45; 95% confidence interval [CI] 1.99 to 5.98; p <0.01), whereas no differences were observed between UAP or NSTEMI and SAP (HR 0.99; 95% CI 0.73 to 1.34; p = 0.94). In women with ACS, use of new-generation DES was associated with reduced risk of major adverse cardiac events (HR 0.58; 95% CI 0.34 to 0.98). The magnitude and direction of the effect with new-generation DES was uniform between women with or without ACS (pinteraction = 0.66). In conclusion, in women across the clinical spectrum of CAD, STEMI was associated with a greater risk of long-term mortality. Conversely, the adjusted risk of mortality between UAP or NSTEMI and SAP was similar. New-generation DESs provide improved long-term clinical outcomes irrespective of the clinical presentation in women. Published by Elsevier Inc.

  8. River recharge sources and the partitioning of catchment evapotranspiration fluxes as revealed by stable isotope signals in a typical high-elevation arid catchment

    Science.gov (United States)

    Guo, Xiaoyu; Tian, Lide; Wang, Lei; Yu, Wusheng; Qu, Dongmei

    2017-06-01

    Catchment-scale hydrological cycles are expected to suffer more extremes under a background of climate change. Quantifying hydrological changes in high and remote areas is practically challenging. However, stable isotopes in river water can be seen to vary, dependent upon the combined influence exerted by recharge sources and local climatic conditions; the study of river water stable isotopes can therefore provide a meaningful method for delineating catchment-scale hydrological studies. In this study, we present high-resolution time series of river δ18O and d-excess values; additionally, we identify the seasonal dynamics of river recharge sources and major components of the catchment-scale water balance, together with precipitation and groundwater isotopes, and concurrent meteorological data recorded in Magazangbu catchment on the northwestern Tibetan Plateau (TP). Using isotopic analysis, and within a proportional framework, we partitioned the isotopic fractionation (E1) or non-fractionation (E2) from soil evaporation fluxes (Esoil) apparent in different processes, using NDVI (Normal Differential Vegetation Index) data collected by MODIS satellites to calculate the vegetation fractional coverage (VFC), and Global Land Data Assimilation System (GLDAS) records to determine evapotranspiration data (ET). Finally, the contributions made by each ET component (Esoil and plant transpiration) to total catchment ET were computed for the high and remote northwestern TP. Our results show that: (1) river δ18O values were high in summer and low in winter, while d-excess values displayed a contrary seasonal cycle; (2) for the monsoon period, precipitation contributed 60.6% to Magazangbu catchment runoff. Deeper groundwater was the main water source for the winter low base flow, and shallow groundwater or high elevation snowmelt was the principal component of the spring thaw and autumn freezing periods; and (3) a substantial proportion of Esoil (96.4% annually; 92.2% during

  9. Co-morbid PTSD and suicidality in individuals with schizophrenia and substance and alcohol abuse.

    Science.gov (United States)

    Tarrier, Nicholas; Picken, Alicia

    2011-11-01

    Suicide risk is high in schizophrenic patients and is further elevated in dual diagnosis patients. Suicide behaviour is a continuum from ideation, plans to attempts. Exposure to traumatic stress and co-morbid PTSD is elevated in schizophrenic patients. Suicide behaviour is also common in non-psychotic PTSD patients. This study aimed to investigate the effect of trauma and co-morbid PTSD on suicide behaviour in dual diagnosis patients and whether co-morbid PTSD would further elevate suicide risk. This was a cross-sectional study in which suicide behaviour was compared in those with and without co-morbid PTSD in 110 patients suffering schizophrenia and alcohol and/or substance abuse. 100 (91%) reported at least one traumatic event with an average of 4.3 events. 31 (28%) patients met criteria for full PTSD. Current suicidal ideation was reported by 39 (35%) and 23 (21%) reported plans and ideation, 69 (63%) reported at least one previous suicide attempt. Suicide behaviour was significantly associated with an increasing number of traumatic events. Suicidality was significantly associated and elevated with co-morbid PTSD. Analysis indicated that the effect of trauma on suicide behaviour appeared to be mediated by hopelessness. Suicide behaviour was not associated with exposure to trauma per se but was associated with incremental exposure to traumatic experiences. Consistent with the study hypotheses, co-morbid PTSD further adds to the risk of suicide behaviour in an already vulnerable group.

  10. Mindfulness in PTSD treatment.

    Science.gov (United States)

    Lang, Ariel J

    2017-04-01

    In recent years, the field has witnessed considerable enthusiasm for the ancient practice of mindfulness. The skills derived from this experience, including focused attention, nonjudgmental acceptance of internal experiences and reduced autonomic reactivity, may be helpful in counteracting pathological responses to trauma. Several types of interventions that incorporate principles of mindfulness have been examined for treatment of posttraumatic stress disorder (PTSD). This nascent literature is inconsistent and methodologically limited but does suggest that mindfulness is a potentially important tool for creating psychological change. The interventions described herein generally would not yet be considered first-line treatments for PTSD. Nonetheless, evidence is building, and mindfulness may provide an impetus for better understanding how to personalize psychological interventions and to evaluate their outcomes. Published by Elsevier Ltd.

  11. Comparison of outcomes of patients ≥ 80 years of age having percutaneous coronary intervention according to presentation (stable vs unstable angina pectoris/non-ST-segment elevation myocardial infarction vs ST-segment elevation myocardial infarction).

    Science.gov (United States)

    Antonsen, Lisbeth; Jensen, Lisette Okkels; Thayssen, Per; Christiansen, Evald Høj; Junker, Anders; Tilsted, Hans-Henrik; Terkelsen, Christian Juhl; Kaltoft, Anne; Maeng, Michael; Hansen, Knud Noerregaard; Ravkilde, Jan; Lassen, Jens Flensted; Madsen, Morten; Sørensen, Henrik Toft; Thuesen, Leif

    2011-11-15

    Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.7%, and "ventricular arrhythmia or congestive heart failure" in 5.1%. Overall 30-day and 1-year mortality rates were 9.2% and 18.1%, respectively. Compared to patients with SAP the adjusted 1-year mortality risk was significantly higher for patients presenting with STEMI (hazard ratio 3.86, 95% confidence interval 3.08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008. In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. PTSD and Problems with Alcohol Use

    Science.gov (United States)

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

  13. Determining Carbon and Oxygen Stable Isotope Systematics in Brines at Elevated p/T Conditions to Enhance Monitoring of CO2 Induced Processes in Carbon Storage Reservoirs

    Science.gov (United States)

    Becker, V.; Myrttinen, A.; Mayer, B.; Barth, J. A.

    2012-12-01

    Stable carbon isotope ratios (δ13C) are a powerful tool for inferring carbon sources and mixing ratios of injected and baseline CO2 in storage reservoirs. Furthermore, CO2 releasing and consuming processes can be deduced if the isotopic compositions of end-members are known. At low CO2 pressures (pCO2), oxygen isotope ratios (δ18O) of CO2 usually assume the δ18O of the water plus a temperature-dependent isotope fractionation factor. However, at very high CO2 pressures as they occur in CO2 storage reservoirs, the δ18O of the injected CO2 may in fact change the δ18O of the reservoir brine. Hence, changing δ18O of brine constitutes an additional tracer for reservoir-internal carbon dynamics and allows the determination of the amount of free phase CO2 present in the reservoir (Johnson et al. 2011). Further systematic research to quantify carbon and oxygen isotope fractionation between the involved inorganic carbon species (CO2, H2CO3, HCO3-, CO32-, carbonate minerals) and kinetic and equilibrium isotope effects during gas-water-rock interactions is necessary because p/T conditions and salinities in CO2 storage reservoirs may exceed the boundary conditions of typical environmental isotope applications, thereby limiting the accuracy of stable isotope monitoring approaches in deep saline formations (Becker et al. 2011). In doing so, it is crucial to compare isotopic patterns observed in laboratory experiments with artificial brines to similar experiments with original fluids from representative field sites to account for reactions of dissolved inorganic carbon (DIC) with minor brine components. In the CO2ISO-LABEL project, funded by the German Ministry for Education and Research, multiple series of laboratory experiments are conducted to determine the influence of pressure, temperature and brine composition on the δ13C of DIC and the δ18O of brines in water-CO2-rock reactions with special focus placed on kinetics and stable oxygen and carbon isotope fractionation

  14. Social support, oxytocin, and PTSD

    NARCIS (Netherlands)

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

    2014-01-01

    A lack of social support and recognition by the environment is one of the most consistent risk factors for posttraumatic stress disorder (PTSD), and PTSD patients will recover faster with proper social support. The oxytocin system has been proposed to underlie beneficial effects of social support as

  15. The genetic background to PTSD

    NARCIS (Netherlands)

    Broekman, B. F. P.; Olff, M.; Boer, F.

    2007-01-01

    Although extensive research has already been done on the genetic bases of psychiatric disorders, little is known about polygenetic influences in posttraumatic stress disorder (PTSD). This article reviews molecular genetic studies relating to PTSD that were found in a literature search in Medline,

  16. Predicting PTSD following bank robbery

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

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

  17. Predictors of PTSD 40 years after combat: Findings from the National Vietnam Veterans longitudinal study.

    Science.gov (United States)

    Steenkamp, Maria M; Schlenger, William E; Corry, Nida; Henn-Haase, Clare; Qian, Meng; Li, Meng; Horesh, Danny; Karstoft, Karen-Inge; Williams, Christianna; Ho, Chia-Lin; Shalev, Arieh; Kulka, Richard; Marmar, Charles

    2017-08-01

    Few studies have longitudinally examined predictors of posttraumatic stress disorder (PTSD) in a nationally representative sample of US veterans. We examined predictors of warzone-related PTSD over a 25-year span using data from the National Vietnam Veterans Longitudinal Study (NVVLS). The NVVLS is a follow-up study of Vietnam theater veterans (N = 699) previously assessed in the National Vietnam Veterans Readjustment Study (NVVRS), a large national-probability study conducted in the late 1980s. We examined the ability of 22 premilitary, warzone, and postmilitary variables to predict current warzone-related PTSD symptom severity and PTSD symptom change in male theater veterans participating in the NVVLS. Data included a self-report Health Questionnaire survey and a computer-assisted telephone Health Interview Survey. Primary outcomes were self-reported PTSD symptoms assessed by the PTSD Checklist for DSM-5 (PCL 5) and Mississippi PTSD Scale (M-PTSD). Predictors of current PTSD symptoms most robust in hierarchical multivariable models were African-American race, lower education level, negative homecoming reception, lower current social support, and greater past-year stress. PTSD symptoms remained largely stable over time, and symptom exacerbation was predicted by African-American race, lower education level, younger age at entry into Vietnam, greater combat exposure, lower current social support, and greater past-year stressors. Findings confirm the robustness of a select set of risk factors for warzone-related PTSD, establishing that these factors can predict PTSD symptom severity and symptom change up to 40 years postdeployment. © 2017 Wiley Periodicals, Inc.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative...

  19. Sentiment analysis for PTSD signals

    CERN Document Server

    Kagan, Vadim; Sapounas, Demetrios

    2013-01-01

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

  20. Using the Single Prolonged Stress Model to Examine the Pathophysiology of PTSD

    Directory of Open Access Journals (Sweden)

    Rimenez R. Souza

    2017-09-01

    Full Text Available The endurance of memories of emotionally arousing events serves the adaptive role of minimizing future exposure to danger and reinforcing rewarding behaviors. However, following a traumatic event, a subset of individuals suffers from persistent pathological symptoms such as those seen in posttraumatic stress disorder (PTSD. Despite the availability of pharmacological treatments and evidence-based cognitive behavioral therapy, a considerable number of PTSD patients do not respond to the treatment, or show partial remission and relapse of the symptoms. In controlled laboratory studies, PTSD patients show deficient ability to extinguish conditioned fear. Failure to extinguish learned fear could be responsible for the persistence of PTSD symptoms such as elevated anxiety, arousal, and avoidance. It may also explain the high non-response and dropout rates seen during treatment. Animal models are useful for understanding the pathophysiology of the disorder and the development of new treatments. This review examines studies in a rodent model of PTSD with the goal of identifying behavioral and physiological factors that predispose individuals to PTSD symptoms. Single prolonged stress (SPS is a frequently used rat model of PTSD that involves exposure to several successive stressors. SPS rats show PTSD-like symptoms, including impaired extinction of conditioned fear. Since its development by the Liberzon lab in 1997, the SPS model has been referred to by more than 200 published papers. Here we consider the findings of these studies and unresolved questions that may be investigated using the model.

  1. PTSD: An Elusive Definition.

    Science.gov (United States)

    Kirkbride, Jared F

    2012-01-01

    The Global War on Terrorism became the longest standing conflict in United States military history on June 7, 2010. It is estimated that 1.64 million U.S. troops have been deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom (p xix).1 Both conflicts have produced high numbers of casualties as the result of ground combat. The amount of casualties though has been relatively low compared to other conflicts. Some of this can be attributed to the advances in body armor and emergency medicine that allow many servicemembers to survive conditions that previously led to death. Conversely, surviving these situations leaves those same members with memories that are psychologically difficult to live with and cause chronic difficulties. Unlike an amputee, or the victim of severe burns where the signs and symptoms of their injuries are obvious, patients with psychological disorders can have a range of signs and symptoms common in many other mental disorders, making it difficult to diagnose and treat Soldiers suffering from Post-traumatic Stress Disorder (PTSD). 2012.

  2. Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013): a latent profile analysis.

    Science.gov (United States)

    Knefel, Matthias; Garvert, Donn W; Cloitre, Marylene; Lueger-Schuster, Brigitte

    2015-01-01

    The World Health Organization (WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD) separate and distinct from posttraumatic stress disorder (PTSD). To determine whether the symptoms endorsed by individuals who had experienced childhood institutional abuse form classes that are consistent with diagnostic criteria for ICD-11 CPTSD as distinct from PTSD. A latent profile analysis (LPA) was conducted on 229 adult survivors of institutional abuse using the Brief Symptom Inventory and the PTSD Checklist-Civilian Version to assess current psychopathological symptoms. The LPA revealed four classes of individuals: (1) a class with elevated symptoms of CPTSD (PTSD symptoms and disturbances in self-organization); (2) a class with elevated symptoms of PTSD and low disturbances in self-organization; (3) a class with elevated disturbances in self-organization symptoms and some elevated PTSD symptoms; and (4) a class with low symptoms. The results support the existence of a distinct group in our sample, that could be described by the proposed diagnostic category termed CPTSD more precisely than by normal PTSD. In addition, there seems to be a group of persons that do not fulfill the criteria for a trauma-related disorder but yet suffer from psychopathological symptoms.

  3. Update to an evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse by Knefel & Lueger-Schuster (2013: a latent profile analysis

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2015-01-01

    Full Text Available Background: The World Health Organization (WHO International Classification of Diseases, 11th version (ICD-11, has proposed a trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD separate and distinct from posttraumatic stress disorder (PTSD. Objective: To determine whether the symptoms endorsed by individuals who had experienced childhood institutional abuse form classes that are consistent with diagnostic criteria for ICD-11 CPTSD as distinct from PTSD. Methods: A latent profile analysis (LPA was conducted on 229 adult survivors of institutional abuse using the Brief Symptom Inventory and the PTSD Checklist—Civilian Version to assess current psychopathological symptoms. Results: The LPA revealed four classes of individuals: (1 a class with elevated symptoms of CPTSD (PTSD symptoms and disturbances in self-organization; (2 a class with elevated symptoms of PTSD and low disturbances in self-organization; (3 a class with elevated disturbances in self-organization symptoms and some elevated PTSD symptoms; and (4 a class with low symptoms. Conclusions: The results support the existence of a distinct group in our sample, that could be described by the proposed diagnostic category termed CPTSD more precisely than by normal PTSD. In addition, there seems to be a group of persons that do not fulfill the criteria for a trauma-related disorder but yet suffer from psychopathological symptoms.

  4. Tailored antiplatelet therapy to improve prognosis in patients exhibiting clopidogrel low-response prior to percutaneous coronary intervention for stable angina or non-ST elevation acute coronary syndrome

    DEFF Research Database (Denmark)

    Paarup Dridi, Nadia; Johansson, Pär I; Lønborg, Jacob T

    2015-01-01

    Abstract Aim: To investigate whether an intensified antiplatelet regimen could improve prognosis in stable or non-ST elevation in acute coronary syndrome (ACS) patients exhibiting high on-treatment platelet reactivity (HTPR) on clopidogrel and treated with percutaneous coronary intervention (PCI......). There is a wide variability in the platelet reactivity to clopidogrel and HTPR has been associated with a poor prognosis. Methods: In this observational study, 923 consecutive patients without ST-elevation myocardial infarction (STEMI) and adequately pre-treated with clopidogrel were screened for HTPR...... was demonstrated in 237 patients (25.7%). Of these, 114 continued on conventional clopidogrel therapy, while the remaining 123 received intensified antiplatelet therapy with either double-dose clopidogrel (150 mg daily, n = 55) or the newer P2Y12-inhibitors, prasugrel or ticagrelor (n = 68) for at least 30 days...

  5. Comparison of plaque characteristics in narrowings with ST-elevation myocardial infarction (STEMI), non-STEMI/unstable angina pectoris and stable coronary artery disease (from the ADAPT-DES IVUS Substudy).

    Science.gov (United States)

    Dong, Liang; Mintz, Gary S; Witzenbichler, Bernhard; Metzger, D Christopher; Rinaldi, Michael J; Duffy, Peter L; Weisz, Giora; Stuckey, Thomas D; Brodie, Bruce R; Yun, Kyeong Ho; Xu, Ke; Kirtane, Ajay J; Stone, Gregg W; Maehara, Akiko

    2015-04-01

    Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents (ADAPT-DES) was a prospective, multicenter registry of 8,582 consecutive stable and unstable patients who underwent percutaneous coronary intervention using a drug-eluting stent. We sought to identify key morphologic features leading to ST-segment elevation myocardial infarction (STEMI) versus non-STEMI (NSTEMI) or unstable angina pectoris (UA) versus stable coronary artery disease (CAD) presentation. In the prespecified grayscale and virtual histology (VH) substudy of ADAPT-DES, preintervention imaging identified 676 patients with a single culprit lesion. The relation between lesion morphology and clinical presentation was compared among patients with (1) STEMI, (2) NSTEMI or UA, and (3) stable CAD. Intravascular ultrasound identified more plaque rupture and VH thin-cap fibroatheroma (TCFA) in STEMI lesions compared with NSTEMI/UA or stable CAD lesions; conversely, fibroatheromas appeared more often calcified with a thick fibrous cap in stable CAD. Minimum lumen cross-sectional area (MLA) was smaller with larger plaque burden and positive remodeling in STEMI lesions. Lesions with plaque rupture versus those without plaque rupture showed higher prevalence of VH-TCFA and larger plaque burden with positive remodeling, especially in patients with STEMI. Multivariate analysis showed that in the lesions with plaque rupture, plaque burden at the MLA site was the only independent predictor for STEMI (cutoff of plaque burden = 85%) and in lesions without plaque rupture, MLA was the only independent predictor for STEMI (cutoff of MLA = 2.3 mm(2)). In conclusion, culprit lesions causing STEMI have smaller lumen areas, greater plaque burden, and more plaque rupture or VH-TCFA compared with NSTEMI/UA or stable CAD; in lesions with plaque rupture, only plaque burden predicted STEMI, and in lesions without plaque rupture, only MLA area predicted STEMI. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Elevating your elevator talk

    Science.gov (United States)

    An important and often overlooked item that every early career researcher needs to do is compose an elevator talk. The elevator talk, named because the talk should not last longer than an average elevator ride (30 to 60 seconds), is an effective method to present your research and yourself in a clea...

  7. Post-Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    Post-traumatic stress disorder (PTSD) Overview Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, ...

  8. Trauma, PTSD, and the Developing Brain.

    Science.gov (United States)

    Herringa, Ryan J

    2017-08-19

    PTSD in youth is common and debilitating. In contrast to adult PTSD, relatively little is known about the neurobiology of pediatric PTSD, nor how neurodevelopment may be altered. This review summarizes recent neuroimaging studies in pediatric PTSD and discusses implications for future study. Pediatric PTSD is characterized by abnormal structure and function in neural circuitry supporting threat processing and emotion regulation. Furthermore, cross-sectional studies suggest that youth with PTSD have abnormal frontolimbic development compared to typically developing youth. Examples include declining hippocampal volume, increasing amygdala reactivity, and declining amygdala-prefrontal coupling with age. Pediatric PTSD is characterized by both overt and developmental abnormalities in frontolimbic circuitry. Notably, abnormal frontolimbic development may contribute to increasing threat reactivity and weaker emotion regulation as youth age. Longitudinal studies of pediatric PTSD are needed to characterize individual outcomes and determine whether current treatments are capable of restoring healthy neurodevelopment.

  9. Internalized HIV Stigma and Mindfulness: Associations With PTSD Symptom Severity in Trauma-Exposed Adults With HIV/AIDS.

    Science.gov (United States)

    Gonzalez, Adam; Locicero, Briana; Mahaffey, Brittain; Fleming, Crystal; Harris, Jalana; Vujanovic, Anka A

    2016-01-01

    Rates of both traumatic event exposure and posttraumatic stress disorder (PTSD; 22%-54%) are disproportionately elevated among people living with HIV/AIDS (PLHA). Trauma and related psychopathology significantly affect quality of life and disease management in this patient population. The current study examined associations between internalized HIV stigma, mindfulness skills, and the severity of PTSD symptoms in trauma-exposed PLHA. Participants included 137 PLHA (14.6% female; Mage = 48.94, SD = 8.89) who reported experiencing on average, five (SD = 2.67) traumatic events; 34% met diagnostic criteria for PTSD. Results indicate that after controlling for sex, age, education, and number of traumatic events, internalized HIV stigma was positively related to overall PTSD symptom severity (β = .16, p PTSD symptom clusters. Among the mindfulness facets measured, acting with awareness was uniquely negatively related to the overall severity of PTSD symptoms (β = -.25, p PTSD symptom clusters. These effects were observed after accounting for covariates and shared variance with other mindfulness facets. Theoretically, the present findings suggest that internalized HIV stigma may serve as a vulnerability factor for the severity of certain PTSD symptoms, whereas acting with awareness may function as a protective or resiliency factor for the severity of PTSD symptoms. Implications for the treatment of trauma-exposed PLHA are discussed. © The Author(s) 2015.

  10. Prospective risk factors for adolescent PTSD: sources of differential exposure and differential vulnerability.

    Science.gov (United States)

    Milan, Stephanie; Zona, Kate; Acker, Jenna; Turcios-Cotto, Viana

    2013-02-01

    There are two types of risk factors for developing PTSD: factors that increase the likelihood of experiencing a potentially traumatizing event and factors that increase the likelihood of developing symptoms following such events. Using prospective data over a two-year period from a large, diverse sample of urban adolescents (n = 1242, Mean age = 13.5), the current study differentiates these two sources of risk for developing PTSD in response to violence exposure. Five domains of potential risk and protective factors were examined: community context (e.g., neighborhood poverty), family risk (e.g., family conflict), behavioral maladjustment (e.g., internalizing symptoms), cognitive vulnerabilities (e.g., low IQ), and interpersonal problems (e.g., low social support). Time 1 interpersonal violence history, externalizing behaviors, and association with deviant peers were the best predictors of subsequent violence, but did not further increase the likelihood of PTSD in response to violence. Race/ethnicity, thought disorder symptoms, and social problems were distinctly predictive of the development of PTSD following violence exposure. Among youth exposed to violence, Time 1 risk factors did not predict specific event features associated with elevated PTSD rates (e.g., parent as perpetrator), nor did interactions between Time 1 factors and event features add significantly to the prediction of PTSD diagnosis. Findings highlight areas for refinement in adolescent PTSD symptom measures and conceptualization, and provide direction for more targeted prevention and intervention efforts.

  11. Correlation of stable elevations in striatal mu-opioid receptor availability in detoxified alcoholic patients with alcohol craving: a positron emission tomography study using carbon 11-labeled carfentanil.

    Science.gov (United States)

    Heinz, Andreas; Reimold, Matthias; Wrase, Jana; Hermann, Derik; Croissant, Bernhard; Mundle, Götz; Dohmen, Bernhard M; Braus, Dieter F; Braus, Dieter H; Schumann, Gunter; Machulla, Hans-Jürgen; Bares, Roland; Mann, Karl

    2005-01-01

    The pleasant effects of food and alcohol intake are partially mediated by mu-opiate receptors in the ventral striatum, a central area of the brain reward system. Blockade of mu-opiate receptors with naltrexone reduces the relapse risk among some but not all alcoholic individuals. To test the hypothesis that alcohol craving is pronounced among alcoholic individuals with a high availability of mu-opiate receptors in the brain reward system. Patients and comparison sample. The availability of central mu-opiate receptors was measured in vivo with positron emission tomography (PET) and the radioligand carbon 11-labeled carfentanil in the ventral striatum and compared with the severity of alcohol craving as assessed by the Obsessive Compulsive Drinking Scale (OCDS). Hospitalized care. Volunteer sample of 25 male alcohol-dependent inpatients assessed after detoxification of whom 12 underwent PET again 5 weeks later. Control group of 10 healthy men. After 1 to 3 weeks of abstinence, the availability of mu-opiate receptors in the ventral striatum, including the nucleus accumbens, was significantly elevated in alcoholic patients compared with healthy controls and remained elevated when 12 alcoholic patients had these levels measured 5 weeks later (P<.05 corrected for multiple testing). Higher availability of mu-opiate receptors in this brain area correlated significantly with the intensity of alcohol craving as assessed by the OCDS. Abstinent alcoholic patients displayed an increase in mu-opiate receptors in the ventral striatum, including the nucleus accumbens, which correlated with the severity of alcohol craving. These findings point to a neuronal correlate of alcohol urges.

  12. The Time Profile of Pentraxin 3 in Patients with Acute ST-Elevation Myocardial Infarction and Stable Angina Pectoris Undergoing Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Ragnhild Helseth

    2014-01-01

    Full Text Available Background. High levels of Pentraxin 3 (PTX3 are reported in acute myocardial infarction (AMI. Aim. To investigate circulating levels and gene expression of PTX3 in patients with AMI and stable angina pectoris (AP undergoing PCI. Methods. Ten patients with AP and 20 patients with AMI were included. Blood samples were drawn before PCI in the AP group and after 3 and 12 hours and days 1, 3, 5, 7, and 14 in both groups. Results. Circulating PTX3 levels were higher in AMI compared to AP at 3 and 12 hours (P<0.001 and P=0.003. Within the AMI group, reduction from 3 hours to all later time points was observed (all P≤0.001. Within the AP group, increase from baseline to 3 hours (P=0.022, followed by reductions thereafter (all P<0.05, was observed. PTX3 mRNA increased in the AMI group from 3 hours to days 7 and 14 in a relative manner of 62% and 73%, while a relative reduction from baseline to 3 and 12 hours of 29% and 37% was seen in the AP group. Conclusion. High circulating PTX3 levels shortly after PCI in AMI indicate that AMI itself influences PTX3 levels. PTX3 mRNA might be in response to fluctuations in circulating levels.

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

    Science.gov (United States)

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

    2014-01-01

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

  14. Maternal, not paternal PTSD, is related to increased risk for PTSD in offspring of Holocaust survivors

    Science.gov (United States)

    Yehuda, Rachel; Bell, Amanda; Bierer, Linda M.; Schmeidler, James

    2008-01-01

    Background A significant association between parental PTSD and the occurrence of PTSD in offspring has been noted, consistent with the idea that risk for PTSD is transmitted from parent to child. Two recent reports linking maternal PTSD and low cortisol in offspring prompted us to examine the relative contributions of maternal vs. paternal PTSD in the prediction of PTSD and other psychiatric diagnoses. Methods 117 men and 167 women, recruited from the community, were evaluated using a comprehensive psychiatric battery designed to identify traumatic life experiences and lifetime psychiatric diagnoses. 211 of the subjects were the adult offspring of Holocaust survivors and 73 were demographically comparable Jewish controls. Participants were further subdivided based on whether their mother, father, neither, or both parents met the diagnostic criteria for lifetime PTSD. Results A higher prevalence of lifetime PTSD, mood, anxiety disorders, and to a lesser extent, substance abuse disorders, was observed in offspring of Holocaust than controls. The presence of maternal PTSD was specifically associated with PTSD in adult offspring. However, the other diagnoses did not show specific effects associated with maternal PTSD. Conclusion The tendency for maternal PTSD to make a greater contribution to PTSD risk suggests that classic genetic mechanisms are not the sole model of transmission, and pave way for the speculation that epigenetic factors may be involved. In contrast, PTSD in any parent contributes to risk for depression, and parental traumatization is associated with increased anxiety disorders in offspring. PMID:18281061

  15. Posttraumatic stress disorder (PTSD) symptoms in PTSD patients' families of origin.

    Science.gov (United States)

    Watson, C G; Anderson, P E; Gearhart, L P

    1995-10-01

    Posttraumatic stress disorder (PTSD) patients, psychiatric controls, and hospital employee controls rated their father, mother, and oldest sibling of each sex on 14 PTSD Interview (PTSD-I) symptom ratings. The stress disorder patients assigned their relatives significantly higher PTSD-I ratings than the control group members did in 35 of 120 comparisons. The number of significant differences was nearly identical in the fathers, mothers, sisters, and brothers. Differences were particularly frequent on items pertaining to intrusive thoughts, impoverished relationships, and guilt. The results suggest that a trauma survivor's risk for PTSD may be related to his family's history for PTSD-like behaviors.

  16. Unravelling the Relationship Between Parent and Child PTSD and Pediatric Chronic Pain: the Mediating Role of Pain Catastrophizing.

    Science.gov (United States)

    Neville, Alexandra; Soltani, Sabine; Pavlova, Maria; Noel, Melanie

    2018-02-01

    Clinically elevated rates of post-traumatic stress disorder (PTSD) symptoms are found among many youth with chronic pain and their parents and are linked to worse child pain outcomes. Conceptual models of mutual maintenance in pediatric PTSD and chronic pain posit that child and parent pain catastrophizing are key mechanisms underlying this co-occurrence. To our knowledge, the current study is the first to examine child and parent pain catastrophizing as potential mediators in the child PTSD-child pain and parent PTSD-child pain relationships among a cohort of youth with chronic pain. One hundred two children (72.5% female, mean age=13.5 years), recruited from a tertiary level chronic pain program, and 1 of their parents participated. At intake, parents completed psychometrically sound self-report measures of PTSD symptoms and catastrophizing about child pain. Children completed self-report measures of PTSD symptoms, pain catastrophizing, pain interference, and pain intensity. Findings revealed that relationships between child PTSD and child pain as well as parent PTSD and child pain were mediated by child (but not parent) pain catastrophizing. This suggests that children's catastrophic thinking about pain may explain how child and parent PTSD symptoms influence children's experience of chronic pain and is a potential target in family-based interventions to improve pain and mental health outcomes. Consistent with conceptual models of co-occurring PTSD and chronic pain, children's catastrophic thinking about child pain mediated relationships between parent and child PTSD symptoms and child chronic pain outcomes. Child pain catastrophizing may be a fruitful target in interventions to improve children's chronic pain and mental health outcomes. Copyright © 2017 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  17. A review of current evidence regarding the ICD-11 proposals for diagnosing PTSD and complex PTSD.

    Science.gov (United States)

    Brewin, Chris R; Cloitre, Marylène; Hyland, Philip; Shevlin, Mark; Maercker, Andreas; Bryant, Richard A; Humayun, Asma; Jones, Lynne M; Kagee, Ashraf; Rousseau, Cécile; Somasundaram, Daya; Suzuki, Yuriko; Wessely, Simon; van Ommeren, Mark; Reed, Geoffrey M

    2017-12-01

    The World Health Organization's proposals for posttraumatic stress disorder (PTSD) in the 11th edition of the International Classification of Diseases, scheduled for release in 2018, involve a very brief set of symptoms and a distinction between two sibling disorders, PTSD and Complex PTSD. This review of studies conducted to test the validity and implications of the diagnostic proposals generally supports the proposed 3-factor structure of PTSD symptoms, the 6-factor structure of Complex PTSD symptoms, and the distinction between PTSD and Complex PTSD. Estimates derived from DSM-based items suggest the likely prevalence of ICD-11 PTSD in adults is lower than ICD-10 PTSD and lower than DSM-IV or DSM-5 PTSD, but this may change with the development of items that directly measure the ICD-11 re-experiencing requirement. Preliminary evidence suggests the prevalence of ICD-11 PTSD in community samples of children and adolescents is similar to DSM-IV and DSM-5. ICD-11 PTSD detects some individuals with significant impairment who would not receive a diagnosis under DSM-IV or DSM-5. ICD-11 CPTSD identifies a distinct group who have more often experienced multiple and sustained traumas and have greater functional impairment than those with PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Metabolic syndrome: relative risk associated with post-traumatic stress disorder (PTSD) severity and antipsychotic medication use.

    Science.gov (United States)

    Heppner, Pia S; Lohr, James B; Kash, Taylor P; Jin, Hua; Wang, Hongjun; Baker, Dewleen G

    2012-01-01

    In recent years, numerous lines of converging evidence have revealed an association between post-traumatic stress disorder (PTSD) and impaired physical health outcomes, including cardiovascular disease and metabolic syndrome. Although these findings have been interpreted as indicating a direct association of PTSD with metabolic syndrome and obesity, previous studies have not addressed the important confound of antipsychotic drug usage in this population. Second generation antipsychotic medications themselves are associated with metabolic syndrome and obesity, and it is unclear whether the common utilization of these drugs in PTSD may account for some if not all of the observed metabolic problems. The present study examined the relative contributions of PTSD severity and use of antipsychotic medications to risk of metabolic syndrome among veterans. Cross-sectional clinical data, including five factors representing metabolic syndrome, psychiatric diagnoses, and medications were gathered from 253 veterans enrolling in mental health services. We used a logistic regression model to measure the relative association of antipsychotic medication use and PTSD severity on risk of metabolic syndrome. We found that antipsychotic medication usage was not uniquely associated with elevated risk of metabolic syndrome (Wald = 0.30, ns) when PTSD severity and other sociodemographic, psychiatric, and behavioral variables were accounted for. Furthermore, PTSD severity continued to be a significant and unique predictor of risk for metabolic syndrome (Wald = 4.04, p PTSD, independent of antipsychotic medications, is associated with increased risk of metabolic syndrome. Published by Elsevier Inc.

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

    Science.gov (United States)

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

    2017-04-01

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

  20. Self-Compassion as a Prospective Predictor of PTSD Symptom Severity Among Trauma-Exposed U.S. Iraq and Afghanistan War Veterans

    Science.gov (United States)

    Hiraoka, Regina; Meyer, Eric C.; Kimbrel, Nathan A.; DeBeer, Bryann B.; Gulliver, Suzy Bird; Morissette, Sandra B.

    2016-01-01

    U. S. combat veterans of the Iraq and Afghanistan wars have elevated rates of posttraumatic stress disorder (PTSD) compared to the general population. Self-compassion, characterized by self-kindness, a sense of common humanity when faced with suffering, and mindful awareness of suffering, is a potentially modifiable factor implicated in the development and maintenance of PTSD. We examined the concurrent and prospective relationship between self-compassion and PTSD symptom severity after accounting for level of combat exposure and baseline PTSD severity. Participants at baseline assessment were 115 Iraq and Afghanistan war veterans exposed to 1 or more traumatic events during deployment (n = 101 at follow-up). PTSD symptoms were assessed using the Clinician Administered PTSD Scale for DSM-IV at baseline and 12 months. Self-compassion and combat exposure were assessed at baseline via self-report. Self-compassion was associated with baseline PTSD symptoms after accounting for combat exposure (β = −.59; p PTSD symptom severity after accounting for combat exposure and baseline PTSD severity (β = −.24; p = .008; ΔR2 = .03; f2 = .08; small effect). Findings suggest that interventions that increase self-compassion may be beneficial for treating chronic PTSD symptoms among some Iraq and Afghanistan war veterans. PMID:25808565

  1. Complete versus incomplete revascularization with drug-eluting stents for multi-vessel disease in stable, unstable angina or non-ST-segment elevation myocardial infarction: A meta-analysis.

    Science.gov (United States)

    Ando, Tomo; Takagi, Hisato; Grines, Cindy L

    2017-08-01

    To determine whether drug-eluting stent (DES) coronary complete revascularization (CR) confers clinical benefit over incomplete revascularization (IR) in patients with multivessel coronary artery disease (MVD). Clinical benefit of CR over IR in patients with MVD with angina (both stable and unstable) and non-ST-segment elevation myocardial infarction (NSTEMI) in DES has not been well studied. We conducted a systematic online literature search of PUBMED and EMBASE. Literatures that compared the clinical outcomes between CR and IR with exclusively or majority (>80%) using DES in patients without or included only small portion (meta-analysis. CR was associated with lower incident of all-cause mortality (HR 0.71, P = 0.001), major adverse events (HR 0.75, P Meta-regression analysis showed that CR significantly reduced the risk of all-cause mortality in advanced age, triple vessel disease and male sub-groups. CR with DES conferred favorable outcomes compared to IR in MVD patients with stable, unstable angina or NTEMI. Further research to achieve higher CR in MVD patients may lead to improvement in prognosis in these cohorts. © 2017, Wiley Periodicals, Inc.

  2. Common paths to ASD and PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

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

  3. ASD and PTSD in Rape Victims

    DEFF Research Database (Denmark)

    Elklit, Ask; Christiansen, Dorte M

    2010-01-01

    In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims...... shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A2 and F criteria was best identified by classifying...... victims according to a full ASD diagnosis. Regardless of whether cases were classified according to full PTSD status or according to meeting the criteria for the three PTSD core symptom clusters, the classification was correct only in approximately two thirds of the cases. A regression analysis based...

  4. Dual-hormone stress reactivity predicts downstream war-zone stress-evoked PTSD.

    Science.gov (United States)

    Josephs, Robert A; Cobb, Adam R; Lancaster, Cynthia L; Lee, Han-Joo; Telch, Michael J

    2017-04-01

    The crucial role of the hypothalamic-pituitary-adrenal axis (HPA) in stress-related homeostasis suggests dysregulated HPA involvement in the pathogenesis of post-traumatic stress disorder (PTSD), yet most studies examining linkages between HPA axis measures and PTSD have yielded null findings. One untested explanation for this inconsistency is a failure to account for simultaneous adrenal and gonadal influence. Here we tested the singular and interactive effects of cortisol (C R ) and testosterone (T R ) reactivity as moderators of war-zone stress evoked PTSD emergence in the war-zone. U.S. soldiers (N=120) scheduled for deployment to Iraq completed pre-deployment measures of C R and T R stress reactivity to a CO 2 inhalation challenge. Once deployed, monthly assessments of exposure to traumatic war-zone stressors and PTSD symptoms were collected via a web-based assessment system. Cortisol hypo-reactivity potentiated the pathogenic impact of war-zone stressors only in soldiers for whom the CO 2 challenge did not elevate testosterone, suggesting that the dual hormone stress reactivity profile of blunted cortisol and testosterone may confer increased risk for PTSD emergence by potentiating the pathogenic effects of war-zone stressors. Findings underscore the utility of assessing both HPA and HPG stress reactivity when assessing PTSD vulnerability and may help inform efforts for enhanced soldier screening and inoculation to war-zone stressors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. PTSD co-morbid with HIV: Separate but equal, or two parts of a whole?

    Science.gov (United States)

    Neigh, Gretchen N; Rhodes, Siara T; Valdez, Arielle; Jovanovic, Tanja

    2016-08-01

    Approximately 30 million people currently live with HIV worldwide and the incidence of stress-related disorders, such as post-traumatic stress disorder (PTSD), is elevated among people living with HIV as compared to those living without the virus. PTSD is a severely debilitating, stress-related psychiatric illness associated with trauma exposure. Patients with PTSD experience intrusive and fearful memories as well as flashbacks and nightmares of the traumatic event(s) for much of their lives, may avoid other people, and may be constantly on guard for new negative experiences. This review will delineate the information available to date regarding the comorbidity of PTSD and HIV and discuss the biological mechanisms which may contribute to the co-existence, and potential interaction of, these two disorders. Both HIV and PTSD are linked to altered neurobiology within areas of the brain involved in the startle response and altered function of the hypothalamic-pituitary-adrenal axis. Collectively, the data highlighted suggest that PTSD and HIV are more likely to actively interact than to simply co-exist within the same individual. Multi-faceted interactions between PTSD and HIV have the potential to alter response to treatment for either independent disorder. Therefore, it is of great importance to advance the understanding of the neurobiological substrates that are altered in comorbid PTSD and HIV such that the most efficacious treatments can be administered to improve both mental and physical health and reduce the spread of HIV. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Veteran-child communication about parental PTSD: A mixed methods pilot study.

    Science.gov (United States)

    Sherman, Michelle D; Larsen, Jessica; Straits-Troster, Kristy; Erbes, Christopher; Tassey, John

    2015-08-01

    The majority of adults with posttraumatic stress disorder (PTSD) are parents. Parents with PTSD report lower levels of parenting satisfaction, poorer parent-child relationships, and elevated incidence of child distress and behavioral problems in comparison with parents without PTSD. Although literature exists regarding parent-child communication about serious mental illness and physical health problems, research has yet to examine this communication regarding parental PTSD. This 3-site, mixed methods study involved 19 veteran parents who had a diagnosis of PTSD; participants were recruited from VA medical centers. Veterans participated in focus groups or individual interviews and completed questionnaires, responding to questions about motivations and barriers for disclosure of their PTSD to their children, the content of such disclosure, experiences at the VA as a parent, and desired VA family resources. Although many veterans described a desire to talk with their children about PTSD, they experience many barriers to doing so, including both personal reservations and feelings (e.g., avoidance of discussing PTSD, shame) and concerns about the consequences of disclosure on their children (e.g., child distress, loss of child's respect for veteran). Regarding veterans' experience at the VA, 21% reported that none of their providers had assessed if they have children, and 21% experienced the VA system as not welcoming to them as parents, citing both logistical issues (e.g., lack of childcare) and provider neglect of parenting concerns. Veterans indicated they would like the VA to offer parenting classes, workshops for families, child care, and family therapy. (c) 2015 APA, all rights reserved).

  7. Factors predicting risk for PTSD among highly exposed civilians: two longitudinal studies.

    Science.gov (United States)

    Ben-Ezra, Menachem; Palgi, Yuval; Hamama-Raz, Yaira; Shrira, Amit

    2015-03-01

    The impact of exposure to constant, prolonged, life threatening, war-related stress is understudied. Previous studies did not examine stressors with an objective history of exposure to a traumatic event such as armed conflict. A set of predictors were assessed in two longitudinal studies. The studies included a civilian population (Study 1, N = 194; Study 2, N = 26) that was exposed to war-related stress. Both groups had a documented objective history of the stressor. A set of logistic regression models in Study 1 and an hierarchical multiple regression in Study 2 were conducted in order to assess the relationship between various predictors from the aforementioned domains and PTSD symptoms. In Study 1, having an elevated risk for clinical level of ASD led to a higher probability of elevated risk for clinical level of PTSD (odds ratio = 7.772, 95% CI 1.225-49.300; p PTSD symptoms (standardized β = .644; t = 3.183; p PTSD in studies which focused mainly on the impact of a single traumatic event, ASD was a major and potent predictor of PTSD in the current studies which focused on prolonged traumatic exposure to war-related stress.

  8. Genetic and serum biomarker evidence for a relationship between TNFα and PTSD in Vietnam war combat veterans.

    Science.gov (United States)

    Bruenig, Dagmar; Mehta, Divya; Morris, Charles P; Harvey, Wendy; Lawford, Bruce; Young, Ross McD; Voisey, Joanne

    2017-04-01

    Posttraumatic stress disorder (PTSD) is associated with increased inflammation and comorbid medical conditions. However, study findings for individual inflammatory marker levels have been inconsistent. Some research suggests that resilience may play a role in decreased inflammation. A polymorphism in the promoter region of the tumor necrosis factor α gene (TNFα), TNFA -308 (rs1800629) is associated with psychiatric illness but its role in PTSD is yet to be elucidated. This study investigates a key inflammatory marker, TNFα, for its role in PTSD severity. In a cohort of trauma-exposed Vietnam War veterans (n=299; 159 cases, 140 controls) TNF α serum levels and TNFα polymorphism rs1800629 were correlated with PTSD severity and resilience scores. The polymorphism was associated with PTSD severity (p=0.045). There were significant group differences between cases and controls with regards to serum TNFα levels (p=0.036). Significant correlations were found between PTSD severity and elevated TNFα levels (r=0.153; p=0.009), and between resilience and decreased TNFα levels at a trend level (p=0.08) across the entire cohort. These relationships were non-significant after controlling for covariates. In the PTSD diagnostic group, a correlation of TNFα and PTSD severity was observed on a trend level (p=0.06), the relationship between TNFα and resilience remained non-significant. To our knowledge, this is the first time rs1800629 has been investigated in PTSD contributing to a growing body of literature that identifies the GG as a risk genotype for psychiatric disorders in Caucasian cohorts. However, more research is needed to replicate our results in larger, equally well-characterized cohorts. The relationship between serum TNFα levels and PTSD severity and resilience requires further investigation. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  9. Elevation of Non-Classical (CD14+/lowCD16++) Monocytes Is Associated with Increased Albuminuria and Urine TGF-β1 in HIV-Infected Individuals on Stable Antiretroviral Therapy.

    Science.gov (United States)

    Mitchell, Brooks I; Byron, Mary Margaret; Ng, Roland C; Chow, Dominic C; Ndhlovu, Lishomwa C; Shikuma, Cecilia M

    2016-01-01

    High rates of albuminuria are observed among HIV-infected individuals on stable antiretroviral therapy (ART). Though pro-inflammatory and pro-fibrotic responses are described as components of albuminuria in the general population, it is unclear how these responses are associated to albuminuria in ART-treated chronic HIV. We investigated the relationship of monocyte subsets and urine inflammatory and fibrotic biomarkers to albuminuria in ART-treated HIV-infected participants. Cross-sectional analyses were performed on Hawaii Aging with HIV-cardiovascular disease study cohort participants who were required at entry to be ≥40 years old and on ART ≥3 months. Monocyte subpopulations were determined in banked peripheral blood mononuclear cells (PBMC) using multi-parametric flow-cytometry. Entry random urine samples were assessed for albumin-to-creatinine ratios (UACR). Urine samples were measured for inflammatory and fibrotic biomarkers using Luminex technology. Among 96 HIV-infected subjects with measured UACR (87% male, 59% Caucasian, and 89% undetectable HIV RNA with median CD4 of 495.5 cells/μL), 18 patients (19%) had albuminuria. Non-classical (CD14low/+CD16++) monocytes were significantly elevated in subjects with albuminuria (p = 0.034) and were correlated to UACR (r = 0.238, p = 0.019). Elevated non-classical monocyte counts were significant predictors of worsening albuminuria, independent of traditional- and ART-associated risk factors (β = 0.539, p = 0.007). Urine TGF-β1 and collagen-IV were significantly higher in albuminuric compared to non-albuminuric participants (TGF-β1; p = 0.039 and collagen-IV; p = 0.042). Urine TGF-β1 was significantly correlated with non-classical monocyte counts (r = 0.464, p = 0.017). Alterations in monocyte subpopulations and urine pro-fibrotic factors may play a role in kidney dysfunction during chronic HIV infection and warrants further study.

  10. A PTSD Scale for the MCMI.

    Science.gov (United States)

    Choca, James P.; And Others

    A post-traumatic stress disorder (PTSD) scale for the Millon Clinical Multiaxial Inventory (MCMI) was developed using an outpatient sample consisting of 45 clients meeting criteria for the PTSD syndrome in accordance with the Diagnostic and Statistical Manual (DSM-III), and an equal number of matched controls. The scale was derived empirically by…

  11. The psychobiology of PTSD: coping with trauma

    NARCIS (Netherlands)

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

    2005-01-01

    Posttraumatic stress disorder (PTSD) is one of the few psychiatric conditions where a specific psychosocial stressor is explicitly tied to etiology. Although a majority of people experience a traumatic event in their life, most of them will not develop PTSD or other mental health problems such as

  12. Sexual Revictimization and PTSD: An Exploratory Study.

    Science.gov (United States)

    Arata, Catalina M.

    1999-01-01

    This study examines the relationship between adult/adolescent sexual revictimization and the development of Post Traumatic Stress Disorder (PTSD) in women with histories of child sexual abuse (N=41). Results show that women with repeated victimization were significantly more likely to have a lifetime diagnosis of PTSD, and the majority of repeated…

  13. Return to work: Police personnel and PTSD

    NARCIS (Netherlands)

    Plat, Marie-Christine J.; Westerveld, Gre J.; Hutter, Renée C.; Olff, Miranda; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2013-01-01

    This study i) describes the number of police personnel with PTSD who are working and those who are on sick leave before and after an out-patient-clinic treatment program and ii) examines which factors are related to return to work. Police personnel treated for PTSD (n=121). In this retrospective

  14. ASD and PTSD in Rape Victims

    Science.gov (United States)

    Elklit, Ask; Christiansen, Dorte M.

    2010-01-01

    In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD…

  15. Alternative models of DSM-5 PTSD

    DEFF Research Database (Denmark)

    Murphy, Siobhan; Hansen, Maj; Elklit, Ask

    2018-01-01

    The factor structure of DSM-5 posttraumatic stress disorder (PTSD) has been extensively debated with evidence supporting the recently proposed seven-factor Hybrid model. However, despite myriad studies examining PTSD symptom structure few have assessed the diagnostic implications of these proposed...... models. This study aimed to generate PTSD prevalence estimates derived from the 7 alternative factor models and assess whether pre-established risk factors associated with PTSD (e.g., transportation accidents and sexual victimisation) produce consistent risk estimates. Seven alternative models were...... estimated within a confirmatory factor analytic framework using the PTSD Checklist for DSM-5 (PCL-5). Data were analysed from a Malaysian adolescent community sample (n=481) of which 61.7% were female, with a mean age of 17.03 years. The results indicated that all models provided satisfactory model fit...

  16. PTSD in older bereaved people

    DEFF Research Database (Denmark)

    O'Connor, Maja

    2010-01-01

      Late life bereavement has been associated with psychological problems, mainly depression. A few studies indicated that Posttraumatic Stress Disorder (PTSD) was an important issue to investigate in late life bereavement reactions. This study aimed to assess the prevalence of PTSD in recently...... bereaved elderly people compared to married controls and to investigate whether the loss of a spouse in old age, in contrast with earlier assumptions, could lead to PTSD. Two hundred and ninety six Danish elderly bereaved people (mean age 73 years, 113 males) were chosen from national registers and were...... subsequently assessed two months post-bereavement. They were compared with a control group of 276 married elderly people. The prevalence of PTSD and depression were measured through a self-report questionnaire. Results showed that 16% of the bereaved and 4% of the control group had a PTSD diagnosis (ES=.35...

  17. Recovery from PTSD following Hurricane Katrina.

    Science.gov (United States)

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

    2011-06-01

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

  18. Rape survivors' trauma-related beliefs before and after Cognitive processing therapy: associations with PTSD and depression symptoms.

    Science.gov (United States)

    Iverson, Katherine M; King, Matthew W; Cunningham, Katherine C; Resick, Patricia A

    2015-03-01

    This study examined whether cognitive distortions (i.e., assimilated and overaccommodated thoughts) and realistic (i.e., accommodated) thoughts assessed from impact statements written 5-10 years after completing cognitive processing therapy (CPT) accurately predicted posttreatment maintenance or decline in treatment gains during the same period. The sample included 50 women diagnosed with posttraumatic stress disorder (PTSD) secondary to rape who participated in a randomized clinical trial of CPT for PTSD. Cognitions were assessed via coding and analyses of participants' written impact statements at three time points: beginning of treatment, end of treatment, and at 5-10 years follow-up. Primary mental health outcomes were symptoms of PTSD (Clinician-Administered PTSD Scale) and depression (Beck Depression Inventory). Changes in trauma-related beliefs between the end of treatment and long-term follow-up were associated with concomitant changes in PTSD and depression symptoms (effect sizes ranging from r = .35-.54). Declines in accommodated thinking and increases in overaccommodated thinking were associated with elevations in symptomatology. Improvement in accommodated thinking and declines in overaccommodated thinking were associated with lower PTSD and depression symptoms during this same time period. Findings provided support for the role of changes in accommodated and overaccommodated thinking being associated with level of PTSD and depression many years after participating in CPT. Published by Elsevier Ltd.

  19. Examining various subthreshold definitions of PTSD using the Clinician Administered PTSD Scale for DSM-5.

    Science.gov (United States)

    Franklin, C Laurel; Raines, Amanda M; Chambliss, Jessica L; Walton, Jessica L; Maieritsch, Kelly P

    2018-07-01

    The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychiatric Association [APA], 2013) includes Other- and Unspecified- Trauma and Stressor-Related Disorders to capture subthreshold Posttraumatic Stress Disorder (PTSD) symptoms. However, the DSM-5 does not specify the number or type of symptoms needed to assign them. The purpose of the current study was to extend our understanding of subthreshold PTSD by comparing four commonly used definitions adapted to the DSM-5 PTSD criteria in an outpatient treatment-seeking sample. Veterans (N = 193) presenting to PTSD clinics were assessed using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5). Participants reported a criterion A traumatic event, but did not meet criteria for threshold-PTSD. We hypothesized that the number of veterans captured would be highest when fewer specific criterion sets were required by the subthreshold definition. Our hypothesis was upheld in that the more criteria required by the subthreshold PTSD definition, the lower the number of veterans counted within the group. The study consisted primarily of trauma treatment-seeking male veterans, with chronic PTSD symptoms. In addition, the sample size was small and was collected as part of routine clinical care. These results support previous contentions around careful decision making when defining what constitutes subthreshold PTSD in research and clinical work. It also points to the need for continued research to better understand the diagnostic and treatment implications of subthreshold PTSD. Published by Elsevier B.V.

  20. 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.

  1. PTSD

    African Journals Online (AJOL)

    as a condition of memory impairment3 that manifests only in psycho-genetically ... When presented with visual or auditory fear-inducing stimuli, ... relevant memory. Why we need targeted therapy: The complex nature of trauma and delayed re-experiencing. As alluded to above, a rapid neuronal response at the time of first.

  2. PTSD in Depressed Mothers in Home Visitation

    Science.gov (United States)

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

    2013-01-01

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

  3. Distress in spouses of service members with symptoms of combat-related PTSD: secondary traumatic stress or general psychological distress?

    Science.gov (United States)

    Renshaw, Keith D; Allen, Elizabeth S; Rhoades, Galena K; Blais, Rebecca K; Markman, Howard J; Stanley, Scott M

    2011-08-01

    Combat-related posttraumatic stress disorder (PTSD) is linked with elevated psychological distress in service members'/veterans' spouses. Researchers use a variety of terms to describe this distress, and recently, secondary traumatic stress and secondary traumatic stress disorder (STS/STSD) have become increasingly commonly used. Although STS/STSD connotes a specific set of symptoms that are linked to service members'/veterans' symptoms, researchers often use general measures of distress or generically worded measures of PTSD symptoms to assess STS/STSD. To determine how often scores on such measures appear to be an accurate reflection of STS/STSD, we examined responses to a measure of PTSD symptoms in 190 wives of male service members with elevated levels of PTSD symptoms. Wives rated their own PTSD symptoms, and then answered questions about their attributions for the symptoms they endorsed. Fewer than 20% of wives who endorsed symptoms on the PTSD measure attributed these symptoms completely to their husbands' military experiences. Moreover, compared with wives who attributed symptoms only to events in their own lives, wives who attributed symptoms completely or partially to their husbands' military experiences had a greater overlap between some of their responses on the PTSD measure and their responses to a measure of general psychological distress. These results suggest that most wives of service members/veterans with PTSD experience generic psychological distress that is not conceptually consistent with STS/STSD, although a subset does appear to endorse a reaction consistent with this construct. Implications of these findings for intervention and research with this vulnerable population are discussed.

  4. Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters.

    Science.gov (United States)

    Stanley, Ian H; Hom, Melanie A; Spencer-Thomas, Sally; Joiner, Thomas E

    2017-08-01

    Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model. Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Longitudinal course of anxiety sensitivity and PTSD symptoms in cognitive-behavioral therapies for PTSD.

    Science.gov (United States)

    Gutner, Cassidy A; Nillni, Yael I; Suvak, Michael; Wiltsey-Stirman, Shannon; Resick, Patricia A

    2013-10-01

    Anxiety sensitivity (AS) has been conceptualized as trait-like vulnerability and maintenance factor for PTSD. Although recent literature has demonstrated its malleability during treatment, few have examined its influence on and effect from PTSD treatment. Using multilevel regression analyses we examined: (a) changes in AS during treatment and (b) whether pre-treatment AS predicted PTSD treatment response, in sample of female victims of interpersonal trauma receiving one of three treatments (cognitive processing therapy, cognitive processing therapy-cognitive, and written accounts). Participants exhibited reductions in total ASI scores from pre- to post-treatment. Growth curve modeling revealed slightly different trajectories of PTSD symptoms as a function of pre-treatment AS, and overall decreases in PTSD symptoms during treatment were not associated with pretreatment AS. Pretreatment AS dimensions impacted PTSD total scores and symptoms clusters differentially. Clinical and theoretical implications for these results are discussed. Published by Elsevier Ltd.

  6. Traumatiske fødselsopplevelser og PTSD

    OpenAIRE

    Aashaug, Elisabeth

    2006-01-01

    ABSTRACT For a long time it has been known that a childbirth can bee traumatic for some women. With the changes in DSM-IV in 1994, the diagnosis of Posttraumatic Stress Disorder (PTSD) can be made based upon a traumatic birth experience. Based on a literature search, this paper look at the experience of a traumatic birth, and how it can develop into postnatal PTSD. It also looks at the incident, potential risk factors and treatment for postnatal PTSD. A MEDLINE, PSYCHLIT and COCHRANE...

  7. Elevation of Non-Classical (CD14+/lowCD16++ Monocytes Is Associated with Increased Albuminuria and Urine TGF-β1 in HIV-Infected Individuals on Stable Antiretroviral Therapy.

    Directory of Open Access Journals (Sweden)

    Brooks I Mitchell

    Full Text Available High rates of albuminuria are observed among HIV-infected individuals on stable antiretroviral therapy (ART. Though pro-inflammatory and pro-fibrotic responses are described as components of albuminuria in the general population, it is unclear how these responses are associated to albuminuria in ART-treated chronic HIV. We investigated the relationship of monocyte subsets and urine inflammatory and fibrotic biomarkers to albuminuria in ART-treated HIV-infected participants.Cross-sectional analyses were performed on Hawaii Aging with HIV-cardiovascular disease study cohort participants who were required at entry to be ≥40 years old and on ART ≥3 months. Monocyte subpopulations were determined in banked peripheral blood mononuclear cells (PBMC using multi-parametric flow-cytometry. Entry random urine samples were assessed for albumin-to-creatinine ratios (UACR. Urine samples were measured for inflammatory and fibrotic biomarkers using Luminex technology.Among 96 HIV-infected subjects with measured UACR (87% male, 59% Caucasian, and 89% undetectable HIV RNA with median CD4 of 495.5 cells/μL, 18 patients (19% had albuminuria. Non-classical (CD14low/+CD16++ monocytes were significantly elevated in subjects with albuminuria (p = 0.034 and were correlated to UACR (r = 0.238, p = 0.019. Elevated non-classical monocyte counts were significant predictors of worsening albuminuria, independent of traditional- and ART-associated risk factors (β = 0.539, p = 0.007. Urine TGF-β1 and collagen-IV were significantly higher in albuminuric compared to non-albuminuric participants (TGF-β1; p = 0.039 and collagen-IV; p = 0.042. Urine TGF-β1 was significantly correlated with non-classical monocyte counts (r = 0.464, p = 0.017.Alterations in monocyte subpopulations and urine pro-fibrotic factors may play a role in kidney dysfunction during chronic HIV infection and warrants further study.

  8. Predictors of PTSD and delayed PTSD after disaster: the impact of exposure and psychosocial resources.

    Science.gov (United States)

    Adams, Richard E; Boscarino, Joseph A

    2006-07-01

    In the present study we sought to identify factors associated with posttraumatic stress disorder (PTSD) following the World Trade Center Disaster (WTCD) and examine changes in PTSD status over time. Our data come from a two-wave, prospective cohort study of New York City adults who were living in the city on September 11, 2001. We conducted a baseline survey 1 year after the attacks (year 1), followed by a survey 1 year later (year 2). Overall, 2368 individuals completed the year 1 survey, and 1681 were interviewed at year 2. Analyses for year 1 indicated that being younger, being female, experiencing more WTCD events, reporting more traumatic events other than the WTCD, experiencing more negative life events, having low social support, and having low self-esteem increased the likelihood of PTSD. For year 2, being middle-aged, being Latino, experiencing more negative life events and traumas since the WTCD, and having low self-esteem increased the likelihood of PTSD. Exposure to WTCD events was not related to year 2 PTSD once other factors were controlled. Following previous research, we divided study respondents into four categories: resilient cases (no PTSD years 1 or 2), remitted cases (PTSD year 1 but not year 2), delayed cases (no PTSD year 1 but PTSD year 2), and acute cases (PTSD both years 1 and 2). Factors predicting changes in PTSD between year 1 and year 2 suggested that delayed PTSD cases were more likely to have been Latino, to have experienced more negative life events, and to have had a decline in self-esteem. In contrast, remitted cases experienced fewer negative life events and had an increase in self-esteem. We discuss these findings in light of the psychosocial context associated with community disasters and traumatic stress exposures.

  9. Nightmares that mislead to diagnosis of reactivation of PTSD

    OpenAIRE

    Roepke, Stefan; Hansen, Marie-Luise; Peter, Anita; Merkl, Angela; Palafox, Carla; Danker-Hopfe, Heidi

    2013-01-01

    Background: Sleep disturbance is a common characteristic of patients with post-traumatic stress disorder (PTSD). Besides the clinical descriptions of nightmares and insomnia, periodic limb movements (PLMs) are reported to co-occur in PTSD. Although the causal relationship between sleep disturbance and PTSD is not fully understood, sleep disturbance is an independent risk factor for the development and reactivation of PTSD. In contrast, the link between PTSD and REM sleep behaviour disorder (R...

  10. The STRONG STAR Multidisciplinary PTSD Research Consortium

    Science.gov (United States)

    2009-09-01

    movement desensitization and reprocessing ( EMDR ) for PTSD rape victims. J Trauma Stress 18:607-616. Saunders, J. B., Aasland, O. G., Babor, T. F., De La...reprocessing: Basic principles, protocols, and procedures. New York: Guilford. Shapiro F (1996) Eye movement desensitization and reprocessing ( EMDR ...Evaluation of controlled PTSD research. J Behavior Ther and Exp Psychiatr 27:209-218. Shapiro F (1999) Eye movement desensitization and reprocessing ( EMDR

  11. Proximal relationships between PTSD and drinking behavior

    Directory of Open Access Journals (Sweden)

    Debra Kaysen

    2014-12-01

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

  12. Stable isotopes

    International Nuclear Information System (INIS)

    Evans, D.K.

    1986-01-01

    Seventy-five percent of the world's stable isotope supply comes from one producer, Oak Ridge Nuclear Laboratory (ORNL) in the US. Canadian concern is that foreign needs will be met only after domestic needs, thus creating a shortage of stable isotopes in Canada. This article describes the present situation in Canada (availability and cost) of stable isotopes, the isotope enrichment techniques, and related research programs at Chalk River Nuclear Laboratories (CRNL)

  13. PTSD and Sexual Dysfunction in Men and Women.

    Science.gov (United States)

    Yehuda, Rachel; Lehrner, Amy; Rosenbaum, Talli Y

    2015-05-01

    Difficulties in sexual desire and function often occur in persons with posttraumatic stress disorder (PTSD), but many questions remain regarding the mechanisms underlying the occurrence of sexual problems in PTSD. The aim of this review was to present a model of sexual dysfunction in PTSD underpinned by an inability to regulate and redirect the physiological arousal needed for healthy sexual function away from aversive hyperarousal and intrusive memories. A literature review pertaining to PTSD and sexual function was conducted. Evidence for the comorbidity of sexual dysfunction and PTSD is presented, and biological and psychological mechanisms that may underlie this co-occurrence are proposed. This manuscript presents evidence of sexual dysfunction in conjunction with PTSD, and of the neurobiology and neuroendocrinology of PTSD and sexual function. Sexual dysfunction following trauma exposure may be mediated by PTSD-related biological, cognitive, and affective processes. The treatment of PTSD must include attention to sexual dysfunction and vice versa. © 2015 International Society for Sexual Medicine.

  14. Risk factors of post-traumatic stress disorder (PTSD) after Wenchuan earthquake: a case control study.

    Science.gov (United States)

    Cheng, Yongzhong; Wang, Fang; Wen, Jin; Shi, Yingkang

    2014-01-01

    Few clues were found in the literature about the independent risk factors for PTSD among earthquake survivors in Sichuan province three years after the 2008 earthquake. Ours was the first case-control study with matching factors of age and distance from the epicenter among survivors age 16 years or older, three years after the catastrophe. To identify independent risk factors for PTSD among earthquake survivors. We performed a population-based matched case-control study. The cases were drawn from earthquake areas three years after the Wenchuan earthquake, including 113 cases who met positive criteria for PTSD symptoms according to the PCL-C (PTSD Checklist-Civilian Version) score and 452 controls who did not meet the criteria. Cases and controls were matched individually by birth year (+ three years) and the town they lived in when the earthquake occurred. Independent risk factors for PTSD symptoms included two-week disease prevalence (odds ratio [OR],1.92; 95% confidence interval [CI],1.18-3.13), witnessing someone being killed in the earthquake (OR, 2.04;95%CI, 1.17-3.58), having no regular income after the earthquake (OR, 0.52; 95%CI, 0.28-0.98), receiving mental health support only one time after the earthquake (OR, 2.43; 95%CI, 1.09-5.42) and lower social support (lower PSSS score) (OR, 0.95; 95%CI, 0.93-0.97). Earthquake experience, suffering from physical illnesses, lack of stable income, and lower social support were associated with PTSD symptoms.

  15. A Longitudinal Study of PTSD in the Elderly Bereaved: Prevalence and Predictors

    DEFF Research Database (Denmark)

    O'Connor, Maja

    2010-01-01

    -report questionnaires measuring traumatic stress (HTQ), coping style (CSQ), crisis support (CSS), and personality (e.g. NEO-FFI). Elderly bereaved people (N=296, Mean=73 years) participated at two, 6, 13, and 18 months post bereavement. The control group consisted of married elderly people who had experienced at least...... one significant loss (N=276, Mean=70 years). The PTSD-frequency within the sample was high (16%) compared to the control group (4%) and remained stable across time. Individually analyzed each domain was a predictor of PTSD 18 months post loss. Most predictors remained stable across time....... A hierarchical regression analysis of the four domains predicted 49% of the variance, indicating a considerable overlap between the domains. Only one predictor, early posttraumatic distress, remained significant in the hierarchical model. The results confirm that loss of a spouse in old age is traumatic for some...

  16. Executive deficits in chronic PTSD related to political violence.

    Science.gov (United States)

    Kanagaratnam, Pushpa; Asbjørnsen, Arve E

    2007-01-01

    Twenty-two subjects with chronic PTSD were compared to 23 subjects with no diagnoses (NPD) on tests of executive functioning (EF) that are assumed to have clinical significance after exposure to political violence. The three cognitive components of EF, intentionality, inhibition and executive memory [Burgess, P. W., Alderman, N., Evans, J., Emslie, H., Wilson, B. A. (1998). The ecological validity of tests of executive function. Journal of the International Neuropsychological Society, 4, 547-58], were measured using the Tower of London, Stroop Color-Word Test and Wisconsin Card Sorting Test (WCST), respectively. The PTSD group was impaired on tasks measuring automatic processing and executive memory. Executive memory problems were related to elevated posttraumatic symptoms, but the executive components intentionality and inhibition did not differentiate the groups. Arousal and intrusive symptoms had no impact on intentionality. Posttraumatic symptoms are related to automatic processing problems and impairment in executive memory. Observed dysfunctions in mental flexibility could have a negative impact on the cognitive processing of traumatic memory, thus preventing from recovery.

  17. Comorbidity of PTSD, Major Depression, and Substance Use Disorder Among Adolescent Victims of the Spring 2011 Tornadoes in Alabama and Joplin, Missouri.

    Science.gov (United States)

    Adams, Zachary W; Danielson, Carla Kmett; Sumner, Jennifer A; McCauley, Jenna L; Cohen, Joseph R; Ruggiero, Kenneth J

    2015-01-01

    The purpose of this study was twofold: (1) to estimate the prevalence of comorbid posttraumatic stress disorder (PTSD), major depressive episode (MDE), and substance use disorder (SUD); and (2) to identify risk factors for patterns of comorbidity among adolescents affected by disasters. A population-based sample of 2,000 adolescents (51% female; 71% Caucasian, 26% African American) aged 12 to 17 years (M = 14.5, SD = 1.7) and their parents was recruited from communities affected by the spring 2011 tornadoes in Alabama and Joplin, Missouri. Participants completed structured telephone interviews assessing demographic characteristics, impact of disaster, prior trauma history, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), symptoms of posttraumatic stress disorder (PTSD) and major depressive episode (MDE), and substance use disorder (SUD) symptoms. Prevalence estimates were calculated for PTSD + MDE, PTSD + SUD, MDE + SUD, and PTSD + MDE + SUD. Hierarchical logistic regression was used to identify risk factors for each comorbidity profile. Overall prevalence since the tornado was 3.7% for PTSD + MDE, 1.1% for PTSD + SUD, 1.0% for MDE + SUD, and 0.7% for PTSD + MDE + SUD. Girls were significantly more likely than boys to meet criteria for PTSD + MDE and MDE + SUD (ps < .05). Female gender, exposure to prior traumatic events, and persistent loss of services were significant risk factors for patterns of comorbidity. Parental injury was associated with elevated risk for PTSD + MDE. Adolescents should be evaluated for comorbid problems, including SUD, following disasters so that appropriate referrals to evidence-based treatments can be made. Results suggest that screening procedures to identify adolescents at risk for comorbid disorders should assess demographic characteristics (gender), impact of the disaster on the family, and adolescents' prior history of stressful events.

  18. Auditory hallucinations and PTSD in ex-POWS

    DEFF Research Database (Denmark)

    Crompton, Laura; Lahav, Yael; Solomon, Zahava

    2017-01-01

    (PTSD) symptoms, over time. Former prisoners of war (ex-POWs) from the 1973 Yom Kippur War (n = 99) with and without PTSD and comparable veterans (n = 103) were assessed twice, in 1991 (T1) and 2003 (T2) in regard to auditory hallucinations and PTSD symptoms. Findings indicated that ex-POWs who suffered...... from PTSD reported higher levels of auditory hallucinations at T2 as well as increased hallucinations over time, compared to ex-POWs without PTSD and combatants who did not endure captivity. The relation between PTSD and auditory hallucinations was unidirectional, so that the PTSD overall score at T1...... predicted an increase in auditory hallucinations between T1 and T2, but not vice versa. Assessing the role of PTSD clusters in predicting hallucinations revealed that intrusion symptoms had a unique contribution, compared to avoidance and hyperarousal symptoms. The findings suggest that auditory...

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

    National Research Council Canada - National Science Library

    Shea, M. T; Hebert, Norman J

    2007-01-01

    The primary research aims are to examine the early longitudinal course of PTSD symptoms and test hypotheses regarding risk factors for chronic PTSD in military personnel returning from Iraq or Afghanistan...

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  2. Replicability and generalizability of PTSD networks

    DEFF Research Database (Denmark)

    Eiko I., Fried; Eidhof, Marloes B.; Palic, Sabina

    2018-01-01

    The growing literature conceptualizing mental disorders like Posttraumatic Stress Disorder (PTSD) as networks of interacting symptoms faces three key challenges. Prior studies predominantly used (a) small samples with low power for precise estimation, (b) non-clinical samples, and (c) single...... samples. This renders network structures in clinical data, and the extent to which networks replicate across datasets, unknown. To overcome these limitations, the present cross-cultural multisite study estimated regularized partial correlation networks of 16 PTSD symptoms across four datasets...... of traumatized patients receiving treatment for PTSD (total N=2,782). Despite differences in culture, trauma-type and severity of the samples, considerable similarities emerged, with moderate to high correlations between symptom profiles (0.43-0.82), network structures (0.62-0.74), and centrality estimates (0...

  3. The psychobiology of PTSD: coping with trauma.

    Science.gov (United States)

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

    2005-11-01

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

  4. Improving Voluntary Engagement for PTSD Treatment among Soldiers

    Science.gov (United States)

    2017-12-01

    disorder , early intervention, motivational enhancement therapy, service members, Army, Air Force 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...personnel who are experiencing symptoms of posttraumatic stress disorder (PTSD), but who are not currently engaged in PTSD treatment. The...who have a current PTSD diagnosis via local publicity. The recruitment period will extend over a period of 24 months. Following screening and a

  5. Data Elevator

    Energy Technology Data Exchange (ETDEWEB)

    2017-04-29

    Data Elevator: Efficient Asynchronous Data Movement in Hierarchical Storage Systems Multi-layer storage subsystems, including SSD-based burst buffers and disk-based parallel file systems (PFS), are becoming part of HPC systems. However, software for this storage hierarchy is still in its infancy. Applications may have to explicitly move data among the storage layers. We propose Data Elevator for transparently and efficiently moving data between a burst buffer and a PFS. Users specify the final destination for their data, typically on PFS, Data Elevator intercepts the I/O calls, stages data on burst buffer, and then asynchronously transfers the data to their final destination in the background. This system allows extensive optimizations, such as overlapping read and write operations, choosing I/O modes, and aligning buffer boundaries. In tests with large-scale scientific applications, Data Elevator is as much as 4.2X faster than Cray DataWarp, the start-of-art software for burst buffer, and 4X faster than directly writing to PFS. The Data Elevator library uses HDF5's Virtual Object Layer (VOL) for intercepting parallel I/O calls that write data to PFS. The intercepted calls are redirected to the Data Elevator, which provides a handle to write the file in a faster and intermediate burst buffer system. Once the application finishes writing the data to the burst buffer, the Data Elevator job uses HDF5 to move the data to final destination in an asynchronous manner. Hence, using the Data Elevator library is currently useful for applications that call HDF5 for writing data files. Also, the Data Elevator depends on the HDF5 VOL functionality.

  6. The impact of different diagnostic criteria on PTSD prevalence

    DEFF Research Database (Denmark)

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

    2007-01-01

    The diagnostic criteria for PTSD have undergone several changes in the last two decades. This may in part explain the great variance in PTSD prevalence found in existing research. The objective of this study is to investigate the influence of different diagnostic criteria and different combinations...... of criteria on PTSD prevalence. A sample of 242 Danish social work students (M =29.2 years) completed a list of potentially traumatizing events, major life events and the Harvard Trauma Questionnaire. A considerable difference in PTSD prevalence as a result of different diagnostic criteria of PTSD was found...

  7. Efficacy of Adjunctive Sleep Interventions for PTSD

    Science.gov (United States)

    2008-03-01

    included obstructive sleep apnea , lack of interest and incompatible time requests, substance use disorder, and severe ongoing psychiatric conditions...therapeutic strategies for post-deployment mental health difficulties, and provide novel information regarding predictors of sleep treatment response...Returning Veterans with PTSD: Preliminary Findings. Oral Presentation. Sleep 2008, June 7-12, 2008, Baltimore, MD • Walsh C, Germain A

  8. Forskning i musikterapi - posttraumatisk stressbelastning (PTSD)

    DEFF Research Database (Denmark)

    Beck, Bolette Daniels; Mumm, Helle

    2015-01-01

    Denne artikel præsenterer videnskabelige undersøgelser af musikterapi med mennesker, der har fået diagnosen PTSD. Der er forskningsmæssig evidens for at musikterapi kan reducere symptomer på posttraumatisk stress hos børn, unge og voksne. Undersøgelser af musikterapi med voksne med posttraumatisk...

  9. Amygdala habituation to emotional faces in adolescents with internalizing disorders, adolescents with childhood sexual abuse related PTSD and healthy adolescents.

    Science.gov (United States)

    van den Bulk, Bianca G; Somerville, Leah H; van Hoof, Marie-José; van Lang, Natasja D J; van der Wee, Nic J A; Crone, Eveline A; Vermeiren, Robert R J M

    2016-10-01

    Adolescents with internalizing disorders and adolescents with childhood sexual abuse related post-traumatic stress disorder (CSA-related PTSD) show a large overlap in symptomatology. In addition, brain research indicated hyper-responsiveness and sustained activation instead of habituation of amygdala activation to emotional faces in both groups. Little is known, however, about whether the same patterns of amygdala habituation are present in these two groups. The current study examined habituation patterns of amygdala activity to emotional faces (fearful, happy and neutral) in adolescents with a DSM-IV depressive and/or anxiety disorder (N=25), adolescents with CSA-related PTSD (N=19) and healthy controls (N=26). Behaviourally, the adolescents from the internalizing and CSA-related PTSD group reported more anxiety to fearful and neutral faces than adolescents from the control group and adolescents from the CSA-related PTSD group reacted slower compared to the internalizing group. At the whole brain level, there was a significant interaction between time and group within the left amygdala. Follow-up ROI analysis showed elevated initial activity in the amygdala and rapid habituation in the CSA-related PTSD group compared to the internalizing group. These findings suggest that habituation patterns of amygdala activation provide additional information on problems with emotional face processing. Furthermore, the results suggest there are differences in the underlying neurobiological mechanisms related to emotional face processing for adolescents with internalizing disorders and adolescents with CSA-related PTSD. Possibly CSA-related PTSD is characterized by a stronger primary emotional response driven by the amygdala. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Philip J Ebenezer

    Full Text Available 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.

  11. 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.

  12. Amygdala habituation to emotional faces in adolescents with internalizing disorders, adolescents with childhood sexual abuse related PTSD and healthy adolescents

    Directory of Open Access Journals (Sweden)

    Bianca G. van den Bulk

    2016-10-01

    Full Text Available Adolescents with internalizing disorders and adolescents with childhood sexual abuse related post-traumatic stress disorder (CSA-related PTSD show a large overlap in symptomatology. In addition, brain research indicated hyper-responsiveness and sustained activation instead of habituation of amygdala activation to emotional faces in both groups. Little is known, however, about whether the same patterns of amygdala habituation are present in these two groups. The current study examined habituation patterns of amygdala activity to emotional faces (fearful, happy and neutral in adolescents with a DSM-IV depressive and/or anxiety disorder (N = 25, adolescents with CSA-related PTSD (N = 19 and healthy controls (N = 26. Behaviourally, the adolescents from the internalizing and CSA-related PTSD group reported more anxiety to fearful and neutral faces than adolescents from the control group and adolescents from the CSA-related PTSD group reacted slower compared to the internalizing group. At the whole brain level, there was a significant interaction between time and group within the left amygdala. Follow-up ROI analysis showed elevated initial activity in the amygdala and rapid habituation in the CSA-related PTSD group compared to the internalizing group. These findings suggest that habituation patterns of amygdala activation provide additional information on problems with emotional face processing. Furthermore, the results suggest there are differences in the underlying neurobiological mechanisms related to emotional face processing for adolescents with internalizing disorders and adolescents with CSA-related PTSD. Possibly CSA-related PTSD is characterized by a stronger primary emotional response driven by the amygdala.

  13. Evaluating the stability of DSM-5 PTSD symptom network structure in a national sample of U.S. military veterans.

    Science.gov (United States)

    von Stockert, Sophia H H; Fried, Eiko I; Armour, Cherie; Pietrzak, Robert H

    2018-03-15

    Previous studies have used network models to investigate how PTSD symptoms associate with each other. However, analyses examining the degree to which these networks are stable over time, which are critical to identifying symptoms that may contribute to the chronicity of this disorder, are scarce. In the current study, we evaluated the temporal stability of DSM-5 PTSD symptom networks over a three-year period in a nationally representative sample of trauma-exposed U.S. military veterans. Data were analyzed from 611 trauma-exposed U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). We estimated regularized partial correlation networks of DSM-5 PTSD symptoms at baseline (Time 1) and at three-year follow-up (Time 2), and examined their temporal stability. Evaluation of the network structure of PTSD symptoms at Time 1 and Time 2 using a formal network comparison indicated that the Time 1 network did not differ significantly from the Time 2 network with regard to network structure (p = 0.12) or global strength (sum of all absolute associations, i.e. connectivity; p = 0.25). Centrality estimates of both networks (r = 0.86) and adjacency matrices (r = 0.69) were highly correlated. In both networks, avoidance, intrusive, and negative cognition and mood symptoms were among the more central nodes. This study is limited by the use of a self-report instrument to assess PTSD symptoms and recruitment of a relatively homogeneous sample of predominantly older, Caucasian veterans. Results of this study demonstrate the three-year stability of DSM-5 PTSD symptom network structure in a nationally representative sample of trauma-exposed U.S. military veterans. They further suggest that trauma-related avoidance, intrusive, and dysphoric symptoms may contribute to the chronicity of PTSD symptoms in this population. Published by Elsevier B.V.

  14. Personal wellbeing in posttraumatic stress disorder (PTSD): association with PTSD symptoms during and following treatment.

    Science.gov (United States)

    Berle, David; Hilbrink, Dominic; Russell-Williams, Clare; Kiely, Rachael; Hardaker, Laura; Garwood, Natasha; Gilchrist, Anne; Steel, Zachary

    2018-03-02

    It remains unclear to what extent treatment-related gains in posttraumatic stress disorder (PTSD) symptoms translate to improvements in broader domains of personal wellbeing, such as community connectedness, life achievement and security. We sought to determine whether: 1. personal wellbeing improves during the course of a treatment program and 2. changes in core symptom domains (PTSD, anxiety and depression) were associated with improvements in overall personal wellbeing. Participants (N = 124) completed the PTSD Checklist, the Depression and Anxiety Stress Scales and the Personal Wellbeing Index at the start and end of a 4-week Trauma Focused CBT residential program, as well as 3- and 9-months post-treatment. Personal wellbeing improved significantly across the 9-months of the study. Generalised estimating equations analyses indicated that (older) age and improvements in PTSD and depressive symptoms were independent predictors of personal wellbeing across time. Although personal wellbeing improved in tandem with PTSD symptoms, the magnitude of improvement was small. These findings highlight a need to better understand how improvements in personal wellbeing can be optimised following PTSD treatment.

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

    Science.gov (United States)

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

    2017-06-01

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

  16. Preventing PTSD with oxytocin: effects of oxytocin administration on fear neurocircuitry and PTSD symptom development in recently trauma-exposed individuals

    NARCIS (Netherlands)

    Frijling, Jessie L.

    2017-01-01

    Background: Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder which develops in approximately 10% of trauma-exposed individuals. Currently, there are few early preventive interventions available for PTSD. Intranasal oxytocin administration early posttrauma may prevent PTSD

  17. EFT (Emotional Freedom Techniques) and Resiliency in Veterans at Risk for PTSD: A Randomized Controlled Trial.

    Science.gov (United States)

    Church, Dawson; Sparks, Terry; Clond, Morgan

    2016-01-01

    Prior research indicates elevated but subclinical posttraumatic stress disorder (PTSD) symptoms as a risk factor for a later diagnosis of PTSD. This study examined the progression of symptoms in 21 subclinical veterans. Participants were randomized into a treatment as usual (TAU) wait-list group and an experimental group, which received TAU plus six sessions of clinical emotional freedom techniques (EFT). Symptoms were assessed using the PCL-M (Posttraumatic Checklist-Military) on which a score of 35 or higher indicates increased risk for PTSD. The mean pretreatment score of participants was 39 ± 8.7, with no significant difference between groups. No change was found in the TAU group during the wait period. Afterward, the TAU group received an identical clinical EFT protocol. Posttreatment groups were combined for analysis. Scores declined to a mean of 25 (-64%, P < .0001). Participants maintained their gains, with mean three-month and six-month follow-up PCL-M scores of 27 (P < .0001). Similar reductions were noted in the depth and breadth of psychological conditions such as anxiety. A Cohen's d = 1.99 indicates a large treatment effect. Reductions in traumatic brain injury symptoms (P = .045) and insomnia (P = .004) were also noted. Symptom improvements were similar to those assessed in studies of PTSD-positive veterans. EFT may thus be protective against an increase in symptoms and a later PTSD diagnosis. As a simple and quickly learned self-help method, EFT may be a clinically useful element of a resiliency program for veterans and active-duty warriors. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Clinical Decision-Making Following Disasters: Efficient Identification of PTSD Risk in Adolescents.

    Science.gov (United States)

    Danielson, Carla Kmett; Cohen, Joseph R; Adams, Zachary W; Youngstrom, Eric A; Soltis, Kathryn; Amstadter, Ananda B; Ruggiero, Kenneth J

    2017-01-01

    The present study aimed to utilize a Receiver Operating Characteristic (ROC) approach in order to improve clinical decision-making for adolescents at risk for the development of psychopathology in the aftermath of a natural disaster. Specifically we assessed theoretically-driven individual, interpersonal, and event-related vulnerability factors to determine which indices were most accurate in forecasting PTSD. Furthermore, we aimed to translate these etiological findings by identifying clinical cut-off recommendations for relevant vulnerability factors. Our study consisted of structured phone-based clinical interviews with 2000 adolescent-parent dyads living within a 5-mile radius of tornados that devastated Joplin, MO, and northern Alabama in Spring 2011. Demographics, tornado incident characteristics, prior trauma, mental health, and family support and conflict were assessed. A subset of youth completed two behavioral assessment tasks online to assess distress tolerance and risk-taking behavior. ROC analyses indicated four variables that significantly improved PTSD diagnostic efficiency: Lifetime depression (AUC = .90), trauma history (AUC = .76), social support (AUC = .70), and family conflict (AUC = .72). Youth were 2-3 times more likely to have PTSD if they had elevated scores on any of these variables. Of note, event-related characteristics (e.g., property damage) were not related to PTSD diagnostic status. The present study adds to the literature by making specific recommendations for empirically-based, efficient disaster-related PTSD assessment for adolescents following a natural disaster. Implications for practice and future trauma-related developmental psychopathology research are discussed.

  19. Over-reporting bias and the modified Stroop effect in Operation Enduring and Iraqi Freedom veterans with and without PTSD.

    Science.gov (United States)

    Constans, Joseph I; Kimbrell, Timothy A; Nanney, John T; Marx, Brian P; Jegley, Susan; Pyne, Jeffrey M

    2014-02-01

    The current study investigated in a sample of Operation Enduring and Iraqi Freedom (OEF/OIF) veterans how a symptom overreporting response style might influence the association between PTSD diagnostic status and color-naming response latency for trauma-related stimuli during the Modified Stroop Task (i.e., the Modified Stroop Task effect, MST effect). It was hypothesized that, if an overreporting response style reflected feigning or exaggerating PTSD symptoms, an attenuated MST effect would be expected in overreporters with PTSD as compared with PTSD-diagnosed veterans without an overreporting style. If, however, overreporting stemmed from high levels of distress, the MST effect might be greater in overreporters compared with those with a neutral response style. The results showed that veterans with PTSD and an overreporting response style demonstrated an augmented MST effect in comparison with those with a more neutral style of response. Overreporters also reported greater levels of psychopathology, including markedly elevated reports of dissociative experiences. We suggest that dissociation-prone overreporters may misattribute emotional distress to combat experiences leading to the enhanced MST effect. Other possible explanations for these results are also discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  20. Stable particles

    International Nuclear Information System (INIS)

    Samios, N.P.

    1994-01-01

    I have been asked to review the subject of stable particles, essentially the particles that eventually comprised the meson and baryon octets, with a few more additions - with an emphasis on the contributions made by experiments utilizing the bubble chamber technique. In this activity, much work had been done by the photographic emulsion technique and cloud chambers - exposed to cosmic rays as well as accelerator based beams. In fact, many if not most of the stable particles were found by these latter two techniques, however, the foree of the bubble chamber (coupled with the newer and more powerful accelerators) was to verify, and reinforce with large statistics, the existence of these states, to find some of the more difficult ones, mainly neutrals and further to elucidate their properties, i.e., spin, parity, lifetimes, decay parameters, etc. (orig.)

  1. Stable particles

    International Nuclear Information System (INIS)

    Samios, N.P.

    1993-01-01

    I have been asked to review the subject of stable particles, essentially the particles that eventually comprised the meson and baryon octets. with a few more additions -- with an emphasis on the contributions made by experiments utilizing the bubble chamber technique. In this activity, much work had been done by the photographic emulsion technique and cloud chambers-exposed to cosmic rays as well as accelerator based beams. In fact, many if not most of the stable particles were found by these latter two techniques, however, the forte of the bubble chamber (coupled with the newer and more powerful accelerators) was to verify, and reinforce with large statistics, the existence of these states, to find some of the more difficult ones, mainly neutrals and further to elucidate their properties, i.e., spin, parity, lifetimes, decay parameters, etc

  2. Monocular Elevation Deficiency - Double Elevator Palsy

    Science.gov (United States)

    ... Español Condiciones Chinese Conditions Monocular Elevation Deficiency/ Double Elevator Palsy En Español Read in Chinese What is monocular elevation deficiency (Double Elevator Palsy)? Monocular Elevation Deficiency, also known by the ...

  3. Latent profiles of DSM-5 PTSD symptoms and the "Big Five" personality traits.

    Science.gov (United States)

    Contractor, Ateka A; Armour, Cherie; Shea, M Tracie; Mota, Natalie; Pietrzak, Robert H

    2016-01-01

    Typologies of DSM-5 PTSD symptoms and personality traits were evaluated in regard to coping styles and treatment preferences using data from 1266 trauma-exposed military veterans of which the majority were male (n=1097; weighted 89.6%). Latent profile analyses indicated a best-fitting 5-class solution; PTSD asymptomatic and emotionally stable (C1); predominant re-experiencing and avoidance symptoms and less emotionally stable (C2); subsyndromal PTSD (C3); predominant negative alterations in mood/cognitions and combined internalizing-externalizing traits (C4); and high PTSD severity and combined internalizing-externalizing traits (C5). Compared to C5, C1 members were less likely to use self-distraction, denial, and substance use and more likely to use active coping; C2 and C4 members were less likely to use denial and more likely to use behavioral disengagement; C3 members were less likely to use denial and instrumental coping and more likely to use active coping; most classes were less likely to seek mental health treatment. Compared to C1, C2 members were more likely to use self-distraction, substance use, behavioral disengagement and less likely to use active coping; C3 members were more likely to use self-distraction, and substance use, and less likely to use positive reframing, and acceptance; and C4 members were more likely to use denial, substance use, emotional support, and behavioral disengagement, and less likely to use active coping, positive reframing, and acceptance; all classes were more likely to seek mental health treatment. Emotional stability was most distinguishing of the typologies. Other implications are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. The impact of intolerance of emotional distress and uncertainty on veterans with co-occurring PTSD and substance use disorders.

    Science.gov (United States)

    Banducci, Anne N; Bujarski, Sarah J; Bonn-Miller, Marcel O; Patel, Amee; Connolly, Kevin M

    2016-06-01

    The risk of developing a substance use disorder (SUD) is significantly higher among veterans with posttraumatic stress disorder (PTSD). Veterans with this co-occurrence have poorer outcomes than singly diagnosed veterans, which may be related to two risk factors: intolerance uncertainty (IU) and low tolerance of emotional distress (TED). We hypothesized low TED and high IU would independently and interactively relate to heightened PTSD symptomatology and trauma-cue elicited SUD cravings. A sample of 70 veterans (M age=50; 95% men; 65% Black) with co-occurring PTSD-SUD was recruited. The Posttraumatic Stress Disorder Checklist (PCL), Craving Questionnaire, Distress Tolerance Scale, and Intolerance of Uncertainty Scale were administered. In general, low TED and high IU were significantly correlated with the PCL total and subscale scores. When examined within regression models, low TED was associated with elevated PCL scores and trauma-cue elicited SUD cravings; IU was not. However, there was a significant interaction between IU and TED; veterans with elevated IU and low TED had higher PCL Total, Hyperarousal, and Intrusions scores. This highlights the importance of assessing TED and IU among veterans with co-occurring PTSD-SUD, as these risk factors may not only be prognostic indicators of outcomes, but also treatment targets. Published by Elsevier Ltd.

  5. Stable beams

    CERN Multimedia

    2015-01-01

    Stable beams: two simple words that carry so much meaning at CERN. When LHC page one switched from "squeeze" to "stable beams" at 10.40 a.m. on Wednesday, 3 June, it triggered scenes of jubilation in control rooms around the CERN sites, as the LHC experiments started to record physics data for the first time in 27 months. This is what CERN is here for, and it’s great to be back in business after such a long period of preparation for the next stage in the LHC adventure.   I’ve said it before, but I’ll say it again. This was a great achievement, and testimony to the hard and dedicated work of so many people in the global CERN community. I could start to list the teams that have contributed, but that would be a mistake. Instead, I’d simply like to say that an achievement as impressive as running the LHC – a machine of superlatives in every respect – takes the combined effort and enthusiasm of everyone ...

  6. Predicting impaired extinction of traumatic memory and elevated startle.

    Directory of Open Access Journals (Sweden)

    Rebecca Nalloor

    Full Text Available Emotionally traumatic experiences can lead to debilitating anxiety disorders, such as phobias and Post-Traumatic Stress Disorder (PTSD. Exposure to such experiences, however, is not sufficient to induce pathology, as only up to one quarter of people exposed to such events develop PTSD. These statistics, combined with findings that smaller hippocampal size prior to the trauma is associated with higher risk of developing PTSD, suggest that there are pre-disposing factors for such pathology. Because prospective studies in humans are limited and costly, investigating such pre-dispositions, and thus advancing understanding of the genesis of such pathologies, requires the use of animal models where predispositions are identified before the emotional trauma. Most existing animal models are retrospective: they classify subjects as those with or without a PTSD-like phenotype long after experiencing a traumatic event. Attempts to create prospective animal models have been largely unsuccessful.Here we report that individual predispositions to a PTSD-like phenotype, consisting of impaired rate and magnitude of extinction of an emotionally traumatic event coupled with long-lasting elevation of acoustic startle responses, can be revealed following exposure to a mild stressor, but before experiencing emotional trauma. We compare, in rats, the utility of several classification criteria and report that a combination of criteria based on acoustic startle responses and behavior in an anxiogenic environment is a reliable predictor of a PTSD-like phenotype.There are individual predispositions to developing impaired extinction and elevated acoustic startle that can be identified after exposure to a mildly stressful event, which by itself does not induce such a behavioral phenotype. The model presented here is a valuable tool for studying the etiology and pathophysiology of anxiety disorders and provides a platform for testing behavioral and pharmacological

  7. Can 'partial' PTSD explain differences in diagnosis of PTSD by questionnaire self-report and interview after head injury?

    Science.gov (United States)

    Chalton, L D; McMillan, T M

    2009-02-01

    Can the concept of 'partial' PTSD explain the disparity between the relatively high incidence of PTSD found using self-report questionnaires and the relatively low incidence using structured interview? It was hypothesized that self-report of greater PTSD symptom severity is associated with increased heart rate and movement when responding to questions about the traumatic event, if 'partial' PTSD is an explanation. A within participants single group design. Twenty-one adults with head injury underwent self-report (Post-traumatic Stress Disorder Scale) and interview (Clinical Assessment of PTSD) assessments of PTSD, the Traumatic Memory Interview, self-report of mood (Hospital Anxiety and Depression Scale) and cognitive assessment (Wechsler Test of Adult Reading, Auditory Verbal Learning Test, Hayling Test, Digit Symbol Test), during which heart rate and motor activity were recorded. Self-report of greater PTSD symptom severity was not associated with increases in heart rate or movement during questions about the traumatic event. In fact, heart rate decreased from baseline in those with higher self-report scores for PTSD, consistent with curiosity about the traumatic event and not 'partial' PTSD. These preliminary findings agree with an emerging theme suggesting that, although PTSD can occur after head injury, it is easily over-diagnosed.

  8. Epigenetic Risk Factors in PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Florian Joachim Raabe

    2013-08-01

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

  9. 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...

  10. Assessing PTSD with the Millon Clinical Multiaxial Inventory-III.

    Science.gov (United States)

    Craig, R J; Olson, R

    1997-12-01

    We studied the utility of the Millon Clinical Multiaxial Inventory-III (MCMI-III) in assessing substance-abusing (n = 228), combat-related PTSD patients (n = 32). The MCMI-III produced a code type (16A) that was quite different from MCMI-I and MCMI-II code types (8A2) among similar populations. The PTSD Scale (R) successfully differentiated between a PTSD and non-PTSD substance-abusing group using mean Base Rate scores, was the best predictor of PTSD in a multiple regression equation, and the scale's sensitivity and specificity in detecting and/or ruling out the disorder was above that provided by chance alone and higher than the values reported in the test manual for that scale. The MCMI-III may be used as a broad band screening instrument for PTSD, at least among patients with combat-related stress.

  11. PTSD symptomics: network analyses in the field of psychotraumatology.

    Science.gov (United States)

    Armour, Cherie; Fried, Eiko I; Olff, Miranda

    2017-01-01

    Recent years have seen increasing attention on posttraumatic stress disorder (PTSD) research. While research has largely focused on the dichotomy between patients diagnosed with mental disorders and healthy controls - in other words, investigations at the level of diagnoses - recent work has focused on psychopathology symptoms. Symptomics research in the area of PTSD has been scarce so far, although several studies have focused on investigating the network structures of PTSD symptoms. The present special issue of EJPT adds to the literature by curating additional PTSD network studies, each looking at a different aspect of PTSD. We hope that this special issue encourages researchers to conceptualize and model PTSD data from a network perspective, which arguably has the potential to inform and improve the efficacy of therapeutic interventions.

  12. Predicting PTSD in women with a history of childhood rape.

    Science.gov (United States)

    Epstein, J N; Saunders, B E; Kilpatrick, D G

    1997-10-01

    The impact of factors that predispose childhood rape victims to develop posttraumatic stress disorder (PTSD) is important in understanding both the impact of childhood rape and the development of PTSD as a psychological disorder. The present study attempted to determine which crime, perpetrator, victim, and aftermath characteristics are related to PTSD status. A national representative sample of women (N = 3,220) were interviewed about their history of rape, trauma-related variables, and PTSD status. Consistent with research on crime victims, life threat and physical injury discriminated PTSD status in a sample of childhood rape victims. In addition, two other domains were related to PTSD development: (1) testification about rape and (2) rape types. The present findings are discussed in relation to previous research.

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

    Science.gov (United States)

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

    2011-04-01

    Two models of posttraumatic stress disorder (PTSD) have received the most empirical support in confirmatory factor analytic studies: King, Leskin, King, and Weathers' (1998) Emotional Numbing model of reexperiencing, avoidance, emotional numbing and hyperarousal; and Simms, Watson, and Doebbeling's (2002) Dysphoria model of reexperiencing, avoidance, dysphoria and hyperarousal. These models only differ in placement of three PTSD symptoms: sleep problems (D1), irritability (D2), and concentration problems (D3). In the present study, we recruited 252 women victims of domestic violence and tested whether there is empirical support to separate these three PTSD symptoms into a fifth factor, while retaining the Emotional Numbing and Dysphoria models' remaining four factors. Confirmatory factor analytic findings demonstrated that separating the three symptoms into a separate factor significantly enhanced model fit for the Emotional Numbing and Dysphoria models. These three symptoms may represent a unique latent construct. Implications are discussed. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. Enhancing Battlemind: Preventing PTSD by Coping with Intrusive Thoughts

    Science.gov (United States)

    2015-09-01

    Training enhancement (not treatment)  Addressing intrusive thoughts (secondary prevention of PTSD ?? decrease distress)  Mindfulness based intervention...AWARD NUMBER: W81XWH-09-1-0535 TITLE: Enhancing BATTLEMIND: Preventing PTSD by Coping with Intrusive Thoughts PRINCIPAL INVESTIGATOR...SUBTITLE 5a. CONTRACT NUMBER W81XWH-09-1-0535 Enhancing BATTLEMIND: Preventing PTSD by Coping With Intrusive Thoughts 5b. GRANT NUMBER 08194004

  15. Prospective Effects of Sexual Victimization on PTSD and Problem Drinking

    Science.gov (United States)

    Najdowski, Cynthia J.; Ullman, Sarah E.

    2009-01-01

    Posttraumatic stress disorder (PTSD) and problem drinking are common and often co-occurring sequelae experienced by women survivors of adult sexual assault, yet it remains unclear whether survivors drink to cope with PTSD symptoms or whether PTSD symptoms are exacerbated by drinking. Thus, we used a cross-lagged panel design with a large (N = 555), ethnically diverse sample of women assault survivors to determine whether PTSD prospectively led to problem drinking or vice versa. We also examined whether cumulative sexual victimization experiences related to greater PTSD and problem drinking. Structural equation modeling revealed that child sexual abuse was associated with greater symptoms of PTSD and problem drinking and intervening sexual victimization was associated with greater symptoms of PTSD and problem drinking 1 year later. We found no evidence, however, that PTSD directly influenced problem drinking over the long term, or vice versa. Rather, experiencing revictimization during the study predicted survivors' prospective PTSD and problem drinking symptoms. Implications and recommendations for future research are discussed. PMID:19501469

  16. Shamanic Healing for Veterans with PTSD: A Case Series.

    Science.gov (United States)

    Wahbeh, Helané; Shainsky, Lauri; Weaver, Angela; Engels-Smith, Jan

    Posttraumatic stress disorder (PTSD) is a serious health concern. Current evidence-based treatments for PTSD are efficacious; however, they are not appropriate or tolerated by everyone who needs them. Alternative treatment approaches are needed. Shamanic healing is one such therapy that may potentially be beneficial but no systematic research has been conducted on it for PTSD. The objectives of the case series are to (1) develop a structured replicable shamanic treatment plan for veterans with posttraumatic stress disorder (PTSD); (2) collect preliminary data on PTSD-related outcomes, and (3) explore the feasibility and potential for adverse events of the plan. Case series. Clinical. Veterans with PTSD. Shamanic healing. PTSD symptoms, quality of life, and piritual wellness. A semi-structured shamanic healing protocol was created with the following components: rapport building, power animal retrieval, extraction, compassionate spirit release, curse unraveling, soul retrieval, forgiveness/cord-cutting, aspect maturing/soul rematrixing, and divination. Six veterans enrolled in the study (mean age = 49.3 ± 13.1). Qualitative descriptions of the participants, their histories, and effects from the intervention are reported. Preliminary data was collected on PTSD-related outcomes. The protocol was found feasible and acceptable and recommendations for its future use are suggested. Future research is warranted and needed to evaluate the efficacy of shamanic healing as a potential therapy for veterans with PTSD. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Victimisation and PTSD in a Greenlandic Youth sample

    DEFF Research Database (Denmark)

    Karsberg, Sidsel; Lasgaard, Mathias; Elklit, Ask

    2012-01-01

    by others, and attempted suicide. The estimated lifetime prevalence of PTSD was 17.1%, whereas another 14.2% reached a subclinical level of PTSD (missing the full diagnosis by one symptom). Following exposure, girls were three times more likely to suffer from PTSD compared to boys. Education level...... of the father, type of school, living in a single parent household, and being exposed to multiple direct and indirect PTEs was significantly associated with an increase in PTSD symptoms. Conclusion: The findings indicate that various types of PTE’s which Greenlandic adolescents are exposed to, have...

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

    Science.gov (United States)

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

    2017-01-01

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

  19. 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. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Dresden PTSD treatment study: randomized controlled trial of motor vehicle accident survivors

    Directory of Open Access Journals (Sweden)

    Menning Hans

    2006-07-01

    Full Text Available Abstract Background We translated, modified, and extended a cognitive behavioral treatment (CBT protocol by Blanchard and Hickling (2003 for the purpose of treating survivors of MVA with full or subsyndromal posttraumatic stress disorder (PTSD whose native language is German. The treatment manual included some additional elements, e. g. cognitive procedures, imaginal reliving, and facilitating of posttraumatic growth. The current study was conducted in order to test the efficacy of the modified manual by administering randomized controlled trial in which a CBT was compared to a wait-list control condition. Methods Forty-two motor vehicle accident survivors with chronic or severe subsyndromal posttraumatic stress disorder (PTSD completed the treatment trial with two or three detailed assessments (pre, post, and 3-month follow-up. Results CAPS-scores showed significantly greater improvement in the CBT condition as compared to the wait list condition (group × time interaction effect size d = 1.61. Intent-to-treat analysis supported the outcome (d = 1.34. Categorical diagnostic data indicated clinical recovery of 67% (post-treatment and 76% (3 months FU in the treatment group. Additionally, patients of the CBT condition showed significantly greater reductions in co-morbid major depression than the control condition. At follow-up the improvements were stable in the active treatment condition. Conclusion The degree of improvement in our treatment group was comparable to that in previously reported treatment trials of PTSD with cognitive behavioral therapy. Trial registration ISRCTN66456536

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

    Science.gov (United States)

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

    2015-06-01

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

  2. A Prospective Study of Trait Anger and PTSD Symptoms in Police

    OpenAIRE

    Meffert, Susan M.; Metzler, Thomas J.; Henn-Haase, Clare; McCaslin, Shannon; Inslicht, Sabra; Chemtob, Claude; Neylan, Thomas; Marmar, Charles R.

    2008-01-01

    It is unknown whether anger is a risk factor for the development of posttraumatic stress disorder (PTSD) symptoms, arises as a consequence of PTSD, or both. Two hypotheses were tested in 180 police recruits: Greater trait anger during training will predict greater PTSD symptoms at one year; greater PTSD symptoms at one year will predict greater state anger at one year. Both hypotheses were confirmed, suggesting that trait anger is a risk factor for PTSD symptoms, but that PTSD symptoms are al...

  3. Posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as per ICD-11 proposals: A population study in Israel.

    Science.gov (United States)

    Ben-Ezra, Menachem; Karatzias, Thanos; Hyland, Philip; Brewin, Chris R; Cloitre, Marylene; Bisson, Jonathan I; Roberts, Neil P; Lueger-Schuster, Brigitte; Shevlin, Mark

    2018-02-16

    The current study sought to advance the existing literature by providing the first assessment of the factorial and discriminant validity of the ICD-11 proposals for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in a nationwide level. A nationally representative sample from Israel (n = 1,003) using a disorder-specific measure (ITQ; International Trauma Questionnaire) in order to assess PTSD and CPTSD along with the Life Events Checklist and the World Health Organization Well-Being Index. Estimated prevalence rates of PTSD and CPTSD were 9.0 and 2.6%, respectively. The structural analyses indicated that PTSD and disturbances in self-organization symptom clusters were multidimensional, but not necessarily hierarchical, in nature and there were distinct classes that were consistent with PTSD and CPTSD. These results partially support the factorial validity and strongly support the discriminant validity of the ICD-11 proposals for PTSD and CPTSD in a nationally representative sample using a disorder-specific measure; findings also supported the international applicability of these diagnoses. Further research is required to determine the prevalence rates of PTSD and CPTSD in national representative samples across different countries and explore the predictive utility of different types of traumatic life events on PTSD and CPTSD. © 2018 Wiley Periodicals, Inc.

  4. An elevator

    Energy Technology Data Exchange (ETDEWEB)

    Rastorguyev, M.A.; Maloyarovslavtesv, D.A.; Prokopov, O.I.; Tukayev, Sh.V.; Zanilov, I.F.

    1983-01-01

    An elevator is proposed which includes a body with a turning collar locking device and a rod with longitudinal grooves, which are flexibly linked with jaws positioned in grooves in the body. To increase safety through ensuring automatic locking of the jaws in the closed position, the locking device is made in the form of head on wedges, spring loaded relative to the collar and made with cams and positioned with the capability of interacting with the grooves of the rod and through the cams with the collar.

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

    Directory of Open Access Journals (Sweden)

    F. Jackie June ter Heide

    2016-02-01

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

  6. PTSD, depression, prescription drug use, and health care utilization of Chinese workers affected by the WTC attacks.

    Science.gov (United States)

    de Bocanegra, Heike Thiel; Moskalenko, Sophia; Kramer, Elizabeth J

    2006-07-01

    This study assessed the impact of the World Trade Center (WTC) attacks on emotional problems, prescription drug usage, and utilization of medical and mental health services within the Chinese community in lower Manhattan. We administered a survey to 148 randomly selected Chinese workers affected by the WTC attacks in March 2003. Although nearly half of the respondents had elevated PTSD and/or elevated depression scores, only a few (4.4%) had talked to a counselor. However, nearly all (86%) reported having visited a physician at least once since September 11, 2001. Individuals with elevated PTSD scores were significantly more likely to have gone to a physician after 9/11. They were also more likely to have received prescription drugs and to indicate an interest in counseling after 9/11 than individuals with low PTSD scores. The findings highlight the role of the primary care physician as gatekeeper for mental health symptoms after a disaster. They further suggest that primary care physicians should use screening tools for depression and posttraumatic stress after a major disaster and that they should be sensitive to potential emotional problems that are associated with somatic complaints.

  7. Cognitive-Behavioral Conjoint Therapy for PTSD Improves Various PTSD Symptoms and Trauma-related Cognitions: Results from a Randomized Controlled Trial

    OpenAIRE

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

    2015-01-01

    Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing C...

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

    Science.gov (United States)

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

    2017-09-01

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

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

    NARCIS (Netherlands)

    Rademaker, Arthur R.; van Minnen, Agnes; Ebberink, Freek; van Zuiden, Mirjam; Hagenaars, Muriel A.; Geuze, Elbert

    2012-01-01

    As of yet, no collective agreement has been reached regarding the precise factor structure of posttraumatic stress disorder (PTSD). Several alternative factor-models have been proposed in the last decades. The current study examined the fit of a hierarchical adaptation of the Simms et al. (2002)

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

    Science.gov (United States)

    Sessa, Ben

    2017-05-10

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

  11. Bucket elevator

    OpenAIRE

    Chromek, Jiří

    2013-01-01

    Cílem této bakalářské práce je návrh svislého korečkového elevátoru, který má sloužit k dopravě obilovin s dopravní výškou 19 m a dopravovaným množstvím 100 t/hod. Práce se skládá z popisu korečkového elevátoru a jeho hlavních částí, zmiňující se v úvodní rešerši. Tato práce je zaměřena na funkční a kapacitní výpočet, určení pohonu a napínacího zařízení. Další výpočet je kontrolní, skládající se z pevnostní kontroly hnacího hřídele, výpočtu pera, životnosti ložisek a výpočtu napínacího zaříze...

  12. Elevated Brain Cannabinoid CB1 Receptor Availability in Posttraumatic Stress Disorder: A Positron Emission Tomography Study

    Science.gov (United States)

    Neumeister, Alexander; Normandin, Marc D.; Pietrzak, Robert H.; Piomelli, Daniele; Zheng, Ming-Qiang; Gujarro-Anton, Ana; Potenza, Marc N.; Bailey, Christopher R.; Lin, Shu-fei; Najafzadeh, Soheila; Ropchan, Jim; Henry, Shannan; Corsi-Travali, Stefani; Carson, Richard E.; Huang, Yiyun

    2013-01-01

    Endocannabinoids and their attending cannabinoid type 1 receptor (CB1) have been implicated in animal models of posttraumatic stress disorder (PTSD). However, their specific role has not been studied in people with PTSD. Herein, we present an in vivo imaging study using positron emission tomography (PET) and the CB1-selective radioligand [11C]OMAR in individuals with PTSD, and healthy controls with lifetime histories of trauma (trauma controls [TC]) and those without such histories (healthy controls [HC]). Untreated individuals with PTSD (N=25) with non-combat trauma histories, and TC (N=12) and HC (N=23) participated in a magnetic resonance (MR) imaging scan and a resting PET scan with the CB1 receptor antagonist radiotracer [11C]OMAR, which measures volume of distribution (VT) linearly related to CB1 receptor availability. Peripheral levels of anandamide, 2-arachidonoylglycerol (2-AG), oleoylethanolamide (OEA), palmitoylethanolamide (PEA), and cortisol were also assessed. In the PTSD group, relative to the HC and TC groups, we found elevated brain-wide [11C]OMAR VT values (F(2,53)=7.96, p=.001; 19.5% and 14.5% higher, respectively) which were most pronounced in women (F(1,53)=5.52, p=.023). Anandamide concentrations were reduced in the PTSD relative to the TC (53.1% lower) and HC (58.2% lower) groups. Cortisol levels were lower in the PTSD and TC groups relative to the HC group. Three biomarkers examined collectively—OMAR VT, anandamide, and cortisol—correctly classified nearly 85% of PTSD cases. These results suggest that abnormal CB1 receptor-mediated anandamide signaling is implicated in the etiology of PTSD, and provide a promising neurobiological model to develop novel, evidence-based pharmacotherapies for this disorder. PMID:23670490

  13. 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

  14. 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

  15. 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

  16. Evidence of the dissociative PTSD subtype: A systematic literature review of latent class and profile analytic studies of PTSD.

    Science.gov (United States)

    Hansen, Maj; Ross, Jana; Armour, Cherie

    2017-04-15

    The dissociative PTSD (D-PTSD) subtype was first introduced into the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. Prior to this, studies using latent profile analysis (LPA) or latent class analysis (LCA), began to provide support for the D-PTSD construct and associated risk factors. This research is important, because dissociative symptoms in the context of PTSD may potentially interfere with treatment course or outcome. The aims of the present study were twofold: to systematically review the LCA and LPA studies investigating support for the D-PTSD construct; and to review the associated research on the risk factors or covariates of D-PTSD in the identified studies. Six databases (PubMed, Web of Science, Scopus, PILOTS, PsychInfo, and Embase) were systematically searched for relevant papers. Eleven studies were included in the present review. The majority of the studies were supportive of the D-PTSD subtype; primarily characterized by depersonalization and derealization. Several covariates of the D-PTSD subtype have been investigated with mixed results. Many limitations relate to the state of the current literature, including a small number of studies, the use of self-report measurements of PTSD, and heterogeneity across the samples in investigated covariates. The results were overall supportive of the D-PTSD construct. Future research on D-PTSD and associated risk factors is needed to shed light on the possibilities of facilitating preventive actions, screening, and implications on treatment effects. Copyright © 2017 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Yunchun Chen

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

  18. Trauma, resilience and vulnerability to PTSD: A review and clinical ...

    African Journals Online (AJOL)

    A literature review examines the proportion of individuals who develop PTSD following trauma and the factors associated with vulnerability and resilience. These include gender, developmental factors, social support and personality factors. Psychological factors associated with maintenance of chronic PTSD are also briefly ...

  19. Specificity of Stroop interference in patients with pain and PTSD.

    Science.gov (United States)

    Beck, J G; Freeman, J B; Shipherd, J C; Hamblen, J L; Lackner, J M

    2001-11-01

    The authors investigated processing of threat words in motor vehicle accident survivors using a modified Stroop procedure. Three samples were included: 28 participants with comorbid posttraumatic stress disorder (PTSD) and pain, 26 participants with pain without PTSD, and 21 participants without pain or any psychiatric conditions. Four word categories were used: (a) accident words, (b) pain words, (c) positive words, and (d) neutral words. This study examined whether processing biases would occur to accident words only in participants with PTSD or if these biases would also be noted in the No PTSD/Pain sample. Additionally, this study examined whether processing biases would be noted to pain words in the 2 pain samples, irrespective of PTSD. Overall, color naming was significantly slower in the PTSD/Pain group in comparison with the other groups. As well, the PTSD/Pain sample showed significant response delays to both accident and pain-related words, whereas patients with No PTSD/Pain showed delays to pain stimuli only.

  20. Intervening on persistent PTSD and co-morbid depression ...

    African Journals Online (AJOL)

    Improvement in PTSD is a function of the improvement in rumination, social sharing and loneliness. Regarding rumination mode, decrease in analytic “WHY” thinking rumination is the best predictor of the improvement in PTSD. Depression improvement is positively associated with loneliness. The findings suggest that an ...

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

    National Research Council Canada - National Science Library

    Tyrka, Audrey R

    2008-01-01

    .... Cortisol samples have been obtained from 96 of these subjects. Hormone and genetic data will be used to predict the development of PTSD and chronic PTSD. In addition, interactions of these biomarkers with trauma severity and other stressors as well as social supports will be examined.

  2. PTSD in relation to dissociation in traumatized police officers

    NARCIS (Netherlands)

    Carlier, I. V.; Lamberts, R. D.; Fouwels, A. J.; Gersons, B. P.

    1996-01-01

    The assumed relationship between dissociation and symptoms of posttraumatic stress disorder (PTSD) was examined. From a group of police officers who had experienced a traumatic event, the authors assessed the chronic dissociative symptoms of 42 police officers with PTSD, 50 police officers with

  3. PTSD after childbirth : A predictive ethological model for symptom development

    NARCIS (Netherlands)

    Haagen, Joris F G; Moerbeek, Mirjam|info:eu-repo/dai/nl/197476651; Olde, Eelco; Van Der Hart, Onno|info:eu-repo/dai/nl/068230265; Kleber, Rolf J.|info:eu-repo/dai/nl/069316929

    2015-01-01

    Abstract Background: Childbirth can be a traumatic experience occasionally leading to posttraumatic stress disorder (PTSD). This study aimed to assess childbirth-related PTSD risk-factors using an etiological model inspired by the transactional model of stress and coping. Methods: 348 out of 505

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

    Science.gov (United States)

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

    2018-04-01

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

  5. Feature: Post Traumatic Stres Disorder PTSD: Symptoms, Diagnosis, Treatment

    Science.gov (United States)

    ... Home Current Issue Past Issues Feature PTSD Symptoms, Diagnosis , Treatment Past Issues / Winter 2009 Table of Contents For ... that can help rule out similar conditions. PTSD diagnosis is made based on a certain set of symptoms that begin or ... is yielding new, improved therapies that can ...

  6. Treatment improves symptoms shared by PTSD and disordered eating.

    Science.gov (United States)

    Mitchell, Karen S; Wells, Stephanie Y; Mendes, Adell; Resick, Patricia A

    2012-10-01

    Eating disorders and posttraumatic stress disorder (PTSD) are debilitating conditions that frequently co-occur. Although the two disorders have different clinical presentations, they share associated features, including cognitive disturbances, emotion dysregulation, dissociation, and impulsivity. We hypothesized that reductions in PTSD symptoms following cognitive processing therapy (CPT) and its treatment components (CPT without the written account or the written account only) would be associated with improvements in symptoms common to PTSD and eating disorders. Participants in the current investigation included women with PTSD (N = 65) who reported a history of rape or physical assault, were in a randomized dismantling study of CPT, and completed the Eating Disorder Inventory-2 (EDI-2) at pre- and posttreatment. Latent growth modeling results indicated that decreases in PTSD symptom scores were significantly associated with reductions in the Impulse Regulation, Interoceptive Awareness, Interpersonal Distrust, Ineffectiveness, and Maturity Fears subscales of the EDI-2. Thus, PTSD treatment affected symptoms shared by PTSD and eating disorders. Currently, there are no clear guidelines for treatment of comorbid PTSD and eating disorders. Traditional CPT may impact symptoms common to both, but additional therapy may be needed for specific disordered eating attitudes and behaviors. Published 2012. This article is a US Government work and is in the public domain in the USA.

  7. Stress Detection for PTSD via the StartleMart Game

    DEFF Research Database (Denmark)

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

    2013-01-01

    a stress detection mechanism profiles the severity and type of PTSD via skin conductance responses to those in-game stress elicitors. The initial study and analysis of 14 PTSD-diagnosed veteran soldiers presented in this paper reveals clear correspondence between diagnostic standard measures of PTSD...... for stress inoculation training. This points to future avenues of research toward discerning between degrees and types of PTSD using game-based diagnostic and treatment tools.......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...

  8. The relationship between childhood support and later emergence of PTSD.

    Science.gov (United States)

    Lauterbach, Dean; Koch, Ellen I; Porter, Katherine

    2007-10-01

    The authors examine the relationship between three sources of social support (maternal, paternal, and peer) and the development of posttraumatic stress disorder (PTSD). This study utilized data from the National Comorbidity Survey (NCS), a large (N = 5,877) nationally representative population survey. Persons with and without a lifetime history of PTSD and those with and without a history of trauma exposure were compared on levels of social support received prior to age 15. Persons with a history of PTSD reported that they received less maternal, paternal, and peer support as children than those without PTSD. Importantly, persons who developed PTSD after the age of 17 reported lower levels of early childhood support from their fathers.

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

    Directory of Open Access Journals (Sweden)

    Sadeghi-Bazargani H

    2011-07-01

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

  10. The Child PTSD Symptom Scale: Psychometric Properties in Female Adolescent Sexual Assault Survivors

    Science.gov (United States)

    Gillihan, Seth J.; Aderka, Idan M.; Conklin, Phoebe H.; Capaldi, Sandra; Foa, Edna B.

    2013-01-01

    Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and…

  11. Reward functioning in PTSD: a systematic review exploring the mechanisms underlying anhedonia

    NARCIS (Netherlands)

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

    2015-01-01

    Post-traumatic stress disorder (PTSD) is a debilitating psychiatric disorder. An important diagnostic feature of PTSD is anhedonia, which may result from deficits in reward functioning. This has however never been studied systematically in PTSD. To determine if PTSD is associated with reward

  12. Determining what works in the treatment of PTSD.

    Science.gov (United States)

    Wampold, Bruce E; Imel, Zac E; Laska, Kevin M; Benish, Steven; Miller, Scott D; Flückiger, Christoph; Del Re, Aaron C; Baardseth, Timothy P; Budge, Stephanie

    2010-12-01

    Many researchers accept that trauma-focused treatments are superior to non-trauma focused treatments for Post-Traumatic Stress Disorder (PTSD). However, Benish, Imel, and Wampold (2008) recently published a meta-analysis of clinical trials directly comparing 'bona fide' PTSD treatments that failed to reject the null hypothesis that PTSD treatments are similarly effective. They concluded that the results of previous meta-analysis may have been influenced by several confounds, including the use of control treatments, to make conclusions about the relative efficacy of specific PTSD treatments. Ehlers et al. (2010) claim that the selection procedures of the Benish et al. meta-analysis were biased and cite results from individual studies and previous meta-analyses that suggest trauma-focused psychological treatments are superior to non-trauma focused treatments. We first offer a review and justification of the coding criteria and procedure used in Benish et al. In addition, we discuss the appropriateness of utilizing treatments designed to control for non-specifics or common factors such as 'supportive therapy' for determining the relative efficacy of specific PTSD treatments. Finally, we note several additional confounds, such as therapist effects, allegiance, and alteration of legitimate protocols, in PTSD research and describe conceptual problems involved in the classification scheme used to determine the "trauma focus" of interventions, which lead to inappropriate conclusions about what works in the treatment of PTSD. Copyright © 2010 Elsevier Ltd. All rights reserved.

  13. A Randomized Controlled Clinical Trial of Dialogical Exposure Therapy versus Cognitive Processing Therapy for Adult Outpatients Suffering from PTSD after Type I Trauma in Adulthood.

    Science.gov (United States)

    Butollo, Willi; Karl, Regina; König, Julia; Rosner, Rita

    2016-01-01

    Although there are effective treatments for posttraumatic stress disorder (PTSD), there is little research on treatments with non-cognitive-behavioural backgrounds, such as gestalt therapy. We tested an integrative gestalt-derived intervention, dialogical exposure therapy (DET), against an established cognitive-behavioural treatment (cognitive processing therapy, CPT) for possible differential effects in terms of symptomatic outcome and drop-out rates. We randomized 141 treatment-seeking individuals with a diagnosis of PTSD to receive either DET or CPT. Therapy length in both treatments was flexible with a maximum duration of 24 sessions. Dropout rates were 12.2% in DET and 14.9% in CPT. Patients in both conditions achieved significant and large reductions in PTSD symptoms (Impact of Event Scale - Revised; Hedges' g = 1.14 for DET and d = 1.57 for CPT) which were largely stable at the 6-month follow-up. At the posttreatment assessment, CPT performed statistically better than DET on symptom and cognition measures. For several outcome measures, younger patients profited better from CPT than older ones, while there was no age effect for DET. Our results indicate that DET merits further research and may be an alternative to established treatments for PTSD. It remains to be seen whether DET confers advantages in areas of functioning beyond PTSD symptoms. © 2015 S. Karger AG, Basel.

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

    Directory of Open Access Journals (Sweden)

    CAROLINA BOTERO GARCÍA

    2005-07-01

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

  15. The role of personality traits in posttraumatic stress disorder (PTSD).

    Science.gov (United States)

    Jakšić, Nenad; Brajković, Lovorka; Ivezić, Ena; Topić, Radmila; Jakovljević, Miro

    2012-09-01

    A number of studies have shown that although exposure to potentially traumatic events is common, development of PTSD is relatively rare, which is one of the reasons PTSD still remains a controversial psychiatric entity. The aim of this article was to provide an overview of the research on the role of personality traits in the vulnerability, resilience, posttraumatic growth and expressions associated with PTSD. Personality based approach represents a dimensional aspect of the transdisciplinary integrative model of PTSD. We conducted a systematic search on PubMed, PsycINFO, and Academic Search Complete from 1980 (the year PTSD was first included in the DSM) and 2012 (the year the literature search was performed). Manual examination of secondary sources such as the reference sections of selected articles and book chapters were also conducted. Most of the reviewed studies dealing with personality traits as vulnerability and protective factors for PTSD examined the relationship between basic personality dimensions and severity of symptoms of PTSD. These studies have applied three types of methodological designs: cross-sectional, post-trauma and pre-trauma longitudinal studies, with latter being the least common option. Finding that appears relatively consistent is that PTSD is positively related to negative emotionality, neuroticism, harm avoidance, novelty-seeking and self-transcendence, as well as to trait hostility/anger and trait anxiety. On the other hand, PTSD symptoms are negatively associated with extraversion, conscientiousness, self-directedness, the combination of high positive and low negative emotionality, as well as with hardiness and optimism, while posttraumatic growth shows inverse relation to most of these traits. Furthermore, a number of studies have confirmed the existence of three distinct personality-based subtypes of PTSD: internalizing, externalizing and low pathology PTSD. These findings may help in further uncovering etiological mechanisms and

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

    Science.gov (United States)

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

    2016-02-01

    Numerous studies document an association between posttraumatic stress disorder (PTSD) and impairments in intimate relationship functioning, and there is evidence that PTSD symptoms and associated impairments are improved by cognitive-behavioral conjoint therapy for PTSD (CBCT for PTSD; Monson & Fredman, 2012). The present study investigated changes across treatment in clinician-rated PTSD symptom clusters and patient-rated trauma-related cognitions in a randomized controlled trial comparing CBCT for PTSD with waitlist in a sample of 40 individuals with PTSD and their partners (N = 40; Monson et al., 2012). Compared with waitlist, patients who received CBCT for PTSD immediately demonstrated greater improvements in all PTSD symptom clusters, trauma-related beliefs, and guilt cognitions (Hedge's gs -.33 to -1.51). Results suggest that CBCT for PTSD improves all PTSD symptom clusters and trauma-related cognitions among individuals with PTSD and further supports the value of utilizing a couple-based approach to the treatment of PTSD. (c) 2016 APA, all rights reserved).

  17. The Child PTSD Symptom Scale: Psychometric Properties in Female Adolescent Sexual Assault Survivors

    OpenAIRE

    Gillihan, Seth J.; Aderka, Idan M.; Conklin, Phoebe H.; Capaldi, Sandra; Foa, Edna B.

    2012-01-01

    Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and valid measure of PTSD symptom severity in school-age children exposed to natural disasters (Foa, Johnson, Feeny & Treadwell, 2001). However, the ps...

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

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2013-12-01

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

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

    Science.gov (United States)

    Knefel, Matthias; Lueger-Schuster, Brigitte

    2013-01-01

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

  20. Corticosterone mitigates the stress response in an animal model of PTSD.

    Science.gov (United States)

    Jia, Min; Smerin, Stanley E; Zhang, Lei; Xing, Guoqiang; Li, Xiaoxia; Benedek, David; Ursano, Robert; Li, He

    2015-01-01

    Activation of glucocorticoid receptor signaling in the stress response to traumatic events has been implicated in the pathogenesis of stress-associated psychiatric disorders such as post-traumatic stress disorder (PTSD). Elevated startle response and hyperarousal are hallmarks of PTSD, and are generally considered to evince fear (DSM V). To further examine the efficacy of corticosterone in treating hyperarousal and elevated fear, the present study utilized a learned helplessness stress model in which rats are restrained and subjected to tail shock for three days. These stressed rats develop a delayed long-lasting exaggeration of the acoustic startle response (ASR) and retarded body weight growth, similar to symptoms of PTSD patients (Myers et al., 2005; Speed et al., 1989). We demonstrate that both pre-stress and post-stress administration of corticosterone (3 mg/kg/day) mitigates a subsequent exaggeration of the ASR measured 14 days after cessation of the stress protocol. Furthermore, the mitigating efficacy of pre-stress administration of corticosterone (3 mg/kg/day for three days) appeared to last significantly longer, up to 21 days after the cessation of the stress protocol, in comparison to that of post-stress administration of corticosterone. However, pre-stress administration of corticosterone at 0.3 mg/kg/day for three days did not mitigate stress-induced exaggeration of the ASR measured at both 14 and 21 days after the cessation of the stress protocol. In addition, pre-stress administration of corticosterone (3 mg/kg/day for three days) mitigates the retardation of body weight growth otherwise resulting from the stress protocol. Congruently, co-administration of the corticosterone antagonist RU486 (40 mg/kg/day for three days) with corticosterone (3 mg/kg/day) prior to stress diminished the mitigating efficacy of the exogenous corticosterone on exaggerated ASR and stress-retarded body weight. The relative efficacy of pre versus post administration of

  1. Multimodal PTSD characterization via the StartleMart game

    DEFF Research Database (Denmark)

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

    2015-01-01

    Computer games have recently shown promise as a diagnostic and treatment tool for psychiatric rehabilitation. This paper examines the potential of combining multiple modalities for detecting affective responses of patients interacting with a simulation built on game technology, aimed...... at the treatment of mental diagnoses such as post traumatic stress disorder (PTSD). For that purpose, we couple game design and game technology to create a game-based tool for exposure therapy and stress inoculation training that utilizes stress detection for the automatic profiling and potential personalization...... of PTSD treatments. The PTSD treatment game we designed forces the player to go through various stressful experiences while a stress detection mechanism profiles the severity and type of PTSD by analyzing the physiological responses to those in-game stress elicitors in two separate modalities: skin...

  2. Chronic Pain and PTSD: A Guide for Patients

    Science.gov (United States)

    ... standing in line at a grocery store, going shopping, or working. Many patients with chronic pain cannot ... Advanced Search Where to Get Help PTSD Coach Online Tools to help you manage stress. Search Pilots ...

  3. VA's National PTSD Brain Bank: a National Resource for Research.

    Science.gov (United States)

    Friedman, Matthew J; Huber, Bertrand R; Brady, Christopher B; Ursano, Robert J; Benedek, David M; Kowall, Neil W; McKee, Ann C

    2017-08-25

    The National PTSD Brain Bank (NPBB) is a brain tissue biorepository established to support research on the causes, progression, and treatment of PTSD. It is a six-part consortium led by VA's National Center for PTSD with participating sites at VA medical centers in Boston, MA; Durham, NC; Miami, FL; West Haven, CT; and White River Junction, VT along with the Uniformed Services University of Health Sciences. It is also well integrated with VA's Boston-based brain banks that focus on Alzheimer's disease, ALS, chronic traumatic encephalopathy, and other neurological disorders. This article describes the organization and operations of NPBB with specific attention to: tissue acquisition, tissue processing, diagnostic assessment, maintenance of a confidential data biorepository, adherence to ethical standards, governance, accomplishments to date, and future challenges. Established in 2014, NPBB has already acquired and distributed brain tissue to support research on how PTSD affects brain structure and function.

  4. Stable Isotope Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Tissue samples (skin, bone, blood, muscle) are analyzed for stable carbon, stable nitrogen, and stable sulfur analysis. Many samples are used in their entirety for...

  5. Developing Memory Reconsolidation Blockers as Novel PTSD Treatments

    Science.gov (United States)

    2013-08-01

    women who were pregnant or breast feeding; (vi) borderline personality disorder , “complex” PTSD, mild PTSD as determined by a pre-treatment CAPS... borderline personality disorder with or without comorbid posttraumatic stress disorder : a randomized, double-blind, placebo-controlled trial. J Clin...Pharmacologic treatment approaches for children and adolescents with posttraumatic stress disorder . Child Adolesc Psychiatr Clin N Am 12: 251–269. Duvarci S

  6. Sexual revictimization, PTSD, and problem drinking in sexual assault survivors.

    Science.gov (United States)

    Ullman, Sarah E

    2016-02-01

    Posttraumatic stress disorder (PTSD) and problem drinking are common and often co-occurring sequelae experienced by women survivors of adult sexual assault, yet revictimization may mediate risk of symptoms over time. Structural equation modeling was used to examine data from a 3-wave panel design with a large (N=1012), ethnically diverse sample of women assault survivors to examine whether repeated sexual victimization related to greater PTSD and problem drinking. Structural equation modeling revealed that child sexual abuse was associated with greater symptoms of PTSD and problem drinking and intervening sexual victimization was associated with greater symptoms of PTSD and problem drinking at both 1 and 2year follow-ups. We found no evidence, however, that PTSD directly influenced problem drinking over the long term or vice versa, although they were correlated at each timepoint. Revictimization during the study predicted survivors' prospective PTSD and problem drinking symptoms inconsistently. Implications and recommendations for future research are discussed. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Thomas Maier

    2015-10-01

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

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

    Science.gov (United States)

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

    2013-06-01

    No treatment, to date, has been developed to improve both posttraumatic stress disorder (PTSD) and medically unexplained physical symptoms (MUPS), despite mounting evidence of high comorbidity between PTSD and MUPS. This study assessed the feasibility, acceptability, and treatment outcomes of an adapted cognitive behavioral therapy for PTSD and abridged somatization in a sample of eight participants. Fifteen percent of completers did not meet PTSD criteria after treatment completion and 62.5% improved their somatic symptoms. There was a significant difference between pre- and post-treatment depression symptoms, as well as in psychological and physical functioning measures. Results indicated a small to moderate effect size (d = 0.27-0.78) in PTSD severity scores, and moderate to large effect size in depression symptoms and psychosocial and physical functioning variables (d = 0.39-1.12). Preliminary evidence of acceptability indicates that the current CBT intervention may be suitable for Latinos individuals with PTSD and MUPS. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. PTSD prevalence among Polish World War II survivors.

    Science.gov (United States)

    Lis-Turlejska, Maja; Łuszczyńska, Aleksandra; Szumiał, Szymon

    2016-10-31

    Over the past decade research has been published in several Western European countries on the prevalence of PTSD among World War II survivors, mostly civilians. Prevalence rates ranged from 1.9% to 10.8 %. The aim of the study was to measure the frequency of PTSD occurrence among Polish WWII survivors. Data from 96 persons: 59 women and 37 men, aged 70-96 were analyzed. All participants were born before 1945. They completed Polish adaptations of: Posttraumatic Diagnostic Scale (PDS), Impact of Events Scale (IES), Beck's Depression Inventory (BDI) and WWII trauma related questionnaire. Prevalence rate of potential PTSD was 32,3% Mean values of both number and severity of symptoms of PTSD were significantly higher for respondents with at least one war related trauma comparing to the participants who did note relate any such trauma. Comparing to other studies on WWII related PTSD the prevalence rate of possible PTSD was very high. Looking for possible explanation of such results seems to be an important challenge.

  10. Law enforcement preferences for PTSD treatment and crisis management alternatives.

    Science.gov (United States)

    Becker, Carolyn Black; Meyer, Glenn; Price, John S; Graham, Melissa M; Arsena, Ashley; Armstrong, David A; Ramon, Elizabeth

    2009-03-01

    Evidence-based treatments (EBT) for posttraumatic stress disorder (PTSD) remain underutilized. Analog research, however, indicates that patients may be more amenable to receiving EBT for PTSD than utilization rates suggest. This study sought to extend previous studies by investigating PTSD treatment preferences among law enforcement individuals (i.e., active duty officers, cadets, criminal justice students). We asked 379 participants, with varying trauma histories, to read a police traumatic event and imagine they had developed PTSD. Participants rated the credibility of six treatment options which they might encounter in a treatment setting, and chose their most and least preferred treatments. Next, they evaluated a widely used debriefing intervention aimed at preventing PTSD. Almost 90% of participants chose exposure or Cognitive Processing Therapy as their first or second most preferred treatment, and they rated these interventions as significantly more credible than the other four treatment options. The sample showed ambivalence regarding the perceived efficacy of debriefing but found the rationale credible. This study supports previous analog research indicating that patients may be more interested in EBT than indicated by utilization rates, and suggests that law enforcement departments should consider offering EBT to officers who develop PTSD.

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

    Science.gov (United States)

    Shin, Sung-Man; Kim, Hyun Jeong; Liw, Lina; Kim, Sungjae

    2009-06-01

    The objectives were (a) to establish prevalence of depression and post-traumatic stress disorder (PTSD) in Afghanistan and, (b) to investigate sociodemographic and quality of life variables, which predict depression and PTSD. Translated versions of the Beck Depression Inventory, Impact of Event Scale-Revised, and Quality of Life Inventory were administered to 125 Pashtun women in Kandahar, and statistically analyzed. Approximately half of the participants showed moderate to severe levels of depression, and more than half of the participants exhibited symptoms of PTSD. Education and income showed significant associations with PTSD symptoms or depression. The way one spends time, general health status, and general feeling towards life predicted low levels of depression and PTSD. The high prevalence of depression and PTSD indicate the continuing need for mental health intervention. While education has been found to be a protective factor for mental health in previous studies, the relationship between education and mental health appear to be more complex among Afghan women. Quality of life variables could be further investigated and incorporated into mental health interventions for Afghan women.

  12. Impulsivity facets’ predictive relations with DSM-5 PTSD symptom clusters

    Science.gov (United States)

    Roley, Michelle E.; Contractor, Ateka A.; Weiss, Nicole H.; Armour, Cherie; Elhai, Jon D.

    2017-01-01

    Objective Posttraumatic Stress Disorder (PTSD) has a well-established theoretical and empirical relation with impulsivity. Prior research has not used a multidimensional approach for measuring both PTSD and impulsivity constructs when assessing their relationship. Method The current study assessed the unique relationship of impulsivity facets on PTSD symptom clusters among a non-clinical sample of 412 trauma-exposed adults. Results Linear regression analyses revealed that impulsivity facets best accounted for PTSD’s arousal symptoms. The negative urgency facet of impulsivity was most predictive, as it was associated with all of PTSD’s symptom clusters. Sensation seeking did not predict PTSD’s intrusion symptoms, but did predict the other symptom clusters of PTSD. Lack of perseverance only predicted intrusion symptoms, while lack of premeditation only predicted PTSD’s mood/cognition symptoms. Conclusions Results extend theoretical and empirical research on the impulsivity-PTSD relationship, suggesting that impulsivity facets may serve as both risk and protective factors for PTSD symptoms. PMID:27243571

  13. Frequency of posttraumatic stress disorder (ptsd) among flood affected individuals

    International Nuclear Information System (INIS)

    Aslam, N.; Kamal, A.

    2014-01-01

    Objectives: To investigate the relationship of exposure to a traumatic event and the subsequent onset of Posttraumatic Stress Disorder (PTSD) in the population exposed to floods in Pakistan. Study Design: Cross sectional study. Place and duration of study: Individuals exposed to the 2010 flood in district Shadadkot, Sindh from April 2012 to September 2012. Methodology: Sample of the study comprised of 101 individuals from the flood affected areas in Pakistan. Age range of the participants was 15 to 50 years (M=27.73, SD = 7.19), with participation of both males and females. PTSD was assessed by using the self report measure, impact of Event Scale (IES) and the subjective and objective experience to flood was assessed through Flood Related Exposure Scale (FRES) devised by the authors. Results: The prevalence rate of PTSD among the flood affected population was 35.5%. Trauma had significant positive relation with objective flood exposure and subjective flood exposure (r=.27 and r =.38) respectively. Inverse relation appeared between age and PTSD (r=-.20). PTSD was higher among females as compared to males. Conclusion: Understanding the prevalence of PTSD helps the mental health professionals in devising intervention strategies. A longitudinal study design is recommended that may be developed for better understanding of trajectories of trauma response across time span. Our findings may help identify populations at risk for treatment research. (author)

  14. Predicting the future development of depression or PTSD after injury.

    Science.gov (United States)

    Richmond, Therese S; Ruzek, Josef; Ackerson, Theimann; Wiebe, Douglas J; Winston, Flaura; Kassam-Adams, Nancy

    2011-01-01

    The objective was to develop a predictive screener that when given soon after injury will accurately differentiate those who will later develop depression or posttraumatic stress disorder (PTSD) from those who will not. This study used a prospective, longitudinal cohort design. Subjects were randomly selected from all injured patients in the emergency department; the majority was assessed within 1 week postinjury with a short predictive screener, followed with in-person interviews after 3 and 6 months to determine the emergence of depression or PTSD within 6 months after injury. A total of 192 completed a risk factor survey at baseline; 165 were assessed over 6 months. Twenty-six subjects [15.8%, 95% confidence interval (CI) 10.2-21.3] were diagnosed with depression, four (2.4%, 95% CI 0.7-5.9) with PTSD and one with both. The final eight-item predictive screener was derived; optimal cutoff scores were ≥2 (of 4) depression risk items and ≥3 (of 5) PTSD risk items. The final screener demonstrated excellent sensitivity and moderate specificity both for clinically significant symptoms and for the diagnoses of depression and PTSD. A simple screener that can help identify those patients at highest risk for future development of PTSD and depression postinjury allows the judicious allocation of costly mental health resources. Copyright © 2011 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2014-05-01

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

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

    Science.gov (United States)

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

    2017-05-01

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

  17. PTSD Care Among Veterans With and Without Co-Occurring Substance Use Disorders.

    Science.gov (United States)

    Mansfield, Alyssa J; Greenbaum, Mark A; Schaper, Kim M; Banducci, Anne N; Rosen, Craig S

    2017-06-01

    This study examined whether a co-occurring substance use disorder contributed to disparities in receipt of Veterans Health Administration (VHA) posttraumatic stress disorder (PTSD) specialty care or psychotherapy. Logistic regression, controlling for sociodemographic characteristics, was used to examine predictors of PTSD care among 424,211 veterans with confirmed PTSD (two or more PTSD diagnosis encounters) who accessed care in a VHA facility between fiscal years 2009 and 2010. Overall, 16% of veterans had PTSD and a co-occurring substance use disorder diagnosis. In adjusted analyses, veterans with a co-occurring substance use disorder were more likely than veterans with PTSD alone to receive any outpatient PTSD specialty care and complete eight or more sessions of outpatient psychotherapy within 14 weeks, but they were less likely to be treated in inpatient PTSD specialty units. Co-occurring substance use disorders did not appear to hinder receipt of outpatient specialty PTSD treatment or of sufficient psychotherapy among VHA-enrolled veterans.

  18. EMDR beyond PTSD: A Systematic Literature Review

    Science.gov (United States)

    Valiente-Gómez, Alicia; Moreno-Alcázar, Ana; Treen, Devi; Cedrón, Carlos; Colom, Francesc; Pérez, Víctor; Amann, Benedikt L.

    2017-01-01

    Background: Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapeutic approach that has demonstrated efficacy in the treatment of Post-traumatic Stress Disorder (PTSD) through several randomized controlled trials (RCT). Solid evidence shows that traumatic events can contribute to the onset of severe mental disorders and can worsen their prognosis. The aim of this systematic review is to summarize the most important findings from RCT conducted in the treatment of comorbid traumatic events in psychosis, bipolar disorder, unipolar depression, anxiety disorders, substance use disorders, and chronic back pain. Methods: Using PubMed, ScienceDirect, and Scopus, we conducted a systematic literature search of RCT studies published up to December 2016 that used EMDR therapy in the mentioned psychiatric conditions. Results: RCT are still scarce in these comorbid conditions but the available evidence suggests that EMDR therapy improves trauma-associated symptoms and has a minor effect on the primary disorders by reaching partial symptomatic improvement. Conclusions: EMDR therapy could be a useful psychotherapy to treat trauma-associated symptoms in patients with comorbid psychiatric disorders. Preliminary evidence also suggests that EMDR therapy might be useful to improve psychotic or affective symptoms and could be an add-on treatment in chronic pain conditions. PMID:29018388

  19. EMDR beyond PTSD: A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Alicia Valiente-Gómez

    2017-09-01

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

  20. Mixed Reality for PTSD/TBI Assessment.

    Science.gov (United States)

    Fidopiastis, Cali; Hughes, Charles E; Smith, Eileen

    2009-01-01

    Mixed Reality (MR) refers to the blending of virtual content into the real world. Using MR, we create contextually meaningful scenarios in which users carry out tasks encountered in the presence of visual and aural distracters. Visual distracters can include subtle ones - people walking; and more abrupt ones - cartons falling. Aural distracters can include gentle ones - fans whirring; and more aggressive ones - automobiles backfiring. The intensity of these distracters can be dynamically controlled by a therapist or software that takes into account the patient's perceived level of stress. Intensity can also be controlled between experiences. For example, one may increase the stress level in a subsequent session, attempting to improve a person's tolerance. Assessment of progress includes psychophysical metrics (stress indicators) and the performance of tasks (accuracy and adherence to time constraints). By accurately capturing a patient's interaction with the environment in the context of simulation events, we can use MR as a tool for assessment and rehabilitation planning for individuals with stress-related injuries. This paper reports on the MR environment we have developed and its efficacy (realized and potential) for the assessment of post-traumatic stress disorder (PTSD) with or without traumatic brain injury (TBI).

  1. [Novel therapeutic approach for the treatment of post-traumatic stress disorder (PTSD): facilitating fear extinction].

    Science.gov (United States)

    Fujita, Yosuke; Yamamoto, Shigeto; Morinobu, Shigeru

    2012-08-01

    Pharmacological agents enhancing fear extinction may be promising tools for the treatment of PTSD. Histone acetylation is involved in memory formation, and histone deacetylase (HDAC) inhibitors increase histone acetylation and subsequently enhance fear extinction. In this study, we examined whether vorinostat, an HDAC inhibitor, facilitated fear extinction, using a contextual fear conditioning (FC) paradigm. We found that vorinostat facilitated fear extinction. Next, the levels of global acetylated histone were measured by Western blotting. We also assessed the effect of vorinostat on the hippocampal levels of NMDA receptor mRNA by real-time quantitative PCR (RT-PCR). The levels of acetylated histone and NR2B mRNA, but not NR1 or NR2A mRNA, were elevated in the hippocampus 2 h after administration of vorinostat. We investigated the levels of acetylated histones and phospho-CREB (p-CREB) binding at the promoter of the NR2B gene using the chromatin immunoprecipitation (ChIP) assay followed by RT-PCR. The levels of acetylated histone and the binding of p-CREB to its binding site at the promoter of the NR2B gene were increased. These findings suggest that vorinostat in conjunction with exposure therapy can be a promising new avenue for the treatment of PTSD.

  2. Elevated Liver Enzymes

    Science.gov (United States)

    Symptoms Elevated liver enzymes By Mayo Clinic Staff Elevated liver enzymes may indicate inflammation or damage to cells in the liver. Inflamed or ... than normal amounts of certain chemicals, including liver enzymes, into the bloodstream, which can result in elevated ...

  3. National Elevation Dataset (NED)

    Data.gov (United States)

    Kansas Data Access and Support Center — The U.S. Geological Survey has developed a National Elevation Database (NED). The NED is a seamless mosaic of best-available elevation data. The 7.5-minute elevation...

  4. Integrated Exposure-Based Therapy for Co-Occurring Post Traumatic Stress Disorder (PTSD and Substance Dependence: Predictors of Change in PTSD Symptom Severity

    Directory of Open Access Journals (Sweden)

    Katherine L. Mills

    2016-11-01

    Full Text Available This paper examines factors associated with change in PTSD symptom severity among individuals randomised to receive an integrated exposure-based psychotherapy for PTSD and substance dependence–Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE. Outcomes examined include change in PTSD symptom severity as measured by the Clinician Administered PTSD Scale (CAPS, and the reliability and clinical significance of change in PTSD symptom severity. Factors examined include patient baseline characteristics, treatment characteristics, and events over follow-up. The mean difference in CAPS score was 38.24 (SE 4.81. Approximately half (49.1% demonstrated a reliable and clinically significant improvement in PTSD symptom severity. No one was classified as having demonstrated clinically significant worsening of symptoms. Three independent predictors of reductions in PTSD symptom severity were identified: baseline PTSD symptom severity (β 0.77, SE 0.23, p = 0.001, number of traumas experienced prior to baseline (β −0.30, SE 0.15, p = 0.049, and number of sessions attended (β 2.05, SE 0.87, p = 0.024. The present study provides further evidence regarding the safety of the COPE treatment and factors associated with improvement in PTSD symptom severity. The identification of only a small number of predictors of the outcome points to the broad applicability of the COPE treatment to PTSD and substance use disorder (SUD patients.

  5. Stable convergence and stable limit theorems

    CERN Document Server

    Häusler, Erich

    2015-01-01

    The authors present a concise but complete exposition of the mathematical theory of stable convergence and give various applications in different areas of probability theory and mathematical statistics to illustrate the usefulness of this concept. Stable convergence holds in many limit theorems of probability theory and statistics – such as the classical central limit theorem – which are usually formulated in terms of convergence in distribution. Originated by Alfred Rényi, the notion of stable convergence is stronger than the classical weak convergence of probability measures. A variety of methods is described which can be used to establish this stronger stable convergence in many limit theorems which were originally formulated only in terms of weak convergence. Naturally, these stronger limit theorems have new and stronger consequences which should not be missed by neglecting the notion of stable convergence. The presentation will be accessible to researchers and advanced students at the master's level...

  6. A latent class analysis of PTSD symptoms among inner city primary care patients.

    Science.gov (United States)

    Rahman, Akm Fazlur; Manatunga, Amita; Guo, Ying; Peng, Limin; Warnock, Megan; Ressler, Kerry J; Jovanovic, Tanja

    2018-03-01

    Examine evidence for different subclasses of posttraumatic stress disorder (PTSD) symptoms in a sample of trauma exposed, low-income, predominantly African American men and women. Assess the relationship between PTSD subclasses with major depressive disorder (MDD) and types of trauma experienced. Latent class analysis (LCA) using a multivariate normal mixture model on the 17-item PTSD Symptom Scale (PSS) was used to identify latent subclasses of PTSD symptoms (N = 5063). LCA suggested four subclasses of PTSD symptoms: (1) High severity and comorbidity (n = 932, 92.2% current PTSD, 88.7% MDD, 82% both), characterized by high PTSD symptoms, depression, and comorbidity of PTSD and MDD; (2) Moderate severity (n = 1179, 56.5% current PTSD, 53.9% MDD, 34.5% both), which had high avoidance and hyper-vigilance symptoms compared to the other symptoms; (3) Low PTSD and high depression (n = 657, 12.8% current PTSD, 49.9% MDD, 8.8% both) which had high insomnia but otherwise low PTSD symptoms and high depression; and (4) Resilient (n = 2295, 2.0% current PTSD, 16.4% MDD, and 0.6% both) characterized by low mean scores on all PTSD symptoms and depression. The results suggest avoidance and hyper-vigilance are important symptoms in PTSD development and insomnia may be an important indicator for depression. The combination of severe insomnia, avoidance, and hyper-vigilance may be key symptoms for comorbidity of PTSD and MDD. Future studies should focus on these symptoms to better target people at high risk for developing PTSD or MDD. Copyright © 2017. Published by Elsevier Ltd.

  7. PTSD symptoms associated with the experiences of psychosis and hospitalisation: a review of the literature.

    Science.gov (United States)

    Berry, Katherine; Ford, Sarah; Jellicoe-Jones, Lorna; Haddock, Gillian

    2013-06-01

    There is evidence of high rates of PTSD in people with psychosis, but the influence that symptoms or hospitalisation have on PTSD in individuals with psychosis is less clear. This paper reviewed studies investigating the prevalence of PTSD induced as a result of the experience of psychosis and hospitalisation and factors that might influence its development. The review included 24 studies, published between 1980 and 2011. Studies showed high levels of PTSD resulting from the trauma of symptoms and/or hospitalisation, with prevalence rates for actual PTSD resulting from these traumas varying from 11% to 67%. In line with studies of PTSD related to other traumatic events, there were inconsistent associations between PTSD and severity of positive and negative symptoms, but there were consistent associations between affective symptoms and PTSD. There were also inconsistent associations between hospital experiences and PTSD. Consistent with the general PTSD literature, there was some evidence that psychosis-related PTSD was associated with trauma history. There was also some emerging evidence that psychological variables, such as appraisals and coping style may influence psychosis-related PTSD. The review highlights the need for further research into psychological mechanisms that could increase vulnerability to psychosis-related PTSD and treatment approaches. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Fathers with PTSD and depression in pregnancies complicated by preterm preeclampsia or PPROM.

    Science.gov (United States)

    Stramrood, Claire A I; Doornbos, Bennard; Wessel, Ineke; van Geenen, Marloes; Aarnoudse, Jan G; van den Berg, Paul P; Weijmar Schultz, Willibrord C M; van Pampus, Maria G

    2013-04-01

    To assess prevalence and risk factors for posttraumatic stress disorder (PTSD) and depression in fathers after early preeclampsia (PE) or preterm premature rupture of membranes (PPROM). Partners of patients hospitalized for PE or PPROM and partners of healthy controls completed PTSD (PSS-SR) and depression (BDI-II) questionnaires during pregnancy (t 1) and 6 weeks postpartum (t 2). 85 of the 187 eligible men participated (51 partners of patients, 34 partners of control) at t 1, and 66 men participated both time points. No significant differences were found between partners of patients and partners of controls in symptoms of PTSD and depression (t 1: p = 0.28 for PTSD and p = 0.34 for depression; t 2: p = 0.08 for PTSD and p = 0.31 for depression). For partners of patients, correlation between PTSD and depression sum-scores was 0.48 (p depression postpartum in partners of patients. Symptoms of PTSD and depression during pregnancy predicted the occurrence of PTSD symptoms following childbirth in partners of patients. Symptoms of PTSD and depression occurred at a similar rate in partners of women with PE or PPROM and partners of healthy pregnant controls. Symptoms of PTSD and depression during pregnancy predicted the occurrence of PTSD symptoms following childbirth. Increased paternal age predicted more symptoms of PTSD and depression postpartum. At 6 weeks postpartum, a strong association was found between men and women in symptoms of PTSD and depression.

  9. Sports and games for post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Lawrence, Sue; De Silva, Mary; Henley, Robert

    2010-01-20

    Traumatic experiences evoke emotions such as fear, anxiety and distress and may encourage avoidance of similar situations in the future. For a proportion of those exposed to a traumatic event, this emotional reaction becomes uncontrollable and can develop into Post Traumatic Stress Disorder (PTSD) (Breslau 2001). Most of those diagnosed with PTSD fully recover while a small proportion develop a chronic PTSD a year after the event (First 2004). Sports and games may be able to alleviate symptoms of PTSD. 1. To assess the effectiveness of sports, and games in alleviating and/or diminishing the symptoms of PTSD when compared to usual care or other interventions. 2. To assess the effectiveness of different types of sports and games in alleviating and/or diminishing symptoms of PTSD. The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled Trials Registers (CCDAN-CTR) were searched up to June 2008.The following databases were searched up to June 2008: the Cochrane Central registry of Controlled Trials; MEDLINE; EMBASE; CINAHL; PsycINFO. Reference lists of relevant papers were searched and experts in the field were contacted to determine if other studies were available. To be included, participants had to be diagnosed with PTSD using criteria outlined in the Diagnostic and Statistical Manual for Mental Disorders (DSM IV) and/or ICD criteria. Randomised controlled trials (RCTs) that considered one or more well-specified sports or games for alleviating and/or diminishing symptoms of PTSD were included.Sports, and games were defined as any organized physical activity done alone or with a group and non-physical activities such as computer games and card games done alone or with a group. Psychological interventions such as music therapy, art therapy and play therapy and behavioural therapy were excluded. Two reviewers (SL and MD) separately checked the titles and abstracts of the search results to determine which studies met the pre-determined inclusion criteria

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

    Directory of Open Access Journals (Sweden)

    Charlotte Elisabeth Wittekind

    2015-01-01

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

  11. Accelerated DNA Methylation Age: Associations with PTSD and Mortality.

    Science.gov (United States)

    Wolf, Erika J; Logue, Mark W; Stoop, Tawni B; Schichman, Steven A; Stone, Annjanette; Sadeh, Naomi; Hayes, Jasmeet P; Miller, Mark W

    2017-07-20

    Recently-developed indices of cellular age based on DNA methylation (DNAm) data, referred to as DNAm age, are being used to study factors that influence the rate of aging and the health correlates of these metrics of the epigenetic clock. This study evaluated associations between trauma exposure, posttraumatic stress disorder (PTSD) symptoms, and accelerated versus decelerated DNAm age among military veterans. We also examined if accelerated DNAm age predicted mortality over the course of a 6.5-year medical record review period. 339 genotype-confirmed white, non-Hispanic, middle-aged, trauma-exposed veterans underwent psychiatric assessment and genome-wide DNAm analysis. DNAm age was calculated using a previously validated algorithm. Medical records were available for a subset of 241 veterans and were reviewed approximately 6.5 years after DNA collection and PTSD assessment. PTSD hyperarousal symptoms were associated with accelerated DNAm age (β = .20, p = .009) but trauma exposure and total PTSD severity were not. Accelerated DNAm age was also associated with 13% increased risk for all-cause mortality (HR: 1.13, 95% CI: 1.01 - 1.26) during the medical record review period. Findings of this study replicate the association between PTSD and accelerated DNAm age and suggest this effect may be specific to the hyperarousal symptom cluster. Results point to the potential utility of DNAm age algorithms for identifying individuals who are aging at an accelerated rate and for determining the factors that influence this process.

  12. Personality Heterogeneity in PTSD: Distinct Temperament and Interpersonal Typologies

    Science.gov (United States)

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

    2015-01-01

    Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD. PMID:24015858

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

    Science.gov (United States)

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

    2014-03-01

    Researchers examining personality typologies of posttraumatic stress disorder (PTSD) have consistently identified 3 groups: low pathology, internalizing, and externalizing. These groups have been found to predict functional severity and psychiatric comorbidity. In this study, we employed Latent Profile Analysis to compare this previously established typology, grounded in temperament traits (negative emotionality; positive emotionality; constraint), to a novel typology rooted in interpersonal traits (dominance; warmth) in a sample of individuals with PTSD (n = 155). Using Schedule for Nonadaptive and Adaptive Personality (SNAP) traits to create latent profiles, the 3-group temperament model was replicated. Using Interpersonal Circumplex (IPC) traits to create latent profiles, we identified a 4-group solution with groups varying in interpersonal style. These models were nonredundant, indicating that the depiction of personality variability in PTSD depends on how personality is assessed. Whereas the temperament model was more effective for distinguishing individuals based on distress and comorbid disorders, the interpersonal model was more effective for predicting the chronicity of PTSD over the 10 year course of the study. We discuss the potential for integrating these complementary temperament and interpersonal typologies in the clinical assessment of PTSD. 2014 APA

  14. The use of yoga in specialized VA PTSD treatment programs.

    Science.gov (United States)

    Libby, Daniel J; Reddy, Felice; Pilver, Corey E; Desai, Rani A

    2012-01-01

    Posttraumatic stress disorder (PTSD) is a chronic, debilitating anxiety disorder that is highly prevalent among U.S. military veterans. Yoga, defined to include physical postures (asana) and mindfulness and meditation, is being increasingly used as an adjunctive treatment for PTSD and other psychological disorders. No research or administrative data have detailed the use of these services in Department of Veterans Affairs' (VA) 170 PTSD treatment programs. One hundred twenty-five program coordinators or designated staff completed an 81-item survey of their program's use of complementary and alternative medicine modalities in the past year. This report describes data from a subset of 30 questions used to assess the prevalence, nature, and context of the use of yoga, mindfulness, and meditation other than mindfulness practices. Results revealed that these practices are widely offered in VA specialized PTSD treatment programs and that there is great variability in the context and nature of how they are delivered. Understanding how yoga is used by these programs may inform ongoing efforts to define and distinguish yoga therapy as a respected therapeutic discipline and to create patient-centered care models that mindfully fulfill the unmet needs of individuals with mental health issues, including veterans with PTSD.

  15. Pretreatment biomarkers predicting PTSD psychotherapy outcomes: A systematic review.

    Science.gov (United States)

    Colvonen, Peter J; Glassman, Lisa H; Crocker, Laura D; Buttner, Melissa M; Orff, Henry; Schiehser, Dawn M; Norman, Sonya B; Afari, Niloofar

    2017-04-01

    Although our understanding of the relationship between posttraumatic stress disorder (PTSD), brain structure and function, neural networks, stress-related systems, and genetics is growing, there is considerably less attention given to which biological markers predict evidence-based PTSD psychotherapy outcomes. Our systematic PRISMA-informed review of 20 studies examined biomarkers as predictors of evidence-based PTSD psychotherapy outcomes. Results provide preliminary evidence that specific structural and functional neural systems (involved in information processing), glucocorticoid sensitivity and metabolism (part of the hypothalamic-pituitary-adrenal axis and the response to stress), heart rate (involved with fear habituation), gene methylation, and certain genotypes (associated with serotonin and glucocorticoids) predicted positive response to PTSD treatment. These pre-treatment biomarkers are associated with processes integral to PTSD treatment, such as those affecting fear learning and extinction, cognitive restructuring, information processing, emotional processing, and interoceptive monitoring. Identifying pre-treatment biomarkers that predict treatment response may offer insight into the mechanisms of psychological treatment, provide a foundation for improving the pharmaceutical augmentation of treatment, and inform treatment matching. Published by Elsevier Ltd.

  16. Relationships between soldiers' PTSD symptoms and spousal communication during deployment.

    Science.gov (United States)

    Carter, Sarah; Loew, Benjamin; Allen, Elizabeth; Stanley, Scott; Rhoades, Galena; Markman, Howard

    2011-06-01

    Social support, including support from spouses, may buffer against posttraumatic stress disorder (PTSD) symptoms. The current study assessed whether the frequency of spousal communication during a recent deployment, a potentially important source of support for soldiers, was related to postdeployment PTSD symptoms. Data came from 193 married male Army soldiers who returned from military deployment within the past year. For communication modalities conceptualized as delayed (i.e., letters, care packages, and e-mails), greater spousal communication frequency during deployment was associated with lower postdeployment PTSD symptom scores, but only at higher levels of marital satisfaction (p = .009). At lower marital satisfaction, more delayed spousal communication during deployment was associated with more PTSD symptoms (p = .042). For communication modalities conceptualized as interactive (i.e., phone calls, instant messaging, instant messaging with video), the same general direction of effects was seen, but the interaction between communication frequency and marital satisfaction predicting PTSD symptoms did not reach significance. Copyright © 2011 International Society for Traumatic Stress Studies.

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Accelerated DNA Methylation Age: Associations with PTSD and Neural Integrity

    Science.gov (United States)

    Wolf, Erika J.; Logue, Mark W.; Hayes, Jasmeet P.; Sadeh, Naomi; Schichman, Steven A.; Stone, Annjanette; Salat, David H.; Milberg, William; McGlinchey, Regina; Miller, Mark W.

    2015-01-01

    Background Accumulating evidence suggests that post traumatic stress disorder (PTSD) may accelerate cellular aging and lead to premature morbidity and neurocognitive decline. Methods This study evaluated associations between PTSD and DNA methylation (DNAm) age using recently developed algorithms of cellular age by Horvath (2013) and Hannum et al. (2013). These estimates reflect accelerated aging when they exceed chronological age. We also examined if accelerated cellular age manifested in degraded neural integrity, indexed via diffusion tensor imaging. Results Among 281 male and female veterans of the conflicts in Iraq and Afghanistan, DNAm age was strongly related to chronological age (rs ~.88). Lifetime PTSD severity was associated with Hannum DNAm age estimates residualized for chronological age (β = .13, p= .032). Advanced DNAm age was associated with reduced integrity in the genu of the corpus callosum (β = −.17, p= .009) and indirectly linked to poorer working memory performance via this region (indirect β = − .05, p= .029). Horvath DNAm age estimates were not associated with PTSD or neural integrity. Conclusions Results provide novel support for PTSD-related accelerated aging in DNAm and extend the evidence base of known DNAm age correlates to the domains of neural integrity and cognition. PMID:26447678

  19. Panicogens in patients with Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Muhtz, Christoph; Wiedemann, Klaus; Kellner, Michael

    2012-01-01

    Symptom provocation has proved its worth for understanding the pathophysiology of diseases and in general for the development of new therapeutic approaches in the medical field. In the research of anxiety disorders, investigations using experimentally induced panic attacks by various agents, such as sodium lactate, carbon dioxide, cholezystokinine-tetrapetid etc., have a long tradition and allow the exploration of usually naturally occuring spontaneous psychopathological phenomena under controlled conditions. Post-Traumatic Stress Disorder (PTSD) is a prevalent disorder that can develop following exposure to an extreme traumatic event. In DSM-IV it is currently classified as an anxiety disorder and shares phenomenological similarities with panic disorder. The use of panicogenic challenge tests is also an interesting neurobiological approach to learn more about the nature of PTSD and may be a possibility to develop new therapeutic strategies for the treatment of PTSD symptoms. Not only panic anxiety, but also flashbacks and other dissociative symptoms can be provoked by several panicogens in PTSD. The purpose of this review is to evaluate studies using panicogens in PTSD. Methodological short-comings of current studies and needed directions of further research are discussed.

  20. A Randomized Clinical Trial of Primary Care Brief Mindfulness Training for Veterans with PTSD.

    Science.gov (United States)

    Possemato, Kyle; Bergen-Cico, Dessa; Treatman, Scott; Allen, Christy; Wade, Michael; Pigeon, Wilfred

    2016-03-01

    Primary care (PC) patients typically do not receive adequate posttraumatic stress disorder (PTSD) treatment. This study tested if a brief mindfulness training (BMT) offered in PC can decrease PTSD severity. VA PC patients with PTSD (N = 62) were recruited for a randomized clinical trial comparing PCBMT with PC treatment as usual. PCBMT is a 4-session program adapted from mindfulness-based stress reduction. PTSD severity decreased in both conditions, although PCBMT completers reported significantly larger decreases in PTSD and depression from pre- to posttreatment and maintained gains at the 8-week follow-up compared with the control group. Exploratory analyses revealed that the describing, nonjudging, and acting with awareness facets of mindfulness may account for decreases in PTSD. Our data support preliminary efficacy of BMT for Veterans with PTSD. Whether PCBMT facilitates engagement into, or improves outcomes of, full-length empirically supported treatment for PTSD remains to be evaluated. © 2015 Wiley Periodicals, Inc.

  1. Assessing the existence of dissociative PTSD in sub-acute patients of whiplash

    DEFF Research Database (Denmark)

    Hansen, Maj; Hyland, Philip; Armour, Cherie

    2018-01-01

    Numerous studies investigating dissociative posttraumatic stress disorder (D-PTSD) have emerged. However, there is a lack of studies investigating D-PTSD following a wider range of traumatic exposure. Thus, the present study investigates D-PTSD using latent class analysis (LCA) in sub......-acute patients of whiplash and associated risk factors. The results of LCA showed a three-class solution primarily distributed according to PTSD symptom severity and thus no indication of D-PTSD. Dissociative symptoms, psychological distress (i.e. anxiety/depression), and pain severity significantly predicted...... PTSD severity. Combined, the results support the component model of dissociation and PTSD, while still stressing the importance of dissociative symptoms when planning treatment for PTSD....

  2. Relationship Factors Contributing to the Progression of Combat Related PTSD and Suiciality Over Time

    Science.gov (United States)

    2015-04-01

    active-duty, operation enduring freedom (OEF), posttraumatic stress disorder (PTSD), couples adaptation and stress processes, suicide risk 16...suicide. Aim 3: Assess mechanisms of the relationship between PTSD and relationship functioning over time. Aim 4: Determine adaptive and maladaptive

  3. Assessing the existence of dissociative PTSD in sub-acute patients of whiplash.

    Science.gov (United States)

    Hansen, Maj; Hyland, Philip; Armour, Cherie; Andersen, Tonny E

    2018-03-16

    Numerous studies investigating dissociative posttraumatic stress disorder (D-PTSD) have emerged. However, there is a lack of studies investigating D-PTSD following a wider range of traumatic exposure. Thus, the present study investigates D-PTSD using latent class analysis (LCA) in sub-acute patients of whiplash and associated risk factors. The results of LCA showed a three-class solution primarily distributed according to posttraumatic stress disorder (PTSD) symptom severity and thus no indication of D-PTSD. Dissociative symptoms, psychological distress (i.e. anxiety/depression), and pain severity significantly predicted PTSD severity. Combined, the results support the component model of dissociation and PTSD, while still stressing the importance of dissociative symptoms when planning treatment for PTSD.

  4. Type D personality and the development of PTSD symptoms: a prospective study

    NARCIS (Netherlands)

    Rademaker, Arthur R.; van Zuiden, Mirjam; Vermetten, Eric; Geuze, Elbert

    2011-01-01

    Psychological trauma and prolonged stress may cause mental disorders such as posttraumatic stress disorder (PTSD). Pretrauma personality is an important determinant of posttraumatic adjustment. Specifically, trait neuroticism has been identified as a risk factor for PTSD. Additionally, the

  5. Psychological mechanisms of effective cognitive-behavioral treatments for PTSD.

    Science.gov (United States)

    Zalta, Alyson K

    2015-04-01

    Several psychotherapies have been established as effective treatments for posttraumatic stress disorder (PTSD) including prolonged exposure, cognitive processing therapy, and cognitive therapy for PTSD. Understanding the key mechanisms of these treatments, i.e., how these treatments lead to therapeutic benefits, will enable us to maximize the efficacy, effectiveness, and efficiency of these therapies. This article provides an overview of the theorized mechanisms for each of these treatments, reviews the recent empirical evidence on psychological mechanisms of these treatments, discusses the ongoing debates in the field, and provides recommendations for future research. Few studies to date have examined whether changes in purported treatment mechanisms predict subsequent changes in treatment outcomes. Future clinical trials examining treatments for PTSD should use study designs that enable researchers to establish the temporal precedence of change in treatment mechanisms prior to symptom reduction. Moreover, further research is needed that explores the links between specific treatment components, underlying change mechanisms, and treatment outcomes.

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

    Science.gov (United States)

    de Jong, Joop T V M

    2005-09-01

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

  7. stableGP

    Data.gov (United States)

    National Aeronautics and Space Administration — The code in the stableGP package implements Gaussian process calculations using efficient and numerically stable algorithms. Description of the algorithms is in the...

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

    OpenAIRE

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

    2015-01-01

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

  9. Using Propranolol to Block Memory Reconsolidation in Female Veterans with PTSD

    Science.gov (United States)

    2015-11-01

    exposure and other aspects of cognitive therapy , as well as, drug therapies based on serotonin-reuptake inhibiting antidepressant agents. However...criteria, d) CAPS to confirm PTSD diagnosis and determine the severity of PTSD symptoms, e) Questionnaire ratings including Beck Depression Inventory (BDI...assessments to query PTSD diagnosis and determine change in severity of PTSD symptoms, b) Questionnaire ratings including Beck Depression Inventory (BDI

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

    OpenAIRE

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

    2014-01-01

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

  11. Relations between Social Support, PTSD Symptoms, and Substance Use in Veterans

    OpenAIRE

    Gros, Daniel F.; Flanagan, Julianne C.; Korte, Kristina J.; Mills, Adam C.; Brady, Kathleen T.; Back, Sudie E.

    2016-01-01

    Social support plays a significant role in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). However, there has been little investigation of social support with PTSD and its frequent comorbid conditions and related symptoms. Substance use disorders (SUD) are one set of conditions that have yet to be investigated in combination with PTSD and social support. As compared to civilians, veterans are at increased risk for developing both PTSD and SUD. In this stud...

  12. 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

  13. Comparative study on dermatoglyphics in patients with PTSD.

    Science.gov (United States)

    Glamuzina, Ljubomir; Mihanović, Mate; Milicić, Jasna; Devcić, Sanja; Restek-Petrović, Branka

    2009-12-01

    The factors situated at the bases of the genesis and development of PTSD are divided in: biological, psychological and social factors. Primary factor is a stressful event of extremely dangerous and threatening nature. The sort and the intensity of the stressful event too play an important role, followed by the personality structure, the relation with the environment and the genetic constitution. The study was thought to determine the quantitative dermatoglyphic properties of the digito-palmar complex in patients with PTSD aiming to establish whether there are biological, that is, genetic bases for PTSD, in what measure they determine the clinical manifestation of the disorder, and whether there is a dermatoglyphic marker, characteristic for people with PTSD. We analyzed the quantitative properties of the digito-palmer complex on a group of 100 male examinees over 18 years of age with PTSD, no psychiatric comorbidity, and who were two or more times cured at the Psychiatric Hospital "Sveti Ivan", comparing them with the quantitative dermatoglyphic properties of a group of 100 phenotypically healthy male examinees over 18 years of age. Using the method of descriptive statistics, we found no statistically significant differences among the results of the examined groups. With the T-test we evaluated the heterogeneity of the groups, and the results showed the existence of statistically significant differences among the comparison group and the group of patients with PTSD on three variables. We calculated the Fluctuating Asymmetry (FA) measure, which illustrates the compatibility, that is, the symmetry of the observed property on the right and on the left side of the body, indicating a difference on one variable. The outcome did not confirm the existence of a connection between a particular dermatoglyphic result and the genesis of PTSD. This is, however, in line with the hypothesis that, in patients with PTSD and other psychiatric disorders, there is a multiple effect of

  14. Help for Heroes: PTSD, Warrior Recovery, and the Liturgy.

    Science.gov (United States)

    O'Donnell, Karen

    2015-12-01

    The incidence of PTSD is on a steady rise in combative countries around the world, and civilian churches are increasingly like to encounter persons suffering from PTSD. This article will consider the ancient rituals for the purification of warriors after battle to demonstrate the responsibility of the church toward returning warriors and explore how the liturgy can function as a place for recovery. I will demonstrate how the sacraments of Reconciliation, the Eucharist, and the Anointing of the Sick function as sites of re-integration into the world the warriors have fought for, recovery from trauma, and purification after battle.

  15. Adaptive Disclosure: A Combat-Specific PTSD Treatment

    Science.gov (United States)

    2015-10-01

    Award Number: W81XWH-10-1-0810 TITLE: “Adaptive Disclosure: A Combat-Specific PTSD Treatment ” PRINCIPAL INVESTIGATOR: Brett Litz, Ph.D...Disclosure: A Combat-Specific PTSD Treatment ” 5a. CONTRACT NUMBER W81XWH-10-1-0810 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...South Huntington Avenue Boston, MA 02130 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM(S) U.S. Army

  16. Sexual harassment and PTSD: is sexual harassment diagnosable trauma?

    Science.gov (United States)

    Avina, Claudia; O'Donohue, William

    2002-02-01

    Sexual harassment has become a major social, legal, and mental health problem because of its high prevalence and its negative consequences for victims. These consequences can include decreased productivity, loss of job, decreased income, and impaired psychological and physical well-being. Despite evidence from empirical studies that victims often exhibit posttraumatic stress disorder (PTSD) symptoms, some have argued that sexual harassment does not constitute legitimate trauma. We argue that many forms of sexual harassment meet the diagnostic Criteria A1 and A2 of PTSD. Finally, the DSM-IV trauma criterion is explicated, and its relationship with sexual harassment and its effects are discussed.

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  18. Resource Loss and Naturalistic Reduction of PTSD among Inner-City Women

    Science.gov (United States)

    Walter, Kristen H.; Hobfoll, Stevan E.

    2009-01-01

    Halting the process of psychosocial and material resource loss has been theorized as being associated with the reduction of posttraumatic stress disorder (PTSD). This study examines how the limiting of resource loss is related to alleviation of PTSD symptoms among 102 inner-city women, who originally met diagnostic criteria for PTSD after…

  19. Complex posttraumatic stress disorder: an exploratory investigation of PTSD and DES NOS among Dutch war veterans

    NARCIS (Netherlands)

    Jongedijk, R. A.; Carlier, I. V.; Schreuder, B. J.; Gersons, B. P.

    1996-01-01

    The recently developed concept Disorder of Extreme Stress Not Otherwise Specified (DES NOS) or complex posttraumatic stress disorder (complex PTSD) is designed to encompass long-standing symptoms not present in PTSD. An exploratory investigation of PTSD and DES NOS was performed with the Structured

  20. Critical analysis of the current treatment guidelines for complex PTSD in adults

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  2. Mechanistic Role of Emotion Regulation in the PTSD and Alcohol Association.

    Science.gov (United States)

    Radomski, Sharon A; Read, Jennifer P

    2016-06-01

    Posttraumatic Stress Disorder (PTSD) has been linked to problematic alcohol use. Those with PTSD have greater difficulty regulating emotions, which may help to explain the PTSD-drinking co-occurrence. However, emotion regulation as a mediator of PTSD-alcohol associations has been limited. In the present study, we examined this association. College students ( N = 466, M age = 19.5, 53% female) were assessed for PTSD by structured clinical interview, and were categorized into three groups: those who had not experienced a significant trauma (No Trauma, n = 182), those who had experienced a significant trauma but did not have current PTSD symptoms (Trauma Only, n = 171), and those with significant trauma and with current PTSD (partial or full; PTSD, n = 113). Alcohol use over the past six months and emotion regulation were assessed via self-report (DDQ; Collins, Parks, & Marlatt, 1985; DERS; Gratz & Roemer, 2004). Findings revealed that those with trauma and clinically significant PTSD reported greater difficulty with emotion regulation than those who had not been exposed to trauma, which in turn significantly predicted alcohol use. This mediating effect was not found in those with trauma exposure alone, suggesting an important role for PTSD in this pathway. Findings also indicated that the ability to control emotion-based impulses is a particularly relevant mediating facet of emotion regulation. These results implicate emotion regulation as a potential explanatory link between PTSD and alcohol use, lending further support to the inclusion of emotion regulation training in PTSD treatment.

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

    Science.gov (United States)

    Pruneau, Genevieve Mary Catherine

    2010-01-01

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

  4. Predicting PTSD: pre-existing vulnerabilities in glucocorticoid-signaling and implications for preventive interventions

    NARCIS (Netherlands)

    van Zuiden, Mirjam; Kavelaars, Annemieke; Geuze, Elbert; Olff, Miranda; Heijnen, Cobi J.

    2013-01-01

    Posttraumatic stress disorder (PTSD) is an anxiety disorder that may develop in response to a traumatic event. Approximately 10% of trauma-exposed individuals subsequently develop PTSD. It is hypothesized that the development of PTSD is associated with biological vulnerability factors, which are

  5. EFFECTS OF ELEVATED TEMPERATURE ON ELEVATED ...

    African Journals Online (AJOL)

    eobe

    concrete. Data obtained at 7 and 28 days for the effects of temperature with compressive strength are shown in Tables 1 and 2 respectively while the loss of weight as related to elevated temperature and age, are in. Figure 1. The effect of elevated temperature on the compressive strength at 7 days and 28 days for concrete ...

  6. Replicability and generalizability of PTSD networks: A cross-cultural multisite study of PTSD symptoms in four trauma patient samples

    DEFF Research Database (Denmark)

    Fried, Eiko I.; Eidhof, Marloes B.; Palic, Sabina

    2018-01-01

    The growing literature conceptualizing mental disorders like Posttraumatic Stress Disorder (PTSD) asnetworks of interacting symptoms faces three key challenges. Prior studies predominantly used (a)small samples with low power for precise network estimation, (b) non-clinical samples, and (c......) singlesamples. This renders network structures in clinical data, and the extent to which networks replicateacross datasets, unknown. To overcome these limitations, the present cross-cultural multisite studyestimated regularized partial correlation networks of 16 PTSD symptoms across four datasets oftraumatized...... patients receiving treatment for PTSD (total N=2,782), and compared resulting networks.Despite differences in culture, trauma-type and severity of the samples, considerable similaritiesemerged, with moderate to high correlations between symptom profiles (0.43 to 0.82), networkstructures (0.62 to 0...

  7. Identifying trajectories of change to improve understanding of integrated health care outcomes on PTSD symptoms post disaster.

    Science.gov (United States)

    Osofsky, Howard J; Weems, Carl F; Hansel, Tonya Cross; Speier, Anthony H; Osofsky, Joy D; Graham, Rebecca; King, Lucy; Craft, Timothy K

    2017-06-01

    Addressing life stressors is an important function for integrated care, especially for health care homes located in disaster prone environments. This study evaluated trajectories of change for patients with postdisaster posttraumatic stress disorder (PTSD) who were seen in integrated care. In addition to describing the results, this article provides the methods of subgroup analyses as this may be useful for others working in real-world practice. Patients (N = 340) receiving services at 5 rural health clinics self-reported PTSD symptoms as part of an ongoing evaluation to study the effectiveness of integrated health. Analysis of variance was used to assess differences overtime and trajectories were identified with cluster analyses. Disaster and trauma related factors associated with these trajectories were assessed using logistic regression. Significant overall decreases in PTSD symptoms overtime were found; individual trajectories were identified and include stable low, steep declines, stable high symptoms, and increasing symptoms. Stress related to disaster and the number of other traumas patients experienced correctly classified trajectory membership. Trajectories indicate that patients have differing treatment needs and cluster analysis as an evaluation technique may be useful in identifying what treatment works and for whom. The present study addresses a major concern for health care providers serving disaster prone communities and emphasizes the importance of identifying pre incident and disaster related risk vulnerabilities that contribute to mental health outcomes. Subgroup analyses are a useful tool for developing more targeted treatment within integrated care and may be an accessible research strategy for others working in such settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

    OpenAIRE

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

    2017-01-01

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

  9. Psychopharmacological strategies in the management of posttraumatic stress disorder (PTSD): what have we learned?

    Science.gov (United States)

    Bernardy, Nancy C; Friedman, Matthew J

    2015-04-01

    There have been significant advancements in the pharmacologic management of posttraumatic stress disorder (PTSD) in the past two decades. Multisite randomized clinical trials (RCTs) have noted the efficacy of selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNR Is) for PTSD treatment. Unfortunately, there have been no new medications approved to treat PTSD in the past 10 years. Although there have been exciting new findings in our knowledge of the neurobiology of PTSD, clinical trials testing new medications have lagged. This review summarizes recent research that builds on the unique pathophysiology of PTSD and suggests ways to move the field forward.

  10. PTSD and Impaired Eye Expression Recognition: A Preliminary Study

    Science.gov (United States)

    Schmidt, Jakob Zeuthen; Zachariae, Robert

    2009-01-01

    This preliminary study examined whether posttraumatic stress disorder (PTSD) was related to difficulties in identifying the mental states of others in a group of refugees. Sixteen Bosnian refugees, referred to treatment in an outpatient treatment center for survivors of torture and war-related trauma in Denmark (CETT), were compared to 16 non-PTSD…

  11. Learning from traumatic experiences with brief eclectic psychotherapy for PTSD

    NARCIS (Netherlands)

    Gersons, Berthold P. R.; Schnyder, Ulrich

    2013-01-01

    Brief eclectic psychotherapy for PTSD (BEPP) is an evidence-based therapeutic approach that combines and integrates elements from psychodynamic, cognitive-behavioral, and directive psychotherapy. Psychoeducation is done jointly with the patient and his or her partner. Exposure, a structured writing

  12. Common paths to ASD severity and PTSD severity

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

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

  13. Cumulative trauma, PTSD and dissociation among Ethiopian refugees in Israel.

    Science.gov (United States)

    Finklestein, Michal; Solomon, Zahava

    2009-01-01

    The aim of this study was to examine the exposure of Ethiopian refugees to pre-, peri- and post-migration stressful events and their implications for both posttraumatic stress disorder (PTSD) and dissociation. A random sample (N = 478) of three groups of refugees took part in the research ("Moses" immigrants, 1984, n = 165; "Solomon" immigrants, 1991, n = 169; "Family Reunification" immigrants, 1995, n = 144). Exposure to stressful events and posttraumatic symptoms were assessed via the Harvard Trauma Questionnaire (HTQ). Post-migration difficulties were assessed via the Post Migration Living Difficulties (PMLD) scale. Dissociation was evaluated using the Dissociation Experience Scale (DES). Significant differences were found among the groups in the rates of PTSD (27%, 15%, and 26%, respectively), but no differences were found in dissociation. A significant relationship was found between PTSD symptoms and cumulative trauma among the three groups, but no such relationship was found between dissociation and cumulative trauma. The differences among the groups were discussed in light of the unique characteristics of cumulative trauma, PTSD and dissociation among Ethiopian refugees.

  14. Treatments for PTSD and pathological gambling: what do patients want?

    Science.gov (United States)

    Najavits, Lisa M

    2011-06-01

    This study explored the treatment preferences of 106 people with posttraumatic stress disorder (PTSD), pathological gambling (PG), or both. It is the first know study of its type for this comorbidity. Sixteen different treatment types were rated, with a broad array of modalities including manualized psychotherapies, medication, self-help, alternative therapies, coaching, and self-guided treatments (use of books and computerized therapy). A consistent finding was that PTSD treatments were rated more highly than PG treatments, even among those with both disorders. Further, of the sixteen treatment types, the sample expressed numerous preferences for some over others. For example, among PG treatments, self-help was the highest-rated. Among PTSD treatments, psychotherapies were the highest-rated; and individual therapy was rated higher than group therapy. For both PG and PTSD, medications were rated lower than other treatment types. Non-standard treatments (i.e., computerized treatment, books, coaching, family therapy, alternative therapies) were generally rated lower than other types. Discussion includes implications for the design of treatments, as well as methodological limitations.

  15. PTSD symptomics: network analyses in the field of psychotraumatology

    NARCIS (Netherlands)

    Armour, Cherie; Fried, Eiko I.; Olff, Miranda

    2017-01-01

    Recent years have seen increasing attention on posttraumatic stress disorder (PTSD) research. While research has largely focused on the dichotomy between patients diagnosed with mental disorders and healthy controls - in other words, investigations at the level of diagnoses - recent work has focused

  16. Effectiveness of Service Dogs for Veterans with PTSD: Preliminary Outcomes.

    Science.gov (United States)

    Vincent, Claude; Belleville, Geneviève; Gagnon, Dany H; Dumont, Frédéric; Auger, Edouard; Lavoie, Vicky; Besemann, Markus; Champagne, Noël; Lessart, Geneviève

    2017-01-01

    Limited scientific evidence on the effectiveness of psychiatric service dogs used by Veterans with post-traumatic stress disorder (PTSD) is available. This study investigated their short-term effectiveness among 15 Canadian veterans who received a first psychiatric service dog. Preliminary results suggest potential beneficial effects at 3 months on the psychiatric symptoms.

  17. Network analysis of PTSD symptoms following mass violence.

    Science.gov (United States)

    Sullivan, Connor P; Smith, Andrew J; Lewis, Michael; Jones, Russell T

    2018-01-01

    Network analysis is a useful tool for understanding how symptoms interact with one another to influence psychopathology. However, this analytic strategy has not been fully utilized in the PTSD field. The current study utilized network analysis to examine connectedness and strength among PTSD symptoms (employing both partial correlation and regression network analyses) among a community sample of students exposed to the 2007 Virginia Tech shootings. Respondents (N = 4,639) completed online surveys 3-4 months postshootings, with PTSD symptom severity measured via the Trauma Symptom Questionnaire. Data were analyzed via adaptive least absolute shrinkage and selection operator (LASSO) and relative importance networks, as well as Dijkstra's algorithm to identify the shortest path from each symptom to all other symptoms. Relative importance network analysis revealed that intrusive thoughts had the strongest influence on other symptoms (i.e., had many strong connections [highest outdegree]) while computing Dijkstra's algorithm indicated that anger produced the shortest path to all other symptoms (i.e., the strongest connections to all other symptoms). Findings suggest that anger or intrusion likely play a crucial role in the development and maintenance of PTSD (i.e., are more influential within the network than are other symptoms). (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  19. Treating PTSD in South African contexts: A theoretical framework ...

    African Journals Online (AJOL)

    Several psychological factors contribute to the development and maintenance of post-traumatic stress disorder (PTSD) because they interfere with the emotional processing of the traumatic event. These include problematic and painful emotions such as anxiety, shame, guilt and grief, distorted or dysfunctional cognitions, ...

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

    Science.gov (United States)

    Taylor, John G.; Baker, Stanley B.

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sung-Man Shin, DSc

    2009-06-01

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

  2. Metacognitive Therapy for PTSD: A Core Treatment Manual

    Science.gov (United States)

    Wells, Adrian; Sembi, Sundeep

    2004-01-01

    This article describes a new brief treatment for PTSD based on a metacognitive model (Wells, 2000). The treatment derived from this approach can be divided into core and supplementary treatment components. The core treatment manual is presented here. The core treatment does not require imaginal reliving of trauma or cognitive challenging of…

  3. Gratitude, depression and PTSD: Assessment of structural relationships.

    Science.gov (United States)

    Van Dusen, John P; Tiamiyu, Mojisola F; Kashdan, Todd B; Elhai, Jon D

    2015-12-30

    Gratitude, the tendency to appreciate positive occurrences in one's life that can be partially attributed to another person, has been shown to be a robust predictor of greater well-being. Researchers have also found gratitude to be inversely related to several emotional disorders, including major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Both of these emotional disorders are highly comorbid and share dysphoric symptoms (e.g., restricted affect, detachment, anhedonia) that could account for deficits in the experience and expression of gratitude. We used confirmatory factor analysis to test the relationships between gratitude and the symptom factors of PTSD (using the DSM-5 model) and MDD in a sample of trauma-exposed college students (N=202). Results indicated that gratitude is more strongly related to PTSD's negative alterations in mood and cognition (NAMC) factor than to other PTSD factors. Implications of these findings for the study of gratitude and trauma are discussed, including whether gratitude and gratitude-based interventions might prove particularly suited to targeting depressive symptoms. Copyright © 2015. Published by Elsevier Ireland Ltd.

  4. The impact of PTSD clusters on cannabis use in a racially diverse trauma-exposed sample: An analysis from ecological momentary assessment.

    Science.gov (United States)

    Buckner, Julia D; Jeffries, Emily R; Crosby, Ross D; Zvolensky, Michael J; Cavanaugh, Courtenay E; Wonderlich, Stephen A

    2018-02-14

    Accumulating evidence indicates a link between post-traumatic stress disorder (PTSD) and cannabis use and suggests that this link may vary as a function of the PTSD symptom cluster type. Consistent with negative reinforcement models of substance use, individuals with elevated Cluster D (Hyperarousal) symptoms may be more likely to use cannabis in response to elevated state anxiety and experience decreases in state anxiety after using cannabis. We aimed to test hypotheses that the interaction of Cluster D and state anxiety would be related to subsequent cannabis use and that those with elevated Cluster D symptoms who used cannabis would report the greatest decreases in state anxiety. To test the specificity, we tested whether Clusters B (re-experiencing) and C (avoidance) showed similar relationships. The present study used ecological momentary assessment to examine cannabis use among 87 cannabis-using individuals with PTSD symptoms (64.4% male, 56.3% non-Hispanic Caucasian). State anxiety and cannabis use were assessed over the two-week period via signal contingent (six random prompts per day), interval contingent (each bedtime), and event contingent (cannabis use episodes) assessments. Consistent with negative reinforcement models, participants with clinically significant Cluster D symptoms with elevated state anxiety had a greater likelihood of subsequent cannabis use and cannabis use resulted in less subsequent anxiety. The negative reinforcement hypothesis was only partially supported for those with Cluster B and C symptoms. The results suggest that negative reinforcement models may be especially relevant to understanding cannabis use among those with clinically elevated Cluster D symptoms.

  5. Event centrality in trauma and PTSD: relations between event relevance and posttraumatic symptoms

    Directory of Open Access Journals (Sweden)

    Thiago Loreto Garcia da Silva

    2016-01-01

    Full Text Available Abstract Recent investigations propose that cognitive characteristics of autobiographical memory significantly interact with Posttraumatic Stress Disorder (PTSD. A traumatic event becoming more or less central in a person’s identity and life story might influence development of the disorder. Studies show high correlations between event centrality (EC and PTSD. Participated in this study 68 treatment-seeking individuals referred to a specialized service for suspected trauma-related disorder: 39 matched criteria for PTSD and 29 were exposed to trauma without PTSD. Our aims were to explore how the groups differ regarding EC, depression, anxiety, posttraumatic cognitions, PTSD symptom severity, and peritraumatic dissociative experience; and how distinctively EC interacts with the measures in each group. The PTSD group had higher scores in all variables but dissociation. EC correlated with overall PTSD symptoms only in the PTSD group and with dissociation only in the no-PTSD group. Findings support a model emphasizing the role of memory processes in PTSD. People exposed to trauma who developed PTSD had the memory of the traumatic experience more intensively governing their sense of self and thus eliciting more negative cognitive reactions. As EC facilitates recollection of the traumatic event, it could also mediate a semantization process that reinforces and increases posttraumatic symptoms.

  6. Dysregulation in cortical reactivity to emotional faces in PTSD patients with high dissociation symptoms

    Directory of Open Access Journals (Sweden)

    Aleksandra Klimova

    2013-09-01

    Full Text Available Background: Predominant dissociation in posttraumatic stress disorder (PTSD is characterized by restricted affective responses to positive stimuli. To date, no studies have examined neural responses to a range of emotional expressions in PTSD with high dissociative symptoms. Objective: This study tested the hypothesis that PTSD patients with high dissociative symptoms will display increased event-related potential (ERP amplitudes in early components (N1, P1 to threatening faces (angry, fearful, and reduced later ERP amplitudes (Vertex Positive Potential (VPP, P3 to happy faces compared to PTSD patients with low dissociative symptoms. Methods: Thirty-nine civilians with PTSD were classified as high dissociative (n=16 or low dissociative (n=23 according to their responses on the Clinician Administered Dissociative States Scale. ERPs were recorded, whilst participants viewed emotional (happy, angry, fear and neutral facial expressions in a passive viewing task. Results: High dissociative PTSD patients displayed significantly increased N120 amplitude to the majority of facial expressions (neutral, happy, and angry compared to low dissociative PTSD patients under conscious and preconscious conditions. The high dissociative PTSD group had significantly reduced VPP amplitude to happy faces in the conscious condition. Conclusion: High dissociative PTSD patients displayed increased early (preconscious cortical responses to emotional stimuli, and specific reductions to happy facial expressions in later (conscious, face-specific components compared to low dissociative PTSD patients. Dissociation in PTSD may act to increase initial pre-attentive processing of affective stimuli, and specifically reduce cortical reactivity to happy faces when consciously processing these stimuli.

  7. Cognitive dysfunctions associated with PTSD: evidence from World War II prisoners of war.

    Science.gov (United States)

    Hart, John; Kimbrell, Timothy; Fauver, Peter; Cherry, Barbara J; Pitcock, Jeffery; Booe, Leroy Q; Tillman, Gail; Freeman, Thomas W

    2008-01-01

    The authors aim to delineate cognitive dysfunction associated with posttraumatic stress disorder (PTSD) by evaluating a well-defined cohort of former World War II prisoners of war (POWs) with documented trauma and minimal comorbidities. The authors studied a cross-sectional assessment of neuropsychological performance in former POWs with PTSD, PTSD with other psychiatric comorbidities, and those with no PTSD or psychiatric diagnoses. Participants who developed PTSD had average IQ, while those who did not develop PTSD after similar traumatic experiences had higher IQs than average (approximately 116). Those with PTSD performed significantly less well in tests of selective frontal lobe functions and psychomotor speed. In addition, PTSD patients with co-occurring psychiatric conditions experienced impairment in recognition memory for faces. Higher IQ appears to protect individuals who undergo a traumatic experience from developing long-term PTSD, while cognitive dysfunctions appear to develop with or subsequent to PTSD. These distinctions were supported by the negative and positive correlations of these cognitive dysfunctions with quantitative markers of trauma, respectively. There is a suggestion that some cognitive decrements occur in PTSD patients only when they have comorbid psychiatric diagnoses.

  8. Iowa Bedrock Surface Elevation

    Data.gov (United States)

    Iowa State University GIS Support and Research Facility — This Digital Elevation Model (DEM) of the bedrock surface elevation in Iowa was compiled using all available data, principally information from GEOSAM, supplemented...

  9. Negative Emotionality and Disconstraint Influence PTSD Symptom Course via Exposure to New Major Adverse Life Events

    Science.gov (United States)

    Sadeh, Naomi; Miller, Mark W.; Wolf, Erika J.; Harkness, Kate L.

    2015-01-01

    Identifying the factors that influence stability and change in chronic posttraumatic stress disorder (PTSD) is important for improving clinical outcomes. Using a cross-lagged design, we analyzed the reciprocal effects of personality and PTSD symptoms over time and their effects on stress exposure in a sample of 222 trauma-exposed veterans (ages 23 – 68; 90.5% male). Personality functioning and PTSD were measured approximately 4 years apart, and self-reported exposure to major adverse life events during the interim was also assessed. Negative emotionality positively predicted future PTSD symptoms, and this effect was partially mediated by exposure to new events. Constraint (negatively) indirectly affected PTSD via its association with exposure to new events. There were no significant effects of positive emotionality nor did PTSD symptom severity exert influences on personality over time. Results indicate that high negative affect and disconstraint influence the course of PTSD symptoms by increasing exposure to stressful life events. PMID:25659969

  10. Comorbid PTSD and social phobia in a treatment-seeking population: an exploratory study.

    Science.gov (United States)

    Zayfert, Claudia; DeViva, Jason C; Hofmann, Stefan G

    2005-02-01

    The purpose of this study was to examine patterns of comorbidity of posttraumatic stress disorder (PTSD) and social phobia (SP) and explore factors associated with the etiology and effect of this comorbidity. The sample consisted of 443 patients seeking treatment of PTSD, SP, or both. Of 240 patients with principal PTSD, 43% had comorbid SP, whereas only 7% of 57 with principal SP had comorbid PTSD. Patients with principal PTSD and comorbid SP were more likely to meet criteria for major depression and other anxiety disorders, and reported worse depression, anxiety, and physical, mental, and social functioning, than those with only PTSD or SP, regardless of other anxiety comorbidity. PTSD patients with SP reported more trauma-related guilt and higher frequency of childhood abuse than those without SP. The results are discussed in terms of implications for treatment of the comorbid presentation and directions for future research.

  11. Pre-migration Trauma, Repatriation Experiences, and PTSD Among North Korean Refugees.

    Science.gov (United States)

    Kim, Eunyoung; Yun, Minwoo; Jun, Jin Yong; Park, Woong-Sub

    2018-04-12

    Many studies on refugees suggested that refugees' traumatic events associated with post-traumatic stress disorder (PTSD). However, it is unknown whether refugees' PTSD was caused by their negative experience before or after the entry of their destination country. Thus, a separation of refugees' pre-migration from their post-migration experience is particularly important in understanding the causal impact of trauma. Using a sample from North Korean refugees, this study investigates the prevalence of PTSD symptoms, the impact of tortured trauma, repatriation experiences, on PTSD among North Korean refugees (n = 698). We found that North Korean refugees in our sample (a) demonstrated a high rate of current probable PTSD; (b) were demonstrated a higher frequency of repatriation experiences with a greater risk for PTSD symptoms. The findings suggest that particular types of trauma for populations with particular socio-demographic characteristics may be at a greater risk of PTSD.

  12. Substance use disorders and PTSD: an exploratory study of treatment preferences among military veterans.

    Science.gov (United States)

    Back, Sudie E; Killeen, Therese K; Teer, Andrew P; Hartwell, Emily E; Federline, Amanda; Beylotte, Frank; Cox, Elizabeth

    2014-02-01

    Substance use disorders (SUDs) and Post Traumatic Stress Disorder (PTSD) frequently co-occur among Veterans and are associated with poor treatment outcomes. Historically, treatments for SUDs and PTSD have been delivered sequentially and independently. More recently, however, integrated treatments have shown promise. This study investigated Veterans' perceptions of the interrelationship between SUDs and PTSD, as well as treatment preferences. Participants were 35 Veterans of recent military conflicts in Iraq and Afghanistan, and prior operations, who completed the Treatment Preferences Questionnaire as well as an in-depth interview. The majority (94.3%) perceived a relationship between their SUD and PTSD symptoms. Veterans reported that PTSD symptom exacerbation was typically (85.3%) associated with an increase in substance use, and PTSD symptom improvement was typically (61.8%) followed by a decrease in substance use (pdevelopment and provision of care for Veterans with SUDs and PTSD. Published by Elsevier Ltd.

  13. Victimisation and PTSD in a Greenlandic youth sample

    Directory of Open Access Journals (Sweden)

    Sidsel H. Karsberg

    2012-08-01

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

  14. Early PTSD symptom trajectories: persistence, recovery, and response to treatment: results from the Jerusalem Trauma Outreach and Prevention Study (J-TOPS.

    Directory of Open Access Journals (Sweden)

    Isaac R Galatzer-Levy

    Full Text Available Uncovering heterogeneities in the progression of early PTSD symptoms can improve our understanding of the disorder's pathogenesis and prophylaxis.To describe discrete symptom trajectories and examine their relevance for preventive interventions.Latent Growth Mixture Modeling (LGMM of data from a randomized controlled study of early treatment. LGMM identifies latent longitudinal trajectories by exploring discrete mixture distributions underlying observable data.Hadassah Hospital unselectively receives trauma survivors from Jerusalem and vicinity.Adult survivors of potentially traumatic events consecutively admitted to the hospital's emergency department (ED were assessed ten days and one-, five-, nine- and fifteen months after ED admission. Participants with data at ten days and at least two additional assessments (n = 957 were included; 125 received cognitive behavioral therapy (CBT between one and nine months.We used LGMM to identify latent parameters of symptom progression and tested the effect of CBT on these parameters. CBT consisted of 12 weekly sessions of either cognitive therapy (n = 41 or prolonged exposure (PE, n = 49, starting 29.8±5.7 days after ED admission, or delayed PE (n = 35 starting at 151.8±42.4 days. CBT effectively reduced PTSD symptoms in the entire sample.Latent trajectories of PTSD symptoms; effects of CBT on these trajectories.THREE TRAJECTORIES WERE IDENTIFIED: Rapid Remitting (rapid decrease in symptoms from 1- to 5-months; 56% of the sample, Slow Remitting (progressive decrease in symptoms over 15 months; 27% and Non-Remitting (persistently elevated symptoms; 17%. CBT accelerated the recovery of the Slow Remitting class but did not affect the other classes.The early course of PTSD symptoms is characterized by distinct and diverging response patterns that are centrally relevant to understanding the disorder and preventing its occurrence. Studies of the pathogenesis of PTSD may benefit from using

  15. In search of the trauma memory: a meta-analysis of functional neuroimaging studies of symptom provocation in posttraumatic stress disorder (PTSD.

    Directory of Open Access Journals (Sweden)

    Gudrun Sartory

    Full Text Available Notwithstanding some discrepancy between results from neuroimaging studies of symptom provocation in posttraumatic stress disorder (PTSD, there is broad agreement as to the neural circuit underlying this disorder. It is thought to be characterized by an exaggerated amygdalar and decreased medial prefrontal activation to which the elevated anxiety state and concomitant inadequate emotional regulation are attributed. However, the proposed circuit falls short of accounting for the main symptom, unique among anxiety disorders to PTSD, namely, reexperiencing the precipitating event in the form of recurrent, distressing images and recollections. Owing to the technical demands, neuroimaging studies are usually carried out with small sample sizes. A meta-analysis of their findings is more likely to cast light on the involved cortical areas. Coordinate-based meta-analyses employing ES-SDM (Effect Size Signed Differential Mapping were carried out on 19 studies with 274 PTSD patients. Thirteen of the studies included 145 trauma-exposed control participants. Comparisons between reactions to trauma-related stimuli and a control condition and group comparison of reactions to the trauma-related stimuli were submitted to meta-analysis. Compared to controls and the neutral condition, PTSD patients showed significant activation of the mid-line retrosplenial cortex and precuneus in response to trauma-related stimuli. These midline areas have been implicated in self-referential processing and salient autobiographical memory. PTSD patients also evidenced hyperactivation of the pregenual/anterior cingulate gyrus and bilateral amygdala to trauma-relevant, compared to neutral, stimuli. Patients showed significantly less activation than controls in sensory association areas such as the bilateral temporal gyri and extrastriate area which may indicate that the patients' attention was diverted from the presented stimuli by being focused on the elicited trauma memory. Being

  16. High prevalence of posttraumatic stress disorder (PTSD) and pain sensitization in two Scandinavian samples of patients referred for pain rehabilitation

    DEFF Research Database (Denmark)

    Jensen, Troels Staehelin

    2012-01-01

    were asked to report if cold, brush, and pinprick mechanical stimulation resulted in decreased or increased sensation or pain. Results: A high prevalence of PTSD was found in both consecutive samples. Using the DSM-IV criteria, 23% fulfilled the criteria for a possible PTSD diagnosis. There were...... to PTSD. However, hypersensitivity to cold and hyposensitivity to brush were significantly associated with PTSD. Discussion: The prevalence of PTSD in the present study was 23%. Earlier studies finding a lower prevalence rate of PTSD may reflect the use of older diagnostic criteria for PTSD or other...

  17. Change in negative cognitions associated with PTSD predicts symptom reduction in prolonged exposure.

    Science.gov (United States)

    Zalta, Alyson K; Gillihan, Seth J; Fisher, Aaron J; Mintz, Jim; McLean, Carmen P; Yehuda, Rachel; Foa, Edna B

    2014-02-01

    The goal of the current study was to examine mechanisms of change in prolonged exposure (PE) therapy for posttraumatic stress disorder (PTSD). Emotional processing theory of PTSD proposes that disconfirmation of erroneous cognitions associated with PTSD is a central mechanism in PTSD symptom reduction; but to date, the causal relationship between change in pathological cognitions and change in PTSD severity has not been established. Female sexual or nonsexual assault survivors (N = 64) with a primary diagnosis of PTSD received 10 weekly sessions of PE. Self-reported PTSD symptoms, depression symptoms, and PTSD-related cognitions were assessed at pretreatment, each of the 10 PE treatment sessions, and posttreatment. Lagged mixed-effect regression models indicated that session-to-session reductions in PTSD-related cognitions drove successive reductions in PTSD symptoms. By contrast, the reverse effect of PTSD symptom change on change in cognitions was smaller and did not reach statistical significance. Similarly, reductions in PTSD-related cognitions drove successive reductions in depression symptoms, whereas the reverse effect of depression symptoms on subsequent cognition change was smaller and not significant. Notably, the relationships between changes in cognitions and PTSD symptoms were stronger than the relationships between changes in cognitions and depression symptoms. To our knowledge, this is the 1st study to establish change in PTSD-related cognitions as a central mechanism of PE treatment. These findings are consistent with emotional processing theory and have important clinical implications for the effective implementation of PE. PsycINFO Database Record (c) 2014 APA, all rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Jennifer Wild

    2016-11-01

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

  19. The Efficacy and Safety of Add-on Ginko TD (Ginkgo Biloba Treatment for PTSD: Results of a 12-Week Double-Blind Placebo-Controlled Study

    Directory of Open Access Journals (Sweden)

    Laleh Koohi Habibi

    2007-06-01

    Full Text Available "nObjective: Exposure to traumatic stressors lead to activation of arousal responses mediated by serotonergic and noradrenergic systems and it may cause a change in numerous neurotransmitters and neuroendocrine systems. There is ample experimental and clinical evidence to suggest that Ginkgo biloba extract is neuroprotective and has antioxidant properties and can restore stress-induced elevation in brain levels of catecholamines, 5-HT and plasma corticosterone to normal level. "nMethod: In a 12-week, double-blind, placebo-controlled study, the efficacy and safety of adding-on a fixed-dose (200mg of Ginkgo TD to the previous treatment regime of adults with PTSD were examined. Subjects were forty male and female outpatients from a public-owned psychiatric clinic who met criteria for PTSD seven month after a 6.3 Richter earthquake in Bam city on December 26, 2003. The changes in five symptom domains including posttraumatic stress, anxiety and affective symptoms, general health and subjective stress after trauma were ssessed at weeks 0, 12 and 16 to examine effectiveness of the added-on Ginkgo TD and stability of its effects. "nResults: Ginkgo TD was associated with a significantly greater improvement than placebo in PTSD patients as measured by five symptom domain scales including: GHQ-28; Watson PTSD Scale; HAM-D; HAM-A and IES (p= 0.02, 0.01, 0.001, 0.01, 0.02 respectively Four weeks after the discontinuation of intervention, no significant difference was determined between the two groups in the five outcome measures (p= 0.005, 0.01, 0.004, 0.005, 0.01 respectively. No significant difference was observed between the two groups in terms of side effects. "nConclusions: We found Ginkgo TD to be superior to placebo as an adding-on in the treatment of PTSD. Although we did not examine the comparative efficacy of Ginkgo TD on the three main elements of PTSD, beneficial effects both on specific PTSD symptomatology and general conditions including

  20. e-PTSD: an overview on how new technologies can improve prediction and assessment of Posttraumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Bourla, Alexis; Mouchabac, Stephane; El Hage, Wissam; Ferreri, Florian

    2018-01-01

    Background : New technologies may profoundly change our way of understanding psychiatric disorders including posttraumatic stress disorder (PTSD). Imaging and biomarkers, along with technological and medical informatics developments, might provide an answer regarding at-risk patient's identification. Recent advances in the concept of 'digital phenotype', which refers to the capture of characteristics of a psychiatric disorder by computerized measurement tools, is one paradigmatic example. Objective : The impact of the new technologies on health professionals practice in PTSD care remains to be determined. The recent evolutions could disrupt the clinical practices and practitioners in their beliefs, ethics and representations, going as far as questioning their professional culture. In the present paper, we conducted an extensive search to highlight the articles which reflect the potential of these new technologies. Method : We conducted an overview by querying PubMed database with the terms [PTSD] [Posttraumatic stress disorder] AND [Computer] OR [Computerized] OR [Mobile] OR [Automatic] OR [Automated] OR [Machine learning] OR [Sensor] OR [Heart rate variability] OR [HRV] OR [actigraphy] OR [actimetry] OR [digital] OR [motion] OR [temperature] OR [virtual reality]. Results : We summarized the synthesized literature in two categories: prediction and assessment (including diagnostic, screening and monitoring). Two independent reviewers screened, extracted data and quality appraised the sources. Results were synthesized narratively. Conclusions : This overview shows that many studies are underway allowing researchers to start building a PTSD digital phenotype using passive data obtained by biometric sensors. Active data obtained from Ecological Momentary Assessment (EMA) could allow clinicians to assess PTSD patients. The place of connected objects, Artificial Intelligence and remote monitoring of patients with psychiatric pathology remains to be defined. These tools

  1. Predictors of PTSD Treatment Response Trajectories in a Sample of Childhood Sexual Abuse Survivors: The Roles of Social Support, Coping, and PTSD Symptom Clusters.

    Science.gov (United States)

    Fletcher, Shelley; Elklit, Ask; Shevlin, Mark; Armour, Cherie

    2017-11-01

    This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors.

  2. Perceived Treatment Needs Among Women With Co-occurring Substance Use Disorders and PTSD.

    Science.gov (United States)

    Resko, Stella M; Brown, Suzanne; Mendoza, Natasha S; Crosby, Shantel; González-Prendes, Antonio

    2016-01-01

    Perception of need is a key factor that influences decisions to seek help and complete treatment for substance use and mental health problems. In the current study, we examine patterns of perceived treatment needs among women with co-occurring substance use disorders and posttraumatic stress disorder (PTSD) and explore how these patterns are associated with demographics, psychosocial variables, and treatment-related factors. Secondary data analysis of the Women and Trauma Study from the National Institute on Drug Abuse's Clinical Trial Network was conducted. The sample included 353 women with co-occurring substance use disorders and PTSD (full or subthreshold) receiving outpatient substance abuse treatment. Latent class analysis was used to examine patterns of perceived treatment need and multinomial logistic regression was used to identify characteristics associated with these patterns. The sample included women between the ages of 18 and 65 (mean = 39.2, SD = 9.3) and was 46% White, 34% African American, and 21% other races/ethnicities. A three-class model representing unique perceptions of treatment needs demonstrated the best fit (Bayesian information criterion = 2101.43; entropy = 0.76; average posterior probabilities ≤ 0.82). Class one reported elevated needs in multiple areas (38%), class two reported low needs (23%), and class three reported substance use and psychological needs (40%). Living with a substance abuser, depression symptoms, recent substance use, and treatment coercion were significantly associated with membership in class 2 (OR = .28, .84, .22, and 2.32, respectively). Other race, being married, depression symptoms, recent substance use, and criminal justice involvement were associated with membership in class 3 (OR = 2.32, 2.32, .94, .42, and 1.69, respectively). Number of treatment sessions attended was not significantly associated with class membership. Results provide insight into how women with co-occurring PTSD and substance use

  3. Stable isotopes labelled compounds

    International Nuclear Information System (INIS)

    1982-09-01

    The catalogue on stable isotopes labelled compounds offers deuterium, nitrogen-15, and multiply labelled compounds. It includes: (1) conditions of sale and delivery, (2) the application of stable isotopes, (3) technical information, (4) product specifications, and (5) the complete delivery programme

  4. Stable Boundary Layer Issues

    NARCIS (Netherlands)

    Steeneveld, G.J.

    2012-01-01

    Understanding and prediction of the stable atmospheric boundary layer is a challenging task. Many physical processes are relevant in the stable boundary layer, i.e. turbulence, radiation, land surface coupling, orographic turbulent and gravity wave drag, and land surface heterogeneity. The

  5. Evolutionary Stable Strategy

    Indian Academy of Sciences (India)

    IAS Admin

    After Maynard-Smith and Price [1] mathematically derived why a given behaviour or strategy was adopted by a certain proportion of the population at a given time, it was shown that a strategy which is currently stable in a population need not be stable in evolutionary time (across generations). Additionally it was sug-.

  6. 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.

  7. Portuguese version of the PTSD Checklist-Military Version (PCL-M - II: diagnostic utility

    Directory of Open Access Journals (Sweden)

    Teresa Carvalho

    2015-03-01

    Full Text Available Objective: War veterans are at high risk of developing posttraumatic stress disorder (PTSD, and the development of brief self-report instruments that enable screening for PTSD in this population is crucial. The PTSD Checklist-Military Version (PCL-M is widely used for this purpose. This study sought to explore the diagnostic utility of the Portuguese version of the PCL-M. Methods: The participants were 86 Portuguese Colonial War veterans (42 with a PTSD diagnosis and 44 without PTSD. Participants completed a self-report instrument designed to collect sociodemographic data, the PCL-M, and the Clinician-Administered PTSD Scale (CAPS. Results: The area under the receiver operator characteristic (ROC curve showed excellent discriminant ability between subjects with and without PTSD (AUC = 0.94. To achieve a positive PTSD diagnosis, an optimal cutoff point of 49 for the PCL-M total score and cutoff points for each of its 17 items are recommended. Conclusions: This work is a relevant contribution for research and clinical practice in the vast population of Portuguese Colonial War veterans. Use of the PCL-M as a screening tool for PTSD symptoms will allow easier, resource-aware targeting of subjects with a potential PTSD diagnosis, adding to the improvement of public health in Portugal.

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

    Science.gov (United States)

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

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chengqi Cao

    2014-12-01

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

  10. A simple model for prediction postpartum PTSD in high-risk pregnancies.

    Science.gov (United States)

    Shlomi Polachek, Inbal; Dulitzky, Mordechai; Margolis-Dorfman, Lilia; Simchen, Michal J

    2016-06-01

    This study aimed to examine the prevalence and possible antepartum risk factors of complete and partial post-traumatic stress disorder (PTSD) among women with complicated pregnancies and to define a predictive model for postpartum PTSD in this population. Women attending the high-risk pregnancy outpatient clinics at Sheba Medical Center completed the Edinburgh Postnatal Depression Scale (EPDS) and a questionnaire regarding demographic variables, history of psychological and psychiatric treatment, previous trauma, previous childbirth, current pregnancy medical and emotional complications, fears from childbirth, and expected pain. One month after delivery, women were requested to repeat the EPDS and complete the Post-traumatic Stress Diagnostic Scale (PDS) via telephone interview. The prevalence rates of postpartum PTSD (9.9 %) and partial PTSD (11.9 %) were relatively high. PTSD and partial PTSD were associated with sadness or anxiety during past pregnancy or childbirth, previous very difficult birth experiences, preference for cesarean section in future childbirth, emotional crises during pregnancy, increased fear of childbirth, higher expected intensity of pain, and depression during pregnancy. We created a prediction model for postpartum PTSD which shows a linear growth in the probability for developing postpartum PTSD when summing these seven antenatal risk factors. Postpartum PTSD is extremely prevalent after complicated pregnancies. A simple questionnaire may aid in identifying at-risk women before childbirth. This presents a potential for preventing or minimizing postpartum PTSD in this population.

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

    Directory of Open Access Journals (Sweden)

    Anna Tiihonen Möller

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

  12. Intranasal Oxytocin Administration Dampens Amygdala Reactivity towards Emotional Faces in Male and Female PTSD Patients.

    Science.gov (United States)

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

    2016-05-01

    Post-traumatic stress disorder (PTSD) is a disabling psychiatric disorder. As a substantial part of PTSD patients responds poorly to currently available psychotherapies, pharmacological interventions boosting treatment response are needed. Because of its anxiolytic and pro-social properties, the neuropeptide oxytocin (OT) has been proposed as promising strategy for treatment augmentation in PTSD. As a first step to investigate the therapeutic potential of OT in PTSD, we conducted a double-blind, placebo-controlled, cross-over functional MRI study examining OT administration effects (40 IU) on amygdala reactivity toward emotional faces in unmedicated male and female police officers with (n=37, 21 males) and without (n=40, 20 males) PTSD. Trauma-exposed controls were matched to PTSD patients based on age, sex, years of service and educational level. Under placebo, the expected valence-dependent amygdala reactivity (ie, greater activity toward fearful-angry faces compared with happy-neutral faces) was absent in PTSD patients. OT administration dampened amygdala reactivity toward all emotional faces in male and female PTSD patients, but enhanced amygdala reactivity in healthy male and female trauma-exposed controls, independent of sex and stimulus valence. In PTSD patients, greater anxiety prior to scanning and amygdala reactivity during the placebo session were associated with greater reduction of amygdala reactivity after OT administration. Taken together, our results indicate presumably beneficial neurobiological effects of OT administration in male and female PTSD patients. Future studies should investigate OT administration in clinical settings to fully appreciate its therapeutic potential.

  13. The Dissociative Subtype of Posttraumatic Stress Disorder (PTSD) Among Adolescents: Co-Occurring PTSD, Depersonalization/Derealization, and Other Dissociation Symptoms.

    Science.gov (United States)

    Choi, Kristen R; Seng, Julia S; Briggs, Ernestine C; Munro-Kramer, Michelle L; Graham-Bermann, Sandra A; Lee, Robert C; Ford, Julian D

    2017-12-01

    The purpose of this study was to examine the co-occurrence of posttraumatic stress disorder (PTSD) and dissociation in a clinical sample of trauma-exposed adolescents by evaluating evidence for the depersonalization/derealization dissociative subtype of PTSD as defined by the DSM-5 and then examining a broader set of dissociation symptoms. A sample of treatment-seeking, trauma-exposed adolescents 12 to 16 years old (N = 3,081) from the National Child Traumatic Stress Network Core Data Set was used to meet the study objectives. Two models of PTSD/dissociation co-occurrence were estimated using latent class analysis, one with 2 dissociation symptoms and the other with 10 dissociation symptoms. After model selection, groups within each model were compared on demographics, trauma characteristics, and psychopathology. Model A, the depersonalization/derealization model, had 5 classes: dissociative subtype/high PTSD; high PTSD; anxious arousal; dysphoric arousal; and a low symptom/reference class. Model B, the expanded dissociation model, identified an additional class characterized by dissociative amnesia and detached arousal. These 2 models provide new information about the specific ways PTSD and dissociation co-occur and illuminate some differences between adult and adolescent trauma symptom expression. A dissociative subtype of PTSD can be distinguished from PTSD alone in adolescents, but assessing a wider range of dissociative symptoms is needed to fully characterize adolescent traumatic stress responses. Copyright © 2017 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Preventing PTSD with oxytoxin : Effects of oxytocin administration on fear neurocircuitry and PTSD symptom development in recently trauma-exposed individuals

    NARCIS (Netherlands)

    Frijling, J.L.

    2017-01-01

    The overall aim of the current PhD-thesis was to investigate the potential of intranasal oxytocin administration as early preventive intervention for PTSD, by assessing the effects of intranasal oxytocin early after trauma on functioning of the fear neurocircuitry and on PTSD symptom development in

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

    Directory of Open Access Journals (Sweden)

    Suzannah K. Creech

    2017-06-01

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

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

    Science.gov (United States)

    Bader, Heather N; Bierer, Linda M; Lehrner, Amy; Makotkine, Iouri; Daskalakis, Nikolaos P; Yehuda, Rachel

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Heather N Bader

    2014-07-01

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

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

    Science.gov (United States)

    Bader, Heather N.; Bierer, Linda M.; Lehrner, Amy; Makotkine, Iouri; Daskalakis, Nikolaos P.; Yehuda, Rachel

    2014-01-01

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

  19. Pharmacological interventions for preventing post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Amos, Taryn; Stein, Dan J; Ipser, Jonathan C

    2014-07-08

    Post-traumatic stress disorder (PTSD) is a debilitating disorder which, after a sufficient delay, may be diagnosed amongst individuals who respond with intense fear, helplessness or horror to traumatic events. There is some evidence that the use of pharmacological interventions immediately after exposure to trauma may reduce the risk of developing of PTSD. To assess the effects of pharmacological interventions for the prevention of PTSD in adults following exposure to a traumatic event. We searched the Cochrane Depression, Anxiety and Neurosis Controlled Trials Register (CCDANCTR-Studies and CCDANCTR-References) (to 14 February 2014). This register contains relevant reports of randomised controlled trials from the following bibliographic databases: CENTRAL (all years); EMBASE (1974 to date); MEDLINE (1950 to date) and PsycINFO (1967 to date). We identified unpublished trials by searching the National Institute of Health (NIH) Reporter, the metaRegister of Controlled Trials database (mRCT) and the WHO International Clinical Trials Registry Platform (to December 2013). We scanned the reference lists of articles for additional studies. We placed no constraints on language and setting. We restricted studies to randomised controlled trials (RCTs) of pharmacological interventions compared with placebo for the prevention of PTSD in adults. Two authors (TA and JI) independently assessed trials for eligibility and inclusion based on the review selection criteria. We independently extracted sample, methodological, outcome and 'Risk of bias' data, as well as the number of side effects, from each trial and entered these into a customised data extraction form. We contacted investigators for missing information. We calculated summary statistics for continuous and dichotomous variables (if provided). We did not undertake subgroup analyses due to the small number of included studies. We included nine short-term RCTs (duration 12 weeks or less) in the analysis (345 participants

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

    Science.gov (United States)

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

    2016-10-01

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

  1. PTSD after childbirth: A predictive ethological model for symptom development.

    Science.gov (United States)

    Haagen, Joris F G; Moerbeek, Mirjam; Olde, Eelco; van der Hart, Onno; Kleber, Rolf J

    2015-10-01

    Childbirth can be a traumatic experience occasionally leading to posttraumatic stress disorder (PTSD). This study aimed to assess childbirth-related PTSD risk-factors using an etiological model inspired by the transactional model of stress and coping. 348 out of 505 (70%) Dutch women completed questionnaires during pregnancy, one week postpartum, and three months postpartum. A further 284 (56%) also completed questionnaires ten months postpartum. The model was tested using path analysis. Antenatal depressive symptoms (β=.15, pdepressive symptoms (β=.31, pdepression, anxiety and dissociative tendencies. Hospital staff and midwives are advised to be vigilant for perinatal dissociation after intense negative emotions. To help regulate perinatal negative emotional responses, hospital staff and midwifes are recommended to provide information about birth procedures and be attentive to women's birth-related needs. Copyright © 2015 Elsevier B.V. All rights reserved.

  2. Implementing an Assessment Clinic in a Residential PTSD Program

    Directory of Open Access Journals (Sweden)

    Joan McDowell

    2014-08-01

    Full Text Available Creating useful treatment plans can help improve services to consumers of mental health services. As more evidence-based practices are implemented, deciding what treatment, at what time, for whom becomes an important factor in facilitating positive outcomes. Readiness for trauma-focused treatments for Posttraumatic Stress Disorder (PTSD such as Cognitive Processing Therapy or Prolonged Exposure Therapy may influence whether an individual can successfully complete either protocol. In addition, components of adjunctive therapies such as Acceptance and Commitment Therapy or Dialectical Behavior Therapy may be useful in moving a particular patient toward readiness and successful completion of treatment. Psychological assessment adds valuable data to inform these types of treatment decisions. This paper describes the implementation of a psychological assessment clinic in a residential PTSD treatment setting. Barriers to implementation, use of the data, and Veterans’ reactions to the feedback provided to them are included.

  3. Emergence of Transdiagnostic Treatments for PTSD and Posttraumatic Distress.

    Science.gov (United States)

    Gutner, Cassidy A; Galovski, Tara; Bovin, Michelle J; Schnurr, Paula P

    2016-10-01

    Both theoretical and empirical findings have demonstrated similarities across diagnoses, leading to a growing interest in transdiagnostic interventions. Most of the evidence supporting transdiagnostic treatment has accumulated for depression, anxiety, and eating disorders, with minimal attention given to posttraumatic stress disorder and other reactions to traumatic stressors. Although single-diagnosis protocols are effective for posttraumatic stress disorder (PTSD) and other trauma-related disorders, in principle, transdiagnostic approaches may have beneficial applications within a traumatized population. This paper defines different types of transdiagnostic treatments, reviews transdiagnostic approaches used in related disorders, and discusses their applicability to PTSD. Examples are drawn from existing transdiagnostic treatments in order to provide a framework for the application of such interventions to the field of traumatic stress. Implications for implementation and dissemination are also discussed.

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

    Directory of Open Access Journals (Sweden)

    Lucía Del Carmen Quezada Berumen

    2015-11-01

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

  5. Normal modified stable processes

    DEFF Research Database (Denmark)

    Barndorff-Nielsen, Ole Eiler; Shephard, N.

    2002-01-01

    This paper discusses two classes of distributions, and stochastic processes derived from them: modified stable (MS) laws and normal modified stable (NMS) laws. This extends corresponding results for the generalised inverse Gaussian (GIG) and generalised hyperbolic (GH) or normal generalised inverse...... Gaussian (NGIG) laws. The wider framework thus established provides, in particular, for added flexibility in the modelling of the dynamics of financial time series, of importance especially as regards OU based stochastic volatility models for equities. In the special case of the tempered stable OU process...

  6. Applications of stable isotopes

    International Nuclear Information System (INIS)

    Letolle, R.; Mariotti, A.; Bariac, T.

    1991-06-01

    This report reviews the historical background and the properties of stable isotopes, the methods used for their measurement (mass spectrometry and others), the present technics for isotope enrichment and separation, and at last the various present and foreseeable application (in nuclear energy, physical and chemical research, materials industry and research; tracing in industrial, medical and agronomical tests; the use of natural isotope variations for environmental studies, agronomy, natural resources appraising: water, minerals, energy). Some new possibilities in the use of stable isotope are offered. A last chapter gives the present state and forecast development of stable isotope uses in France and Europe

  7. Thermally Stable, Latent Olefin Metathesis Catalysts

    OpenAIRE

    Thomas, Renee M.; Fedorov, Alexey; Keitz, Benjamin K.; Grubbs, Robert H.

    2011-01-01

    Highly thermally stable N-aryl,N-alkyl N-heterocyclic carbene (NHC) ruthenium catalysts were designed and synthesized for latent olefin metathesis. These catalysts showed excellent latent behavior toward metathesis reactions, whereby the complexes were inactive at ambient temperature and initiated at elevated temperatures, a challenging property to achieve with second generation catalysts. A sterically hindered N-tert-butyl substituent on the NHC ligand of the ruthenium complex was found to i...

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

    Science.gov (United States)

    2016-10-01

    B.C. September 25 – September 26, 2015 Evaluating Clinicians’ Use of a Web-based Training in Cognitive Behavioral Therapy for PTSD : Impact on...Psychologically-based treatments and cognitive behavioral therapy (CBT) interventions have been shown to be effective in alleviating symptoms of Post...training methods across a variety of treatment settings. KEYWORDS Behavioral Task Assignment (BTA) Chain Analysis (CA) Cognitive behavioral

  9. Principles for developing animal models of military PTSD

    Directory of Open Access Journals (Sweden)

    Nikolaos P. Daskalakis

    2014-08-01

    Full Text Available The extent to which animal studies can be relevant to military posttraumatic stress disorder (PTSD continues to be a matter of discussion. Some features of the clinical syndrome are more easily modeled than others. In the animal literature, a great deal of attention is focused on modeling the characteristics of military exposures and their impact on measurable behaviors and biological parameters. There are many issues to consider regarding the ecological validity of predator, social defeat or immobilization stress to combat-related experience. In contrast, less attention has been paid to individual variation following these exposures. Such variation is critical to understand how individual differences in the response to military trauma exposure may result to PTSD or resilience. It is important to consider potential differences in biological findings when comparing extremely exposed to non-exposed animals, versus those that result from examining individual differences. Animal models of military PTSD are also critical in advancing efforts in clinical treatment. In an ideal translational approach to study deployment related outcomes, information from humans and animals, blood and brain, should be carefully considered in tandem, possibly even computed simultaneously, to identify molecules, pathways and networks that are likely to be the key drivers of military PTSD symptoms. With the use novel biological methodologies (e.g., optogenetics in the animal models, critical genes and pathways can be tuned up or down (rather than over-expressed or ablated completely in discrete brain regions. Such techniques together with pre-and post-deployment human imaging will accelerate the identification of novel pharmacological and non-pharmacological intervention strategies.

  10. Development and Validation of a PTSD-Related Impairment Scale

    Science.gov (United States)

    2012-06-01

    Applications in AIDS, cystic fibrosis , and arthritis. Mtdical Cau, 27, S27-43. Karschnig, H. (2006). How useful is the concept of quality oflife in...discharge, (2) to promote accurate diagnosis , (3) to guide treatment planning by clarifying the domains in which the individual is experiencing...important implica- tions for both the diagnosis and treatment of individuals with PTSD and other stress-related disorders. With respect to diagnosis

  11. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2017-12-01

    points during the study. The investigation sought to improve treatment outcomes for combat-related psychological health and develop an evidence-based...on Psychological , Neuropsychological, and Speech Symptoms in Comorbid PTSD and TBI. Cognitive and Behavioral Practice, 23, 178-83. doi:10.1016...Society, Washington, D.C. 11 Jak, A.J. (2017). Integrating the ’Neuro’ and ’ Psychology ’ in the Clinical Presentation of Persistent Post

  12. A Nonpharmacologic Method for Enhancing Sleep in PTSD

    Science.gov (United States)

    2016-10-01

    TJ, & Wildzunas, RM. Total sleep time measured by actigraphy predicts academic performance during military training [abstract]. Abstract presented...pharmacologic approach to improving sleep and regulating circadian rhythms among individuals with PTSD. In this study, we will evaluate the effectiveness of a...will be randomly assigned to receive 30 minutes of daily morning blue light therapy (BL) or an amber light placebo treatment (PL). Sleep quality and

  13. A Nonpharmacologic Method for Enhancing Sleep in PTSD

    Science.gov (United States)

    2017-10-01

    strengthens the effective connectivity among cortical and subcortical regions: Evidence for the restorative effects of sleep using H215O PET [abstract...Recent evidence suggests that sleep may play a critical role in the ability to effectively extinguish conditioned fear responses and is necessary for...problems as a secondary effect of PTSD, a novel approach would involve directly targeting and ameliorating the sleep problems, potentially leading to

  14. Towards a better preclinical model of PTSD: characterizing animals with weak extinction, maladaptive stress responses and low plasma corticosterone.

    Science.gov (United States)

    Reznikov, Roman; Diwan, Mustansir; Nobrega, José N; Hamani, Clement

    2015-02-01

    Most of the available preclinical models of PTSD have focused on isolated behavioural aspects and have not considered individual variations in response to stress. We employed behavioural criteria to identify and characterize a subpopulation of rats that present several features analogous to PTSD-like states after exposure to classical fear conditioning. Outbred Sprague-Dawley rats were segregated into weak- and strong-extinction groups on the basis of behavioural scores during extinction of conditioned fear responses. Animals were subsequently tested for anxiety-like behaviour in the open-field test (OFT), novelty suppressed feeding (NSF) and elevated plus maze (EPM). Baseline plasma corticosterone was measured prior to any behavioural manipulation. In a second experiment, rats underwent OFT, NSF and EPM prior to being subjected to fear conditioning to ascertain whether or not pre-stress levels of anxiety-like behaviours could predict extinction scores. We found that 25% of rats exhibit low extinction rates of conditioned fear, a feature that was associated with increased anxiety-like behaviour across multiple tests in comparison to rats showing strong extinction. In addition, weak-extinction animals showed low levels of corticosterone prior to fear conditioning, a variable that seemed to predict extinction recall scores. In a separate experiment, anxiety measures taken prior to fear conditioning were not predictive of a weak-extinction phenotype, suggesting that weak-extinction animals do not show detectable traits of anxiety in the absence of a stressful experience. These findings suggest that extinction impairment may be used to identify stress-vulnerable rats, thus providing a useful model for elucidating mechanisms and investigating potential treatments for PTSD. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. De stille elever

    DEFF Research Database (Denmark)

    Winther-Lindqvist, Ditte Alexandra

    2012-01-01

    Det er blevet en afgørende samværskompetence i uddannelsessystemet at stå aktivt frem og deltage verbalt i skoleklassens liv både fagligt og socialt. Men ikke alle elever deltager lige villigt verbalt i plenum. Artiklen handler om de stille elever og konsekvenserne af stillehed i skolen. Det...... foreslås at skolesystemet sanktionerer ældre elever hårdere for stillehed end yngre elever og det forklares med at skolelivet også er en kultivering henimod elevhed som social identitet og denne er der forventning om at eleverne mestrer i udskolingen....

  16. Analysing Stable Time Series

    National Research Council Canada - National Science Library

    Adler, Robert

    1997-01-01

    We describe how to take a stable, ARMA, time series through the various stages of model identification, parameter estimation, and diagnostic checking, and accompany the discussion with a goodly number...

  17. Stable isotope ratios and reforestation potential in Acacia koa populations on Hawai'i

    Science.gov (United States)

    Shaneka Lawson; Carrie Pike

    2017-01-01

    Stable carbon and nitrogen isotopes can be influenced by a multitude of factors including elevation, precipitation rate, season, and temperature. This work examined variability in foliar stable carbon (δ13C) and nitrogen (δ15N) isotope ratios of koa (Acacia koa) across 17 sites on Hawai'i Island, delineated by elevation and precipitation...

  18. PTSD as a mediator of sexual revictimization: the role of reexperiencing, avoidance, and arousal symptoms.

    Science.gov (United States)

    Risser, Heather J; Hetzel-Riggin, Melanie D; Thomsen, Cynthia J; McCanne, Thomas R

    2006-10-01

    Theory and research suggest that posttraumatic stress disorder (PTSD) may mediate the relationship between child sexual abuse and adult sexual assault. However, little empirical research has examined the mediational role of PTSD. In the present study, the authors use structural equation modeling to examine the degree to which the three symptom clusters that define PTSD (reexperiencing, avoidance, and hyperarousal) contribute to sexual revictimization. To assess PTSD symptomatology, undergraduate women completed questionnaires (N = 1,449), which detailed the history and severity of childhood and adult sexual assault experiences. Results indicated that PTSD mediated sexual revictimization. When PTSD symptom clusters were examined individually, only the hyperarousal cluster was a significant mediator. Results are discussed in terms of information-processing mechanisms that may underlie sexual revictimization.

  19. Assessment and treatment of PTSD after a motor vehicle collision: Empirical findings and clinical observations

    Science.gov (United States)

    Beck, J. Gayle; Coffey, Scott F.

    2007-01-01

    Individuals who experience a serious motor vehicle accident (MVA) are at increased risk for psychological problems, particularly Posttraumatic Stress Disorder (PTSD). In this article, we review the literature on PTSD among MVA survivors, with particular attention to available instruments to screen for and assess symptomatology of the disorder. Approaches to the treatment of PTSD in this population are reviewed, separated into interventions designed to prevent PTSD in unselected samples, treatment targeting individuals with Acute Stress Disorder that are designed to prevent subsequent development of PTSD, and therapy for individuals with chronic PTSD. Treatment process issues are discussed, in an effort to integrate empirical findings with clinical observations. The empirical literature suggests several approaches to treatment that have good potential outcomes, although continued work is needed to identify factors that predict treatment response, as well as augment individual-based treatment formats. PMID:18509507

  20. Gender, trauma type, and PTSD prevalence: a re-analysis of 18 nordic convenience samples

    DEFF Research Database (Denmark)

    Ditlevsen, D. N.; Elklit, A.

    2012-01-01

    Background: The aim of the study was to examine a possible trauma type related variance in the gender difference of posttraumatic stress disorder (PTSD) prevalence. Methods: An analysis was conducted on 18 convenience sample studies including data from a total of 5220 participants. The studies all...... applied the Harvard Trauma Questionnaire - part IV to assess PTSD. Cohen's d was used to measure variance in gender differences. Trauma types included disasters and accidents, violence, loss, chronic disease and non-malignant diseases. Results: The results showed an overall gender difference in PTSD...... prevalence similar to previous findings. Thus, women had a two-fold higher prevalence of PTSD than men. Besides categorical analyses, dimensional analyses of PTSD severity were also performed; the latter were associated with twice as large effect sizes. Females were more vulnerable to PTSD after disasters...

  1. PTSD in former prisoners of war: prewar, wartime, and postwar factors.

    Science.gov (United States)

    Dikel, Thomas N; Engdahl, Brian; Eberly, Raina

    2005-02-01

    We investigated relationships among prewar, wartime, and postwar factors and posttraumatic stress disorder (PTSD) severity in a community sample of 160 former prisoners of war (POWs). Data were collected from structured clinical interviews, self-report questionnaires, and military service records. POW camp trauma was most predictive of PTSD severity, followed by a refined postwar Social Support variable: Interpersonal Connection. Prewar conduct disorder behavior was positively predictive of PTSD and negatively predictive of Interpersonal Connection. Combat exposure and age at capture were also predictive of PTSD. Prewar family closeness was not a significant predictor of PTSD but was predictive of postwar Interpersonal Connection. This study provides further empirical evidence that trauma, when sufficiently severe, is the most significant predictor of PTSD severity.

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

    Science.gov (United States)

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

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

  3. The Relevance of Epigenetics to PTSD: Implications for the DSM-V

    Science.gov (United States)

    Yehuda, Rachel; Bierer, Linda M.

    2009-01-01

    Epigenetic modifications, such as DNA methylation, can occur in response to environmental influences to alter the functional expression of genes in an enduring and potentially, intergenerationally transmissible manner. As such, they may explain inter-individual variation, as well as the long-lasting effects of trauma exposure. While there are currently no findings that suggest epigenetic modifications that are specific to PTSD or PTSD risk, many recent observations are compatible with epigenetic explanations. These include recent findings of stress-related gene expression, in utero contributions to infant biology, the association of PTSD risk with maternal PTSD, and the relevance of childhood adversity to the development of PTSD. The relevance of epigenetic mechanisms to formulations of PTSD for the DSM-V is described. PMID:19813242

  4. Cognitive processing therapy for veterans with comorbid PTSD and alcohol use disorders.

    Science.gov (United States)

    Kaysen, Debra; Schumm, Jeremiah; Pedersen, Eric R; Seim, Richard W; Bedard-Gilligan, Michele; Chard, Kathleen

    2014-02-01

    Posttraumatic stress disorder (PTSD) and alcohol-use disorders (AUD) frequently present comorbidity in veteran populations. Traditionally those with alcohol dependence have been excluded from PTSD treatment outcome studies, thus we do not know how those with alcohol dependence may tolerate or respond to PTSD-specific interventions; no studies to date have examined the extent to which cognitive PTSD interventions are tolerated or effective for those with comorbid PTSD/AUD. The present study examines the extent to which CPT is tolerated by and effective in treating PTSD symptoms for veterans with PTSD and AUD, as compared to veterans with PTSD only in an outpatient treatment setting. Data were obtained through chart review of 536 veterans diagnosed with PTSD who had received at least 1 session of CPT at a Midwestern US Veterans Affairs hospital. Nearly half (n=264, 49.3%) of the veterans in the study exhibited a current or past AUD diagnosis. Participants were grouped into the following diagnostic groups: current AUD (past 12 months), past AUD (prior to 12 months), and no AUD. Participants completed an average of 9 sessions of CPT with no significant difference between AUD diagnostic groups on the number of CPT sessions completed. Individuals with past AUD had higher initial symptoms of self-reported PTSD symptoms than those with no AUD. All groups reported significant reductions in PTSD symptoms and depression over time. Overall, the results suggest that CPT appears well tolerated among veterans with comorbid AUD and is associated with significant reductions in symptoms of PTSD and depression in an outpatient treatment setting. © 2013.

  5. Effectiveness of Group-Delivered Cognitive Therapy and Treatment Length in Women Veterans with PTSD

    OpenAIRE

    Castillo, Diane T.; Lacefield, Katharine; C’de Baca, Janet; Blankenship, Abby; Qualls, Clifford

    2014-01-01

    The effectiveness and length of group-delivered cognitive treatment for Posttraumatic Stress Disorder (PTSD) was examined in a sample of women veterans. The sample included 271 primarily non-Hispanic white (61%) and Hispanic (25%) women veterans treated in 8-, 10-, or 12-group length sessions with manualized cognitive therapy for PTSD. Outcome was measured with the PTSD Symptom Checklist (PCL) in an intention-to-treat analysis (N = 271), in completer subjects (n = 172), and with group as the ...

  6. Veterans’ PTSD Symptoms and their Partners’ Desired Changes in Key Relationship Domains

    OpenAIRE

    LaMotte, Adam D.; Taft, Casey T.; Reardon, Annemarie F.; Miller, Mark W.

    2015-01-01

    There is a growing literature investigating the connection between veterans’ posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans’ PTSD symptoms and their partners’ perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners’ desired changes in the areas of intimacy, shared activities, and respon...

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

    OpenAIRE

    Ruby Charak; Cherie Armour; Ask Elklit; Disket Angmo; Jon D. Elhai; Hans M. Koot

    2014-01-01

    Background: The factor structure of posttraumatic stress disorder (PTSD) has been extensively studied in Western countries. Some studies have assessed its factor structure in Asia (China, Sri Lanka, and Malaysia), but few have directly assessed the factor structure of PTSD in an Indian adult sample. Furthermore, in a largely patriarchal society in India with strong gender roles, it becomes imperative to assess the association between the factors of PTSD and gender. Objective: The purpose of t...

  8. The Separate and Cumulative Effects of TBI and PTSD on Cognitive Function and Emotional Control

    Science.gov (United States)

    2010-04-01

    0086 TITLE: The Separate and Cumulative Effects of TBI and PTSD on Cognitive Function and Emotional Control PRINCIPAL INVESTIGATOR...AND SUBTITLE The Separate and Cumulative Effects of TBI and PTSD on 5a. CONTRACT NUMBER W81XWH-08-2-0086 Cognitive Function and Emotional Control...NOTES 14. ABSTRACT In an emotional Stroop task, combat-related words were more distracting for Veterans with PTSD than for those without. We

  9. Cognitive predictors and risk factors of PTSD following stillbirth: a short-term longitudinal study.

    OpenAIRE

    Horsch, A.; Jacobs, I.; McKenzie-McHarg, K.

    2015-01-01

    This short-term longitudinal study investigated cognitive predictors and risk factors of posttraumatic stress disorder (PTSD) in mothers following stillbirth. After a stillbirth at ≥ 24 weeks gestational age, 65 women completed structured clinical interviews and questionnaires assessing PTSD symptoms, cognitive predictors (appraisals, dysfunctional strategies), and risk factors (perceived social support, trauma history, obstetric history) at 3 and 6 months. PTSD symptoms decreased between 3 a...

  10. PTSD is negatively associated with physical performance and physical function in older overweight military veterans

    OpenAIRE

    Hall, Katherine S.; Beckham, Jean C.; Bosworth, Hayden B.; Sloane, Richard; Pieper, Carl F.; Morey, Miriam C.

    2014-01-01

    This study examines the effect of posttraumatic stress disorder (PTSD) on function and physical performance in older overweight military Veterans with comorbid conditions. This is a secondary data analysis of older Veterans (mean age = 62.9 yr) participating in a physical activity counseling trial. Study participants with PTSD (n = 67) and without PTSD (n = 235) were identified. Self-reported physical function (36-item Short Form Health Survey) and directly measured physical performance (mobi...

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

    OpenAIRE

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

    2014-01-01

    Background: Posttraumatic stress disorder (PTSD) is a complex and severe mental disorder triggered by exposure to an extraordinarily traumatic event. Human and animal studies have implied the functional role of the oxytocin system in the development of PTSD (Cochran, Fallon, Hill, & Frazier, 2013; Koch et al., 2014; Olff, 2012). Specification of the role of the oxytocin system in the emergence and progression of PTSD symptomatology would provide evidence to inform both theory and clinical pra...

  12. Undervisning af tosprogede elever

    DEFF Research Database (Denmark)

    Horst, Christian

    2003-01-01

    Artiklen fremdrager hovedresultaterne fra Virginia P. Collier's og Wayne P. Thomas's længdeundersøgelser af tosprogede elever i USA, som formentlig er de mest omfattende undersøgelser af undervisningen af tosprogede elever overhovedet. Resultaterne diskuteres i relation til udviklingen af en...

  13. DSM-5 PTSD's symptom dimensions and relations with major depression's symptom dimensions in a primary care sample

    DEFF Research Database (Denmark)

    Contractor, A. A.; Durham, T. A.; Brennan, J. A.

    2014-01-01

    Existing literature indicates significant comorbidity between posttraumatic stress disorder (PTSD) and major depression. We examined whether PTSD's dysphoria and mood/cognitions factors, conceptualized by the empirically supported four-factor DSM-5 PTSD models, account for PTSD's inherent...... and somatic/non-somatic depression. Using 181 trauma-exposed primary care patients, confirmatory factor analyses (CFA) indicated a well-fitting DSM-5 PTSD dysphoria model, DSM-5 numbing model and two-factor depression model. Both somatic and non-somatic depression factors were more related to PTSD's dysphoria...

  14. The relationship between DSM-5 PTSD symptom clusters and alcohol misuse among military veterans.

    Science.gov (United States)

    Walton, Jessica L; Raines, Amanda M; Cuccurullo, Lisa-Ann J; Vidaurri, Desirae N; Villarosa-Hurlocker, Margo C; Franklin, C L

    2018-01-01

    Prior research has revealed a strong relationship between Posttraumatic Stress Disorder (PTSD) and alcohol misuse. However, previous attempts to understand nuanced associations between PTSD symptom clusters and alcohol misuse within military veteran samples have produced mixed results. In an attempt to better understand the associations between PTSD and alcohol misuse, the current study examined the unique relationships between the newly classified Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) PTSD symptom clusters and alcohol misuse in an outpatient sample of military veterans seeking treatment for PTSD and Substance Use Disorders. Veterans (N = 100) were administered a brief battery of self-report questionnaires prior to receiving psychological services to aid in diagnostic assessment and treatment planning. Hierarchical regression analyses revealed that PTSD intrusions (cluster B), negative alterations in cognition and mood (cluster D), and arousal/reactivity (cluster E) symptoms were associated with alcohol misuse. The positive association between alcohol misuse and PTSD symptom severity is consistent with a broader body of literature demonstrating the co-occurrence of these disorders, particularly in military samples. Increased alcohol consumption may interfere with current front-line treatments for PTSD, which encourages patients to experience a full range of emotions. As such, future research should explore the impact of substance use on the effectiveness of trauma focused treatments in the alleviation of DSM-5 PTSD symptoms. (Am J Addict 2018;27:23-28). © 2017 American Academy of Addiction Psychiatry.

  15. Effect of cognitive-behavioral couple therapy for PTSD: a randomized controlled trial.

    Science.gov (United States)

    Monson, Candice M; Fredman, Steffany J; Macdonald, Alexandra; Pukay-Martin, Nicole D; Resick, Patricia A; Schnurr, Paula P

    2012-08-15

    Posttraumatic stress disorder (PTSD) is a prevalent condition associated with intimate relationship problems, and intimate relationship factors have been shown to affect individual PTSD treatment outcomes. To compare cognitive-behavioral conjoint therapy for PTSD (a manualized couple therapy delivered to patients with PTSD and their significant others to simultaneously treat PTSD symptoms and enhance relationship satisfaction) with a wait-list condition. Randomized controlled trial of heterosexual and same-sex couples (n = 40 couples; n = 80 individuals) in which one partner met criteria for PTSD according to the Clinician-Administered PTSD Scale, conducted from 2008 to 2012 in a Department of Veterans Affairs outpatient hospital setting in Boston, Massachusetts, and a university-based research center in Toronto, Ontario, Canada. Symptoms of PTSD, comorbid conditions, and relationship satisfaction were collected by blinded assessors at baseline, at mid treatment (median, 8.00 weeks [range, 1.71-20.43 weeks] after baseline), and at posttreatment (median, 15.86 weeks [range, 7.14-38.57 weeks] after baseline). An uncontrolled 3-month follow-up (median, 38.21 weeks [range, 28.43-50.57 weeks] after baseline) was also completed. Couples were randomly assigned to take part in the 15-session cognitive-behavioral conjoint therapy for PTSD protocol immediately (n = 20) or were placed on a wait list for the therapy (n = 20). Clinician-rated PTSD symptom severity was the primary outcome and was assessed with the Clinician-Administered PTSD Scale. Intimate relationship satisfaction, assessed with the Dyadic Adjustment Scale, patient- and partner-rated PTSD symptoms, and comorbid symptoms were secondary outcomes. PTSD symptom severity (score range, 0-136) was significantly more improved in the couple therapy condition than in the wait-list condition (mean change difference, -23.21; 95% CI, -37.87 to -8.55). Similarly, patients' intimate relationship satisfaction (score range, 0

  16. PTSD, emotion dysregulation, and dissociative symptoms in a highly traumatized sample

    Science.gov (United States)

    Powers, Abigail; Cross, Dorthie; Fani, Negar; Bradley, Bekh

    2015-01-01

    Exposure to multiple traumas has been shown to result in many negative mental health outcomes, including posttraumatic stress disorder (PTSD). Dissociation, which involves disruptions in memory, identity, and perceptions, may be a component of PTSD, particularly among individuals who have experienced childhood trauma. Emotion regulation difficulties are also strongly associated with childhood trauma and emotion dysregulation may be a particularly important factor to consider in the development and maintenance of dissociative symptoms. The goal of the present study was to determine whether emotion dysregulation mediated the relationship between PTSD symptoms and dissociation in a sample of 154 (80% female, 97% African-American) adults recruited from a public, urban hospital. PTSD was measured using the Clinician Administered PTSD Scale, emotion dysregulation was measured using the Difficulties in Emotion Regulation Scale, and dissociation was measured using the Multiscale Dissociation Inventory. A linear regression analysis showed that both PTSD and emotion dysregulation were statistically significant predictors of dissociation even after controlling for trauma exposure. Alexithymia and an inability to use emotion regulation strategies in particular were predictive of dissociation above and beyond other predictor variables. Using bootstrapping techniques, we found that overall emotion dyregulation partially mediated the effect of PTSD symptoms on dissociative symptoms. Our results suggest that emotion dysregulation may be important in understanding the relation between PTSD and dissociative symptoms. Treatment approaches may consider a focus on training in emotional understanding and the development of adaptive regulation strategies as a way to address dissociative symptoms in PTSD patients. PMID:25573648

  17. Trauma exposure, resilience, social support, and PTSD construct validity among former prisoners of war.

    Science.gov (United States)

    Gold, P B; Engdahl, B E; Eberly, R E; Blake, R J; Page, W F; Frueh, B C

    2000-01-01

    The aim of this study was to investigate predictors of persistent symptoms of posttraumatic stress disorder (PTSD) and to examine the construct validity of PTSD in a national sample of 270 World War II and Korean Conflict prisoners of war (POWs). POWs were interviewed at two points in time (1965 and 1990). Predictors included PTSD symptomatology measured in 1965 by items from the Cornell Medical Index (CMI), severity of captivity trauma, resilience factors, and post-trauma social support. The criterion, symptomatology in the early 1990s, was evaluated with the PTSD module of the Structured Clinical Interview for DSM (SCID). The CMI provided only partial coverage of PTSD criteria and appeared to provide only a general index of distress. Clustering of SCID items in two-dimensional space via multidimensional scaling analysis offers some construct validation for the DSM's differentiation of PTSD symptoms into criterion groups, although there was not a perfect match. Trauma severity is best related to PTSD symptomatology experienced in 1990, mitigated in part by greater education level and age at the time of trauma exposure. Surprisingly, 1965 distress added only a modest amount to the prediction of current distress, while post-trauma social support added none. These findings support previous work showing the severe psychological sequelae of POW status 40-50 years after captivity, and indicate that trauma severity during captivity is the best predictor of current PTSD symptomatology. Results also add to our understanding of the conceptual differentiation of PTSD symptoms into separate and distinct symptom clusters.

  18. Requiring both avoidance and emotional numbing in DSM-V PTSD: will it help?

    Science.gov (United States)

    Forbes, David; Fletcher, Susan; Lockwood, Emma; O'Donnell, Meaghan; Creamer, Mark; Bryant, Richard A; McFarlane, Alexander; Silove, Derrick

    2011-05-01

    The proposed DSM-V criteria for posttraumatic stress disorder (PTSD) specifically require both active avoidance and emotional numbing symptoms for a diagnosis. In DSM-IV, since both are included in the same cluster, active avoidance is not essential. Numbing symptoms overlap with depression, which may result in spurious comorbidity or overdiagnosis of PTSD. This paper investigated the impact of requiring both active avoidance and emotional numbing on the rates of PTSD diagnosis and comorbidity with depression. We investigated PTSD and depression in 835 traumatic injury survivors at 3 and 12 months post-injury. We used the DSM-IV criteria but explored the potential impact of DSM-IV and DSM-V approaches to avoidance and numbing using comparison of proportion analyses. The DSM-V requirement of both active avoidance and emotional numbing resulted in significant reductions in PTSD caseness compared with DSM-IV of 22% and 26% respectively at 3 and 12 months posttrauma. By 12 months, the rates of comorbid PTSD in those with depression were significantly lower (44% vs. 34%) using the new criteria, primarily due to the lack of avoidance symptoms. These preliminary data suggest that requiring both active avoidance and numbing as separate clusters offers a useful refinement of the PTSD diagnosis. Requiring active avoidance may help to define the unique aspects of PTSD and reduce spurious diagnoses of PTSD in those with depression. Copyright © 2010. Published by Elsevier B.V.

  19. Cognitive predictors and risk factors of PTSD following stillbirth: a short-term longitudinal study.

    Science.gov (United States)

    Horsch, Antje; Jacobs, Ingo; McKenzie-McHarg, Kirstie

    2015-04-01

    This short-term longitudinal study investigated cognitive predictors and risk factors of posttraumatic stress disorder (PTSD) in mothers following stillbirth. After a stillbirth at ≥ 24 weeks gestational age, 65 women completed structured clinical interviews and questionnaires assessing PTSD symptoms, cognitive predictors (appraisals, dysfunctional strategies), and risk factors (perceived social support, trauma history, obstetric history) at 3 and 6 months. PTSD symptoms decreased between 3 and 6 months (Cohen's d ranged .34-.52). Regression analyses also revealed a specific positive relationship between Rumination and concurrent frequency of PTSD symptoms (β = .45). Negative Self-View and Negative World-View related positively and Self-Blame related negatively to concurrent number of PTSD symptoms (β = .48, .44, -.45, respectively). Suppression and Distraction predicted a decrease and Numbing predicted an increase in time-lagged number of PTSD symptoms (β = -.33, -.28, .30, respectively). Risk factors for PTSD symptoms were younger age (β = -.25), lower income (β = -.29), fewer previous pregnancies (β = -.31), and poorer perceived social support (β = -.26). Interventions addressing negative appraisals, dysfunctional strategies, and social support are recommended for mothers with PTSD following stillbirth. Knowledge of cognitive predictors and risk factors of PTSD may inform the development of a screening instrument. Copyright © 2015 Wiley Periodicals, Inc., A Wiley Company.

  20. Legal review on PTSD defense of adolescent patients in criminal cases

    Directory of Open Access Journals (Sweden)

    Xiaofu Li

    2017-02-01

    Full Text Available Post-Traumatic Stress Disorder is nothing new for Chinese society; however, Chinese courts are hesitated to accept the PTSD as a mental defense for adolescent patients. PTSD defense might be popular in future and court shall give proper weight to relevant factors. It is a big problem that there are no procedures or instructions for the connection between diagnosis and judgment. The paper illustrates the origination of PTSD and its development in USA with some relevant cases. Even the American courts consider PTSD as a problem. And there should be detailed regulations in China to keep pace with the development of science technology.

  1. Natural Course of Co-Occurring PTSD and Alcohol Use Disorder Among Recent Combat Veterans.

    Science.gov (United States)

    Possemato, Kyle; Maisto, Stephen A; Wade, Michael; Barrie, Kimberly; Johnson, Emily M; Ouimette, Paige C

    2017-06-01

    Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) commonly co-occur in veterans, yet little is known about the longitudinal course of PTSD and drinking in comorbid populations. This study assessed the natural course of daily alcohol consumption and weekly changes in PTSD symptoms in 112 recent combat veterans over the course of 11 months. Latent class growth mixture modeling was used to classify individuals into distinct classes with similar PTSD symptom and alcohol use growth trajectories. We then investigated theorized predictors of class membership including sociodemographics; pre-, peri-, and postdeployment factors; coping; symptom severity; and number of mental health/substance use appointments attended. Results revealed that most participants had severe and nonremitting PTSD. Trajectories for alcohol use included gradual and drastic declines, and chronic low-level drinking. The use of behavioral health services (odds ratio = 2.47) and fewer current stressors (odds ratio = 0.42) predicted AUD remission. Because little variation was observed in the PTSD course, our study did not observe coordinated fluctuations of PTSD symptoms and heavy drinking. Our findings suggest that treatment impacts the course of AUD and that recent combat veterans who do not seek PTSD treatment may have chronic and severe PTSD symptoms. Copyright © 2017 International Society for Traumatic Stress Studies.

  2. Multiple victimizations before and after leaving home associated with PTSD, depression, and substance use disorder among homeless youth.

    Science.gov (United States)

    Bender, Kimberly; Brown, Samantha M; Thompson, Sanna J; Ferguson, Kristin M; Langenderfer, Lisa

    2015-05-01

    Exposure to multiple forms of maltreatment during childhood is associated with serious mental health consequences among youth in the general population, but limited empirical attention has focused on homeless youth-a population with markedly high rates of childhood maltreatment followed by elevated rates of street victimization. This study investigated the rates of multiple childhood abuses (physical, sexual, and emotional abuse) and multiple street victimizations (robbery, physical assault, and sexual assault) and examined their relative relationships to mental health outcomes (meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, criteria for post-traumatic stress disorder [PTSD], depression, and substance use disorder) among a large (N = 601) multisite sample of homeless youth. Approximately 79% of youth retrospectively reported multiple childhood abuses (two or more types) and 28% reported multiple street victimizations (two or more types). Each additional type of street victimization nearly doubled youths' odds for meeting criteria for substance use disorder. Furthermore, each additional type of childhood abuse experienced more than doubled youths' odds for meeting criteria for PTSD. Both multiple abuses and multiple street victimizations were associated with an approximate twofold increase in meeting depression criteria. Findings suggest the need for screening, assessment, and trauma-informed services for homeless youth who consider multiple types of abuse and victimization experiences. © The Author(s) 2014.

  3. Factor Structure and Psychometric Properties of the Posttraumatic Stress Disorder (PTSD) Checklist and DSM-5 PTSD Symptom Set in a Long-Term Postearthquake Cohort in Armenia.

    Science.gov (United States)

    Demirchyan, Anahit; Goenjian, Armen K; Khachadourian, Vahe

    2015-10-01

    Psychometric properties of the Armenian-language posttraumatic stress disorder (PTSD) Checklist-Civilian version (PCL-C) and the DSM-5 PTSD symptom set were examined in a long-term cohort of earthquake survivors. In 2012, 725 survivors completed the instruments. Item-/scale-level analysis and confirmatory factor analysis (CFA) were performed for both scales. In addition, exploratory factor analysis (EFA) was conducted for DSM-5 symptoms. Also, the differential internal versus external specificity of PTSD symptom clusters taken from the most supported PTSD structural models was examined. Both scales had Cronbach's alpha greater than .9. CFA of PCL-C structure demonstrated an excellent fit by a four-factor (reexperiencing, avoidance, numbing, and hyperarousal) model known as numbing model; however, a superior fit was achieved by a five-factor model (Elhai et al.). EFA yielded a five-factor structure for DSM-5 symptoms with the aforementioned four domains plus a negative state domain. This model achieved an acceptable fit during CFA, whereas the DSM-5 criteria-based model did not. The Armenian-language PCL-C was recommended as a valid PTSD screening tool. The study findings provided support to the proposed new classification of common mental disorders, where PTSD, depression, and generalized anxiety are grouped together as a subclass of distress disorders. Recommendations were made to further improve the PTSD diagnostic criteria. © The Author(s) 2014.

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

    Science.gov (United States)

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

    2014-05-01

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

  5. Same-Day Integrated Mental Health Care and PTSD Diagnosis and Treatment Among VHA Primary Care Patients With Positive PTSD Screens.

    Science.gov (United States)

    Bohnert, Kipling M; Sripada, Rebecca K; Mach, Jennifer; McCarthy, John F

    2016-01-01

    The study examined whether same-day integrated mental health services are associated with increased diagnosis and treatment initiation among primary care patients with positive posttraumatic stress disorder (PTSD) screens. Data were from a national sample of Veterans Health Administration (VHA) primary care patients with a positive PTSD screen (N=21,427). Patients were assessed for PTSD diagnosis and treatment initiation on the screening day and ≤ 7 days, ≤ 12 weeks, ≤ 6 months, and ≤ 1 year after screening positive. The service setting on screening day was categorized as primary care only, same-day primary care-mental health integration (PC-MHI), or same-day specialty mental health care. Multivariable generalized estimating equations logistic regression was used to estimate associations between category of screening day services and diagnosis and treatment initiation, with adjustment for demographic characteristics, prior psychiatric diagnoses, prior VHA service utilization, and PTSD screen score. Of the 21,427 patients with positive PTSD screens, 10,809 (50.4%) received a diagnosis within one year of screening positive. Same-day PC-MHI services were associated with greater odds of PTSD diagnosis, both on the same day as (odds ratio [OR]=2.23) and one year (OR=1.67) after screening positive compared with primary care-only services (pprimary care only (pmental health services may help facilitate PTSD diagnosis and treatment initiation after a positive screen.

  6. 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. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.

  7. Decoding the Traumatic Memory among Women with PTSD: Implications for Neurocircuitry Models of PTSD and Real-Time fMRI Neurofeedback.

    Directory of Open Access Journals (Sweden)

    Josh M Cisler

    Full Text Available Posttraumatic Stress Disorder (PTSD is characterized by intrusive recall of the traumatic memory. While numerous studies have investigated the neural processing mechanisms engaged during trauma memory recall in PTSD, these analyses have only focused on group-level contrasts that reveal little about the predictive validity of the identified brain regions. By contrast, a multivariate pattern analysis (MVPA approach towards identifying the neural mechanisms engaged during trauma memory recall would entail testing whether a multivariate set of brain regions is reliably predictive of (i.e., discriminates whether an individual is engaging in trauma or non-trauma memory recall. Here, we use a MVPA approach to test 1 whether trauma memory vs neutral memory recall can be predicted reliably using a multivariate set of brain regions among women with PTSD related to assaultive violence exposure (N=16, 2 the methodological parameters (e.g., spatial smoothing, number of memory recall repetitions, etc. that optimize classification accuracy and reproducibility of the feature weight spatial maps, and 3 the correspondence between brain regions that discriminate trauma memory recall and the brain regions predicted by neurocircuitry models of PTSD. Cross-validation classification accuracy was significantly above chance for all methodological permutations tested; mean accuracy across participants was 76% for the methodological parameters selected as optimal for both efficiency and accuracy. Classification accuracy was significantly better for a voxel-wise approach relative to voxels within restricted regions-of-interest (ROIs; classification accuracy did not differ when using PTSD-related ROIs compared to randomly generated ROIs. ROI-based analyses suggested the reliable involvement of the left hippocampus in discriminating memory recall across participants and that the contribution of the left amygdala to the decision function was dependent upon PTSD symptom

  8. Elevators or stairs?

    Science.gov (United States)

    Shah, Sachin; O’Byrne, Michael; Wilson, Merne; Wilson, Thomas

    2011-01-01

    Background: Staff in hospitals frequently travel between floors and choose between taking the stairs or elevator. We compared the time savings with these two options. Methods: Four people aged 26–67 years completed 14 trips ranging from one to six floors, both ascending and descending. We compared the amount of time per floor travelled by stairs and by two banks of elevators. Participants reported their fatigue levels using a modified Borg scale. We performed two-way analysis of variance to compare the log-transformed data, with participant and time of day as independent variables. Results: The mean time taken to travel between each floor was 13.1 (standard deviation [SD] 1.7) seconds by stairs and 37.5 (SD 19.0) and 35.6 (SD 23.1) seconds by the two elevators (F = 8.61, p elevator equaled about 15 minutes a day. Self-reported fatigue was less than 13 (out of 20) on the Borg scale for all participants, and they all stated that they were able to continue their duties without resting. The extra time associated with elevator use was because of waiting for its arrival. There was a difference in the amount of time taken to travel by elevator depending on the time of day and day of the week. Interpretation: Taking the stairs rather than the elevator saved about 15 minutes each workday. This 3% savings per workday could translate into improved productivity as well as increased fitness. PMID:22159365

  9. Relations between PTSD and distress dimensions in an Indian child/adolescent sample following the 2008 Mumbai terrorist attacks.

    Science.gov (United States)

    Contractor, Ateka A; Mehta, Panna; Tiamiyu, Mojisola F; Hovey, Joseph D; Geers, Andrew L; Charak, Ruby; Tamburrino, Marijo B; Elhai, Jon D

    2014-08-01

    Posttraumatic stress disorder's (PTSD) four-factor dysphoria model has substantial empirical support (reviewed in Elhai & Palmieri, Journal of Anxiety Disorders, 25, 849-854, 2011; Yufik & Simms, Journal of Abnormal Psychology, 119, 764-776, 2010). However, debatable is whether the model's dysphoria factor adequately captures all of PTSD's emotional distress (e.g., Marshall et al., Journal of Abnormal Psychology, 119(1), 126-135, 2010), which is relevant to understanding the assessment and psychopathology of PTSD. Thus, the present study assessed the factor-level relationship between PTSD and emotional distress in 818 children/adolescents attending school in the vicinity of the 2008 Mumbai terrorist attacks. The effective sample had a mean age of 12.85 years (SD = 1.33), with the majority being male (n = 435, 53.8 %). PTSD and emotional distress were measured by the UCLA PTSD Reaction Index (PTSD-RI) and Brief Symptom Inventory-18 (BSI-18) respectively. Confirmatory factor analyses (CFA) assessed the PTSD and BSI-18 model fit; Wald tests assessed hypothesized PTSD-distress latent-level relations; and invariance testing examined PTSD-distress parameter differences using age, gender and direct exposure as moderators. There were no moderating effects for the PTSD-distress structural parameters. BSI-18's depression and somatization factors related more to PTSD's dysphoria than PTSD's avoidance factor. The results emphasize assessing for specificity and distress variance of PTSD factors on a continuum, rather than assuming dysphoria factor's complete accountability for PTSD's inherent distress. Additionally, PTSD's dysphoria factor related more to BSI-18's depression than BSI-18's anxiety/somatization factors; this may explain PTSD's comorbidity mechanism with depressive disorders.

  10. Effects of emotion regulation strategy use in response to stressors on PTSD symptoms: An ecological momentary assessment study.

    Science.gov (United States)

    Short, Nicole A; Boffa, Joseph W; Clancy, Kevin; Schmidt, Norman B

    2018-04-01

    Although a burgeoning line of research identifies emotion regulation difficulties as a potential maintenance factor for posttraumatic stress disorder (PTSD), little is known in regard to what emotion regulation strategies individuals with PTSD use in their daily lives, their predictors, and their consequences on later PTSD symptoms. The current study utilized ecological momentary assessment (EMA) design to explore prospective relationships between maladaptive and adaptive emotion regulation strategy use and PTSD symptoms in participants with PTSD (N = 30). Participants completed 4 EMAs per day over 8 days, assessing stressors, emotional response, and emotion regulation strategy use. Individuals with PTSD most commonly used avoidance as an emotion regulation strategy. Multilevel modeling indicated that baseline PTSD symptoms predicted maladaptive emotion regulation strategy use. After covarying for morning PTSD symptoms, maladaptive emotion regulation prospectively predicted increased PTSD symptoms later in the day. Adaptive emotion regulation strategies did not uniquely predict later PTSD symptoms. In line with conceptualizations of difficulties in emotion regulation as a transdiagnostic maintenance factor in PTSD, findings indicate that maladaptive emotion regulation strategies in response to stressors exacerbate PTSD symptoms. The use of adaptive emotion regulation strategies had no positive or negative impact on subsequent PTSD symptoms. Future studies should utilize longer-term prospective designs. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Calcium stable isotope geochemistry

    Energy Technology Data Exchange (ETDEWEB)

    Gausonne, Nikolaus [Muenster Univ. (Germany). Inst. fuer Mineralogie; Schmitt, Anne-Desiree [Strasbourg Univ. (France). LHyGeS/EOST; Heuser, Alexander [Bonn Univ. (Germany). Steinmann-Inst. fuer Geologie, Mineralogie und Palaeontologie; Wombacher, Frank [Koeln Univ. (Germany). Inst. fuer Geologie und Mineralogie; Dietzel, Martin [Technische Univ. Graz (Austria). Inst. fuer Angewandte Geowissenschaften; Tipper, Edward [Cambridge Univ. (United Kingdom). Dept. of Earth Sciences; Schiller, Martin [Copenhagen Univ. (Denmark). Natural History Museum of Denmark

    2016-08-01

    This book provides an overview of the fundamentals and reference values for Ca stable isotope research, as well as current analytical methodologies including detailed instructions for sample preparation and isotope analysis. As such, it introduces readers to the different fields of application, including low-temperature mineral precipitation and biomineralisation, Earth surface processes and global cycling, high-temperature processes and cosmochemistry, and lastly human studies and biomedical applications. The current state of the art in these major areas is discussed, and open questions and possible future directions are identified. In terms of its depth and coverage, the current work extends and complements the previous reviews of Ca stable isotope geochemistry, addressing the needs of graduate students and advanced researchers who want to familiarize themselves with Ca stable isotope research.

  12. SAFE for PTSD: noncontact psychophysiological measure based on high-resolution thermal imaging to aid in PTSD diagnosis and assessment of treatment

    Science.gov (United States)

    Familoni, Babajide O.; Ma, Lein; Hutchinson, J. Andrew; Morgan, C. Andrew, III; Rasmusson, Ann; O'Kane, Barbara L.

    2012-06-01

    Post Traumatic Stress Disorder (PTSD) sometimes develops following exposure to very stressful or traumatic events such as motor vehicle accidents, rape, and war. It is arguably the signature injury of the conflicts in Iraq and Afghanistan. Previous studies have demonstrated that PTSD sufferers exhibit autonomic hyper-responsiveness to both neutral and trauma-related stimuli. In this study, we propose using high resolution thermal imaging of sweat-pores to obtain a noncontact, remote, and quantifiable measure of the sympathetic autonomic nervous reactivity to guide diagnosis, assess response to treatment, and tease out important cues to suicidality as a PTSD comorbidity.

  13. Photoreflectance at elevated temperatures

    Science.gov (United States)

    Shen, Hongen

    1990-08-01

    Using the contactiess modulation spectroscopy technique of photoreflectance, the temperature variations of the direct gap E0 of GaAs, InP, GaA1As, InGaAs have been measured at elevated temperatures up to 600°C. The parameters which describe the temperature dependence of the band gap energies have been evaluated. The ability to measure the band gap at elevated temperatures opens up many new possibilities for in-situ monitoring of MBE and MOCVD processes. In this paper, we review some of the recent developments in the use of photoreflectance at elevated temperatures.

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

    Directory of Open Access Journals (Sweden)

    Sara A. Freedman

    2015-12-01

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

  15. PTSD of rape after IS ("Islamic State") captivity.

    Science.gov (United States)

    Kizilhan, Jan Ilhan

    2018-03-10

    Research into the psychological consequences of rape on women in war and warlike situations is limited. The aims of this study were (a) to describe the prevalence and the nature of PTSD symptoms among Yazidi women reporting rape during IS captivity, (b) to describe comorbidity of other psychological disorders, and (c) to examine the risk factors associated with posttraumatic stress disorder.The study included 296 Yazidi women survivors of rape and has been conducted in Germany since January 2016 as part of a special-quota project in the German region of Baden-Wuerttemberg, designed to support the women and children who have escaped after being held hostage by IS.The survivors were recruited into a retrospective, cross-sectional study. Interviews in Germany were done through trained personnel to evaluate the mental health status of raped women.All the investigated women had been raped many times during IS captivity. About 82% of the women were also physically tortured. Of the sample, 67% suffered from somatoform disorder, 53% suffered from depression, 39% from anxiety, and 28% from dissociation. The prevalence of PTSD in those with rape events of more than 20 times was 57% (95% CI = 35.1-65.9%), less than 20 times was 41% (95%, CI = 28.7-4.8% and less than 10 times 39% [95% CI = 28.2-41.8%], respectively.The IS captivity and wartime rapes had deep immediate and long-term consequences on the mental health of women survivors. The high prevalence of PTSD emphasizes the need for culturally sensitive diagnostic and therapeutic services to address the intermediate and long-term consequences of wartime rape.

  16. Ten-Year Follow-Up Study of PTSD Diagnosis, Symptom Severity, and Psychosocial Indices in Aging Holocaust Survivors

    Science.gov (United States)

    Schmeidler, James; Labinsky, Ellen; Bell, Amanda; Morris, Adam; Zemelman, Shelly; Grossman, Robert A.

    2009-01-01

    Objective We performed a longitudinal study of Holocaust survivors with and without PTSD by assessing symptoms and other measures at two intervals, approximately 10 years apart. Method The original cohort consisted of 63 community-dwelling subjects, of whom 40 were available for follow-up. Results There was a general diminution in PTSD symptom severity over time. However, in 10% of the subjects (n=4), new instances of Delayed Onset PTSD developed between the Time 1 and Time 2. Self-report ratings at both assessments revealed a worsening of trauma related symptoms over time in persons without PTSD at Time 1, but an improvement in those with PTSD at Time 1. Conclusion The findings suggest that a nuanced characterization of PTSD trajectory over time is more reflective of PTSD symptomatology than simple diagnostic status at one time. The possibility of Delayed Onset trajectory complicates any simplistic overall trajectory summarizing the longitudinal course of PTSD. PMID:18785948

  17. Evolutionary Stable Strategy

    Indian Academy of Sciences (India)

    2016-08-26

    Aug 26, 2016 ... Home; Journals; Resonance – Journal of Science Education; Volume 21; Issue 9. Evolutionary Stable Strategy: Application of Nash Equilibrium in Biology. General ... Using some examples of classical games, we show how evolutionary game theory can help understand behavioural decisions of animals.

  18. The Stable Concordance Genus

    OpenAIRE

    Kearney, M. Kate

    2013-01-01

    The concordance genus of a knot is the least genus of any knot in its concordance class. Although difficult to compute, it is a useful invariant that highlights the distinction between the three-genus and four-genus. In this paper we define and discuss the stable concordance genus of a knot, which describes the behavior of the concordance genus under connected sum.

  19. Manifolds admitting stable forms

    Czech Academy of Sciences Publication Activity Database

    Le, Hong-Van; Panák, Martin; Vanžura, Jiří

    2008-01-01

    Roč. 49, č. 1 (2008), s. 101-11 ISSN 0010-2628 R&D Projects: GA ČR(CZ) GP201/05/P088 Institutional research plan: CEZ:AV0Z10190503 Keywords : stable forms * automorphism groups Subject RIV: BA - General Mathematics

  20. Stable isotope studies

    International Nuclear Information System (INIS)

    Ishida, T.

    1992-01-01

    The research has been in four general areas: (1) correlation of isotope effects with molecular forces and molecular structures, (2) correlation of zero-point energy and its isotope effects with molecular structure and molecular forces, (3) vapor pressure isotope effects, and (4) fractionation of stable isotopes. 73 refs, 38 figs, 29 tabs

  1. Interactive Stable Ray Tracing

    DEFF Research Database (Denmark)

    Dal Corso, Alessandro; Salvi, Marco; Kolb, Craig

    2017-01-01

    Interactive ray tracing applications running on commodity hardware can suffer from objectionable temporal artifacts due to a low sample count. We introduce stable ray tracing, a technique that improves temporal stability without the over-blurring and ghosting artifacts typical of temporal post-pr...

  2. The stable subgroup graph

    Directory of Open Access Journals (Sweden)

    Behnaz Tolue

    2018-07-01

    Full Text Available In this paper we introduce stable subgroup graph associated to the group $G$. It is a graph with vertex set all subgroups of $G$ and two distinct subgroups $H_1$ and $H_2$ are adjacent if $St_{G}(H_1\\cap H_2\

  3. Indsatser for tosprogede elever

    DEFF Research Database (Denmark)

    Andersen, Dines; Jakobsen, Vibeke; Jensen, Vibeke Myrup

    Fagligt set klarer tosprogede elever sig dårligere i skolen og det videre uddannelsessystem end ’danske’ elever. Kommuner og folkeskoler har derfor sat en række tiltag i værk, som sigter mod at forbedre de tosprogede elevers skole- og uddannelsessituation. Rapporten kortlægger og analyserer...... af klasseundervisningen. Analysen viser, at de elever, der bliver taget ud af klassen for at få ekstra undervisning i dansk som andetsprog, klarer sig dårligere end elever, der modtager ekstraundervisningen i klassen eller uden for skoletid. Undersøgelsen er baseret på spørgeskemaundersøgelser blandt...... kommunale forvaltningschefer, skoleledere, lærere og forældre til børn i 2. klasse samt lærere til og elever i 9. klasse, SFI’s forløbsundersøgelse af årgang 1995 og registerdata. Undersøgelsen er via Ministeriet for Børn og Undervisning betalt med midler fra satspuljeaftalen 2009 om integration....

  4. A Couple-Based Approach to the Reduction of PTSD Avoidance Symptoms: Preliminary Findings

    Science.gov (United States)

    Sautter, Frederic J.; Glynn, Shirley M.; Thompson, Karin E.; Franklin, Laurel; Han, Xiaotong

    2009-01-01

    This study reports preliminary findings regarding the feasibility and efficacy of a novel couple-based treatment, named Strategic Approach Therapy (SAT), for reducing avoidance symptoms of posttraumatic stress disorder (PTSD). Six male Vietnam combat veterans diagnosed with PTSD and their cohabitating marital partners participated in 10 weeks of…

  5. A Cartoon-Based Measure of PTSD Symptomatology in Children Exposed to a Disaster

    Science.gov (United States)

    Elklit, Ask; Nielsen, Louise Hjort; Lasgaard, Mathias; Duch, Christina

    2013-01-01

    Research on childhood posttraumatic stress disorder (PTSD) is sparse. This is partly due to the limited availability of empirically validated measures for children who are insecure readers. The present study examined the reliability and validity of a cartoon-based measure of PTSD symptoms in children exposed to a disaster. Cartoons were generated…

  6. University Counseling Center Use of Prolonged Exposure Therapy: In-Clinic Treatment for Students with PTSD

    Science.gov (United States)

    Bonar, Ted C.

    2015-01-01

    Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including…

  7. Validation of a Brief PTSD Scale for Clients with Severe Mental Illnesses

    Science.gov (United States)

    O'Hare, Thomas; Shen, Ce; Sherrer, Margaret

    2012-01-01

    Trauma and Posttraumatic Stress Disorder (PTSD) are more common in severe mental illnesses (SMI) clients than in the general population, yet brief screens for detecting probable PTSD in SMI clients are nonexistent. In a two-part study, the authors used correlation analysis and receiver operating characteristics (ROC) analysis to develop and…

  8. Treatment of PTSD in Older Adults: Do Cognitive-Behavioral Interventions Remain Viable?

    Science.gov (United States)

    Clapp, Joshua D.; Beck, J. Gayle

    2012-01-01

    The literature examining trauma among older adults is growing, but little is known about the efficacy of empirically supported interventions for PTSD within this population. Clinical writing on this topic often implies that cognitive-behavioral treatments may be ineffective or inappropriate for older adults with PTSD given physical and/or…

  9. Cognitive-Behavioral Therapy for PTSD in Children and Adolescents: A Preliminary Randomized Controlled Trial

    Science.gov (United States)

    Smith, Patrick; Yule, William; Perrin, Sean; Tranah, Troy; Dagleish, Tim; Clark, David M.

    2007-01-01

    Objective: To evaluate the efficacy of individual trauma-focused cognitive-behavioral therapy (CBT) for treating posttraumatic stress disorder (PTSD) in children and young people. Method: Following a 4-week symptom-monitoring baseline period, 24 children and young people (8-18 years old) who met full "DSM-IV" PTSD diagnostic criteria after…

  10. PTSD and comorbid AUD: a review of pharmacological and alternative treatment options

    Science.gov (United States)

    Ralevski, Elizabeth; Olivera-Figueroa, Lening A; Petrakis, Ismene

    2014-01-01

    Background Although posttraumatic stress disorder (PTSD) and alcohol use disorders (AUD) frequently co-occur there are no specific treatments for individuals diagnosed with these comorbid conditions. The main objectives of this paper are to review the literature on pharmacological options for PTSD and comorbid AUD, and to summarize promising behavioral and alternative interventions for those with these dual diagnoses. Methods We conducted a comprehensive search on PsycINFO and MEDLINE/PubMed databases using Medical Subject Headings terms in various combinations to identify articles that used pharmacotherapy for individuals with dual diagnoses of PTSD and AUD. Similar strategies were used to identify articles on behavioral and alternative treatments for AUD and PTSD. We identified and reviewed six studies that tested pharmacological treatments for patients with PTSD and comorbid AUD. Results The literature on treatment with US Food and Drug Administration approved medications for patients with dual diagnosis of PTSD and AUD is very limited and inconclusive. Promising evidence indicates that topiramate and prazosin may be effective in reducing PTSD and AUD symptoms in individuals with comorbidity. Seeking safety has had mixed efficacy in clinical trials. The efficacy of other behavioral and alternative treatments (mindfulness-based, yoga, and acupuncture) is more difficult to evaluate since the evidence comes from small, single studies without comparison groups. Conclusion There is a clear need for more systematic and rigorous study of pharmacological, behavioral, and alternative treatments for patients with dual diagnoses of PTSD and AUD. PMID:24648794

  11. Screening for HIV-related PTSD: Sensitivity and specificity of the 17 ...

    African Journals Online (AJOL)

    Department of Psychology, Stellenbosch University, Cape Town, South Africa. Abstract. Objectives: ... and specificity of the 17-item Post traumatic Stress Diagnostic Scale (PDS), a self-report instrument, in the detection of HIV- related PTSD. .... This study used an adapted version of the PTSD module of. CIDI to determine the ...

  12. Social skills deficits as a mediator between PTSD symptoms and intimate partner aggression in returning veterans.

    Science.gov (United States)

    LaMotte, Adam D; Taft, Casey T; Weatherill, Robin P; Eckhardt, Christopher I

    2017-02-01

    This study examined social skills deficits as a mediator of the relationship between posttraumatic stress disorder (PTSD) symptoms and use of intimate partner aggression (IPA) among returning veterans. Prior research with veterans has focused on PTSD-related deficits at the decoding stage of McFall's (1982) social information processing model, and the current study adds to this literature by examining social skills deficits at the decision stage. Participants were 92 male veterans recruited from the greater Boston area. PTSD symptoms were assessed through clinician interview, IPA use was assessed through self- and partner report, and social skills deficits were assessed in a laboratory task in which veterans listened to a series of problematic marital situations and responded with what they would say or do in the situation. Responses were coded for social competency. Bivariate correlations revealed several significant associations among PTSD symptoms, social skills deficits, and use of IPA. When all PTSD symptom clusters were entered into a regression predicting social skills deficits, only emotional numbing emerged as a unique predictor. Finally, social skills deficits significantly mediated the relationship between veterans' PTSD symptoms and use of psychological (but not physical) IPA. Findings extend prior research on McFall's (1982) social information processing model as it relates to veterans' PTSD symptoms and use of IPA. More research is needed to understand the associations between PTSD symptoms and deficits at each individual step of this model. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Possible Contribution of PTSD to Altered Cortisol Activity in Young Adult Obese African-American Women.

    Science.gov (United States)

    Taylor, Teletia R; Van Kirk, Kendra; Tapscott, Denia; Bernard, Monet; Llano, Juliana; Mellman, Thomas A

    2015-06-01

    African-Americans have been found to experience increased rates of post-traumatic stress disorder (PTSD), obesity, and flatter diurnal cortisol slopes compared to other demographic groups. Further exploration, however, is needed to understand how PTSD impacts diurnal cortisol activity in obese African-American women. The purpose of the current study is to examine the relationship between salivary cortisol levels and PTSD in a sample of obese young adult African-American women and to examine how depression and insomnia influence the relationship. Thirty-four young adult African-American women (mean age = 24.0 years; mean BMI = 37.4 kg/m(2), 6/34 of the sample had a score of 40 or above on the PTSD Checklist (PCL) representing clinically significant PTSD) filled out questionnaires assessing PTSD, lifetime exposure to traumatic events, insomnia severity, and depression. A home-based assessment of salivary cortisol was provided upon awakening at 30 min and 1, 3, 6, and 12 h. There was a significant interaction between PTSD status and diurnal cortisol activity (p cortisol levels at awakening (p cortisol was attenuated by co-varying for depression and insomnia (p > 0.05). PTSD, influenced by depression and insomnia symptoms, has an impact on diurnal cortisol activity in obese young adult African-American women.

  14. Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression

    NARCIS (Netherlands)

    Olff, Miranda; Polak, A Rosaura; Witteveen, Anke B; Denys, D.

    BACKGROUND: Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments

  15. Fathers with PTSD and depression in pregnancies complicated by preterm preeclampsia or PPROM

    NARCIS (Netherlands)

    Stramrood, C.A.I.; Doornbos, B.; Wessel, I.; van Geenen, M.; Aarnoudse, J.G.; van den Berg, P.P.; Weijmar Schultz, W.C.M.; van Pampus, M.G.

    To assess prevalence and risk factors for posttraumatic stress disorder (PTSD) and depression in fathers after early preeclampsia (PE) or preterm premature rupture of membranes (PPROM). Partners of patients hospitalized for PE or PPROM and partners of healthy controls completed PTSD (PSS-SR) and

  16. Gender and Age Differences in Trauma and PTSD Among Dutch Treatment-Seeking Police Officers

    NARCIS (Netherlands)

    van der Meer, Christianne A. I.; Bakker, Anne; Smit, Annika S.; van Buschbach, Susanne; den Dekker, Melissa; Westerveld, Gré J.; Hutter, Renée C.; Gersons, Berthold P. R.; Olff, Miranda

    2017-01-01

    Little is known about how age and gender are associated with posttraumatic stress disorder (PTSD) symptoms and traumatic experiences in treatment-seeking police offers. In this study, we examined 967 diagnostic files of police officers seeking treatment for PTSD. Six hundred twelve (63%) of the

  17. Executive function in posttraumatic stress disorder (PTSD) and the influence of comorbid depression

    NARCIS (Netherlands)

    Olff, Miranda; Polak, A. Rosaura; Witteveen, Anke B.; Denys, Damiaan

    2014-01-01

    Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be

  18. A longitudinal and retrospective study of PTSD among older prisoners of war.

    Science.gov (United States)

    Port, C L; Engdahl, B; Frazier, P

    2001-09-01

    The authors examined the longitudinal changes in posttraumatic stress disorder (PTSD) symptom levels and prevalence rates over a 4-year time period among American former prisoners of war (POWs) from World War II and the Korean War. Retrospective symptom reports by World War II POWs dating back to shortly after repatriation were examined for 1) additional evidence of changing PTSD symptom levels and 2) evidence of PTSD cases with a long-delayed onset. PTSD prevalence rates and symptom levels were measured by the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. For the longitudinal portion of the study, participants were 177 community-dwelling World War II and Korean POWs. For the retrospective portion, participants were 244 community-dwelling World War II POWs. PTSD prevalence rates and symptom levels increased significantly over the 4-year measurement interval. Retrospective symptom reports indicated that symptoms were highest shortly after the war, declined for several decades, and increased within the past two decades. Long-delayed onset of PTSD symptoms was rare. Demographic and psychosocial variables were used to characterize participants whose symptoms increased over 4 years and differentiate participants who reported a long-delayed symptom onset. Both longitudinal and retrospective data support a PTSD symptom pattern of immediate onset and gradual decline, followed by increasing PTSD symptom levels among older survivors of remote trauma.

  19. Predictors of PTSD symptoms in adults admitted to a Level I trauma center: A prospective analysis

    NARCIS (Netherlands)

    Powers, M.B.; Warren, A.M.; Rosenfield, D.; Roden-Foreman, K.; Bennett, M.; Reynolds, M.C.; Davis, M.L.; Foreman, M.; Petrey, L.B.; Smits, J.A.J.

    2014-01-01

    Trauma centers are an ideal point of intervention in efforts to prevent posttraumatic stress disorder (PTSD). In order to assist in the development of prevention efforts, this study sought to identify early predictors of PTSD symptoms among adults admitted to a Level I trauma center using a novel

  20. Integrated and Holistic Treatment Approach to PTSD and SUD: A Synergy

    Science.gov (United States)

    Weis, Melanie

    2010-01-01

    Individuals living with posttraumatic stress disorder (PTSD) and addiction experience a complex and dynamic interaction of symptoms from both diagnoses. However, heretofore, each diagnosis has been approached as if it were a separate treatment consideration. Therefore, an individual may be treated for either a substance use disorder (SUD) or PTSD,…