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Sample records for stress disorders ptsd

  1. Posttraumatic stress disorder (PTSD) Treatment

    Science.gov (United States)

    ... does the current evidence say about treatment for PTSD? Read Psych Health Evidence Briefs , which summarize available ... first-line and emerging PTSD treatments. Psychotherapy for PTSD According to the VA/DoD Clinical Practice Guideline ...

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

    Science.gov (United States)

    2008-05-01

    post - traumatic stress disorder ( PTSD ),” Principal Investigator, 4/07-4/10, $276,422. 12. R01 MH0687670-01 “DEX/CRH Response... Stress Disorder ( PTSD ) PRINCIPAL INVESTIGATOR: Audrey R. Tyrka, M.D., Ph.D. CONTRACTING ORGANIZATION: Butler Hospital... Stress Disorder ( PTSD ) 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-07-1-0269 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Audrey R.

  3. 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.

  4. Sleep and Posttraumatic Stress Disorder (PTSD)

    Science.gov (United States)

    ... National Center for PTSD » Public » Sleep and PTSD PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... code here Enter ZIP code here Sleep and PTSD Public This section is for Veterans, General Public, ...

  5. 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.

  6. Posttraumatic stress disorder (PTSD) and the dermatology patient.

    Science.gov (United States)

    Gupta, Madhulika A; Jarosz, Patricia; Gupta, Aditya K

    Dermatologic symptoms can be associated with posttraumatic stress disorder (PTSD) in several situations: (1) as features of some core PTSD symptoms, such as intrusion symptoms manifesting as cutaneous sensory flashbacks, as autonomic arousal manifesting as night sweats and idiopathic urticaria, and as dissociation manifesting as numbness and dermatitis artefacta; (2) the cutaneous psychosomatic effects of emotional and physical neglect and sexual abuse (eg, infantile eczema, cutaneous self-injury, and body-focused repetitive behaviors such as trichotillomania and skin picking disorder) and eating disorders, which can have dermatologic effects; (3) the direct effect of physical or sexual abuse or catastrophic life events (eg, earthquakes) on the skin; and (4) as a result of significant alterations in hypothalamic-pituitary-adrenal and sympatho-adrenal medullary axes, which can affect neuroendocrine and immune functions, and can lead to exacerbations of stress-reactive inflammatory dermatoses such as psoriasis, chronic urticaria, and atopic dermatitis. Elevated levels of inflammatory biomarkers and impaired epidermal barrier function have been reported in situations involving sustained psychologic stress and sleep deprivation. Some PTSD patients show hypothalamic-pituitary-adrenal axis hyporesponsiveness and higher circulating T lymphocytes, which can exacerbate immune-mediated dermatologic disorders. PTSD should be considered an underlying factor in the chronic, recurrent, or treatment-resistant stress-reactive dermatoses and in patients with self-induced dermatoses. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. 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.

  8. 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)

  9. 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

  10. 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

  11. 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

    2018-06-01

    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

  12. 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

  13. Posttraumatic stress disorder (ptsd and co-morbidity

    Directory of Open Access Journals (Sweden)

    Ifeta Ličanin

    2002-02-01

    Full Text Available Posttraumatic Stress Disorder (PTSD very often occurs accompanied with other psychiatric disorders such as: Alcohol and Drug abuse, Personality Disorder, General Anxiety Disorder, Obsessive Compulsive Disorder, Schizophrenia etc. Sometimes it might be a problem for clinicians to differ PTSD symptoms from symptoms of coexisting psychic disorders. The aim of this study was to present the most common PTSD coexisting psycho-disorders. This research was conducted during the period from April 1998 to October 1999. Participants were divided in two groups each containing 30 examinees. The first group consisted of 30 participants with symptoms of PTSD only while the second group included participants who suffered from both PTSD and other psychic disorders (co-morbidity. Both groups were quite similar regarding participants gender and age. The scientific tools used in the research were: Standard Psychiatric Interview, Harvard Trauma Questionnaire (HTQ, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Drug and Alcohol Abuse Checklist. Our research results are indicating that PTSDsymptoms are most common in middle-aged persons, regardless of their gender and age. We have found following coexisting psychic disorders: personality disorder 46.6% (from which 13.3% is permanent personality disorder after the traumatic experience; depression 29.9% (depression without psychotic symptoms 23.3% and depression with coexisting psychotic symptoms 6.6%; drug abuse 13.3; alcohol abuse 6.7% and dissociative (conversion disorder 3.3%. The results of our work are suggesting that co-morbid psychic symptoms have significant regressive influence on PTSD course and prognosis.

  14. A Memory-Based Model of Posttraumatic Stress Disorder: Evaluating Basic Assumptions Underlying the PTSD Diagnosis

    Science.gov (United States)

    Rubin, David C.; Berntsen, Dorthe; Bohni, Malene Klindt

    2008-01-01

    In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the "Diagnostic and Statistical Manual of Mental Disorders" (4th ed., text rev.; American Psychiatric Association,…

  15. 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.

  16. 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

  17. Are the neural substrates of memory the final common pathway in posttraumatic stress disorder (PTSD)?

    OpenAIRE

    Elzinga, B.M.; Bremner, J.D.

    2002-01-01

    A model for the posttraumatic stress disorder (PTSD) as a disorder of memory is presented drawing both on psychological and neurobiological data. Evidence on intrusive memories and deficits in declarative memory function in PTSD-patients is reviewed in relation to three brain areas that are involved in memory functioning and the stress response: the hippocampus, amygdala, and the prefrontal cortex. Neurobiological studies have shown that the noradrenergic stress-system is involved in enhanced...

  18. 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

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Mohammed Alghamd

    2013-08-01

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

  1. The Genetics of Stress-Related Disorders: PTSD, Depression, and Anxiety Disorders

    Science.gov (United States)

    Smoller, Jordan W

    2016-01-01

    Research into the causes of psychopathology has largely focused on two broad etiologic factors: genetic vulnerability and environmental stressors. An important role for familial/heritable factors in the etiology of a broad range of psychiatric disorders was established well before the modern era of genomic research. This review focuses on the genetic basis of three disorder categories—posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and the anxiety disorders—for which environmental stressors and stress responses are understood to be central to pathogenesis. Each of these disorders aggregates in families and is moderately heritable. More recently, molecular genetic approaches, including genome-wide studies of genetic variation, have been applied to identify specific risk variants. In this review, I summarize evidence for genetic contributions to PTSD, MDD, and the anxiety disorders including genetic epidemiology, the role of common genetic variation, the role of rare and structural variation, and the role of gene–environment interaction. Available data suggest that stress-related disorders are highly complex and polygenic and, despite substantial progress in other areas of psychiatric genetics, few risk loci have been identified for these disorders. Progress in this area will likely require analysis of much larger sample sizes than have been reported to date. The phenotypic complexity and genetic overlap among these disorders present further challenges. The review concludes with a discussion of prospects for clinical translation of genetic findings and future directions for research. PMID:26321314

  2. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Age As Moderator of Emotional Stroop Task Performance in Posttraumatic Stress Disorder (PTSD)

    OpenAIRE

    Bielecki, Maksymilian; Popiel, Agnieszka; Zawadzki, Bogdan; Sedek, Grzegorz

    2017-01-01

    Emotional Stroop task (EST) has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD). Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3) were included in the analysis, ...

  5. Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors.

    Science.gov (United States)

    Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

    2013-03-01

    Childbirth might be a traumatic event for some women. This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 women who were 6-8 weeks postpartum and had been undergone to this center for postpartum and child care. One hundred and three (17. 2%) women had symptoms of PTSD following childbirth based on the PTSD Symptom Scale (PSS). The results of logistic regression analysis revealed a significant correlation between maternal occupation (P = 0.01), depression level (P childbirth. PTSD from childbirth occurs in some women. Early identification of risk factors should lead to early therapeutic intervention in the mothers at risk of PTSD.

  6. 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...

  7. Assessing impact of differential symptom functioning on post-traumatic stress disorder (PTSD) diagnosis

    NARCIS (Netherlands)

    He, Qiwei; Glas, Cornelis A.W.; Veldkamp, Bernard P.

    2014-01-01

    This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as

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

    Directory of Open Access Journals (Sweden)

    author Yulianto

    2015-01-01

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

  9. Diagnostic Biomarkers for Posttraumatic Stress Disorder (PTSD): Promising Horizons from Translational Neuroscience Research

    OpenAIRE

    Michopoulos, Vasiliki; Norrholm, Seth Davin; Jovanovic, Tanja

    2015-01-01

    Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). Although its diagnostic features have been recently re-classified with the emergence of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), the disorder remains characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. T...

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

    Science.gov (United States)

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

    2016-11-01

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

  11. Chronic idiopathic urticaria and post-traumatic stress disorder (PTSD): an under-recognized comorbidity.

    Science.gov (United States)

    Gupta, Madhulika A; Gupta, Aditya K

    2012-01-01

    A large body of literature supports the role of psychologic stress in urticaria; however, the comorbidity between chronic idiopathic urticaria (CIU) and post-traumatic stress disorder (PTSD), a classic stress-mediated syndrome, has received little attention. The underlying etiology of urticaria is not identifiable in about 70% of patients, possibly because of difficulties with identification of a direct cause-and-effect relationship between a potential causative factor and the onset of urticaria. The core features of PTSD (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision [DSMIV-TR]) that are important in urticaria include (1) autonomic nervous system reactivity and state of sympathetic hyperarousal that can manifest as CIU, and (2) the persistent re-experiencing of the traumatic events in PTSD, which can manifest as urticaria or angioedema, or both, affecting a previously traumatized body region (eg, urticarial wheals affecting the body region where the patient had been stabbed years earlier). The following features of PTSD make it difficult to use the cause-and-effect model for the determination of causation: (1) PTSD may first emerge years after the initial trauma and is classified as PTSD with Delayed Onset (DSMIV-TR); and (2) the traumatic triggers that precipitate the PTSD symptoms may be unique and idiosyncratic to the patient and not even qualify as stressful or traumatic by standard criteria (eg, precipitating events for the PTSD may include smell of a certain cologne that was used by the perpetrator or witnessing a scene in a movie that was reminiscent of the location where the abuse occurred). Finally, in PTSD with Delayed Onset, patients may not make a conscious association between their recurrent urticaria and their earlier traumas because they can develop classically conditioned associations between stimuli that are reminiscent of the original abuse situation and their somatic reactions such as urticaria. The clinician

  12. 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.

  13. Representations of Self and Parents, and Relationship Themes, in Adolescents with Post Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Shafran, Naama; Shahar, Golan; Berant, Ety; Gilboa-Schechtman, Eva

    2016-07-01

    Negative perceptions of self and others have lately become one of the criteria for Posttraumatic Stress Disorder (PTSD) among adults and adolescents. Drawing from theories of mental representations in psychopathology, this study examined self-reported negative cognitions, self and parental representations, and relationship themes among adolescents with and without PTSD. Thirty one adolescents with PTSD (11 boys, mean age = 14.06, SD = 2.24) were matched with 29 adolescents who had no psychiatric diagnosis (11 boys, mean age = 14.96, SD = 1.78). Adolescents completed self-report measures, wrote a description of self, mother and father, and were interviewed about positive and negative relationship episodes with mother, father, and peers. Adolescents with PTSD reported more self-criticism and performance evaluation than did controls. Their self-representation exhibited a lower sense of agency, which was related to structural variables (i.e., less integrative description). Although parental representations of adolescents with PTSD were not generally less benevolent or more punitive than those of controls, their relationship themes revealed a higher proportion of the wish to be distant from others. Adolescents with PTSD exhibited more passive responses and perceived more dominant or controlling responses from their parents. Findings point out to a serious impairment in representations of self and relationship patterns in adolescent PTSD.

  14. 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

  15. [Use of hypnosis in the treatment of combat post traumatic stress disorder (PTSD)].

    Science.gov (United States)

    Abramowitz, Eitan G; Bonne, Omer

    2013-08-01

    Clinical reports and observations going back almost two centuries consistently indicate that hypnotherapy is an effective modality for the treatment of post traumatic stress disorder (PTSD). Pierre Janet was the first clinician to describe the successful initiation of stepwise hypnotic techniques in PTSD symptom reduction. Hypnotherapy may accelerate the formation of a therapeutic alliance and contribute to a positive treatment outcome. Hypnotic techniques may be valuable for patients with PTSD who exhibit symptoms such as anxiety, dissociation, widespread somatoform pain complaints and sleep disturbances. Hypnotic techniques may also facilitate the arduous tasks of working through traumatic memories, increasing coping skills, and promoting a sense of competency. In this review we will present guidelines for the stepwise implementation of hypnotherapy in PTSD. Since most data regarding the use of hypnotherapy in PTSD has been gathered from uncontrolled clinical observations, methodologically sound research demonstrating the efficacy of hypnotic techniques in PTSD is required for hypnotherapy to be officially added to the therapeutic armamentarium for this disorder.

  16. Cardiovascular Disease Risk Factors in Patients with Posttraumatic Stress Disorder (PTSD): A Narrative Review.

    Science.gov (United States)

    Šagud, Marina; Jakšić, Nenad; Vuksan-Ćusa, Bjanka; Lončar, Mladen; Lončar, Ivana; Peleš, Alma Mihaljević; Miličić, Davor; Jakovljević, Miro

    2017-12-01

    Posttraumatic stress disorder (PTSD) is a chronic condition related to severe stress and trauma. There is a mounting evidence about increased prevalence and mortality from cardiovascular diseases (CVD) in patients with PTSD. This review summarizes the current data on possible relations between PTSD and increased risks of CVD, including biological, psychological and behavioral factors. Biological factors refer to increased prevalence of metabolic syndrome (MetS), hypertension, elevation of pro-inflammatory cytokines and homocysteine levels. Peripheral Brain-derived neurotropic factor (BDNF), serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and quantitative electroencephalogram (qEEG) are promising surrogate markers of increased cardiovascular risk. Among psychological factors, some personality traits, such as neuroticism and trait impulsivity/hostility, contribute to the development of PTSD, and are associated with general cardiovascular distress. Recently, type-D (distressed) personality is usually investigated in relation to cardiovascular morbidity, but in populations other than PTSD patients. Behavioral factors refer to unhealthy life-styles, encompassing high smoking rate, drug substances abuse and addiction, physical inactivity and unhealthy diet. The relationships among all these factors are complex and yet incompletely taken into consideration. Because of a high prevalence of CVD in patients with PTSD, there is a strong need for a more intensive focus on this vulnerable population in both primary and secondary cardiovascular prevention as well as in effective treatment possibilities.

  17. Are the neural substrates of memory the final common pathway in posttraumatic stress disorder (PTSD)?

    Science.gov (United States)

    Elzinga, B M; Bremner, J D

    2002-06-01

    A model for the posttraumatic stress disorder (PTSD) as a disorder of memory is presented drawing both on psychological and neurobiological data. Evidence on intrusive memories and deficits in declarative memory function in PTSD-patients is reviewed in relation to three brain areas that are involved in memory functioning and the stress response: the hippocampus, amygdala, and the prefrontal cortex. Neurobiological studies have shown that the noradrenergic stress-system is involved in enhanced encoding of emotional memories, sensitization, and fear conditioning, by way of its effects on the amygdala. Chronic stress also affects the hippocampus, a brain area involved in declarative memories, suggesting that hippocampal dysfunction may partly account for the deficits in declarative memory in PTSD-patients. Deficits in the medial prefrontal cortex, a structure that normally inhibits the amygdala, may further enhance the effects of the amygdala, thereby increasing the frequency and intensity of the traumatic memories. Thus, by way of its influence on these brain structures, exposure to severe stress may simultaneously result in strong emotional reactions and in difficulties to recall the emotional event. This model is also relevant for understanding the distinction between declarative and non-declarative memory-functions in processing trauma-related information in PTSD. Implications of our model are reviewed.

  18. Acute obsessive compulsive disorder (OCD) in veterans with posttraumatic stress disorder (PTSD).

    Science.gov (United States)

    Fostick, Leah; Nacasch, Nitsa; Zohar, Joseph

    2012-04-01

    Posttraumatic obsessions have been reported in a few studies and case series. However, as the patients described were chronic, and the onset of their posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) symptoms was dated some time previously, this hampers interpretation of the temporal, biological and psychological relationship of OCD following traumatic events. In the current paper we describe the emergence of posttraumatic obsessions a short time following the exposure to a traumatic event. The emergence of posttraumatic obsessions, a few months after exposure to trauma, is described for five veterans. All the veterans participated in combat during the summer of 2006 (in the Second Lebanon War). For all cases, OCD symptoms were initially related to the trauma but later became generalized and independent. The course of the symptoms suggests a potential environmental role in the development of OCD following an exposure to a traumatic event. These observations suggest a biological linkage between exposure to trauma and OCD.

  19. 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

    Introduction: Correctly identifying chronic pain patients with posttraumatic stress disorder (PTSD) is important because the comorbidity of a chronic pain condition and PTSD is found to compromise treatment success. In addition, the existence of PTSD is associated with pain sensitisation, elevated...... no gender differences in PTSD. The three most reported traumatic events: traffic accidents, serious illness personally or in the family, and the actual loss of someone, were reported as the primary traumatic events by almost 50% of those with PTSD. No particular pain diagnosis was significantly related...

  20. Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena.

    Science.gov (United States)

    Kienzler, Hanna

    2008-07-01

    Researchers have tried to determine and verify the effects of violent conflicts on the mental health of those affected by focusing on war trauma, posttraumatic stress disorder (PTSD), and other trauma-related disorders. This, in turn, led to the development of different kinds of theories and aid programs that aim at preventing and treating the consequences of violence and mental health. Until now, there is no agreement on the public health value of the concept of PTSD and no agreement on the appropriate type of mental-health care. Instead, psychiatrists have engaged in sometimes fierce discussions over the universality of war trauma, PTSD, and other trauma-related disorders. The two most polar positions are those who try to validate PTSD as a universal and cross-culturally valid psychopathological response to traumatic distress which may be cured or ameliorated with (Western) clinical and psychosocial therapeutic measures, and those who argue that the Western discourse on trauma only makes sense in the context of a particular cultural and moral framework and, therefore, becomes problematic in the context of other cultural and social settings. Although these positions seem mutually exclusive, their debates have led to the development of less radical approaches toward war-trauma and PTSD. The purpose of this literature review is to analyse the discourses on and debates over war-trauma and PTSD in the psychiatric literature in order to establish a better understanding for the diverse conceptualizations, interpretations and proposed healing strategies. Moreover, I discuss the cultural construction and conceptualization of war-trauma and PTSD from an anthropological perspective and show how anthropologists contribute to psychiatric debates so as to ensure more sophisticated diagnoses and healing strategies in culturally diverse contexts.

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

    Science.gov (United States)

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

    2010-01-01

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

  2. What explains post-traumatic stress disorder (PTSD) in UK service personnel: deployment or something else?

    Science.gov (United States)

    Jones, M; Sundin, J; Goodwin, L; Hull, L; Fear, N T; Wessely, S; Rona, R J

    2013-08-01

    In previous studies an association between deployment to Iraq or Afghanistan and an overall increased risk for post-traumatic stress disorder (PTSD) in UK armed forces has not been found. The lack of a deployment effect might be explained by including, in the comparison group, personnel deployed on other operations or who have experienced traumatic stressors unrelated to deployment. The sample comprised 8261 regular UK armed forces personnel who deployed to Iraq, Afghanistan or other operational areas or were not deployed. Participants completed the PTSD CheckList-Civilian Version (PCL-C) and provided information about deployment history, demographic and service factors, serious accidents and childhood experiences. Deployment to Iraq or Afghanistan [odds ratio (OR) 1.2, 95% confidence interval (CI) 0.6-2.2] or elsewhere (OR 1.1, 95% CI 0.6-2.0) was unrelated to PTSD although holding a combat role was associated with PTSD if deployed to Iraq or Afghanistan (OR 2.7, 95% CI 1.9-3.9). Childhood adversity (OR 3.3, 95% CI 2.1-5.0), having left service (OR 2.7, 95% CI 1.9-4.0) and serious accident (OR 2.1, 95% CI 1.4-3.0) were associated with PTSD whereas higher rank was protective (OR 0.3, 95% CI 0.12-0.76). For the majority of UK armed forces personnel, deployment whether to Iraq, Afghanistan or elsewhere confers no greater risk for PTSD than service in the armed forces per se but holding a combat role in those deployed to Iraq or Afghanistan is associated with PTSD. Vulnerability factors such as lower rank, childhood adversity and leaving service, and having had a serious accident, may be at least as important as holding a combat role in predicting PTSD in UK armed forces personnel.

  3. Replicability and Generalizability of Posttraumatic Stress Disorder (PTSD) Networks

    DEFF Research Database (Denmark)

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

    2018-01-01

    . This renders network structures in clinical data, and the extent to which networks replicate across data sets, unknown. To overcome these limitations, the present cross-cultural multisite study estimated regularized partial correlation networks of 16 PTSD symptoms across four data sets of traumatized patients...... discuss the importance of future replicability efforts to improve clinical psychological science and provide code, model output, and correlation matrices to make the results of this article fully reproducible....

  4. Non-Antidepressant Long-term Treatment in Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Kerbage, Hala; Richa, Sami

    2015-01-01

    Post-traumatic stress disorder (PTSD) is a frequent and disabling condition that occurs after exposure to a traumatic event, and Selective Serotonin Reuptake Inhibitors (SSRIs) are considered the first-line treatment approach for this disorder. However, a large proportion of patients remain symptomatic and other pharmacological agents have been investigated, based on the understanding of the underlying biological dysfunctions of PTSD. We conducted a review of the literature on the pharmacological options for PTSD other than the antidepressants, using MedLine and Web of Science databases, with search terms including the pharmacologic class of each agent plus PTSD, or pharmacotherapy, or fear conditioning. The literature review covered articles published until august 2012, including reviews and original articles. Agents like antipsychotics, anticonvulsants, benzodiazepines, anti-adrenergic agents, have been studied in randomized clinical trials (RCTs), with general positive results for antipsychotics, especially as adjunct therapy, and for prazosin for sleep-related disturbances. However, one important target for novel medications is the modulation of the fear conditioning process, through the alteration of retrieval/reconsolidation or enhancement of fear extinction. This is traditionally targeted in prolonged exposure therapy, but pre-clinical findings from studies investigating agents like propanolol, clonidine, N-Methyl-D-aspartic Acid Receptor (NMDAR) compounds, 3,4-methylenedioxy-N-methylamphetamine (MDMA) and cannabinoids, indicate promising results in affecting the fear conditioning process and thus improving PTSD core symptoms. Antipsychotics can be considered a reasonable alternative option to PTSD, with the largest body of evidence for risperidone, even though larger RCTs are warranted. Prazosin is also a promising agent, especially for sleep-related disturbances, while anticonvulsants and benzodiazepines lack empirical support. However, the most promising

  5. Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial.

    Science.gov (United States)

    Lewis, Catrin E; Farewell, Daniel; Groves, Vicky; Kitchiner, Neil J; Roberts, Neil P; Vick, Tracey; Bisson, Jonathan I

    2017-06-01

    There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h. Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy. © 2017 Wiley Periodicals, Inc.

  6. Diagnostic Biomarkers for Posttraumatic Stress Disorder (PTSD): Promising Horizons from Translational Neuroscience Research

    Science.gov (United States)

    Michopoulos, Vasiliki; Norrholm, Seth Davin; Jovanovic, Tanja

    2015-01-01

    Posttraumatic stress disorder (PTSD) is a heterogeneous disorder that affects individuals exposed to trauma (e.g., combat, interpersonal violence, and natural disasters). Although its diagnostic features have been recently re-classified with the emergence of the Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), the disorder remains characterized by hyperarousal, intrusive reminders of the trauma, avoidance of trauma-related cues, and negative cognition and mood. This heterogeneity indicates the presence of multiple neurobiological mechanisms underlying the etiology and maintenance of PTSD. Translational research spanning the past few decades has revealed several potential avenues for the identification of diagnostic biomarkers for PTSD. These include, but are not limited to, monoaminergic transmitter systems, the hypothalamic-pituitary-adrenal (HPA) axis, metabolic hormonal pathways, inflammatory mechanisms, psychophysiological reactivity, and neural circuits. The current review provides an update to the literature with regard to the most promising putative PTSD biomarkers with specific emphasis on the interaction between neurobiological influences on disease risk and symptom progression. Such biomarkers will most likely be identified by multi-dimensional models derived from comprehensive descriptions of molecular, neurobiological, behavioral, and clinical phenotypes. PMID:25727177

  7. Anthropological discourses on the globalization of posttraumatic stress disorder (PTSD) in post-conflict societies.

    Science.gov (United States)

    Moghimi, Yavar

    2012-01-01

    Posttraumatic stress disorder (PTSD) is a construct that has moved far beyond its origins in Veterans Administration hospitals after the Vietnam War. It is now commonly used in post-conflict societies by humanitarian agencies and researchers. This article looks at the ever-growing expansion of PTSD and reviews medical anthropologists' critiques of this cross-cultural dissemination of Western psychiatric knowledge. The article also reviews post-conflict ethnographies and their results, which often highlight a mismatch between local priorities and the psycho-social services being provided by outside agencies. Finally, the author highlights interventions that are currently being undertaken by humanitarian agencies in an attempt to bridge psychiatric expertise and local forms of healing. Although PTSD is a useful construct for conceptualizing the experience of those who have suffered traumatic events, it does not lend itself to universal cross-cultural application and should be cautiously applied in post-conflict societies.

  8. 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.

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

    Directory of Open Access Journals (Sweden)

    Karen Barnabas

    Full Text Available Post-traumatic stress disorder (PTSD is a chronic syndrome triggered by exposure to trauma and a failure to recover from a normal negative emotional reaction to traumatic stress. The neurobiology of PTSD and the participation of neuropeptides in the neural systems and circuits that control fear and anxiety are not fully understood. The long-term dysregulation of neuropeptide systems contributes to the development of anxiety disorders, including PTSD. The neuropeptide galanin (Gal and its receptors participate in anxiety-like and depression-related behaviors via the modulation of neuroendocrine and monoaminergic systems. The objective of this research was to investigate how Gal expression changes in the brain of rats 2 weeks after exposure to footshock. Rats exposed to footshocks were subdivided into high responders (HR; immobility>60% and low responders (LR; immobility<40% based on immobility elicited by a novel tone one day after exposure. On day 14, rats were anesthetized, and the amygdala, hypothalamus, pituitary and adrenal glands were removed for analysis using real-time polymerase chain reaction (RT-PCR. Gal mRNA levels were increased in the amygdala and hypothalamus of HR compared with the control and LR. In contrast, Gal mRNA levels were decreased in the adrenal and pituitary glands of HR compared with the control and LR. Thus, the differential regulation (dysregulation of the neuropeptide Gal in these tissues may contribute to anxiety and PTSD development.

  10. Posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment compared to children who survived a major fire disaster

    NARCIS (Netherlands)

    Bronner, M.B.; Knoester, H.; Bos, AP; Last, B.F.; Grootenhuis, M.A.

    2008-01-01

    Background: The goals were to determine the presence of posttraumatic stress disorder (PTSD) in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands. Methods: Children completed the

  11. Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors

    OpenAIRE

    Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

    2013-01-01

    Background Childbirth might be a traumatic event for some women. Objectives This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. Patients and Methods The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 wo...

  12. Age As Moderator of Emotional Stroop Task Performance in Posttraumatic Stress Disorder (PTSD

    Directory of Open Access Journals (Sweden)

    Maksymilian Bielecki

    2017-09-01

    Full Text Available Emotional Stroop task (EST has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD. Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3 were included in the analysis, out of which 136 (70.1% were diagnosed with PTSD. Prior to the psychiatric assessment, participants completed the pictorial version of EST (neutral, positive, negative, and accidents photos were presented. Comparison of the PTSD and control groups revealed a specific increase in reaction times (RTs related to the exposure of trauma-related material. At the same time, previously unreported, moderating effects of age were also discovered. Older participants, in contrast to the younger group, showed no increase in RTs and interference scores in trials where accident photos were presented. Our study points to the key role of age as a previously understudied factor modifying EST performance in PTSD patients.

  13. Age As Moderator of Emotional Stroop Task Performance in Posttraumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Bielecki, Maksymilian; Popiel, Agnieszka; Zawadzki, Bogdan; Sedek, Grzegorz

    2017-01-01

    Emotional Stroop task (EST) has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD). Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3) were included in the analysis, out of which 136 (70.1%) were diagnosed with PTSD. Prior to the psychiatric assessment, participants completed the pictorial version of EST (neutral, positive, negative, and accidents photos were presented). Comparison of the PTSD and control groups revealed a specific increase in reaction times (RTs) related to the exposure of trauma-related material. At the same time, previously unreported, moderating effects of age were also discovered. Older participants, in contrast to the younger group, showed no increase in RTs and interference scores in trials where accident photos were presented. Our study points to the key role of age as a previously understudied factor modifying EST performance in PTSD patients.

  14. Are posttraumatic stress disorder (PTSD) and complex-PTSD distinguishable within a treatment-seeking sample of Syrian refugees living in Lebanon?

    Science.gov (United States)

    Hyland, P; Ceannt, R; Daccache, F; Abou Daher, R; Sleiman, J; Gilmore, B; Byrne, S; Shevlin, M; Murphy, J; Vallières, F

    2018-01-01

    The World Health Organization will publish its 11 th revision of the International Classification of Diseases (ICD-11) in 2018. The ICD-11 will include a refined model of posttraumatic stress disorder (PTSD) and a new diagnosis of complex PTSD (CPTSD). Whereas emerging data supports the validity of these proposals, the discriminant validity of PTSD and CPTSD have yet to be tested amongst a sample of refugees. Treatment-seeking Syrian refugees ( N  = 110) living in Lebanon completed an Arabic version of the International Trauma Questionnaire ; a measure specifically designed to capture the symptom content of ICD-11 PTSD and CPTSD. In total, 62.6% of the sample met the diagnostic criteria for PTSD or CPTSD. More refugees met the criteria for CPTSD (36.1%) than PTSD (25.2%) and no gender differences were observed. Latent class analysis results identified three distinct groups: (1) a PTSD class, (2) a CPTSD class and (3) a low symptom class. Class membership was significantly predicted by levels of functional impairment. Support for the discriminant validity of ICD-11 PTSD and CPTSD was observed for the first time within a sample of refugees. In support of the cross-cultural validity of the ICD-11 proposals, the prevalence of PTSD and CPTSD were similar to those observed in culturally distinct contexts.

  15. Lack of cortisol response in patients with posttraumatic stress disorder (PTSD undergoing a diagnostic interview

    Directory of Open Access Journals (Sweden)

    de Quervain Dominique JF

    2007-10-01

    Full Text Available Abstract Background According to DSM-IV, the diagnosis of posttraumatic stress disorder (PTSD requires the experience of a traumatic event during which the person's response involved intense fear, helplessness, or horror. In order to diagnose PTSD, clinicians must interview the person in depth about his/her previous experiences and determine whether the individual has been traumatized by a specific event or events. However, asking questions about traumatic experiences can be stressful for the traumatized individual and it has been cautioned that subsequent "re-traumatization" could occur. This study investigated the cortisol response in traumatized refugees with PTSD during a detailed and standardized interview about their personal war and torture experiences. Methods Participants were male refugees with severe PTSD who solicited an expert opinion in the Psychological Research Clinic for Refugees of the University of Konstanz. 17 patients were administered the Vivo Checklist of War, Detention, and Torture Events, a standardized interview about traumatic experiences, and 16 subjects were interviewed about absorption behavior. Self-reported measures of affect and arousal, as well as saliva cortisol were collected at four points. Before and after the experimental intervention, subjects performed a Delayed Matching-to-Sample (DMS task for distraction. They also rated the severity of selected PTSD symptoms, as well as the level of intrusiveness of traumatic memories at that time. Results Cortisol excretion diminished in the course of the interview and showed the same pattern for both groups. No specific response was detectable after the supposed stressor. Correspondingly, ratings of subjective well-being, memories of the most traumatic event(s and PTSD symptoms did not show any significant difference between groups. Those in the presumed stress condition did not perform worse than persons in the control condition after the stressor. However, both

  16. Cognitive behavioral therapy (CBT in a Patient with Implantable Cardioverter Defibrillator (ICD and Posttraumatic stress disorder(PTSD.

    Directory of Open Access Journals (Sweden)

    Sahar Ansari

    2014-09-01

    Full Text Available The implantable cardioverter defibrillator (ICD has currently become the standard treatment for preventing sudden cardiac death. There are some psychological consequences in patients with ICD such as posttraumatic stress disorder (PTSD after the shocks induced by ICD. This report aimed to present the case of a 54-year-old man with ICD who had developed PTSD; his PTSD was treated, using cognitive-behavioral psychotherapy consisting of relaxation, mindfulness and problem solving techniques. In patients with ICD who are experiencing PTSD using cognitive behavioral interventions may be helpful to reduce their psychological sufferings.

  17. Hyperbaric Oxygen Therapy in the Treatment of Chronic Mild-Moderate Blast-Induced Traumatic Brain Injury Post-Concussion Syndrome (PCS) and Post Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    2017-10-01

    Post-Concussion Syndrome (PCS) and Post Traumatic Stress Disorder (PTSD) PRINCIPAL INVESTIGATOR: Paul G. Harch, M.D. CONTRACTING ORGANIZATION...Traumatic Brain Injury Post-Concussion Syndrome (PCS) and Post Traumatic Stress Disorder (PTSD) 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR...injury (TBI) and post-traumatic stress disorder (PTSD) affect 11-28% and 13-17%, respectively, of U.S. combat troops returning from Iraq and

  18. Posttraumatic stress disorder (PTSD in children after paediatric intensive care treatment compared to children who survived a major fire disaster

    Directory of Open Access Journals (Sweden)

    Last Bob F

    2008-05-01

    Full Text Available Abstract Background The goals were to determine the presence of posttraumatic stress disorder (PTSD in children after paediatric intensive care treatment, to identify risk factors for PTSD, and to compare this data with data from a major fire disaster in the Netherlands. Methods Children completed the Dutch Children's Responses to Trauma Inventory at three and nine months after discharge from the paediatric intensive care unit (PICU. Comparison data were available from 355 children survivors who completed the same questionnaire 10 months after a major fire disaster. Results Thirty-six children aged eight to 17 years completed questionnaires at three month follow-up, nine month follow-up, or both. More than one third (34.5% of the children had subclinical PTSD, while 13.8% were likely to meet criteria for PTSD. Maternal PTSD was the strongest predictor for child PTSD. There were no significant differences in (subclinical PTSD symptoms either over time or compared to symptoms of survivors from the fire disaster. Conclusion This study shows that a considerable number of children have persistent PTSD after PICU treatment. Prevention of PTSD is important to minimize the profound adverse effects that PTSD can have on children's well-being and future development.

  19. Posttraumatic Stress Disorder

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Posttraumatic Stress Disorder (PTSD) KidsHealth / For Parents / Posttraumatic Stress Disorder ( ... My Child? Looking Ahead Print What Is Posttraumatic Stress Disorder (PTSD)? Someone who is the victim of ( ...

  20. Mismatch of Posttraumatic Stress Disorder (PTSD) Symptoms and DSM-IV Symptom Clusters in a Cancer Sample: Exploratory Factor Analysis of the PTSD Checklist-Civilian Version

    Science.gov (United States)

    Shelby, Rebecca A.; Golden-Kreutz, Deanna M.; Andersen, Barbara L.

    2007-01-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994a) conceptualization of posttraumatic stress disorder (PTSD) includes three symptom clusters: reexperiencing, avoidance/numbing, and arousal. The PTSD Checklist-Civilian Version (PCL-C) corresponds to the DSM-IV PTSD symptoms. In the current study, we conducted exploratory factor analysis (EFA) of the PCL-C with two aims: (a) to examine whether the PCL-C evidenced the three-factor solution implied by the DSM-IV symptom clusters, and (b) to identify a factor solution for the PCL-C in a cancer sample. Women (N = 148) with Stage II or III breast cancer completed the PCL-C after completion of cancer treatment. We extracted two-, three-, four-, and five-factor solutions using EFA. Our data did not support the DSM-IV PTSD symptom clusters. Instead, EFA identified a four-factor solution including reexperiencing, avoidance, numbing, and arousal factors. Four symptom items, which may be confounded with illness and cancer treatment-related symptoms, exhibited poor factor loadings. Using these symptom items in cancer samples may lead to overdiagnosis of PTSD and inflated rates of PTSD symptoms. PMID:16281232

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

    Science.gov (United States)

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

    2016-06-01

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

  2. The relationship between post traumatic stress disorder and post traumatic growth: gender differences in PTG and PTSD subgroups.

    Science.gov (United States)

    Jin, Yuchang; Xu, Jiuping; Liu, Dongyue

    2014-12-01

    This study investigated the post traumatic stress disorder (PTSD) and post traumatic growth (PTG) in 2,300 earthquake survivors 1 year after the 2008 Wenchuan earthquake. This study aimed to investigate the relationship between PTSD and PTG and also tested for the gender differences in PTSD and PTG subgroups. A stratification random sampling strategy and questionnaires were used to collect the data. The PTSD was assessed using the PTSD Check list-Civilian and the PTG was assessed using the Post traumatic growth inventory. 2,300 individuals were involved in the initial survey with 2,080 completing the final questionnaire, a response rate of 90.4%. One-way ANOVA analyses were performed to investigate the gender differences in the PTSD and PTG subgroups. One year following the earthquake, 40.1 and 51.1% of survivors reported PTSD and PTG, respectively. A bivariate correlation analysis indicated that there was a positive association between PTG and PTSD. The PTG and PTSD variance analysis conducted on female and male subgroups suggested that women were more affected than men. Given the relatively high PTG prevalence, it was concluded that researchers need to pay more attention to the positive outcomes of an earthquake rather than just focusing on the negative effects. The surveys and analyses indicated that psychological intervention and care for the earthquake disaster survivors should focus more on females and older people, who tend to be more adversely affected.

  3. Effectiveness and Patient Acceptability of Stellate Ganglion Block (SGB) for Treatment of Posttraumatic Stress Disorder (PTSD) Symptoms Among Active Duty Military Members

    Science.gov (United States)

    2016-03-01

    you were manic-depressive or had bipolar disorder ?* ○ No ○ Yes 9. Have you received therapy for PTS/PTSD in the past month?* ○ No [Go to Question...Posttraumatic Stress Disorder (PTSD) Symptoms among Active Duty Military Members PRINCIPAL INVESTIGATOR: Bradford B. Walters, MD, PhD CONTRACTING...of Posttraumatic Stress Disorder (PTSD) Symptoms among Active Duty Military Members 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER 5e

  4. Improving cognitive control in adolescents with post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Schweizer, Susanne; Samimi, Zobair; Hasani, Jafar; Moradi, Alireza; Mirdoraghi, Fatemeh; Khaleghi, Mohammad

    2017-06-01

    The adverse impact of posttraumatic stress disorder (PTSD) on the developing mind in adolescence can extend well into adulthood. The developmental malleability of cognitive control capacity in this age group, however, may hold particular promise for cognitive training interventions. The present study investigated the effects of affective working memory (aWMT) compared to placebo-training on cognitive and affective functioning in adolescents with PTSD. 30 treatment-seeking adolescents trained for 20 days on either an affective dual n-back task (aWMT; n = 15) or a feature match task (placebo; n = 15). The aWMT group showed greater pre-to post-training increases in cognitive control as measured by the GoNogo task as well as improvements in symptoms of PTSD and increased use of adaptive emotion regulation strategies. These preliminary findings are promising given the potential for free and easy dissemination of the aWMT in schools and online. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Is plasma GABA level a biomarker of Post-Traumatic Stress Disorder (PTSD) severity? A preliminary study.

    Science.gov (United States)

    Trousselard, Marion; Lefebvre, Bertrand; Caillet, Lionel; Andruetan, Yann; de Montleau, Franck; Denis, Josiane; Canini, Frédéric

    2016-07-30

    An increased reactivity to the environment is observed in Post-Traumatic Stress Disorder (PTSD). It would be related to impairment of the Gamma Amino Butyric Acid (GABA) neurotransmission. The study aimed to evaluate plasma GABA concentration as a candidate for PTSD severity biomarker. This hypothesis was studied in 17 PTSD patients and 17 healthy Controls using classic and emotional Stroop paradigms. Plasma GABA concentrations were assessed before and after both Stroop tests to evaluate GABA basal tone and GABA reactivity (change in GABAp), respectively. During baseline, PTSD had lower plasma GABA concentrations than the Controls. After the Stroop conflicts GABA reactivity was also lower in PTSD than in the Controls. The GABA baseline tone was negatively correlated with the severity of the PTSD symptoms. This relation was only marginally observed for GABA reactivity. The results produced a trend due to the small size of the sample compared to the number of statistical results given. Altogether, the reduced GABA concentration observed in PTSD could be considered as a possible biomarker for PTSD severity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  6. Psychological interventions for post-traumatic stress disorder (PTSD) in people with severe mental illness.

    Science.gov (United States)

    Sin, Jacqueline; Spain, Debbie; Furuta, Marie; Murrells, Trevor; Norman, Ian

    2017-01-24

    Increasing evidence indicates that individuals who develop severe mental illness (SMI) are also vulnerable to developing post-traumatic stress disorder (PTSD), due to increased risk of exposure to traumatic events and social adversity. The effectiveness of trauma-focused psychological interventions (TFPIs) for PTSD in the general population is well-established. TFPIs involve identifying and changing unhelpful beliefs about traumatic experiences, processing of traumatic memories, and developing new ways of responding to cues associated with trauma. Little is known about the potential feasibility, acceptability and effectiveness of TFPIs for individuals who have a SMI and PTSD. To evaluate the effectiveness of psychological interventions for PTSD symptoms or other symptoms of psychological distress arising from trauma in people with SMI. We searched the Cochrane Schizophrenia Group's Trials Study-Based Register (up until March 10, 2016), screened reference lists of relevant reports and reviews, and contacted trial authors for unpublished and/or specific outcome data. We included all relevant randomised controlled trials (RCTs) which investigated TFPIs for people with SMI and PTSD, and reported useable data. Three review authors (DS, MF, IN) independently screened the titles and abstracts of all references identified, and read short-listed full text papers. We assessed risk of bias in each case. We calculated the risk ratio (RR) and 95% confidence interval (CI) for binary outcomes, and the mean difference (MD) and 95% CI for continuous data, on an intention-to-treat basis. We assessed quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) and created 'Summary of findings' tables. Four trials involving a total of 300 adults with SMI and PTSD are included. These trials evaluated three active intervention therapies: trauma-focused cognitive behavioural therapy (TF-CBT), eye movement desensitisation and reprocessing (EMDR

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

    NARCIS (Netherlands)

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

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

  8. Assessing impact of differential symptom functioning on post-traumatic stress disorder (PTSD) diagnosis.

    Science.gov (United States)

    He, Qiwei; Glas, Cees A W; Veldkamp, Bernard P

    2014-06-01

    This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as differential item functioning [DIF]) related to various background variables such as gender, marital status and educational level, this study emphasizes the importance of evaluating the impact of DIF on population inferences as made in health surveys and clinical trials, and on the diagnosis of individual patients. Using a sample from the National Comorbidity Study-Replication (NCS-R), four symptoms for gender, one symptom for marital status, and three symptoms for educational level were significantly flagged as DIF, but their impact on diagnosis was fairly small. We conclude that the DSM-IV diagnostic criteria for PTSD do not produce substantially biased results in the investigated subpopulations, and there should be few reservations regarding their use. Further, although the impact of DIF (i.e. the influence of differential symptom functioning on diagnostic results) was found to be quite small in the current study, we recommend that diagnosticians always perform a DIF analysis of various subpopulations using the methodology presented here to ensure the diagnostic criteria is valid in their own studies. Copyright © 2014 John Wiley & Sons, Ltd.

  9. Neuromarkers of Post-Traumatic Stress Disorder (PTSD) in a patient after bilateral hand amputation - ERP case study.

    Science.gov (United States)

    Chrapusta, Anna; Kropotov, Juri D; Pąchalska, Maria

    2017-06-08

    Introduction. There is a lack in the worldwide literature of reports on the Neuromarkers of Post-Traumatic Stress Disorder (PTSD) in patients after bilateral hand amputation The aim of this study was to test a hypothesis regarding developing Post-Traumatic Stress Disorder (PTSD) in a patient after bilateral hand amputation with the use of Event Related Potentials (ERPs). On the basis of previous research, the amplitudes of P3 ERP components elicited in the cued GO/NOGO tasks have been chosen as candidates for neuromarkers of PTSD. Case study. A 24-year-old patient had undergone bilateral hand amputation 12 months previously. The patient was repeatedly operated on (he had undergone successful bilateral hand replantation) and despite the severity of the injuries, he recovered. However, the patient complained of flashbacks, anxiety and sleep difficulties. Specialist tests showed the presence of PTSD. The patient participated in the cued GO/NOGO task (Kropotov, 2009) with recording 19-channel EEG. P3 GO and NOGO waves in this task were found to be significantly smaller, in comparison to a group of healthy control subjects of the same age (N=23) taken from the HBI normative database (https://www.hbimed.com/). This observed pattern of ERP waves in the patient corresponds to the pattern found in PTSD patients. Conclusions. ERPs in a GO/NOGO task can be used in the assessment of the functional brain changes induced by chronic PTSD.

  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. Perspectives of Student Combat Veterans Diagnosed with Posttraumatic Stress Disorder (PTSD) on Their Experiences in Higher Education

    Science.gov (United States)

    Ryder, Richard R., Jr.

    2012-01-01

    The intention of the this qualitative study was to explore the perceptions of military combat veteran college students (MCVCS) who self-identify as having been diagnosed with Posttraumatic Stress Disorder (PTSD). They were offered the opportunity to answer questions on the experiences they have in higher education. The study inquired on the…

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

    Science.gov (United States)

    Flouri, Eirini

    2005-01-01

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

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

    Science.gov (United States)

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

    2016-11-01

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

  15. Identifying Molecular Targets For PTSD Treatment Using Single Prolonged Stress

    Science.gov (United States)

    2014-10-01

    Post - traumatic stress disorder ( PTSD ) is a chronic, debilitating psychiatric disorder that can...SPS animals. Post - traumatic stress disorder ( PTSD ) is associated with neurocognitive impairments that have been attributed to functional deficits...and resilience. 2. KEYWORDS Post - traumatic stress disorder , Single Prolonged Stress , Neurobiological Mechanisms 5 3. ACCOMPLISHMENTS

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

    OpenAIRE

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

    2011-01-01

    A post-traumatic stress disorder (PTSD) is a severe stress disorder and, as such, a severe handicap in daily life. To this date, its treatment is still a big endeavor for therapists. This chapter discusses an exploration towards automatic assistance in treating patients suffering from PTSD. Such assistance should enable objective and unobtrusive stress measurement, provide decision support on whether or not the level of stress is excessive, and, consequently, be able to aid in its treatment. ...

  17. Sudden losses and sudden gains during a DBT-PTSD treatment for posttraumatic stress disorder following childhood sexual abuse

    Directory of Open Access Journals (Sweden)

    Antje Krüger

    2014-09-01

    Full Text Available Background: Exposure-based treatment approaches are first-line interventions for patients suffering from posttraumatic stress disorder (PTSD. However, the dissemination of exposure-based treatments for PTSD is challenging, as a large proportion of clinicians report being concerned about symptoms worsening as a result of this type of intervention and are therefore reluctant to offer it to patients with PTSD. However, there is only little empirical evidence to date on the pattern of symptom worsening during exposure-based treatment for PTSD. Objective: The goal of the present study was to explore the frequency of sudden losses and sudden gains in the course of an exposure-based treatment programme for female patients suffering from PTSD related to childhood sexual abuse who also show severe comorbidity. In addition, the relationship between sudden changes and treatment outcome was examined. Methods: Female participants (N=74 were randomised to either a 12-week residential DBT-PTSD programme or a treatment-as-usual wait list. The pattern of symptom change was assessed via weekly assessments using the Posttraumatic Diagnostic Scale (PDS. Sudden changes were computed as suggested by the literature on sudden gains. Results: During treatment, only one participant (3% experienced a sudden loss, whereas 25% of participants experienced sudden gains. In the waiting condition, 8% of the participants experienced sudden losses and 5% experienced sudden gains during the same time period. No symptom worsening was observed in response to exposure sessions. However, sudden gains occurred during exposure and non-exposure treatment weeks. Patients with sudden gains showed better treatment outcome in the post-treatment and follow-up assessments. Conclusions: Exposure-based treatment did not lead to PTSD symptom worsening in the study sample. Results show that sudden gains occur frequently during PTSD treatment and have a prognostic value for treatment outcome.

  18. Psychological therapies for chronic post-traumatic stress disorder (PTSD) in adults.

    Science.gov (United States)

    Bisson, Jonathan I; Roberts, Neil P; Andrew, Martin; Cooper, Rosalind; Lewis, Catrin

    2013-12-13

    Post-traumatic stress disorder (PTSD) is a distressing condition, which is often treated with psychological therapies. Earlier versions of this review, and other meta-analyses, have found these to be effective, with trauma-focused treatments being more effective than non-trauma-focused treatments. This is an update of a Cochrane review first published in 2005 and updated in 2007. To assess the effects of psychological therapies for the treatment of adults with chronic post-traumatic stress disorder (PTSD). For this update, we searched the Cochrane Depression, Anxiety and Neurosis Group's Specialised Register (CCDANCTR-Studies and CCDANCTR-References) all years to 12th April 2013. This register contains relevant randomised controlled trials from: The Cochrane Library (all years), MEDLINE (1950 to date), EMBASE (1974 to date), and PsycINFO (1967 to date). In addition, we handsearched the Journal of Traumatic Stress, contacted experts in the field, searched bibliographies of included studies, and performed citation searches of identified articles. Randomised controlled trials of individual trauma-focused cognitive behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), non-trauma-focused CBT (non-TFCBT), other therapies (supportive therapy, non-directive counselling, psychodynamic therapy and present-centred therapy), group TFCBT, or group non-TFCBT, compared to one another or to a waitlist or usual care group for the treatment of chronic PTSD. The primary outcome measure was the severity of clinician-rated traumatic-stress symptoms. We extracted data and entered them into Review Manager 5 software. We contacted authors to obtain missing data. Two review authors independently performed 'Risk of bias' assessments. We pooled the data where appropriate, and analysed for summary effects. We include 70 studies involving a total of 4761 participants in the review. The first primary outcome for this review was reduction in the severity of PTSD

  19. Play Therapy Untuk anak-anak Korban Bencana Alam Yang Mengalami Trauma (Post Traumatic Stress Disorder/PTSD

    Directory of Open Access Journals (Sweden)

    Endah Nawangsih

    2016-02-01

    Full Text Available Anywhere in the world, natural disasters events cause loss of life, moreover a deep sorrow and fear for the victims. They were in a state of very uneasy, very scared, never-ending anxiety, and become prone to panic. These conditions called post-traumatic stress disorder (PTSD as a continuous maladaptive reaction to a traumatic experience. In contrast to adults, children are in a state highly vulnerable to the impact caused by a traumatic event. Children with PTSD may show confusion or agitation. This condition brings suffering prolonged, if not given proper treatment. It required a specific intervention design for children with PTSD namely Play Therapy techniques. This intervention is one way that can be used to understand the world of children through playing, so that when used in the right circumstances can be meaningful as physical activity as well as therapy.

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

    OpenAIRE

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

    2015-01-01

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

  1. Diagnosis and Healing In Veterans Suspected of Suffering from Post-Traumatic Stress Disorder (PTSD) Using Reward Gene Testing and Reward Circuitry Natural Dopaminergic Activation

    OpenAIRE

    Blum, Kenneth; Giordano, John; Oscar-Berman, Marlene; Bowirrat, Abdalla; Simpatico, Thomas; Barh, Debmalya

    2012-01-01

    There is a need for understanding and treating post-traumatic stress disorder (PTSD), in soldiers returning to the United States of America after combat. Likewise, it would be beneficial to finding a way to reduce violence committed by soldiers, here and abroad, who are suspected of having post-traumatic stress disorder (PTSD). We hypothesize that even before combat, soldiers with a childhood background of violence (or with a familial susceptibility risk) would benefit from being genotyped fo...

  2. A clinical plan for MDMA (Ecstasy) in the treatment of posttraumatic stress disorder (PTSD): partnering with the FDA.

    Science.gov (United States)

    Doblin, Rick

    2002-01-01

    The FDA and the Spanish Ministry of Health have concluded that the risk/benefit ratio is favorable under certain circumstances for clinical studies investigating MDMA-assisted psychotherapy. Both agencies have approved pilot studies in chronic posttraumatic stress disorder (PTSD) patients who have failed to obtain relief from at least one course of conventional treatment. These studies, the only ones in the world into the therapeutic use of MDMA, are being funded by a nonprofit research and educational organization, the Multidisciplinary Association for Psychedelic Studies (MAPS, www.maps.org). A rationale is offered explaining why MAPS chose to focus its limited resources on MDMA, and also on PTSD patients. A Clinical Plan is elaborated for the conduct of the "adequate and well-controlled" trials necessary to evaluate the safety and efficacy of MDMA-assisted psychotherapy for PTSD, with the studies estimated to cost about 5 million dollars and to take about five years. The Clinical Plan has been developed, in part, through analysis of the studies conducted by Pfizer in its successful effort to have Zoloft approved by the FDA for use with PTSD patients, and through review of transcripts of the FDA's Psychopharmacologic Drugs Advisory Committee meeting that recommended approval of Zoloft for PTSD.

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

    Directory of Open Access Journals (Sweden)

    Tanya Saraiya

    2016-11-01

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

  4. 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

  5. Tonic immobility differentiates stress responses in PTSD

    NARCIS (Netherlands)

    Fragkaki, I; Stins, J.F.; Roelofs, K.; Jongedijk, R.A.; Hagenaars, M.A.

    2016-01-01

    Background: 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

  6. 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.

  7. The relationship between forgiveness, spirituality, traumatic guilt and posttraumatic stress disorder (PTSD) among people with addiction.

    Science.gov (United States)

    Langman, Louise; Chung, Man Cheung

    2013-03-01

    Spirituality and forgiveness have been shown to be associated with psychological well-being, while guilt has been associated with poor health. Little is known, however, about the relationship between forgiveness, spirituality, guilt, posttraumatic stress (PTSD) and psychological co-morbidity among people in recovery from addiction. Eighty-one people (F = 36, M = 45) in recovery from drug and alcohol addiction were recruited from two residential units and two drop-in centres in a city in the United Kingdom. They completed the Posttraumatic Stress Diagnostic Scale (PDS), the General Health Questionnaire-28 (GHQ-28), the Spiritual Involvement and Beliefs Scale (SIBS), the Heartland Forgiveness Scale (HFS), the Traumatic Guilt Inventory (TGI), the Michigan Alcoholism Screening Test (MAST-22) and the Drug Abuse Screening Test (DAST-20). The control group comprised of 83 (F = 34, M = 49) individuals who confirmed that they did not have addiction and completed the PDS & GHQ-28. 54 % of the addiction group met the criteria for full PTSD and reported anxiety, somatic problems and depression. They described themselves as spiritual, had strong feelings of guilt associated with their addiction, and had difficulty in forgiving themselves. Controlling for demographics, number of events and medication management, regression analyses showed that spirituality predicted psychological co-morbidity, whilst feelings of guilt predicted PTSD symptoms and psychological co-morbidity. Unexpectedly, forgiveness did not predict outcomes. This study supports existing literature, which shows that people with drug and alcohol addiction tend to have experienced significant past trauma and PTSD symptoms. Their posttraumatic stress reactions and associated psychological difficulties can be better understood in the light of guilt and spirituality. Meanwhile, their ability to forgive themselves or others did not seem to influence health outcomes.

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

    Science.gov (United States)

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

    2016-12-01

    Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18-30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-01-01

    Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs. Six hundred fourteen young adults (age 18–30 yrs) of Mexican American heritage, largely second generation, were recruited from the community and assessed with the Semi-Structured Assessment for the Genetics of Alcoholism and an acculturation stress scale. More males (51.2%) reported experiencing traumas than females (41.1%), however, a larger proportion of females received a PTSD diagnosis (15%) than males (8%). Alcohol dependence and affective disorders, but not anxiety disorders, antisocial disorders, nicotine, marijuana, or stimulant dependence, were significantly comorbid with PTSD. Endorsing higher levels of acculturation stress was also significantly associated with both trauma exposure and a diagnosis of PTSD. Logistic regression revealed that female gender, having an affective disorder, alcohol dependence, higher levels of acculturation stress, and lower levels of education were all predictors of PTSD status. Additionally, alcohol dependence generally occurred after the PTSD diagnosis in early adulthood in this high-risk population. These studies suggest that treatment and prevention efforts should particularly focus on young adult second generation Mexican American women with higher levels of acculturation stress, who may be at higher risk for PTSD, affective disorder, and alcohol dependence following trauma exposure. PMID:27569652

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

    OpenAIRE

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

    2016-01-01

    Mexican Americans comprise one of the most rapidly growing populations in the United States, and within this population, trauma and post-traumatic stress disorder (PTSD) are associated with physical and mental health problems. Therefore, efforts to delineate factors that may uniquely contribute to increased likelihood of trauma, PTSD, and substance use disorders over the lifetime in Mexican Americans are important to address health disparities and to develop treatment and prevention programs....

  11. Race and incarceration in an aging cohort of Vietnam veterans in treatment for post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Coker, Kendell L; Rosenheck, Robert

    2014-03-01

    Cross sectional studies have addressed the incarceration of Vietnam veterans with post-traumatic stress disorder (PTSD), but no studies have examined changes in incarceration as they age. This study examines patterns of incarceration among Vietnam veterans treated in specialized veterans affairs (VA) intensive PTSD programs over time. Data was drawn from admission data from the initial episode of treatment of Caucasian and African American Vietnam veterans entering VA specialized intensive PTSD programs between 1993 and 2011 (N = 31,707). Bivariate correlations and logistic regression were used to examine associations among race and incarceration over time and the potentially confounding influence of demographic and clinical covariates on this relationship. Rates of reported incarceration declined from 63 to 43%. Over time, African American veterans were 34% more likely than Caucasian veterans to have a lifetime history of incarceration while interaction analysis showed steeper declines for Caucasians than African Americans. Rates of incarceration among these Vietnam veterans declined as they aged. Furthermore, African American veterans were substantially more likely than Caucasian veterans to have been incarcerated and showed less decline as the cohort aged. While reduced, needs for clinical PTSD services remain among aging combat veterans.

  12. Falling out of time: enhanced memory for scenes presented at behaviorally irrelevant points in time in posttraumatic stress disorder (PTSD).

    Science.gov (United States)

    Levy-Gigi, Einat; Kéri, Szabolcs

    2012-01-01

    Spontaneous encoding of the visual environment depends on the behavioral relevance of the task performed simultaneously. If participants identify target letters or auditory tones while viewing a series of briefly presented natural and urban scenes, they demonstrate effective scene recognition only when a target, but not a behaviorally irrelevant distractor, appears together with the scene. Here, we show that individuals with posttraumatic stress disorder (PTSD), who witnessed the red sludge disaster in Hungary, show the opposite pattern of performance: enhanced recognition of scenes presented together with distractors and deficient recognition of scenes presented with targets. The recognition of trauma-related and neutral scenes was not different in individuals with PTSD. We found a positive correlation between memory for scenes presented with auditory distractors and re-experiencing symptoms (memory intrusions and flashbacks). These results suggest that abnormal encoding of visual scenes at behaviorally irrelevant events might be associated with intrusive experiences by disrupting the flow of time.

  13. Falling out of time: enhanced memory for scenes presented at behaviorally irrelevant points in time in posttraumatic stress disorder (PTSD.

    Directory of Open Access Journals (Sweden)

    Einat Levy-Gigi

    Full Text Available Spontaneous encoding of the visual environment depends on the behavioral relevance of the task performed simultaneously. If participants identify target letters or auditory tones while viewing a series of briefly presented natural and urban scenes, they demonstrate effective scene recognition only when a target, but not a behaviorally irrelevant distractor, appears together with the scene. Here, we show that individuals with posttraumatic stress disorder (PTSD, who witnessed the red sludge disaster in Hungary, show the opposite pattern of performance: enhanced recognition of scenes presented together with distractors and deficient recognition of scenes presented with targets. The recognition of trauma-related and neutral scenes was not different in individuals with PTSD. We found a positive correlation between memory for scenes presented with auditory distractors and re-experiencing symptoms (memory intrusions and flashbacks. These results suggest that abnormal encoding of visual scenes at behaviorally irrelevant events might be associated with intrusive experiences by disrupting the flow of time.

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

    Science.gov (United States)

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

    2016-04-01

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

  15. 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.

  16. Evidence of distinct profiles of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD) based on the new ICD-11 Trauma Questionnaire (ICD-TQ).

    Science.gov (United States)

    Karatzias, Thanos; Shevlin, Mark; Fyvie, Claire; Hyland, Philip; Efthymiadou, Erifili; Wilson, Danielle; Roberts, Neil; Bisson, Jonathan I; Brewin, Chris R; Cloitre, Marylene

    2017-01-01

    The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses following exposure to traumatic events; Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). We set out to explore whether the newly developed ICD-11 Trauma Questionnaire (ICD-TQ) can distinguish between classes of individuals according to the PTSD and CPTSD symptom profiles as per ICD-11 proposals based on latent class analysis. We also hypothesized that the CPTSD class would report more frequent and a greater number of different types of childhood trauma as well as higher levels of functional impairment. Methods Participants in this study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland (N=193). Participants completed the ICD-TQ as well as measures of life events and functioning. Overall, results indicate that using the newly developed ICD-TQ, two subgroups of treatment-seeking individuals could be empirically distinguished based on different patterns of symptom endorsement; a small group high in PTSD symptoms only and a larger group high in CPTSD symptoms. In addition, CPTSD was more strongly associated with more frequent and a greater accumulation of different types of childhood traumatic experiences and poorer functional impairment. Sample predominantly consisted of people who had experienced childhood psychological trauma or been multiply traumatised in childhood and adulthood. CPTSD is highly prevalent in treatment seeking populations who have been multiply traumatised in childhood and adulthood and appropriate interventions should now be developed to aid recovery from this debilitating condition. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2012-06-01

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

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

    Science.gov (United States)

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

    2012-01-01

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

  19. Impact of terrorism on the development of posttraumatic stress disorder (PTSD) among the residents of Khyber Bazaar and its immediate surrounding areas in Peshawar, Khyber Pakhtunkhwa, Pakistan.

    Science.gov (United States)

    Abbas, Syed Asad; Hassan, Asad; Ali, Shahid

    2017-01-01

    This study evaluated the prevalence of posttraumatic stress disorder (PTSD) and the severity of PTSD symptoms in survivors, rescuers and witnesses of terrorist attacks on Khyber bazaar, Qissa Khawani bazaar, and All Saints Church in Peshawar city area. Cross-sectional survey is carried out on a sample of one hundred survivors, rescuers and witness of terrorist attacks using structured interviews to assess the severity of posttraumatic stress, five months after the attacks. The study period extended from January 24, 2014 to March 24, 2014 which constitutes a total of period of 8 weeks. PTSD symptoms are measured using Posttraumatic Symptom Scale Interview (PSSI) and conferred to a diagnosis of PTSD at 5 months. Additionally, the severity of PTSD symptoms were determined using PSSI scores, severity ranged from 0-51. Of the one hundred survey respondents, 88% were males and 12% were females. Forty percent (40%) had attained 10 years of education, matriculation, but irrespective of the gender or educational status, all had some degree of PTSD. Sixty-six (66%) percent respondents are diagnosed as having moderate PTSD while 11% of the sample suffered from severe PTSD level. Age, gender, occupation and education level did not have any correlation with PTSD development. The contemporary findings indicate that any person who has witnessed or survived catastrophes of terrorist activities like bomb blast or being exposed to suicide attacks is at risk for developing PTSD, and there is necessity to deliver specialized post-disaster mental health facilities to the people having substantial levels of PTSD after calamities of such great intensity.

  20. [Rational Rehabilitation in the treatment of post-traumatic stress disorder (PTSD). A pilot study].

    Science.gov (United States)

    Tomasoa, A T; Appelo, M T

    2007-01-01

    In a randomised controlled study, a type of cognitive behavior therapy known as Rational Rehabilitation proved effective in the treatment of patients with chronic mental symptoms. Post-traumatic stress disorder is a serious illness that occurs frequently and can last for many years. Rational Rehabilitation may also be an effective treatment for post-traumatic stress disorder. To investigate, via a pilot study, on the effect of Rational Rehabilitation in patients with post-traumatic stress disorder, whether a randomised controlled study is called for. Nineteen patients with post-traumatic stress disorder, who were awaiting regular treatment, opted to join the study. The effect of Rational Rehabilitation was studied in relation to: symptoms of post-traumatic stress disorder, degree of happiness experienced, autonomy, social support and need for further treatment. results Rational Rehabilitation seems to have a positive effect on all outcome measures, except flashbacks. A controlled study of the effect of Rational Rehabilitation in patients with post-traumatic stress disorder seems justified.

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

    Science.gov (United States)

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

    2017-04-01

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

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

    Science.gov (United States)

    Berardi, Andrea; Schelling, Gustav; Campolongo, Patrizia

    2016-09-01

    Post-Traumatic Stress Disorder (PTSD) is a psychiatric chronic disease developing in individuals after the experience of an intense and life-threatening traumatic event. The post-traumatic symptomatology encompasses alterations in memory processes, mood, anxiety and arousal. There is now consensus in considering the disease as an aberrant adaptation to traumatic stress. Pharmacological research, aimed at the discovery of new potential effective treatments, has lately directed its attention towards the "so-called" cognitive enhancers. This class of substances, by modulating cognitive processes involved in the development and/or persistence of the post-traumatic symptomatology, could be of great help in improving the outcome of psychotherapies and patients' prognosis. In this perspective, drugs acting on the endocannabinoid system are receiving great attention due to their dual ability to modulate memory processes on one hand, and to reduce anxiety and depression on the other. The purpose of the present review is to offer a thorough overview of both animal and human studies investigating the effects of cannabinoids on memory processes. First, we will briefly describe the characteristics of the endocannabinoid system and the most commonly used animal models of learning and memory. Then, studies investigating cannabinoid modulatory influences on memory consolidation, retrieval and extinction will be separately presented, and the potential benefits associated with each approach will be discussed. In the final section, we will review literature data reporting beneficial effects of cannabinoid drugs in PTSD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Yellowlees Peter

    2005-04-01

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

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

    Science.gov (United States)

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

    2010-02-01

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

  5. Posttraumatic stress disorder following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity: the impact of alexithymia and coping.

    Science.gov (United States)

    Chung, Man Cheung; Rudd, Hannah; Wall, Natalie

    2012-05-30

    This study investigated the prevalence of post-asthma attack posttraumatic stress disorder (PTSD) and the severity of psychiatric co-morbidity among a group of college students and whether alexithymia and coping strategies would relate to health outcomes. This is a cross-sectional study in which 156 college students who had previously experienced asthma attack were recruited. They completed a demographic page, Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28, Toronto Alexithymia Scale and the COPE. They were also matched with 141 students without asthma. The results showed that 3% met the criteria for full-PTSD, 44% for partial and 53% for no-PTSD. There were no significant differences between the asthma and control groups in severity of psychiatric co-morbid symptoms. Path analyses showed that asthma severity was significantly correlated with PTSD and psychiatric co-morbidity. It was also correlated with alexithymia which was in turn associated with psychiatric co-morbidity but not PTSD. Coping strategies were not correlated with health outcomes. To conclude, people can develop PTSD symptoms and degrees of psychiatric co-morbid symptoms after suffering asthma attack. The severity of these symptoms relates to people's perceptions of asthma severity and alexithymia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Serotonin transporter 5-HTTLPR genotype is associated with intrusion and avoidance symptoms of DSM-5 posttraumatic stress disorder (PTSD) in Chinese earthquake survivors.

    Science.gov (United States)

    Liu, Luobing; Wang, Li; Cao, Chengqi; Cao, Xing; Zhu, Ye; Liu, Ping; Luo, Shu; Zhang, Jianxin

    2018-05-01

    Prior studies have found that the serotonin transporter gene-linked polymorphic region (5-HTTLPR) interacts with trauma exposure to increase general risk for Posttraumatic Stress Disorder (PTSD). However, there is little knowledge about the effects of the interaction on distinct symptom clusters of PTSD. This study aimed to investigate the relation between the interaction of 5-HTTLPR and earthquake-related exposures and a contemporary phenotypic model of DSM-5 PTSD symptoms in a traumatised adult sample from China. A cross-sectional design with gene-environment interaction (G × E) approach was adopted. Participants were 1131 survivors who experienced 2008 Wenchuan earthquake. PTSD symptoms were assessed with the PTSD Checklist for DSM-5 (PCL-5). The 5-HTTLPR polymorphism was genotyped with capillary electrophoresis (CE) in ABI 3730xl genetic Analyzer. Although there was no significant interaction between 5-HTTLPR and traumatic exposure on total PTSD symptoms, respondents with the LL genotype of 5-HTTLPR who were highly exposed to the earthquake experienced lower intrusion and avoidance symptoms than those with the S-allele carriers. The findings suggest that the 5-HTTLPR may have an important impact on the development of PTSD and add to the extant knowledge on understanding and treating of posttraumatic psychopathology.

  7. Voluntary exercise does not ameliorate context memory and hyperarousal in a mouse model for post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Cacciaglia, Raffaele; Krause-Utz, Annegret; Vogt, Miriam A; Schmahl, Christian; Flor, Herta; Gass, Peter

    2013-07-01

    We investigated the effects of voluntary wheel running as model for intervention on the development of contextual fear and hyperarousal in a mouse model of post-traumatic stress disorder (PTSD). Physical exercise in general has been associated with improved hippocampus-dependent memory performance both in animals and humans. However, studies that have tried to link physical exercise and contextual conditioning in an animal model of PTSD, revealed mixed findings. Here we tested contextual fear conditioning, generalized fear response, acoustic startle response and emotionality in C57BL/6NCrl mice which had free access to a running wheel for 28 days, compared with control animals which did not run and mice which did not receive a shock during the conditioning phase. We found no significant effects of voluntary running on the above-mentioned variables, except for enhanced anxiety levels in the Dark-Light-Box and O-Maze tests of running mice. Our results suggest that running as a model for intervention does not ameliorate contextual aversive learning but has the potency to change emotional behaviours.

  8. Chronic Pain Types Differ in Their Reported Prevalence of Post -Traumatic Stress Disorder (PTSD) and There Is Consistent Evidence That Chronic Pain Is Associated with PTSD: An Evidence-Based Structured Systematic Review.

    Science.gov (United States)

    Fishbain, David A; Pulikal, Aditya; Lewis, John E; Gao, Jinrun

    2017-04-01

    The hypotheses of this systematic review were the following: 1) Prevalence of post-traumatic stress disorder (PTSD) will differ between various types of chronic pain (CP), and 2) there will be consistent evidence that CP is associated with PTSD. Of 477 studies, 40 fulfilled the inclusion/exclusion criteria of this review and were grouped according to the type of CP. The reported prevalence of PTSD for each grouping was determined by aggregating all the patients in all the studies in that group. Additionally all patients in all groupings were combined. Percentage of studies that had found an association between CP and PTSD was determined. The consistency of the evidence represented by the percentage of studies finding an association was rated according to the Agency for Health Care Policy and Research guidelines. Grouping PTSD prevalence differed ranging from a low of 0.69% for chronic low back pain to a high of 50.1% in veterans. Prevalence in the general population with CP was 9.8%. Of 19 studies, 16 had found an association between CP and PTSD (84.2%) generating an A consistency rating (consistent multiple studies). Three of the groupings had an A or B (generally consistent) rating. The veterans grouping received a C (finding inconsistent) rating. The results of this systematic review confirmed the hypotheses of this review. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Shevlin, Mark

    2011-01-01

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

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

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Shevlin, Mark

    2011-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Cherie Armour

    2011-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Edward G Meloni

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

  13. The endocannabinoid system as a possible target to treat both the cognitive and emotional features of post-traumatic stress disorder (PTSD)

    OpenAIRE

    Trezza, Viviana; Campolongo, Patrizia

    2013-01-01

    Post-traumatic stress disorder (PTSD) is a psychiatric disorder of significant prevalence and morbidity, whose pathogenesis relies on paradoxical changes of emotional memory processing. An ideal treatment would be a drug able to block the pathological over-consolidation and continuous retrieval of the traumatic event, while enhancing its extinction and reducing the anxiety symptoms. While the latter benefit from antidepressant medications, no drug is available to control the cognitive symptom...

  14. Review: Effect of Sexual Violence in Appearance of Post Traumatic Stress Disorder (PTSD

    Directory of Open Access Journals (Sweden)

    Ja'far Mirzaei

    2007-01-01

    Full Text Available The familial violence is any violent action based on sexual dispute that result in somatic, sexual or psychiatric hurts or pain. One of the familial violence is child and spouse abuse that result in depression, anxiety and PTSD. The aim of this article is study of familial violence phenomena from different psychiatric and social views and the rate of appearance and epidemiology and clinical character of PTSD as the result of sexual rape. This study is based on review of literature and antecedent & internal and external investigations from 1989 to 2004 from internet sites like NC PTSD psychilt – psych Info. Conclusions of different accidental and nonaccidental studies sign the rate of 25 – 30% psychiatric side effects as the result of somatic and sexual abuse and appearance of PTSD-Depression and Anxiety. Because the phenomena of familial and sexual violence has social and psychiatric nature, It is necessary to take health care and educative and preventive methods for prevention of appearance of such injuries in society and support from familial and social network.

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

    Science.gov (United States)

    2015-01-01

    genetic analysis on the serotonin transporter gene 5-HTTLPR. Researchers found evidence to suggest that servicemembers with low-transcription...after exposure to trauma, suggesting a servicemember’s likelihood for developing PTSD may change throughout time regardless of genetic ...Training Requirements and Resources System (ATRRS), this automated promotion system generates a final promotion score. Table 3.2 presents the rubric

  16. Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women.

    Science.gov (United States)

    Gelaye, Bizu; Zheng, Yinnan; Medina-Mora, Maria Elena; Rondon, Marta B; Sánchez, Sixto E; Williams, Michelle A

    2017-05-12

    The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. The reliability of the PCL-C was excellent (Cronbach's alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78-0.92) and a specificity of 0.63 (95% CI: 0.62-0.65). The area under the ROC curve was 0.75 (95% CI: 0.71-0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis.

  17. A new request to the social psychiatry in Ukraine: stress-related disorders and PTSD, are we ready?

    Directory of Open Access Journals (Sweden)

    Oleg Chaban

    2017-06-01

    Full Text Available In early 2014 resulted by the outbreak of conflict in eastern Ukraine 823,000 people became internally displaced, according to the Ukrainian State Emergency Service. All of the above requires a new assessment of the state of people in a situation of chronic stress and distress taking into account their mentality, psychological amortization properties and social situation. We need systematic training of specialists in the field of acute stress and PTSD, with following consistent professional development. It is necessary to develop a national protocol for PTSD management and to implement an appropriate modernization of the Ukrainian health care system.

  18. Influence of Mild Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) on Pain Intensity Levels in OEF/OIF/OND Veterans.

    Science.gov (United States)

    Stojanovic, Milan P; Fonda, Jennifer; Fortier, Catherine Brawn; Higgins, Diana M; Rudolph, James L; Milberg, William P; McGlinchey, Regina E

    2016-11-01

    Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) are common among US veterans of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND). We postulated that these injuries may modulate pain processing in these individuals and affect their subjective pain levels. Cross-sectional. 310 deployed service members of OEF/OIF/OND without a lifetime history of moderate or severe TBI were included in this study. All participants completed a comprehensive evaluation for Blast Exposure, mTBI, PTSD, and Pain Levels. The Boston Assessment of TBI-Lifetime Version (BAT-L) was used to assess blast exposure and potential brain injury during military service. The Clinician-Administered PTSD Scale (CAPS) characterized presence and severity of PTSD. The Visual Analog Scale (VAS) was used to assess pain intensity over the previous month before the interview, with higher scores indicative of worse pain. Statistical analysis was performed by ANOVA and results were adjusted for co-morbidities, clinical characteristics and demographic data. In comparison to control participants (veterans without mTBI or current PTSD), veterans with both current PTSD and mTBI reported the highest pain intensity levels, followed by veterans with PTSD only (P Pain levels in veterans with mTBI only were comparable to control participants. Comorbid PTSD and mTBI is associated with increased self-reported pain intensity. mTBI alone was not associated with increased pain. Published by Oxford University Press on behalf of the American Academy of Pain Medicine 2016. This work is written by US Government employees and is in the public domain in the US.

  19. Post-Traumatic Stress Disorder: MedlinePlus Health Topic

    Science.gov (United States)

    ... National Center for PTSD (Department of Veterans Affairs) Statistics and Research How Common Is PTSD? (National Center for PTSD) Post-Traumatic Stress Disorder (PTSD) (National Institute of Mental Health) Clinical ...

  20. [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.

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

    Directory of Open Access Journals (Sweden)

    Fenghua Tian

    2014-01-01

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

  2. The Effectiveness of Mindfulness Training in Improving the Quality of Life of the War Victims with Post Traumatic stress disorder (PTSD).

    Science.gov (United States)

    Azad Marzabadi, Esfandiar; Hashemi Zadeh, Seyyed Morteza

    2014-10-01

    Those veterans suffering from Post Traumatic stress disorder (PTSD) experience a low quality of life. This study investigated how the quality of life of warfare victims with PTSD was influenced by mindfulness training (MT). This study followed a randomized controlled trial and included a pre-test, post-test and delayed post- and was conducted in 2012 at Shahid Rajaee Hospital in Isfahan, Iran. The participants were 28 randomly selected male warfare victims with PTSD who were assigned into control and experimental groups. Data were collected using World Health Organization Quality of Life Questionnaire-26 (WHOQOL-26). Repeated measures ANOVA was run to analyze the data. The findings of this study indicated a statistically significant decrease in the mean score of the experimental group in both post-test and delayed post-test. Also, in comparison with the control group, there was a statistically significant increase in the mean scores of the physical and psychiatric health, social relationship and social setting and condition of the experimental group in the post-test and delayed post-test (psupport to the effectiveness of MT in improving the quality of life of those veterans with PTSD and have significant implications for drawing our attention to mindfulness-based treatments as a way to enhance the quality of life of warfare victims suffering from PTSD.

  3. The Effectiveness of Mindfulness Training in Improving the Quality of Life of the War Victims with Post Traumatic stress disorder (PTSD.

    Directory of Open Access Journals (Sweden)

    Esfandiar Azad Marzabadi

    2014-12-01

    Full Text Available Those veterans suffering from Post Traumatic stress disorder (PTSD experience a low quality of life. This study investigated how the quality of life of warfare victims with PTSD was influenced by mindfulness training (MT.This study followed a randomized controlled trial and included a pre-test, post-test and delayed post- and was conducted in 2012 at Shahid Rajaee Hospital in Isfahan, Iran. The participants were 28 randomly selected male warfare victims with PTSD who were assigned into control and experimental groups. Data were collected using World Health Organization Quality of Life Questionnaire-26 (WHOQOL-26. Repeated measures ANOVA was run to analyze the data.The findings of this study indicated a statistically significant decrease in the mean score of the experimental group in both post-test and delayed post-test. Also, in comparison with the control group, there was a statistically significant increase in the mean scores of the physical and psychiatric health, social relationship and social setting and condition of the experimental group in the post-test and delayed post-test (p< 0.01.The findings of this study lend support to the effectiveness of MT in improving the quality of life of those veterans with PTSD and have significant implications for drawing our attention to mindfulness-based treatments as a way to enhance the quality of life of warfare victims suffering from PTSD.

  4. 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.

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

    Science.gov (United States)

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

    2014-01-01

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

  6. Imaging Neuroinflammation in Post Traumatic Stress Disorder

    Science.gov (United States)

    2012-11-01

    Post traumatic stress disorder ( PTSD ) is a complex...several central nervous system conditions including post - traumatic stress disorder ( PTSD ) and traumatic brain injury (TBI). Microglia represent over...trials. We have subsequently identified a better agent for interrogating TSPO in post - traumatic stress disorder ( PTSD ) subjects, 18-F PBR111, a

  7. 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.

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

    Science.gov (United States)

    Yu, Hongrun; Watt, Heather; Kesavan, Chandrasekhar; Johnson, Patrick J; Wergedal, Jon E; Mohan, Subburaman

    2012-01-01

    Post-traumatic stress disorder (PTSD) is an anxiety disorder that not only affects mental health, but may also affect bone health. However, there have been no studies to examine the direct relationship between PTSD and bone. We employed electric shocks in mice to simulate traumatic events that cause PTSD. We also injected the anxiogenic drug FG-7142 prior to electric shocks. Electric shocks created lasting conditioned fear memory in all mice. In young mice, electric shocks elicited not only behavioral response but also skeletal response, and injection of FG-7142 appeared to increase both types of response. For example in behavioral response within the first week, mice shocked alone froze an average of 6.2 sec in 10 sec tests, and mice injected with FG-7142 froze 7.6 sec, both significantly different (PPTSD-like behavior was associated with reduced bone mass acquisition. This is the first study to document evidence that traumatic events induce lasting consequences on both behavior and skeletal growth, and electric shocks coupled with injection of anxiogenic FG-7142 in young mice can be used as a model to study the effect of PTSD-like symptoms on bone development.

  9. 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

  10. [Posttraumatic stress disorder (PTSD) as a consequence of the interaction between an individual genetic susceptibility, a traumatogenic event and a social context].

    Science.gov (United States)

    Auxéméry, Y

    2012-10-01

    Why are some individuals more likely than others to develop a posttraumatic stress disorder (PTSD) in the face of similar levels of trauma exposure? Monitoring the traumatic process combining the antecedents, the determinants of the psychic trauma and the acute symptoms can clarify the causes of the final onset of a chronic repetition syndrome. Epidemiologic research has clarified risk factors that increase the likelihood of PTSD after exposure to a potentially traumatic event. PTSD is an interaction between a subject, a traumatogenic factor and a social context. With each epidemiological, psychopathological and more particularly neurogenetic study, we will expand on the impact of these interactions on the therapeutic treatment of psycho-traumatised persons. Most studies have shown that unrelated to the traumatic event, additional risk factors for developing PTSD include younger age at the time of the trauma, female gender, lower social economic statuts, lack of social support, premorbid personality characteristics and preexisting anxiety or depressive disorders increase the risk of PTSD. The psychic trauma is firmly attached to the repetition and the previous traumas are as many risks of developing a subsequent PTSD in the wake of a new trauma: PTSD in adults may represent a prolonged symptomatic reaction to prior traumatic assault, child abuse and childhood adversities. Related to the traumatic event, the organic pain, the traumatic brain injury, but also the sight of blood can lead to a trauma being considered as more serious or more harmful to life. It is useful to recognize the acute reactions of exhaustion stress as they can guide both the pharmacotherapeutic and the psychotherapeutic treatment thanks to debriefings. Even though the majority of people with acute stress disorder subsequently develop PTSD, the current data indicate that too many people can develop PTSD without initially displaying acute stress disorder. Though peritraumatic dissociation and

  11. Eye movement desensitization and reprocessing (EMDR) for DSM-5 posttraumatic stress disorder (PTSD) in adults with intellectual disabilities: A case study review.

    Science.gov (United States)

    Jowett, Sally; Karatzias, Thanos; Brown, Michael; Grieve, Alan; Paterson, Douglas; Walley, Robert

    2016-11-01

    People with intellectual disabilities may be at a greater risk for exposure to traumatic events and consequently develop posttraumatic stress disorder (PTSD). Although eye movement desensitization and reprocessing (EMDR) is an established treatment for PTSD in the general population, research on people with intellectual disabilities is limited. This review aims to critically appraise for the 1st time case studies published in this area, because no controlled investigations are available at present. An in-depth literature review was conducted, and 6 case studies were identified from peer-reviewed journals describing EMDR therapy for psychological trauma in 14 adults with a mild to severe intellectual disability. These case studies were reviewed in terms of methods of assessing PTSD and trauma histories and delivery of EMDR therapy in order to establish the usefulness and acceptability of this intervention for people with intellectual disabilities. All cases demonstrated improvement in symptoms following EMDR therapy, with around half of the cases stating no disturbance at posttreatment and at follow-up assessments. No adverse effects were reported, demonstrating that EMDR is well tolerated by people with intellectual disabilities. EMDR is a safe and acceptable intervention for people with intellectual disabilities, and there is now sufficient evidence to conduct a randomized control trial to establish its effectiveness for DSM-5 PTSD in this population group. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Prolonged exposure therapy for the treatment of patients diagnosed with psychogenic non-epileptic seizures (PNES) and post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Myers, Lorna; Vaidya-Mathur, Urmi; Lancman, Marcelo

    2017-01-01

    Although there is general consensus that psychogenic non-epileptic seizures (PNES) are treated with psychotherapy, the effectiveness of most psychotherapeutic modalities remains understudied. In this treatment series of 16 patients dually diagnosed with PNES and post-traumatic stress disorder (PTSD), we evaluated the effect of prolonged exposure therapy (PE) on reduction of PNES. Secondary measures included Beck Depression Inventory (BDI-II) and Post-Traumatic Disorder Diagnostic Scale (PDS). Subjects diagnosed with video EEG-confirmed PNES and PTSD confirmed through neuropsychological testing and clinical interview were treated with traditional PE psychotherapy with certain modifications for the PNES. Treatment was conducted over the course of 12-15 weekly sessions. Seizure frequency was noted in each session by examining the patients' seizure logs, and mood and PTSD symptomatology was assessed at baseline and on the final session. Eighteen subjects enrolled, and 16 (88.8%) completed the course of treatment. Thirteen of the 16 (81.25%) therapy completers reported no seizures by their final PE session, and the other three reported a decline in seizure frequency (Z=-3.233, p=0.001). Mean scores on scales of depression (M=-13.56, SD=12.27; t (15)=-4.420, pPTSD symptoms (M=-17.1875, SD=13.01; t (15)=-5.281, pPTSD reduced the number of PNES and improved mood and post traumatic symptomatology. Follow-up revealed that gains made in seizure control on the last day of treatment were maintained over time. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  13. Music therapy versus treatment as usual for refugees diagnosed with posttraumatic stress disorder (PTSD): study protocol for a randomized controlled trial

    DEFF Research Database (Denmark)

    Beck, Bolette Daniels; Lund, Steen; Søgaard, Ulf

    2018-01-01

    BACKGROUND: Meta-analyses of studies on psychological treatment of refugees describe highly varying outcomes, and research on multi-facetted and personalized treatment of refugees with post-traumatic stress disorder (PTSD) is needed. Music therapy has been found to affect arousal regulation...... session. DISCUSSION: The effect of music therapy can be explained by theories on affect regulation and social engagement, and the impact of music on brain regions affected by PTSD. The study will shed light on the role of therapy for the attainment of a safe attachment style, which recently has been shown...... and emotional processing, and a pilot study on the music therapy method Trauma-focused Music and Imagery (TMI) with traumatized refugees resulted in significant changes of trauma symptoms, well-being and sleep quality. The aim of the trial is to test the efficacy of TMI compared to verbal psychotherapy. METHODS...

  14. The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study.

    Science.gov (United States)

    Gökçe İsbir, Gözde; İnci, Figen; Önal, Hatice; Yıldız, Pelin Dıkmen

    2016-11-01

    Fear of birth and low childbirth self-efficacy is predictive of post-traumatic stress disorder symptoms following childbirth. The efficacy of antenatal education classes on fear of birth and childbirth self-efficacy has been supported; however, the effectiveness of antenatal classes on post-traumatic stress disorder symptoms after childbirth has received relatively little research attention. This study examined the effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder symptoms following childbirth. Quasi-experimental study. The study was conducted in a city located in the Middle Anatolia region of Turkey and data were collected between December 2013 and May 2015. Two groups of women were compared-an antenatal education intervention group (n=44), and a routine prenatal care control group (n=46). The Wijma Delivery Expectancy/Experience Questionnaire, Version A and B, Childbirth Self-efficacy Inventory and Impact of Event Scale-Revised was used to assess fear of childbirth, maternal self-efficacy and PTSD symptoms following childbirth. Compared to the control group, women who attended antenatal education had greater childbirth self-efficacy, greater perceived support and control in birth, and less fear of birth and post-traumatic stress disorder symptoms following childbirth (all comparisons, ppost-traumatic stress disorder symptoms after childbirth. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Differential accounts of refugee and resettlement experiences in youth with high and low levels of posttraumatic stress disorder (PTSD) symptomatology: A mixed-methods investigation.

    Science.gov (United States)

    McGregor, Lucy S; Melvin, Glenn A; Newman, Louise K

    2015-07-01

    In recent years there has been increased debate and critique of the focus on psychopathology in general, and posttraumatic stress disorder (PTSD) in particular, as a predominant consequence of the refugee experience. This study was conducted to broaden the conceptualization and examination of the outcomes of the refugee experience by jointly examining how adaptive processes, psychosocial factors, and psychopathology are implicated. A mixed-methods approach was used to specifically examine whether adolescents' (N = 10) accounts of their refugee and resettlement experiences differed according to their level, "high" or "low," of PTSD symptomatology. The superordinate themes of cultural belongingness and identification, psychological functioning, family unit functioning and relationships, and friendships and interpersonal processes, were identified as having particular relevance for the study's participants and in distinguishing between participants with high and low levels of PTSD symptomatology. Findings were characterized by marked differences between adolescents' accounts according to their symptomatology levels, and may thereby inform important avenues for future research as well as clinical prevention and intervention programs with refugee youth. (c) 2015 APA, all rights reserved).

  16. Posttraumatic stress disorder (PTSD) in the German Armed Forces: a retrospective study in inpatients of a German army hospital

    OpenAIRE

    Bandelow, Borwin; Koch, Manuel; Zimmermann, Peter; Biesold, Karl-Heinz; Wedekind, Dirk; Falkai, Peter

    2012-01-01

    In 2006 and 2007, around 0.4 and 0.7% of all German soldiers involved in missions abroad were registered as suffering from PTSD. The frequency of PTSD in the German Armed Forces was assessed from army records. All soldiers admitted to the German Military Hospital in Hamburg, Germany, with PTSD (n = 117) in the years 2006 and 2007 were assessed by using questionnaires and structure interviews. Risk factors associated with PTSD were identified. Of the 117 soldiers with PTSD, 39.3% were in missi...

  17. Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    S Seedat

    2013-08-01

    Full Text Available Post-traumatic stress disorder (PTSD is among the most prevalentanxiety disorders, both in terms of lifetime and 12-month prevalencerates documented in epidemiological studies worldwide.

  18. 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 purpo...

  19. Childhood traumatic stress and obesity in women: the intervening effects of PTSD and MDD.

    Science.gov (United States)

    Dedert, Eric A; Becker, Mary E; Fuemmeler, Bernard F; Braxton, Loretta E; Calhoun, Patrick S; Beckham, Jean C

    2010-12-01

    In this study, symptoms of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) were modeled as intervening variables in the relationship between childhood traumatic stress and weight outcomes in civilian women in the United States. Of the 148 participants, 72 had current PTSD, 64 had current MDD, and 32 had neither disorder. In separate single indirect effect models, there were significant indirect effects of both PTSD and depressive symptoms on body mass index and waist-hip ratio. When models included both PTSD and depressive symptoms, an indirect effect of PTSD symptoms was evident in the relationship between childhood traumatic stress and waist-hip ratio. Posttraumatic stress disorder may play a particularly important role in the development of central adiposity. Copyright © 2010 International Society for Traumatic Stress Studies.

  20. Deconstructing delayed posttraumatic stress disorder

    NARCIS (Netherlands)

    Smid, G

    2011-01-01

    According to the Diagnostic and Statistical Manual of Mental Disorders, delayed posttraumatic stress disorder (PTSD) must be diagnosed in individuals fulfilling criteria for PTSD if the onset of symptoms is at least six months after the trauma. The purpose of this thesis was to establish the

  1. Predicting persistent posttraumatic stress disorder (PTSD) in UK military personnel who served in Iraq: a longitudinal study.

    Science.gov (United States)

    Rona, Roberto J; Jones, Margaret; Sundin, Josefin; Goodwin, Laura; Hull, Lisa; Wessely, Simon; Fear, Nicola T

    2012-09-01

    In a longitudinal study we assessed which baseline risk factors are associated with persistent and partially remitted PTSD in comparison to fully remitted PTSD. 6427 (68%) of a randomly selected sample of UK service personnel completed the PTSD checklist (PCL) between 2004 and 2006 (Phase 1) and between 2007 and 2009 (Phase 2). 230 (3.9%) had possible PTSD at baseline. 66% of those with possible PTSD at baseline remitted (PCL score perception of poor or fair health (OR 2.84, 95% CI 1.28-6.27), older age and perception of risk to self (increasing with the number of events reported, p = 0.04). Deploying but not with a parent unit and psychological distress were associated in the partially remitted PTSD when compared to the fully remitted group. The positive and negative likelihood ratios for the factors most highly associated with persistent PTSD indicated they were of marginal value to identify those whose presumed PTSD would be persistent. Many factors contribute to the persistence of PTSD but none alone is useful for clinical prediction. Copyright © 2012 Elsevier Ltd. All rights reserved.

  2. Post-Traumatic Stress Disorder (PDQ)

    Science.gov (United States)

    ... stress (PTS) is a lot like post-traumatic stress disorder (PTSD) but not as severe. Patients have a ... PTS) are a lot like symptoms of other stress-related disorders. PTS has many of the same symptoms as ...

  3. Evaluation of the effectiveness of neurofeedback in the reduction of Posttraumatic stress disorder (PTSD in a patient following high-voltage electric shock with the use of ERPs

    Directory of Open Access Journals (Sweden)

    Anna Chrapusta

    2015-09-01

    Full Text Available Background. The aim of our research was an evaluation of the effectiveness of neurofeedback in reducing the symptoms of Post-trauma stress disorder (PTSD, which had developed as a result of a high-voltage electric burn to the head. Quantitative EEG (QEEG and Event related potentials (ERPs were utilised in the evaluation. Case study. A 21-year-old patient, experienced 4[sup]th[/sup] degree burns to his head as a result of a high-voltage electric burn. The patient was repeatedly operated on and despite the severity of the injuries was to recover. However the patient complained of flashbacks, difficulties with sleeping as well as an inability to continue work in his given profession. Specialist tests were to show the presence within him of PTSD. As a result of which the patient was provided with neurofeedback therapy. The effectiveness of this therapy in the reduction (eradication of the symptoms of PTSD were evaluated through the utilisation of qantitative eeg (Qeeg and event related potentials (ERPs. Results. It was found that in the first examination that ERPs display the most significant deviations from the reference in the two components: (1 the one component is generated within the cingulate cortex. The pattern of its deviation from the norms is similar to that found in a group of OCD patients. In contrast to healthy subjects the component repeats itself twice; (2 the second component is generated in the medial prefrontal cortex. Its pattern (neuromarker is similar to that found in PTSD patients. There is a delay in the late part of the component, which probably reflects the flashbacks. In the second examination, after neurofeedback training, the ERPs were similar to the norm. The patient returned to work. Conclusions. Chronic PTSD developed within the patient as a result of a high-voltage electric burn. The application of a method of therapy (neurofeedback resulted in the withdrawal of the syndrome symptoms. ERPs in a GO/NOGO task can be

  4. Evaluation of the effectiveness of neurofeedback in the reduction of Posttraumatic stress disorder (PTSD) in a patient following high-voltage electric shock with the use of ERPs.

    Science.gov (United States)

    Chrapusta, Anna; Pąchalska, Maria; Wilk-Frańczuk, Magdalena; Starczyńska, Małgorzata; Kropotov, Juri D

    2015-01-01

    The aim of our research was an evaluation of the effectiveness of neurofeedback in reducing the symptoms of Post-trauma stress disorder (PTSD), which had developed as a result of a high-voltage electric burn to the head. Quantitative EEG (QEEG) and Event related potentials (ERPs) were utilised in the evaluation. A 21-year-old patient, experienced 4(th) degree burns to his head as a result of a high-voltage electric burn. The patient was repeatedly operated on and despite the severity of the injuries was to recover. However the patient complained of flashbacks, difficulties with sleeping as well as an inability to continue work in his given profession. Specialist tests were to show the presence within him of PTSD. As a result of which the patient was provided with neurofeedback therapy. The effectiveness of this therapy in the reduction (eradication) of the symptoms of PTSD were evaluated through the utilisation of qantitative eeg (Qeeg) and event related potentials (ERPs). It was found that in the first examination that ERPs display the most significant deviations from the reference in the two components: (1) the one component is generated within the cingulate cortex. The pattern of its deviation from the norms is similar to that found in a group of OCD patients. In contrast to healthy subjects the component repeats itself twice; (2) the second component is generated in the medial prefrontal cortex. Its pattern (neuromarker) is similar to that found in PTSD patients. There is a delay in the late part of the component, which probably reflects the flashbacks. In the second examination, after neurofeedback training, the ERPs were similar to the norm. The patient returned to work. Chronic PTSD developed within the patient as a result of a high-voltage electric burn. The application of a method of therapy (neurofeedback) resulted in the withdrawal of the syndrome symptoms. ERPs in a GO/NOGO task can be used to plan neurofeedback and in the assessment of functional brain

  5. Gender differences in posttraumatic stress disorder

    NARCIS (Netherlands)

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

    2007-01-01

    One of the most consistent findings in the epidemiology of posttraumatic stress disorder (PTSD) is the higher risk of this disorder in women. Explanations reviewed within a psychobiological model of PTSD suggest that women's higher PTSD risk may be due to the type of trauma they experience, their

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

    Science.gov (United States)

    Kok, Tim; de Haan, Hein A; van der Velden, Helena J W; van der Meer, Margreet; Najavits, Lisa M; de Jong, Cor A J

    2013-03-01

    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 measures for diagnostic efficiency in predicting PTSD compared to the Clinician-Administered PTSD Scale (CAPS). The sample consisted of 197 SUD patients receiving residential substance use treatment who completed questionnaires regarding substance use and trauma-related symptoms, all abstinent from substance for 4weeks. The PTSD section of the Mini International Neuropsychiatric Interview plus (MINIplus) and the Self-Report Inventory for PTSD (SRIP) are compared to the CAPS. Results showed low sensitivity (.58) and high specificity (.91) for the PTSD section of the MINIplus. The SRIP showed high sensitivity (.80) and moderately high specificity (.73) at a cut-off score of 48. The prevalence of PTSD as measured with the CAPS was 25.4% current and 46.2% lifetime. Results indicate that the MINIplus, a short clinical interview, has insufficient quality as a screener for PTSD. The SRIP, however, is a reliable instrument in detecting PTSD in a SUD inpatient population in The Netherlands. Screening for PTSD is time efficient and increases detection of PTSD in SUD treatment settings. Copyright © 2012 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Science.gov (United States)

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

    2016-01-01

    Abstract Many people exposed to torture later suffer from torture-related post-traumatic stress disorder (TR-PTSD). The aim of this study was to analyze the morphologic and functional brain changes in patients with TR-PTSD using magnetic resonance imaging (MRI) and positron emission tomography (PET). This study evaluated 19 subjects. Thirteen subcortical brain structures were evaluated using FSL software. On the T1-weighted images, normalized brain volumes were measured using SIENAX software. The study compared the volume of the brain and 13 subcortical structures in 9 patients suffering from TR-PTSD after torture and 10 healthy volunteers (HV). Diffusion-weighted imaging (DWI) was performed in the transverse plane. In addition, the 18F-FDG PET data were evaluated to identify the activity of the elected regions. The mean left hippocampal volume for the TR-PTSD group was significantly lower than in the HV group (post hoc test (Bonferroni) P PTSD and the HV group (post hoc test (Bonferroni) P PTSD group showed low significant expansion of the ventricles in contrast to the HV group (post hoc test (Bonferroni) P PTSD and HV group (post hoc test (Bonferroni) P PTSD, in the temporal lobe in 1 of the 9 patients, and in the caudate nucleus in 5 of the 9 patients. In 2 cases, additional hypometabolism was observed in the posterior cingulate cortex and in the parietal and frontal lobes. The findings from this study show that TR-PTSD might have a deleterious influence on a set of specific brain structures. This study also demonstrated that PET combined with MRI is sensitive in detecting possible metabolic and structural brain changes in TR-PTSD. PMID:27082610

  9. The effects of trauma exposure and posttraumatic stress disorder (PTSD on the emotion-induced memory trade-off

    Directory of Open Access Journals (Sweden)

    Katherine R. Mickley Steinmetz

    2012-06-01

    Full Text Available Many studies of memory changes in individuals with PTSD have focused on memory for trauma. However, it is unclear if these mnemonic differences extend beyond trauma memory to memory for other positive and negative information and if they are specific to individuals with PTSD or extend to other individuals who have experienced trauma. The present study examined the influences of trauma exposure and PTSD on an effect that may parallel tunnel memory in PTSD: the emotion-induced memory trade-off, whereby emotional aspects of an experience are remembered at the expense of the nonemotional context. Three groups (25 with current PTSD, 27 who had experienced trauma but did not have current PTSD, and 25 controls who had neither experienced significant trauma nor met criteria for current PTSD were shown complex visual scenes that included an item (positive, negative, or neutral placed on a neutral background. 45 minutes later, participants underwent a recognition memory test for the items and backgrounds separately. An emotion-induced memory trade-off was said to occur when there was a significant difference in item and background memory for emotional scenes, but not for neutral scenes. People with PTSD, like the other groups, were more likely to remember positive and negative items than neutral items. People with PTSD exhibited a memory trade-off, but this trade-off was no larger than for the non-trauma control group. Trauma-exposed people without a current diagnosis of PTSD did not show a trade-off, because they remembered the items within scenes better than their contexts even for neutral scenes. These results suggest that i the effect of emotion on memory for visual scenes is similar in people with PTSD and control participants, and ii people who have experienced trauma, but do not have PTSD, may have a different way of attending to and remembering visual scenes, exhibiting less of a memory trade-off than either control participants or people with

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

    Directory of Open Access Journals (Sweden)

    I Ketut Agus Indra Adhiputra

    2014-02-01

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

  11. 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.

  12. 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.

  13. Design and challenges for a randomized, multi-site clinical trial comparing the use of service dogs and emotional support dogs in Veterans with post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Saunders, Gabrielle H; Biswas, Kousick; Serpi, Tracey; McGovern, Stephanie; Groer, Shirley; Stock, Eileen M; Magruder, Kathryn M; Storzbach, Daniel; Skelton, Kelly; Abrams, Thad; McCranie, Mark; Richerson, Joan; Dorn, Patricia A; Huang, Grant D; Fallon, Michael T

    2017-11-01

    Posttraumatic stress disorder (PTSD) is a leading cause of impairments in quality of life and functioning among Veterans. Service dogs have been promoted as an effective adjunctive intervention for PTSD, however published research is limited and design and implementation flaws in published studies limit validated conclusions. This paper describes the rationale for the study design, a detailed methodological description, and implementation challenges of a multisite randomized clinical trial examining the impact of service dogs on the on the functioning and quality of life of Veterans with PTSD. Trial design considerations prioritized participant and intervention (dog) safety, selection of an intervention comparison group that would optimize enrollment in all treatment arms, pragmatic methods to ensure healthy well-trained dogs, and the selection of outcomes for achieving scientific and clinical validity in a Veteran PTSD population. Since there is no blueprint for conducting a randomized clinical trial examining the impact of dogs on PTSD of this size and scope, it is our primary intent that the successful completion of this trial will set a benchmark for future trial design and scientific rigor, as well as guiding researchers aiming to better understand the role that dogs can have in the management of Veterans experiencing mental health conditions such as PTSD. Published by Elsevier Inc.

  14. The association of PTSD with physical and mental health functioning and disability (VA Cooperative Study #569: the course and consequences of posttraumatic stress disorder in Vietnam-era Veteran twins)

    Science.gov (United States)

    Magruder, Kathryn M.; Forsberg, Christopher W.; Kazis, Lewis E.; Üstün, T. Bedirhan; Friedman, Matthew J.; Litz, Brett T.; Vaccarino, Viola; Heagerty, Patrick J.; Gleason, Theresa C.; Huang, Grant D.; Smith, Nicholas L.

    2018-01-01

    Purpose To assess the relationship of posttraumatic stress disorder (PTSD) with health functioning and disability in Vietnamera Veterans. Methods A cross-sectional study of functioning and disability in male Vietnam-era Veteran twins. PTSD was measured by the Composite International Diagnostic Interview; health functioning and disability were assessed using the Veterans RAND 36-Item Health Survey (VR-36) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). All data collection took place between 2010 and 2012. Results Average age of the 5,574 participating Veterans (2,102 Vietnam theater and 3,472 non-theater) was 61.0 years. Veterans with PTSD had poorer health functioning across all domains of VR-36 and increased disability for all subscales of WHODAS 2.0 (all p < .001) compared with Veterans without PTSD. Veterans with PTSD were in poorer overall health on the VR-36 physical composite summary (PCS) (effect size = 0.31 in theater and 0.47 in non-theater Veterans; p < .001 for both) and mental composite summary (MCS) (effect size = 0.99 in theater and 0.78 in non-theater Veterans; p < .001 for both) and had increased disability on the WHODAS 2.0 summary score (effect size = 1.02 in theater and 0.96 in non-theater Veterans; p < .001 for both). Combat exposure, independent of PTSD status, was associated with lower PCS and MCS scores and increased disability (all p < .05, for trend). Within-pair analyses in twins discordant for PTSD produced consistent findings. Conclusions Vietnam-era Veterans with PTSD have diminished functioning and increased disability. The poor functional status of aging combat-exposed Veterans is of particular concern. PMID:24318083

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

    Science.gov (United States)

    2017-10-01

    have mental health , in the same way that we all have physical health . We worry about our physical fitness probably now more than we ever have before...families where the father does not have PTSD. Initial analyses have shown a moderately high level of adolescent mental health problems (approximately...Military Families, Adolescents, Mental Health , Emotional Wellbeing, Family Functioning, Natural Language Processing 16. SECURITY CLASSIFICATION OF: 17

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

    Science.gov (United States)

    2015-10-01

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

  17. [Psychological distress and post-traumatic stress disorder (PTSD) in young survivors of L'Aquila earthquake].

    Science.gov (United States)

    Pollice, Rocco; Bianchini, Valeria; Roncone, Rita; Casacchia, Massimo

    2012-01-01

    The aim of the study is to evaluate the presence of PTSD diagnosis, psychological distress and post-traumatic symptoms in a population of young earthquake survivors after L'Aquila earthquake. Between April 2009 and January 2010, 187 young people seeking help consecutively at the Service for Monitoring and early Intervention against psychoLogical and mEntal suffering in young people (SMILE) of L'Aquila University Psychiatric Department, underwent clinical interview with the Semi-Structured Clinical Interview DSM-IV-I and-II (SCID-I and SCID-II) and psychometric evaluation with Impact Event Scale-Revised (IES-R) and General Health Questionnaire-12 items (GHQ-12). 44.2% and 37.4% respectively, showed high and moderate levels of psychological distress. 66.7% reported the presence of a significant post-traumatic symptoms (Post-traumatic Syndrome) with an IES-R>28, while a diagnosis of PTSD was made in 13.8% of the sample. The obsessive-compulsive trait, female sex and high level of distress (GHQ ≥20) appear to be the main risk factors for the development of PTSD than those who had a post-traumatic syndrome for which the displacement and social disruption, appear to be more associated with post-traumatic aftermaths. Our findings, in line with recent literature, confirm that a natural disaster produces an high psychological distress with long-term aftermaths. Early intervention for survivors of collective or individual trauma, regardless of the presence of a PTSD diagnosis should be a primary goal in a program of Public Health.

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

    Directory of Open Access Journals (Sweden)

    Martine Hébert

    2014-03-01

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

  19. Music therapy versus treatment as usual for refugees diagnosed with posttraumatic stress disorder (PTSD): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Beck, Bolette Daniels; Lund, Steen Teis; Søgaard, Ulf; Simonsen, Erik; Tellier, Thomas Christian; Cordtz, Torben Oluf; Laier, Gunnar Hellmund; Moe, Torben

    2018-05-30

    Meta-analyses of studies on psychological treatment of refugees describe highly varying outcomes, and research on multi-facetted and personalized treatment of refugees with post-traumatic stress disorder (PTSD) is needed. Music therapy has been found to affect arousal regulation and emotional processing, and a pilot study on the music therapy method Trauma-focused Music and Imagery (TMI) with traumatized refugees resulted in significant changes of trauma symptoms, well-being and sleep quality. The aim of the trial is to test the efficacy of TMI compared to verbal psychotherapy. A randomized controlled study with a non-inferiority design is carried out in three locations of a regional outpatient psychiatric clinic for refugees. Seventy Arabic-, English- or Danish-speaking adult refugees (aged 18-67 years) diagnosed with PTSD are randomized to 16 sessions of either music therapy or verbal therapy (standard treatment). All participants are offered medical treatment, psychoeducation by nurses, physiotherapy or body therapy and social counseling as needed. Outcome measures are performed at baseline, post therapy and at 6 months' follow-up. A blind assessor measures outcomes post treatment and at follow-up. Questionnaires measuring trauma symptoms (HTQ), quality of life (WHO-5), dissociative symptoms (SDQ-20, DSS-20) and adult attachment (RAAS) are applied, as well as physiological measures (salivary oxytocin, beta-endorphin and substance P) and participant evaluation of each session. The effect of music therapy can be explained by theories on affect regulation and social engagement, and the impact of music on brain regions affected by PTSD. The study will shed light on the role of therapy for the attainment of a safe attachment style, which recently has been shown to be impaired in traumatized refugees. The inclusion of music and imagery in the treatment of traumatized refugees hopefully will inform the choice of treatment method and expand the possibilities for

  20. Some Haematological Parameters in Posttraumatic Stress Disorder ...

    African Journals Online (AJOL)

    Posttraumatic stress disorder (PTSD) is an emotional disorder which occurs as a result of a life threatening experience. Individuals with PTSD are more likely to develop medical conditions related to stress and research has shown that they may have altered neuro endocrine and immune system abnormalities.2 Diagnosis of ...

  1. Predicting symptom clusters of posttraumatic stress disorder (PTSD) in Croatian war veterans: the role of socio-demographics, war experiences and subjective quality of life.

    Science.gov (United States)

    Lončar, Mladen; Plašć, Ivana Dijanić; Bunjevac, Tomislav; Hrabač, Pero; Jakšić, Nenad; Kozina, Slavica; Henigsberg, Neven; Sagud, Marina; Marčinko, Darko

    2014-09-01

    Previous research has documented multiple chains of risk in the development of PTSD among war veterans. However, existing studies were mostly carried out in the West, while they also did not analyze specific symptom clusters of PTSD. The aim of this study was to examine the role of socio-demographic characteristics, war experiences and subjective quality of life in the prediction of three clusters of PTSD symptoms (i.e., avoidance, intrusion, hyperarousal). This study comprised 184 male participants who have survived war imprisonment during the Croatian Homeland War in the period from 1991 to 1995. The data was collected through several self-report measuring instruments: questionnaire on socio-demographic data, war experiences (Questionnaire on Traumatic Combat and War Experiences), subjective quality of life (WHO-Five Well-being Index), and PTSD symptoms (Impact of Events Scale - Revised). The level of three symptom clusters of PTSD was found to be moderate to high, as indicated by the scores on the IES-R. Results of the three hierarchical regression analyses showed the following: traumatic war experiences were significant predictors of avoidance symptoms; traumatic war experiences and subjective quality of life were significant predictors of hyperarousal symptoms; and traumatic war experiences, material status and subjective quality of life were significant predictors of intrusion symptoms. These findings support the widespread belief that the development of war-related PTSD is accounted for by multiple chains of risk, while traumatic war experiences seem to be the only predictor of all three symptom clusters. Future research should put more emphasis on specific PTSD symptom clusters when investigating the etiopathogenesis of this disorder among war-affected populations.

  2. Pharmacotherapy for post-traumatic stress disorder- a systematic ...

    African Journals Online (AJOL)

    Post-traumatic stress disorder (PTSD) is a prevalent ... j (n:J:J Medical Research Council Unit on Anxiety and Stress Disorders, .... of the drugs used. ...... in the treatment of posttraumatic stress disorder related to childhood abuse in women.

  3. 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.

  4. PTSD symptom presentation among people with alcohol and drug use disorders: Comparisons by substance of abuse.

    Science.gov (United States)

    Dworkin, Emily R; Wanklyn, Sonya; Stasiewicz, Paul R; Coffey, Scott F

    2018-01-01

    Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) commonly co-occur, and there is some evidence to suggest that PTSD symptom clusters are differentially related to various substances of abuse. However, few studies to date have compared PTSD symptom patterns across people with different types of SUDs, and fewer still have accounted for the presence of comorbidity across types of SUDs in understanding symptom patterns. Thus, in the current study, we use a treatment-seeking sample of people with elevated symptoms of PTSD and problem alcohol use to explore differential associations between past-year SUDs with active use and PTSD symptoms, while accounting for the presence of multiple SUDs. When comparing alcohol and drug use disorders, avoidance symptoms were elevated in those with alcohol use disorder, and hyperarousal symptoms were elevated in those who had a drug use disorder. In the subsample with alcohol use disorder, hyperarousal symptoms were elevated in people with co-occurring cocaine use disorders and numbing symptoms were elevated in people with co-occurring sedative/hypnotic/anxiolytic use disorder. These findings provide evidence for different symptom cluster patterns between PTSD and various types of SUDs and highlight the importance of examining the functional relationship between specific substances of abuse when understanding the interplay between PTSD and SUDs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Improving PTSD Symptoms and Preventing Progression of Subclinical PTSD to an Overt Disorder by Treating Comorbid OSA With CPAP.

    Science.gov (United States)

    Ullah, M I; Campbell, Douglas G; Bhagat, Rajesh; Lyons, Judith A; Tamanna, Sadeka

    2017-10-15

    Obstructive sleep apnea (OSA) and posttraumatic stress disorder (PTSD) are common in United States veterans. These conditions often coexist and symptoms overlap. Previous studies reported improvement in PTSD symptoms with continuous positive airway pressure (CPAP) therapy for comorbid OSA but its effect has not been assessed in a non-PTSD cohort. We have prospectively assessed the effect of CPAP therapy on clinical symptom improvement as a function of CPAP compliance levels among PTSD and non-PTSD veterans. Veterans in whom OSA was newly diagnosed were enrolled in our study (n = 192). Assignment to PTSD and non-PTSD cohorts was determined by chart review. Each patient completed the military version of the PTSD Checklist (PCL), Epworth Sleepiness Scale (ESS), and reported nightmare frequency (NMF) at baseline and 6 months after CPAP therapy. CPAP adherence was objectively documented from machine compliance data. We had complete data for 177 veterans (PTSD n = 59, non-PTSD n = 118) for analysis. The mean ages were 51.24 years in the PTSD cohort and 52.36 years in the non-PTSD cohort ( P = .30). In the PTSD cohort, the mean total PCL score (baseline = 66.06, post-CPAP = 61.27, P = .004, d = -0.34) and NMF (baseline = 4.61, post-CPAP = 1.49, P = .0001, d = -0.51) decreased after 6 months of CPAP treatment. Linear regression analysis showed that the CPAP compliance was the only significant predictor for these changes among veterans with PTSD (PCL score: P = .033, R 2 = .65; NMF; P = .03, R 2 = .61). Further analysis by CPAP compliance quartiles in this cohort (Q1 = 0% to 25%, Q2 = 26% to 50%, Q3 = 51% to 75%, Q4 > 75%) revealed that mean total PCL score declined in Q2 (change = -3.91, P = .045, d = 0.43), Q3 (change = -6.6, P = .002, d = 0.59), and Q4 (change = -7.94, P = .037, d = 0.49). In the non-PTSD cohort, the PCL score increased despite CPAP therapy in lower CPAP compliance quartiles Q1 (change = 8.71, P = .0001, d = 0.46) and Q2 (change = 4.51, P = .046, d = 0

  6. Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up.

    Science.gov (United States)

    Murphy, Dominic; Hodgman, Georgina; Carson, Carron; Spencer-Harper, Lucy; Hinton, Mark; Wessely, Simon; Busuttil, Walter

    2015-03-20

    Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up. A within subject design. UK veterans with a diagnosis of PTSD who accessed Combat Stress. 246 veterans who received treatment between late 2012 and early 2014. An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation. Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment. We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up. In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first

  7. Mediational Significance of PTSD in the Relationship of Sexual Trauma and Eating Disorders

    Science.gov (United States)

    Holzer, Sarah R.; Uppala, Saritha; Wonderlich, Stephen A.; Crosby, Ross D.; Simonich, Heather

    2008-01-01

    Objective: To examine the mediational significance of posttraumatic stress disorder (PTSD) and the development of eating disorder symptomatology following sexually traumatic experiences. Method: Seventy-one victims of sexual trauma and 25 control subjects completed interviews and questionnaires assessing eating disorder psychopathology and…

  8. VA Health Care: VA Spends Millions on Post-Traumatic Stress Disorder Research and Incorporates Research Outcomes into Guidelines and Policy for Post-Traumatic Stress Disorder Services

    Science.gov (United States)

    2011-01-01

    post - traumatic stress disorder ( PTSD ) and...Veterans Affairs (VA) Intramural Post - Traumatic Stress Disorder ( PTSD ) Research Funding and VA’s Medical and Prosthetic Research Appropriation...Table 6: Department of Veterans Affairs (VA) Research Centers and Programs That Conduct or Support Post - Traumatic Stress Disorder ( PTSD ) Research

  9. 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.

  10. Prospective Analysis of Risk Factors Related to Depression and Post Traumatic Stress Disorder in Deployed United States Navy Personnel

    Science.gov (United States)

    2011-03-28

    post traumatic stress disorder ( PTSD ) and depression (MDD) than...United States Several epidemiological studies have been conducted on the prevalence of post traumatic stress disorder ( PTSD ) and major depression in...forms contain the same 4-item screener for post - traumatic stress disorder ( PTSD ). This screener was developed by the National Center for PTSD and

  11. Does Acute Stress Disorder Predict Posttraumatic Stress Disorder Following Bank Robbery?

    Science.gov (United States)

    Hansen, Maj; Elklit, Ask

    2013-01-01

    Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies following nonsexual assault. The present study…

  12. 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.

  13. Relationships between GAT1 and PTSD, Depression, and Substance Use Disorder

    Directory of Open Access Journals (Sweden)

    Kaitlin E. Bountress

    2017-01-01

    Full Text Available Post-traumatic stress disorder (PTSD, Major Depressive Disorder (MDD, and Substance Use Disorder (SUD have large public health impacts. Therefore, researchers have attempted to identify those at greatest risk for these phenotypes. PTSD, MDD, and SUD are in part genetically influenced. Additionally, genes in the glutamate and gamma-aminobutyric acid (GABA system are implicated in the encoding of emotional and fear memories, and thus may impact these phenotypes. The current study examined the associations of single nucleotide polymorphisms in GAT1 individually, and at the gene level, using a principal components (PC approach, with PTSD, PTSD comorbid with MDD, and PTSD comorbid with SUD in 486 combat-exposed veterans.  Findings indicate that several GAT1 SNPs, as well as one of the GAT1 PCs, was associated with PTSD, with and without MDD and SUD comorbidity. The present study findings provide initial insights into one pathway by which shared genetic risk influences PTSD-MDD and PTSD-SUD comorbidities, and thus identify a high-risk group (based on genotype on whom prevention and intervention efforts should be focused.

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

    Science.gov (United States)

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

    2014-09-10

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

  15. The associations of earlier trauma exposures and history of mental disorders with PTSD after subsequent traumas.

    Science.gov (United States)

    Kessler, R C; Aguilar-Gaxiola, S; Alonso, J; Bromet, E J; Gureje, O; Karam, E G; Koenen, K C; Lee, S; Liu, H; Pennell, B-E; Petukhova, M V; Sampson, N A; Shahly, V; Stein, D J; Atwoli, L; Borges, G; Bunting, B; de Girolamo, G; Gluzman, S F; Haro, J M; Hinkov, H; Kawakami, N; Kovess-Masfety, V; Navarro-Mateu, F; Posada-Villa, J; Scott, K M; Shalev, A Y; Ten Have, M; Torres, Y; Viana, M C; Zaslavsky, A M

    2017-09-19

    Although earlier trauma exposure is known to predict posttraumatic stress disorder (PTSD) after subsequent traumas, it is unclear whether this association is limited to cases where the earlier trauma led to PTSD. Resolution of this uncertainty has important implications for research on pretrauma vulnerability to PTSD. We examined this issue in the World Health Organization (WHO) World Mental Health (WMH) Surveys with 34 676 respondents who reported lifetime trauma exposure. One lifetime trauma was selected randomly for each respondent. DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition) PTSD due to that trauma was assessed. We reported in a previous paper that four earlier traumas involving interpersonal violence significantly predicted PTSD after subsequent random traumas (odds ratio (OR)=1.3-2.5). We also assessed 14 lifetime DSM-IV mood, anxiety, disruptive behavior and substance disorders before random traumas. We show in the current report that only prior anxiety disorders significantly predicted PTSD in a multivariate model (OR=1.5-4.3) and that these disorders interacted significantly with three of the earlier traumas (witnessing atrocities, physical violence victimization and rape). History of witnessing atrocities significantly predicted PTSD after subsequent random traumas only among respondents with prior PTSD (OR=5.6). Histories of physical violence victimization (OR=1.5) and rape after age 17 years (OR=17.6) significantly predicted only among respondents with no history of prior anxiety disorders. Although only preliminary due to reliance on retrospective reports, these results suggest that history of anxiety disorders and history of a limited number of earlier traumas might usefully be targeted in future prospective studies as distinct foci of research on individual differences in vulnerability to PTSD after subsequent traumas.Molecular Psychiatry advance online publication, 19 September 2017; doi:10.1038/mp.2017.194.

  16. DBS in Treatment of Post-Traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Angelo Lavano

    2018-01-01

    Full Text Available Post-traumatic stress disorder (PTSD is a debilitating psychiatric condition for which pharmacological therapy is not always solvable. Various treatments have been suggested and deep brain stimulation (DBS is currently under investigation for patients affected by PTSD. We review the neurocircuitry and up-to-date clinical concepts which are behind the use of DBS in posttraumatic stress disorder (PTSD. The role of DBS in treatment-refractory PTSD patients has been investigated relying on both preclinical and clinical studies. DBS for PTSD is in its preliminary phases and likely to provide hope for patients with medical refractory PTSD following the results of randomized controlled studies.

  17. Neuropsychological Effects of Posttraumatic Stress Disorder in Children and Adolescents

    Science.gov (United States)

    Turley, Matthew R.; Obrzut, John E.

    2012-01-01

    Posttraumatic Stress Disorder (PTSD) can affect people of all ages but the literature is lacking on children and adolescents who experience PTSD. The consequences of this disorder extend beyond the basic symptoms by which it is defined. Neuroanatomically, the brains of children with PTSD have been found to be abnormally symmetrical in several…

  18. Monoamine Oxidase A Gene Methylation and Its Role in Posttraumatic Stress Disorder: First Evidence from the South Eastern Europe (SEE)-PTSD Study.

    Science.gov (United States)

    Ziegler, Christiane; Wolf, Christiane; Schiele, Miriam A; Feric Bojic, Elma; Kucukalic, Sabina; Sabic Dzananovic, Emina; Goci Uka, Aferdita; Hoxha, Blerina; Haxhibeqiri, Valdete; Haxhibeqiri, Shpend; Kravic, Nermina; Muminovic Umihanic, Mirnesa; Cima Franc, Ana; Jaksic, Nenad; Babic, Romana; Pavlovic, Marko; Warrings, Bodo; Bravo Mehmedbasic, Alma; Rudan, Dusko; Aukst-Margetic, Branka; Kucukalic, Abdulah; Marjanovic, Damir; Babic, Dragan; Bozina, Nada; Jakovljevic, Miro; Sinanovic, Osman; Avdibegovic, Esmina; Agani, Ferid; Dzubur-Kulenovic, Alma; Deckert, Jürgen; Domschke, Katharina

    2018-05-01

    Posttraumatic stress disorder is characterized by an overactive noradrenergic system conferring core posttraumatic stress disorder symptoms such as hyperarousal and reexperiencing. Monoamine oxidase A is one of the key enzymes mediating the turnover of noradrenaline. Here, DNA methylation of the monoamine oxidase A gene exonI/intronI region was investigated for the first time regarding its role in posttraumatic stress disorder risk and severity. Monoamine oxidase A methylation was analyzed via direct sequencing of sodium bisulfite-treated DNA extracted from blood cells in a total sample of N=652 (441 male) patients with current posttraumatic stress disorder, patients with remitted posttraumatic stress disorder, and healthy probands (comparison group) recruited at 5 centers in Bosnia-Herzegovina, Croatia, and the Republic of Kosovo. Posttraumatic stress disorder severity was measured by means of the Clinician-Administered Posttraumatic Stress Disorder Scale and its respective subscores representing distinct symptom clusters. In the male, but not the female sample, patients with current posttraumatic stress disorder displayed hypermethylation of 3 CpGs (CpG3=43656362; CpG12=43656514; CpG13=43656553, GRCh38.p2 Assembly) as compared with remitted Posttraumatic Stress Disorder patients and healthy probands. Symptom severity (Clinician-Administered Posttraumatic Stress Disorder Scale scores) in male patients with current posttraumatic stress disorder significantly correlated with monoamine oxidase A methylation. This applied particularly to symptom clusters related to reexperiencing of trauma (cluster B) and hyperarousal (cluster D). The present findings suggest monoamine oxidase A gene hypermethylation, potentially resulting in enhanced noradrenergic signalling, as a disease status and severity marker of current posttraumatic stress disorder in males. If replicated, monoamine oxidase A hypermethylation might serve as a surrogate marker of a hyperadrenergic subtype of

  19. [The post-traumatic stress disorder--PTSD--in psychiatry by children and teenagers: diagnostic and treatments].

    Science.gov (United States)

    Thoua, V; François, A

    2010-01-01

    News confronts us daily with various traumatic events, like armed conflict, terrorist attacks, natural disasters, not to mention the cases of abuse and incest. The impact of these traumas on the psychological development of children is often very important and we can observe among them, symptoms of severe mental traumatisms immediately and sometimes deferred. The purpose of this paper is to highlight the existence of this disorder by children, to develop its symptoms and its possible developments, and to address the different therapeutic approaches.

  20. Combat Blast Injuries: Injury Severity and Posttraumatic Stress Disorder Interaction on Career Outcomes in Male Servicemembers

    Science.gov (United States)

    2013-01-01

    post - traumatic stress disorder . INTRODUCTION Blasts are the most...Metzler TJ, Golding JM, Stewart A, Schlenger WE, Wells KB. Post - traumatic stress disorder and functioning and quality of life outcomes in a nationally...proportions were higher in those with posttraumatic stress disorder ( PTSD ) than in those without PTSD . There was a significant interaction between PTSD

  1. Association Between Traumatic Brain Injury and Risk of Posttraumatic Stress Disorder in Active-Duty Marines

    Science.gov (United States)

    2013-01-01

    traumatic brain injury (TBI) is a risk factor for posttraumatic stress disorder ( PTSD ) has been difficult to determine because of the prevalence of...Qualification Test; CAPS, Clinician-Administered PTSD Scale; PTSD , posttraumatic stress disorder ; TBI, traumatic brain injury. a For the zeromodel, base...New onset and persistent symptoms of post - traumatic stress disorder self reported after deployment and combat exposures. BMJ.

  2. Reintegration of National Guard Soldiers with Post-Traumatic Stress Disorder

    Science.gov (United States)

    2010-03-01

    Post - Traumatic Stress Disorder ( PTSD ). An alarming number of soldiers returning from our current wars in Iraq...veterans have been diagnosed with the invisible wounds of Post - Traumatic Stress Disorder ( PTSD ). An alarming number of soldiers returning from our current...returning veterans have been diagnosed with the invisible wounds of Post - Traumatic Stress Disorder ( PTSD ). These veterans’ coping skills have

  3. Post traumatic stress disorder: undiagnosed cases in a tertiary ...

    African Journals Online (AJOL)

    Posttraumatic stress disorder (PTSD) may develop after a ... with other mood- and anxiety disorders, we postulated that this disorder may be under- diagnosed in therapeutic wards ..... disorder and major depression with greater risk for suicidal.

  4. The Child and Family Traumatic Stress Intervention: Secondary Prevention for Youth at Risk of Developing PTSD

    Science.gov (United States)

    Berkowitz, Steven J.; Stover, Carla Smith; Marans, Steven R.

    2011-01-01

    Objective: This pilot study evaluated the effectiveness of a four-session, caregiver-child Intervention, the Child and Family Traumatic Stress Intervention (CFTSI), to prevent the development of chronic posttraumatic stress disorder (PTSD) provided within 30 days of exposure to a potentially traumatic event (PTE). Method: One-hundred seventy-six 7…

  5. Does acute stress disorder predict posttraumatic stress disorder following bank robbery?

    DEFF Research Database (Denmark)

    Hansen, M.; Elklit, A.

    2013-01-01

    Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies...... following nonsexual assault. The present study investigated the predictive power of different aspects of the ASD diagnosis and symptom severity on PTSD prevalence and symptom severity in 132 bank employees. The PTSD diagnosis, based on the three core symptom clusters, was best identified using cutoff scores...... on the Acute Stress Disorder scale. ASD severity accounted for 40% and the inclusion of other risk factors accounted for 50% of the PTSD severity variance. In conclusion, results indicated that ASD appears to predict PTSD differently following nonsexual assault than other trauma types. ASD severity...

  6. Maternal PTSD and Children's Adjustment: Parenting Stress and Emotional Availability as Proposed Mediators.

    Science.gov (United States)

    Samuelson, Kristin W; Wilson, Christina K; Padrón, Elena; Lee, Suellen; Gavron, Lauren

    2017-06-01

    Maternal posttraumatic stress disorder (PTSD) is a risk factor for negative child adjustment, but it is unclear whether this association is direct (e.g., a mother's PTSD symptoms are observed, learned, and internalized by children which results in behavioral and emotional problems) or indirect, through parent-child relationship difficulties or parenting stress. We hypothesized that parenting stress and maternal emotional availability would exhibit indirect effects on relationships between maternal PTSD and children's functioning. Participants were 52 trauma-exposed mothers and their children (aged 7-12 years). Mothers completed measures of PTSD and parenting stress and reported on their children's functioning. Emotional availability was assessed through observer-rated mother-child interactions. Emotional availability was not related to PTSD or child outcomes. Parenting stress had a substantial indirect effect on the relationships between maternal PTSD and child emotion regulation, internalizing, and externalizing behaviors. Results highlight the need to target parenting stress in interventions with trauma-exposed families. © 2016 Wiley Periodicals, Inc.

  7. Mitigating PTSD: Emotionally Intelligent Leaders

    Science.gov (United States)

    2010-05-28

    stress . Post Traumatic Stress Disorder ( PTSD ) is a signature injury of this war with far...to combat related stress . Post Traumatic Stress Disorder ( PTSD ) is a signature injury of this war with far reaching implications that include reduced...Washington DC: American Psychiatric Association,1994). 3 Babette Rothschild, “ Post - Traumatic Stress Disorder : Identification and Diagnosis,”

  8. Normative Life Events and PTSD in Children: How Easy Stress Can Affect Children’s Brain

    Directory of Open Access Journals (Sweden)

    Maryam Kousha

    2013-01-01

    Full Text Available Exposure to traumatic events is common in children and adolescent. Post traumatic stress disorder (PTSD is an emotional reaction to traumatic events, which is increasingly recognized to be a prevalent and disabling disorder. The aim of this study is to determine the distribution of normative life events which predicts PTSD in youth who referred to an outpatient clinic in Rasht, Iran. This study is a cross-sectional descriptive study. The samples of children and adolescents ranging from 1-18 yr old who were diagnosed PTSD based on DSM-IV criteria in psychiatric interview and K-SADS (Kiddie-schedule for affective disorder and schizophrenia for school age children semi-structured diagnostic interview, from 2005 until 2008.The information consist of: age, sex, comorbidity with PTSD, events accompanying with PTSD, and time interval between events and visit. Eighty four youth who met the diagnosis of PTSD and their parents participated in the survey. Half of PTSD youth were 6-11 years old and admitted to clinic in the first 3 months after events. The most common events were witnessing violent or fearful scenes on TV followed by witnessing someone's death or funeral ceremony. The most comorbidity with PTSD included: attention deficit hyperactivity disorder, depression and anxiety. Our results indicate that youth exposure to violent or fearful scenes on TV could be very traumatic for them. Informing parents about the potential effect of low-magnitude stressors such as violent or fearful scenes on TV and funeral ceremony can decrease the prevalence of PTSD in youth.

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

    Science.gov (United States)

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

    2013-01-01

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

  10. the prevalence of post-traumatic stress disorder among sexually ...

    African Journals Online (AJOL)

    2013-10-10

    Oct 10, 2013 ... Background: Post-Traumatic Stress Disorder (PTSD) develops ... like child sexual abuse can develop post-traumatic stress disorder ... MATERIALS AND METHODS ..... abuse and development of behavior problem ranging.

  11. One-year follow-up of basic body awareness therapy in patients with posttraumatic stress disorder. A small intervention study of effects on movement quality, PTSD symptoms, and movement experiences.

    Science.gov (United States)

    Blaauwendraat, Conny; Levy Berg, Adrienne; Gyllensten, Amanda Lundvik

    2017-07-01

    The present study with mixed methods design evaluated the long-term effects of Basic Body Awareness Therapy (BBAT) for patients with posttraumatic stress disorder (PTSD). Fifteen patients received 12 individual sessions of BBAT treatment as usual (TAU) when needed. The patients were assessed at baseline (T0), directly after treatment (T1) and at one-year follow-up (T2), using the Body Awareness Scale Movement Quality and Experience (BAS MQ-E), the Visual Analog Scale (VAS), and the Impact of Event Scale-Revised (IES-R). The results at T1 showed significant improvement in the quality of movement (p = 0.001), body experience (p = 0.007), and symptoms (p = 0.001). At T2, the improvements were sustained. Pain in stillness (p = 0.017) and during movement (p = 0.007) had decreased. The verbal ability to describe the body experiences in words was poor at T0, but became more detailed at T1 and even more so at T2. Our findings suggest that BBAT in addition to TAU can be a viable physiotherapeutic treatment for patients with PTSD. This knowledge may influence future treatment strategies for patients with PTSD and be of guidance to physiotherapists working with persons with trauma experiences in the community or psychiatry/mental healthcare areas.

  12. Lower stress-reactive cortisol in female veterans associated with military status but not PTSD.

    Science.gov (United States)

    Pierce, Meghan E; Pritchard, Laurel M

    2016-09-01

    Female veterans are a growing yet understudied population. Currently, 14.6% of all troops deployed to Afghanistan and Iraq are female. Military service is associated with an increased risk for trauma exposure and subsequent development of posttraumatic stress disorder (PTSD). Dysregulation of the hypothalamic-pituitary-adrenal axis is frequently associated with PTSD. Few studies have examined females diagnosed with PTSD and only one study, to our knowledge, has examined HPA-axis dysregulation in female veterans. This study examined salivary cortisol in 52 female veterans and civilians both with and without PTSD. We collected saliva samples at bedtime and awakening, as well as in response to the Trier social stress test (TSST). We found that female veterans had blunted cortisol concentrations at all time points during the TSST compared to female civilians, regardless of PTSD status. Even though all groups showed the expected diurnal decline in cortisol, the difference between awakening and bedtime samples were significant only in civilians without PTSD. The results of our study suggest that stressors specific to the military may lead to lower than normal cortisol, which may not be associated with the expressions of PTSD.

  13. Increased Resilience is Associated with Positive Treatment Outcomes for Veterans with Comorbid PTSD and Substance Use Disorders.

    Science.gov (United States)

    McGuire, Adam P; Mota, Natalie P; Sippel, Lauren M; Connolly, Kevin M; Lyons, Judith A

    2018-04-18

    Resilience has been associated with less severe psychiatric symptomatology and better treatment outcomes among individuals with posttraumatic stress disorder (PTSD) and substance use disorders. However, it remains unknown whether resilience increases during psychotherapy within the comorbid PTSD and substance use disorder population with unique features of dual diagnosis, including trauma cue-related cravings. We tested whether veterans seeking psychotherapy for comorbid PTSD and substance use disorder reported increased resilience from pre- to posttreatment. We also tested whether increased resilience was associated with greater decreases in posttreatment PTSD and substance use disorder symptoms. Participants were 29 male veterans (M age = 49.07 years, SD = 11.24 years) receiving six-week residential day treatment including cognitive processing therapy for PTSD and cognitive behavioral therapy for substance use disorder. Resilience, PTSD symptoms, and trauma cue-related cravings were assessed at pre- and posttreatment. Veterans reported a large, significant increase in resilience posttreatment (M diff = 14.24, t = -4.22, p resilience were significantly associated with fewer PTSD symptoms (β = -0.37, p = .049, sr = -.36) and trauma-cued cravings (β = -0.39, p = .006, sr = -.38) posttreatment when controlling for pretreatment scores and baseline depressive symptoms. Results suggest that evidence-based psychotherapy for comorbid PTSD and substance use disorder may facilitate strength-based psychological growth, which may further promote sustained recovery.

  14. Trauma-focused cognitive behaviour therapy versus treatment as usual for post traumatic stress disorder (PTSD) in young children aged 3 to 8 years: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Dalgleish, Tim; Goodall, Benjamin; Chadwick, Isobel; Werner-Seidler, Aliza; McKinnon, Anna; Morant, Nicola; Schweizer, Susanne; Panesar, Inderpal; Humphrey, Ayla; Watson, Peter; Lafortune, Louise; Smith, Patrick; Meiser-Stedman, Richard

    2015-03-25

    Following horrific or life-threatening events approximately 10 to 15% of young children develop post traumatic stress disorder (PTSD). The symptoms of this disorder are distressing - nightmares, flashbacks, anger outbursts and disturbed play. These symptoms cause major disruption to a child's functioning and, if left untreated, can persist for many years. As yet, there are no established empirically-validated treatments for PTSD in young children. Trauma-focused cognitive behaviour therapy (TF-CBT) is a psychological intervention that is effective in treating the disorder in older children (8 to 12 years), adolescents and adults. This study examines TF-CBT adapted for children aged between 3 and 8 years. This protocol describes a two-arm exploratory randomised controlled trial comparing TF-CBT to treatment as usual (TAU) in children aged 3 to 8 years with a principal diagnosis of PTSD following a single-event discrete trauma. Using a half-crossover design, 44 participants will be randomly allocated to receive the intervention or to receive TAU. Those allocated to TAU will be offered TF-CBT at the end of the 'treatment' period (approximately 12 weeks) if still indicated. The primary outcome is PTSD diagnosis according to DSM-5 criteria for children 6 years and younger at post-treatment. Secondary outcomes include effects on co-morbid diagnoses and changes in emotion and trauma symptoms at each of the follow-up points (post-treatment, 3-months, 12-months). Additionally, broader efficacy will be considered with regard to treatment feasibility, acceptability and service utilisation. The key targets of the intervention are trauma memory, the interpretation of the meaning of the event, and the management of symptoms. This is the first European trial to examine the efficacy of TF-CBT in alleviating PTSD in very young children. As well as providing much-needed data on the utility of the intervention, this exploratory trial will also allow us to gather important information

  15. Post-traumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    H Javidi

    2011-12-01

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

  16. Dialectical behavior therapy as a precursor to PTSD treatment for suicidal and/or self-injuring women with borderline personality disorder.

    Science.gov (United States)

    Harned, Melanie S; Jackson, Safia C; Comtois, Katherine A; Linehan, Marsha M

    2010-08-01

    This study examined the efficacy of dialectical behavior therapy (DBT) in reducing behaviors commonly used as exclusion criteria for posttraumatic stress disorder (PTSD) treatment. The sample included 51 suicidal and/or self-injuring women with borderline personality disorder (BPD), 26 (51%) of whom met criteria for PTSD. BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT. By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment. Borderline personality disorder clients with PTSD who began treatment with a greater number of recent suicide attempts and more severe PTSD were significantly less likely to become eligible for PTSD treatment.

  17. Glutamatergic system abnormalities in posttraumatic stress disorder.

    Science.gov (United States)

    Nishi, Daisuke; Hashimoto, Kenji; Noguchi, Hiroko; Hamazaki, Kei; Hamazaki, Tomohito; Matsuoka, Yutaka

    2015-12-01

    Accumulating evidence suggests involvement of the glutamatergic system in the biological mechanisms of posttraumatic stress disorder (PTSD), but few studies have demonstrated an association between glutamatergic system abnormalities and PTSD diagnosis or severity. We aimed to examine whether abnormalities in serum glutamate and in the glutamine/glutamate ratio were associated with PTSD diagnosis and severity in severely injured patients at risk for PTSD and major depressive disorder (MDD). This is a nested case-control study in TPOP (Tachikawa project for prevention of posttraumatic stress disorder with polyunsaturated fatty acid) trial. Diagnosis and severity of PTSD were assessed 3 months after the accidents using the Clinician-Administered PTSD Scale. The associations of glutamate levels and the glutamine/glutamate ratio with diagnosis and severity of PTSD and MDD were investigated by univariate and multiple linear regression analyses. Ninety-seven of 110 participants (88 %) completed assessments at 3 months. Serum glutamate levels were significantly higher for participants with full or partial PTSD than for participants without PTSD (p = 0.049) and for participants with MDD than for participants without MDD (p = 0.048). Multiple linear regression analyses showed serum glutamate levels were significantly positively associated with PTSD severity (p = 0.02) and MDD severity (p = 0.03). The glutamine/glutamate ratio was also significantly inversely associated with PTSD severity (p = 0.03), but not with MDD severity (p = 0.07). These findings suggest that the glutamatergic system may play a major role in the pathogenesis of PTSD and the need for new treatments targeting the glutamatergic system to be developed for PTSD.

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  19. Work-related posttraumatic stress disorder (PTSD) and other emotional diseases as consequence of traumatic events in public transportation: a systematic review.

    Science.gov (United States)

    Clarner, Annika; Graessel, Elmar; Scholz, Johanna; Niedermeier, Alexander; Uter, Wolfgang; Drexler, Hans

    2015-07-01

    Drivers in public transportation are at risk of experiencing potential traumatic events such as accidents involving persons, collisions, or suicides. In this context, the question arises to what extent psychological traumatization and posttraumatic diseases occur. The aim of this systematic review was to describe the frequency and nature of work-related posttraumatic disorders, to analyze risk and prognostic factors after potentially traumatic events (accidents resulting in damage to property and/or in injury or death), and address sick leave after such events in the realm of public transportation, based on the available literature. Systematic review based on four databases (PubMed, PSYNDEX/MEDLINE, ScienceDirect, PILOTS) between 1980 and June 2013. We identified seven studies (four longitudinal, three cross-sectional) that examine employees after person under train (PUT) events. PTSD prevalences varied broadly between 0.7 and 17 %. The same applies to dysthymia/neurotic depression (1-26 %). However, similarly low prevalences of major depression (1.3-2.8 %) and panic disorder (0.5-1.3 %) have been observed. Risk factors of PTSD comprised individual, work-related, event-related, and prognostic aspects. Following the traumatic event, a total of 69-81 % of the drivers were absent, and if sick leave occurs, this was on average 3-19 days. It became evident that drivers in public transportation run a high risk of sick leave. It was also striking that despite the immense impact of PUT and high number of suicides, only an infinitesimal number of studies exists. Due to various differences (period of follow-up, instrument of measurement and study period), it turned out that the comparability of the results of the studies is limited. For various reasons, further research is urgently needed, as from an occupational health point of view the issue of posttraumatic diseases and implications for fitness for service should be addressed.

  20. Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder

    NARCIS (Netherlands)

    Chalavi, Sima; Vissia, Eline M.; Giesen, Mechteld E.; Nijenhuis, Ellert R. S.; Draijer, Nel; Barker, Gareth J.; Veltman, Dick J.; Reinders, Antje A. T. S.

    2015-01-01

    Neuroanatomical evidence on the relationship between posttratimatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16

  1. [Factors that influence comorbidity from panic disorder and PTSD after earthquakes].

    Science.gov (United States)

    Leiva-Bianchi, Marcelo; Candia, Claudia; Montecino, Karla

    2014-01-01

    After the earthquake and tsunami in Chile (F-27), we studied the effect of socio-demographic factors, exposure to the event, and state aid received on comorbidity from panic disorder (PD) and posttraumatic stress disorder (PTSD). Surveys that include the administration of the Davidson Trauma Scale (DTS) to 246 inhabitants. 19.1 % comorbidity was found (r=.583, R(2)=.340, pearthquakes/tsunamis and an instrument to detect cases at risk of PTSD. We suggest guidelines so that the government can improve its role after disasters.

  2. Integrated, exposure-based treatment for PTSD and comorbid substance use disorders: Predictors of treatment dropout.

    Science.gov (United States)

    Szafranski, Derek D; Snead, Alexandra; Allan, Nicholas P; Gros, Daniel F; Killeen, Therese; Flanagan, Julianne; Pericot-Valverde, Irene; Back, Sudie E

    2017-10-01

    High rates of comorbid posttraumatic stress disorder (PTSD) and substance use disorders (SUD) have been noted in veteran populations. Fortunately, there are a number of evidence-based psychotherapies designed to address comorbid PTSD and SUD. However, treatments targeting PTSD and SUD simultaneously often report high dropout rates. To date, only one study has examined predictors of dropout from PTSD/SUD treatment. To address this gap in the literature, this study aimed to 1) examine when in the course of treatment dropout occurred, and 2) identify predictors of dropout from a concurrent treatment for PTSD and SUD. Participants were 51 male and female veterans diagnosed with current PTSD and SUD. All participants completed at least one session of a cognitive-behavioral treatment (COPE) designed to simultaneously address PTSD and SUD symptoms. Of the 51 participants, 22 (43.1%) dropped out of treatment prior to completing the full 12 session COPE protocol. Results indicated that the majority of dropout (55%) occurred after session 6, with the largest amount of dropout occurring between sessions 9 and 10. Results also indicated a marginally significant relationship between greater baseline PTSD symptom severity and premature dropout. These findings highlight inconsistencies related to timing and predictors of dropout, as well as the dearth of information noted about treatment dropout within PTSD and SUD literature. Suggestions for procedural changes, such as implementing continual symptom assessments during treatment and increasing dialog between provider and patient about dropout were made with the hopes of increasing consistency of findings and eventually reducing treatment dropout. Published by Elsevier Ltd.

  3. Defense Health Care: Research on Hyperbaric Oxygen Therapy to Treat Traumatic Brain Injury and Post-Traumatic Stress Disorder

    Science.gov (United States)

    2015-12-01

    Traumatic Brain Injury and Post - Traumatic Stress Disorder Why GAO Did This Study TBI and PTSD are signature...injury (TBI) and post - traumatic stress disorder ( PTSD ), most of which were focused solely on TBI (29 articles). The 32 articles consisted of 7 case...Case Report Articles on Hyperbaric Oxygen Therapy to Treat Traumatic Brain Injury (TBI) or Post - Traumatic Stress Disorder ( PTSD ),

  4. Sexual violence, post-traumatic stress disorder and dementia.

    Science.gov (United States)

    McCartney, J R; Severson, K

    1997-01-01

    Little is known of Post-Traumatic Stress Disorder (PTSD) in older people. No literature exists on this disorder in older women exposed to sexual assault. A case of apparent PTSD in a demented woman raises questions of the anatomy and phenomenology of this disorder. Difficulties in diagnosis in a demented population may cloud the issues or prevent a proper therapeutic outcome.

  5. A Dyadic Perspective on PTSD Symptoms' Associations with Couple Functioning and Parenting Stress in First-Time Parents.

    Science.gov (United States)

    Fredman, Steffany J; Le, Yunying; Marshall, Amy D; Brick, Timothy R; Feinberg, Mark E

    2017-06-01

    Posttraumatic stress disorder (PTSD) symptoms are associated with disruptions in both couple functioning and parenting, and limited research suggests that, among military couples, perceptions of couple functioning and parenting stress are a function of both one's own and one's partner's mental health symptoms. However, this work has not been generalized to civilian couples, and little is known about the associations between PTSD symptoms and family adjustment in specific family developmental contexts. We examined PTSD symptoms' associations with perceived couple functioning and parenting stress within a dyadic context in civilian couples who had participated in a randomized controlled trial of a universal, couple-based transition to parenthood program and at least one member of the couple reported having experienced a Criterion A1 traumatic event. Results of actor-partner interdependence models revealed that parents' own and partners' PTSD symptoms were negatively associated with perceived couple functioning; contrary to expectation, the association of partners' PTSD symptoms with perceived couple functioning was strongest among men who received the intervention. A parent's own PTSD symptoms were positively associated with parenting stress for both men and women and were unexpectedly strongest for men who received the intervention. Partner PTSD symptoms were also positively associated with increased parenting stress for both men and women. Findings support a dyadic conceptualization of the associations between spouses' PTSD symptoms and family outcomes during the transition to parenthood and suggest that participating in a couple-based, psychoeducational program during this phase in the family life cycle may be particularly salient for men.

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

    Science.gov (United States)

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

    2006-03-01

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

  7. 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

  8. Post-traumatic Stress Disorder Post Partum

    Science.gov (United States)

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

    2012-01-01

    Traumatic birth experiences may lead to serious psychological impairment. Recent studies show that a considerable number of women can develop post-traumatic stress disorder (PTSD), in some cases in a subsyndromal form. Until now, the possibility that postpartum psychological symptoms might be a continuum of a pre-existing disorder in pregnancy has rarely been considered. This study therefore aimed to evaluate the proportion of women who develop post-traumatic stress disorder as a result of childbirth. Materials and Methods: 56 multiparous women were recruited for the study. The diagnosis of PTSD was made according to the criteria for psychological disorders in the DSM-IV (Diagnostics and Statistical Manual of Mental Disorders). The data were collected in structured interviews in the 30th to 38th week of gestation and in the 6th week post partum. Results: Of the 56 women participating, 52 (93 %) completed the survey. Uncontrolled results showed that 21.15 % of the multiparous women met the full diagnostic PTSD criteria in the 6th week post partum. After the exclusion of all cases already characterised by all criteria or a subsyndromal form of PTSD caused by previous traumatisation, the PTSD rate was below 8 % at 6 weeks postpartum (= incidence rate of PTSD post partum). Conclusions: The present study is the first prospective longitudinal study to demonstrate the occurrence of full criteria PTSD in multiparous women as a result of childbirth after having excluded pre-existing PTSD. The results of our study show a high prevalence rate of PTSD during pregnancy. A number of women report all aspects of post-traumatic stress disorder as a result of childbirth. PMID:25253905

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

    Science.gov (United States)

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

    2015-02-01

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

  10. 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 relatio...

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  12. Severe, multimodal stress exposure induces PTSD-like characteristics in a mouse model of single prolonged stress.

    Science.gov (United States)

    Perrine, Shane A; Eagle, Andrew L; George, Sophie A; Mulo, Kostika; Kohler, Robert J; Gerard, Justin; Harutyunyan, Arman; Hool, Steven M; Susick, Laura L; Schneider, Brandy L; Ghoddoussi, Farhad; Galloway, Matthew P; Liberzon, Israel; Conti, Alana C

    2016-04-15

    Appropriate animal models of posttraumatic stress disorder (PTSD) are needed because human studies remain limited in their ability to probe the underlying neurobiology of PTSD. Although the single prolonged stress (SPS) model is an established rat model of PTSD, the development of a similarly-validated mouse model emphasizes the benefits and cross-species utility of rodent PTSD models and offers unique methodological advantages to that of the rat. Therefore, the aims of this study were to develop and describe a SPS model for mice and to provide data that support current mechanisms relevant to PTSD. The mouse single prolonged stress (mSPS) paradigm, involves exposing C57Bl/6 mice to a series of severe, multimodal stressors, including 2h restraint, 10 min group forced swim, exposure to soiled rat bedding scent, and exposure to ether until unconsciousness. Following a 7-day undisturbed period, mice were tested for cue-induced fear behavior, effects of paroxetine on cue-induced fear behavior, extinction retention of a previously extinguished fear memory, dexamethasone suppression of corticosterone (CORT) response, dorsal hippocampal glucocorticoid receptor protein and mRNA expression, and prefrontal cortex glutamate levels. Exposure to mSPS enhanced cue-induced fear, which was attenuated by oral paroxetine treatment. mSPS also disrupted extinction retention, enhanced suppression of stress-induced CORT response, increased mRNA expression of dorsal hippocampal glucocorticoid receptors and decreased prefrontal cortex glutamate levels. These data suggest that the mSPS model is a translationally-relevant model for future PTSD research with strong face, construct, and predictive validity. In summary, mSPS models characteristics relevant to PTSD and this severe, multimodal stress modifies fear learning in mice that coincides with changes in the hypothalamo-pituitary-adrenal (HPA) axis, brain glucocorticoid systems, and glutamatergic signaling in the prefrontal cortex

  13. The Honolulu posttraumatic stress disorder stimulus set.

    Science.gov (United States)

    Chemtob, C M; Roitblat, H L; Hamada, R S; Carlson, J G; Muraoka, M Y; Bauer, G B

    1997-04-01

    We present word and picture stimuli constituting a validated stimulus set appropriate for cognitive investigations of posttraumatic stress disorder (PTSD). Combat related and neutral words and pictures were rated by Vietnam veterans with PTSD and by three comparison groups along four dimensions: unpleasantness, Vietnam relevance, stressfulness, and memorability. There were distinctive patterns of responses by the PTSD group which efficiently discriminated the individuals in this group from those in the control groups. These stimuli have the potential to be developed as a diagnostic instrument.

  14. Does Reintegration Stress Contribute to Suicidal Ideation Among Returning Veterans Seeking PTSD Treatment?

    Science.gov (United States)

    Haller, Moira; Angkaw, Abigail C; Hendricks, Brittany A; Norman, Sonya B

    2016-04-01

    Although posttraumatic stress disorder (PTSD) and other psychiatric symptoms are well-established risk factors for suicidal ideation among returning veterans, less attention has been paid to whether the stress of reintegrating into civilian society contributes to suicidal ideation. Utilizing a sample of 232 returning veterans (95% male, mean age = 33.63 years) seeking PTSD treatment, this study tested whether reintegration difficulties contribute to suicidal ideation over and above the influence of PTSD symptoms, depression symptoms, and potential substance misuse. Logistic regressions indicated that reintegration stress had a unique effect on suicidal ideation over and above PTSD and depression symptoms. Reintegration stress interacted with substance misuse to predict suicidal ideation, such that the effect of reintegration stress on suicidal ideation was much larger for those with potential substance misuse. Exploratory analyses also examined which types of reintegration difficulties were associated with suicidal ideation, and found that difficulty maintaining military friendships, difficulty getting along with relatives, difficulty feeling like you belong in civilian society, and difficulty finding meaning/purpose in life were all significantly associated with suicidal ideation, beyond the effects of psychiatric symptoms and potential substance misuse. Findings highlight the importance of addressing reintegration stress for the prevention of suicide among returning veterans. Implications for treatment are discussed. © Published 2015. This article is a U.S. Government work and is in the public domain in the USA.

  15. Stress, trauma and PTSD: translational insights into the core synaptic circuitry and its modulation.

    Science.gov (United States)

    Bennett, Maxwell R; Hatton, Sean N; Lagopoulos, Jim

    2016-06-01

    Evidence is considered as to whether behavioral criteria for diagnosis of post-traumatic stress disorder (PTSD) are applicable to that of traumatized animals and whether the phenomena of acquisition, extinction and reactivation of fear behavior in animals are also successfully applicable to humans. This evidence suggests an affirmative answer in both cases. Furthermore, the deficits in gray matter found in PTSD, determined with magnetic resonance imaging, are also observed in traumatized animals, lending neuropsychological support to the use of animals to probe what has gone awry in PTSD. Such animal experiments indicate that the core synaptic circuitry mediating behavior following trauma consists of the amygdala, ventral-medial prefrontal cortex and hippocampus, all of which are modulated by the basal ganglia. It is not clear if this is the case in PTSD as the observations using fMRI are equivocal and open to technical objections. Nevertheless, the effects of the basal ganglia in controlling glutamatergic synaptic transmission through dopaminergic and serotonergic synaptic mechanisms in the core synaptic circuitry provides a ready explanation for why modifying these mechanisms delays extinction in animal models and predisposes towards PTSD. In addition, changes of brain-derived neurotrophic factor (BDNF) in the core synaptic circuitry have significant effects on acquisition and extinction in animal experiments with single nucleotide polymorphisms in the BDNF gene predisposing to PTSD.

  16. Genetic approaches to understanding post-traumatic stress disorder

    Science.gov (United States)

    Almli, Lynn M.; Fani, Negar; Smith, Alicia K.; Ressler, Kerry J.

    2015-01-01

    Post-traumatic stress disorder (PTSD) is increasingly recognized as both a disorder of enormous mental health and societal burden, but also as an anxiety disorder that may be particularly understandable from a scientific perspective. Specifically, PTSD can be conceptualized as a disorder of fear and stress dysregulation, and the neural circuitry underlying these pathways in both animals and humans are becoming increasingly well understood. Furthermore, PTSD is the only disorder in psychiatry in which the initiating factor, the trauma exposure, can be identified. Thus, the pathophysiology of the fear and stress response underlying PTSD can be examined and potentially interrupted. Twin studies have shown that the development of PTSD following a trauma is heritable, and that genetic risk factors may account for up to 30–40% of this heritability. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review will examine gene pathways that have recently been analysed, primarily through candidate gene studies (including neuroimaging studies of candidate genes), in addition to genome-wide associations and the epigenetic regulation of PTSD. Future and on-going studies are utilizing larger and collaborative cohorts to identify novel gene candidates through genome-wide association and other powerful genomic approaches. Identification of PTSD biological pathways strengthens the hope of progress in the mechanistic understanding of a model psychiatric disorder and allows for the development of targeted treatments and interventions. PMID:24103155

  17. Genetic approaches to understanding post-traumatic stress disorder.

    Science.gov (United States)

    Almli, Lynn M; Fani, Negar; Smith, Alicia K; Ressler, Kerry J

    2014-02-01

    Post-traumatic stress disorder (PTSD) is increasingly recognized as both a disorder of enormous mental health and societal burden, but also as an anxiety disorder that may be particularly understandable from a scientific perspective. Specifically, PTSD can be conceptualized as a disorder of fear and stress dysregulation, and the neural circuitry underlying these pathways in both animals and humans are becoming increasingly well understood. Furthermore, PTSD is the only disorder in psychiatry in which the initiating factor, the trauma exposure, can be identified. Thus, the pathophysiology of the fear and stress response underlying PTSD can be examined and potentially interrupted. Twin studies have shown that the development of PTSD following a trauma is heritable, and that genetic risk factors may account for up to 30-40% of this heritability. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review will examine gene pathways that have recently been analysed, primarily through candidate gene studies (including neuroimaging studies of candidate genes), in addition to genome-wide associations and the epigenetic regulation of PTSD. Future and on-going studies are utilizing larger and collaborative cohorts to identify novel gene candidates through genome-wide association and other powerful genomic approaches. Identification of PTSD biological pathways strengthens the hope of progress in the mechanistic understanding of a model psychiatric disorder and allows for the development of targeted treatments and interventions.

  18. From Pavlov to PTSD: The extinction of conditioned fear in rodents, humans, and in anxiety disorders

    Science.gov (United States)

    VanElzakker, Michael B.; Dahlgren, M. Kathryn; Davis, F. Caroline; Dubois, Stacey; Shin, Lisa M.

    2014-01-01

    Nearly 100 years ago, Ivan Pavlov demonstrated that dogs could learn to use a neutral cue to predict a biologically relevant event: after repeated predictive pairings, Pavlov's dogs were conditioned to anticipate food at the sound of a bell, which caused them to salivate. Like sustenance, danger is biologically relevant, and neutral cues can take on great salience when they predict a threat to survival. In anxiety disorders such as posttraumatic stress disorder (PTSD), this type of conditioned fear fails to extinguish, and reminders of traumatic events can cause pathological conditioned fear responses for decades after danger has passed. In this review, we use fear conditioning and extinction studies to draw a direct line from Pavlov to PTSD and other anxiety disorders. We explain how rodent studies have informed neuroimaging studies of healthy humans and humans with PTSD. We describe several genes that have been linked to both PTSD and fear conditioning and extinction and explain how abnormalities in fear conditioning or extinction may reflect a general biomarker of anxiety disorders. Finally, we explore drug and neuromodulation treatments that may enhance therapeutic extinction in anxiety disorders. PMID:24321650

  19. From Pavlov to PTSD: the extinction of conditioned fear in rodents, humans, and anxiety disorders.

    Science.gov (United States)

    VanElzakker, Michael B; Dahlgren, M Kathryn; Davis, F Caroline; Dubois, Stacey; Shin, Lisa M

    2014-09-01

    Nearly 100 years ago, Ivan Pavlov demonstrated that dogs could learn to use a neutral cue to predict a biologically relevant event: after repeated predictive pairings, Pavlov's dogs were conditioned to anticipate food at the sound of a bell, which caused them to salivate. Like sustenance, danger is biologically relevant, and neutral cues can take on great salience when they predict a threat to survival. In anxiety disorders such as posttraumatic stress disorder (PTSD), this type of conditioned fear fails to extinguish, and reminders of traumatic events can cause pathological conditioned fear responses for decades after danger has passed. In this review, we use fear conditioning and extinction studies to draw a direct line from Pavlov to PTSD and other anxiety disorders. We explain how rodent studies have informed neuroimaging studies of healthy humans and humans with PTSD. We describe several genes that have been linked to both PTSD and fear conditioning and extinction and explain how abnormalities in fear conditioning or extinction may reflect a general biomarker of anxiety disorders. Finally, we explore drug and neuromodulation treatments that may enhance therapeutic extinction in anxiety disorders. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Sleep disturbances and post-traumatic stress disorder; a perpetual circle?

    NARCIS (Netherlands)

    van Liempt, S.

    2012-01-01

    Background: Sleep facilitates the consolidation of fear extinction memory. Disrupted sleep has been proposed as a vulnerability factor for the development of posttraumatic stress disorder (PTSD). Moreover, nightmares and insomnia are hallmark symptoms of PTSD, possibly interfering with fear

  1. Dexamethasone-suppressed cortisol awakening response predicts treatment outcome in posttraumatic stress disorder

    NARCIS (Netherlands)

    Nijdam, M. J.; van Amsterdam, J. G. C.; Gersons, B. P. R.; Olff, M.

    2015-01-01

    Posttraumatic stress disorder (PTSD) has been associated with several alterations in the neuroendocrine system, including enhanced cortisol suppression in response to the dexamethasone suppression test. The aim of this study was to examine whether specific biomarkers of PTSD predict treatment

  2. Specificity of posttraumatic stress disorder symptoms: an investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatment-seeking veterans.

    Science.gov (United States)

    Gros, Daniel F; Simms, Leonard J; Acierno, Ron

    2010-12-01

    In response to high levels of comorbidity and symptom overlap between posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and other disorders, much attention has been devoted to the role of specific and nonspecific symptoms among the disorders. The present study investigated the overlapping symptoms of PTSD and MDD in treatment-seeking veterans. Exploratory factor analyses were used to identify latent factors of both self-reported and clinician-rated symptoms of PTSD and MDD. Results of exploratory factor analyses supported a 2-factor model representing symptoms of depression and PTSD; however, a subset of PTSD symptoms, characterized by emotional numbing and dysphoria, loaded onto the depression factor, rather than the PTSD factor. These nonspecific PTSD symptoms were predictive of comorbid MDD and increased depression symptomatology in patients with PTSD. Together, these findings demonstrate the importance of accounting for nonspecific symptoms in diagnosis and treatment of PTSD, highlighting a need for revisions to our current diagnostics.

  3. The management of trauma and posttraumatic stress disorder in HIV ...

    African Journals Online (AJOL)

    Women are disproportionately affected by the HIV epidemic and also carry a higher burden of early childhood trauma, other life traumas (e.g. rape and partner violence) and post-traumatic stress disorder (PTSD).1,2 Yet PTSD and other common psychiatric disorders (e.g. depression, alcohol abuse) are commonly ...

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

    Science.gov (United States)

    2015-10-01

    Post - traumatic stress disorder ( PTSD ), military sexual trauma (MST), suicide, combat-exposed veterans, PTSD ...develop the first longitudinal registry of combat-exposed men and women with post - traumatic stress disorder ( PTSD ), 1649 participants from across the...Keane, T. M. (2012). Project VALOR: Design and methods of a longitudinal registry of post - traumatic stress disorder ( PTSD ) in

  5. Diagnosis and management of post-traumatic stress disorder.

    Science.gov (United States)

    Grinage, Bradley D

    2003-12-15

    Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The lifetime prevalence of PTSD in the United States is 8 to 9 percent, and approximately 25 to 30 percent of victims of significant trauma develop PTSD. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one comorbid psychiatric disorder. The most common comorbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology. Selective serotonin reuptake inhibitors are the mainstay of pharmacologic treatment.

  6. Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria.

    Science.gov (United States)

    Price, Matthew; van Stolk-Cooke, Katherine

    2015-11-01

    Exposure to traumatic events places individuals at high risk for multiple psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The high rates of comorbidity among these conditions merit evaluation in order to improve diagnosis and treatment approaches. The current study evaluated the association between PTSD, MDD, and GAD factors as presented in the DSM 5. 602 trauma-exposed individuals who experienced an event that met Criterion A for the DSM 5 PTSD diagnosis were recruited through Amazon.com, Inc.'s Mechanical Turk (MTurk) to complete an assessment of the impact of stressful events on their lives. High interrelations were detected among the 4 PTSD factors, 2 MDD factors that corresponded to somatic and affective symptoms, and the single GAD factor. The affective factor of MDD was most strongly related to the emotional numbing factor of PTSD, whereas the somatic factor of MDD was most strongly related to the hyperarousal factor of PTSD. The GAD factor was most strongly related to the hyperarousal factor of PTSD, relative to the other PTSD factors. The strength of the interrelations between factors of the three disorders is largely a function of the overlap in symptoms and calls into question the uniqueness of negative affective symptoms of PTSD, MDD and GAD. Results suggest that improved understanding of the trauma reaction requires a focus on the unique presentation of each individual and assessment of multiple disorders. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Posttraumatic stress disorder in the wake of heart disease

    DEFF Research Database (Denmark)

    Spindler, Helle; Pedersen, Susanne S.

    2014-01-01

    There is increasing recognition that patients after a cardiac event may be at risk of posttraumatic stress disorder (PTSD). The present article reviews studies looking at PTSD as a sequel of heart disease with a focus on prevalence, risk factors, and future research directions.......There is increasing recognition that patients after a cardiac event may be at risk of posttraumatic stress disorder (PTSD). The present article reviews studies looking at PTSD as a sequel of heart disease with a focus on prevalence, risk factors, and future research directions....

  8. The association of posttraumatic stress disorder, complex posttraumatic stress disorder, and borderline personality disorder from a network analytical perspective.

    Science.gov (United States)

    Knefel, Matthias; Tran, Ulrich S; Lueger-Schuster, Brigitte

    2016-10-01

    Posttraumatic Stress Disorder (PTSD), Complex PTSD, and Borderline Personality Disorder (BPD) share etiological risk factors and an overlapping set of associated symptoms. Since the ICD-11 proposal for trauma-related disorders, the relationship of these disorders has to be clarified. A novel approach to psychopathology, network analysis, allows for a detailed analysis of comorbidity on symptom level. Symptoms were assessed in adult survivors of childhood abuse (N=219) using the newly developed ICD-11 Trauma-Questionnaire and the SCID-II. The psychopathological network was analyzed using the network approach. PTSD and Complex PTSD symptoms were strongly connected within disorders and to a lesser degree between disorders. Symptoms of BPD were weakly connected to others. Re-experiencing and dissociation were the most central symptoms. Mental disorders are no discrete entities, clear boundaries are unlikely to be found. The psychopathological network revealed central symptoms that might be important targets for specific first interventions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. The Effect of Post Traumatic Stress Disorder on Military Leadership: An Historical Perspective

    Science.gov (United States)

    2011-05-19

    Post Traumatic Stress Disorder ( PTSD ) on military leadership. For over twenty years, the United States Army has used the Be...Introduction Multiple deployment cycles to Iraq and Afghanistan combat zones and the increase in Post - Traumatic Stress Disorder ( PTSD ) have resulted...Approved for Public Release; Distribution is Unlimited The Effect of Post Traumatic Stress Disorder on Military Leadership: An

  10. Postdeployment Symptom Changes and Traumatic Brain Injury and/or Posttraumatic Stress Disorder in Men

    Science.gov (United States)

    2012-01-01

    Post - Deployment Health Assessment, according to traumatic brain injury (TBI) and posttraumatic stress disorder ( PTSD ...Key words: blasts, deployment, males, military, odds ratio, percent change, Post -Deployment Health Assessment, post - traumatic stress disorder ...Care Posttraumatic Stress Disorder Screen, PDHA = Post -Deployment Health Assessment, PDHRA = Post - Deployment Health Reassessment, PTSD =

  11. Multisite Randomized Trial of Behavioral Interventions for Women with Co-Occurring PTSD and Substance Use Disorders

    Science.gov (United States)

    Hien, Denise A.; Wells, Elizabeth A.; Jiang, Huiping; Suarez-Morales, Lourdes; Campbell, Aimee N. C.; Cohen, Lisa R.; Miele, Gloria M.; Killeen, Therese; Brigham, Gregory S.; Zhang, Yulei; Hansen, Cheri; Hodgkins, Candace; Hatch-Maillette, Mary; Brown, Chanda; Kulaga, Agatha; Kristman-Valente, Allison; Chu, Melissa; Sage, Robert; Robinson, James A.; Liu, David; Nunes, Edward V.

    2009-01-01

    The authors compared the effectiveness of the Seeking Safety group, cognitive-behavioral treatment for substance use disorder and posttraumatic stress disorder (PTSD), to an active comparison health education group (Women's Health Education [WHE]) within the National Institute on Drug Abuse's Clinical Trials Network. The authors randomized 353…

  12. Posttraumatic Stress Disorder among Motor Vehicle Accident Victims

    Directory of Open Access Journals (Sweden)

    Marina Yuabova

    2013-05-01

    Full Text Available Motor vehicle accidents (MVA have been a leading contributor to posttraumatic stress disorder (PTSD. Given the high rate of MVA incidents, it is of crucial importance to detect and diagnose PTSD in primary care. Assessing PTSD requires detecting and treating physiologic responses associated with MVA incidents. Responses such as elevated heart rate and blood pressure following an incident as well as psychological processes have been found to predict the likelihood of developing PTSD months or years after the occurrence. Screening for PTSD requires the implementation of multiple assessment tools to accurately detect the presence of PTSD. Clinicians chose assessment tools based on scales used to screen for anxiety, social dysfunction, somatic complaints and depression. Indeed, it cannot be overstated that clinicians must conduct early assessment and diagnosis of PTSD while evaluating the multiple factors that impact upon whether or not an individual will develop PTSD after a MVA.

  13. 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

  14. Imagery Rescripting in Posttraumatic Stress Disorder

    Science.gov (United States)

    Hackmann, Anne

    2011-01-01

    This article provides an overview of methods of working with imagery to change meanings and ameliorate posttraumatic stress disorder (PTSD). It opens with a description of phenomenology in this disorder, usually characterized by a small number of recurrent images of the trauma, each representing a moment that warned of a threat to the physical or…

  15. Whiplash and post-traumatic stress disorder

    NARCIS (Netherlands)

    Jaspers, JPC

    1998-01-01

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

  16. Whiplash and post-traumatic stress disorder

    NARCIS (Netherlands)

    Jaspers, JPC

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

  17. Evaluation of the effectiveness of neurofeedback in the reduction of Posttraumatic stress disorder (PTSD in a patient following high-voltage electric shock with the use of ERPs

    Directory of Open Access Journals (Sweden)

    Anna Chrapusta

    2015-09-01

    Chronic PTSD developed within the patient as a result of a high-voltage electric burn. The application of a method of therapy (neurofeedback resulted in the withdrawal of the syndrome symptoms. ERPs in a GO/NOGO task can be used to plan neurofeedback and in the assessment of functional brain changes induced by neurotherapeutic programmes. Funds Collection: Private sources.

  18. Posttraumatic Stress Disorder, obesity, and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    Posttraumatic Stress Disorder (PTSD) has frequently been found to have an impact on the development of obesity, with the relationship between past traumatic episodes and obesity usually thought of as uni-directional. The purpose of the present study was to examine whether the level of PTSD......-symptoms would decrease as a result of weight loss in obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently, a significant decline in the level of PTSD symptoms was also reported. During the first week...

  19. Posttraumatic Stress Disorder in Individuals with Diagnosis of Autistic Spectrum Disorders

    Science.gov (United States)

    Mehtar, Mohamad; Mukaddes, Nahit Motavalli

    2011-01-01

    Although children and adolescents with developmental disabilities are said to have higher risks of abuse than those without, trauma and Posttraumatic Stress Disorder (PTSD) are little examined in those diagnosed with Autistic Spectrum Disorders (ASDs). Our study aims to assess trauma types, prevalence, risk factors and symptoms; and PTSD in…

  20. Behavioral Activation in the Treatment of Comorbid Posttraumatic Stress Disorder and Major Depressive Disorder

    Science.gov (United States)

    Mulick, Patrick S.; Naugle, Amy E.

    2009-01-01

    This study investigated the efficacy of 10-weeks of Behavioral Activation (BA) in the treatment of comorbid Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) in four adults using a nonconcurrent multiple baseline across participants design. All participants met full "DSM-IV" criteria for both MDD and PTSD at the…

  1. Feature: Post Traumatic Stres Disorder PTSD: A Growing Epidemic / Neuroscience and PTSD Treatments

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Feature PTSD PTSD: A Growing Epidemic Past Issues / Winter 2009 Table ... 20 percent of Iraqi war veterans Neuroscience and PTSD Treatments Dr. Barbara Rothbaum believes current research is ...

  2. Posttraumatic stress disorder in bosnian war veterans: Analysis of stress events and risk factors

    Directory of Open Access Journals (Sweden)

    Kuljić Blagoje

    2004-01-01

    Full Text Available The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD, the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson’s PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen, Impact of Event Scale (Horowitz, Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40, marital status (married, lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.

  3. Invisible Bleeding: The Command Team’s Role in the Identification, Understanding, and Treatment of Traumatic Brain Injury and Post Traumatic Stress Disorder

    Science.gov (United States)

    2013-04-11

    Traumatic Brain Injury, Post Traumatic Stress Disorder , TBI, PTSD , Wounded...Brain Injury (TBI) and Post Traumatic Stress Disorder ( PTSD ). Command teams must leverage the existing programs and infrastructure while demonstrating a...subsequent struggle with Traumatic Brain Injury (TBI) and Post Traumatic Stress Disorder ( PTSD ) have given me the unique insight to tackle

  4. Examining the latent structure mechanisms for comorbid posttraumatic stress disorder and major depressive disorder.

    Science.gov (United States)

    Hurlocker, Margo C; Vidaurri, Desirae N; Cuccurullo, Lisa-Ann J; Maieritsch, Kelly; Franklin, C Laurel

    2018-03-15

    Posttraumatic stress disorder (PTSD) is a complex psychiatric illness that can be difficult to diagnose, due in part to its comorbidity with major depressive disorder (MDD). Given that researchers have found no difference in prevalence rates of PTSD and MDD after accounting for overlapping symptoms, the latent structures of PTSD and MDD may account for the high comorbidity. In particular, the PTSD Negative Alterations in Cognition and Mood (NACM) and Hyperarousal factors have been characterized as non-specific to PTSD. Therefore, we compared the factor structures of the Diagnostic and Statistical Manual of Mental Disorders, 5 th edition (DSM-5) PTSD and MDD and examined the mediating role of the PTSD NACM and Hyperarousal factors on the relationship between MDD and PTSD symptom severity. Participants included 598 trauma-exposed veterans (M age = 48.39, 89% male) who completed symptom self-report measures of DSM-5 PTSD and MDD. Confirmatory factor analyses indicated an adequate-fitting four-factor DSM-5 PTSD model and two-factor MDD model. Compared to other PTSD factors, the PTSD NACM factor had the strongest relationship with the MDD Affective factor, and the PTSD NACM and Hyperarousal factors had the strongest association with the MDD Somatic factor. Further, the PTSD NACM factor explained the relationship between MDD factors and PTSD symptom severity. More Affective and Somatic depression was related to more NACM symptoms, which in turn were related to increased severity of PTSD. Limitations include the reliance on self-report measures and the use of a treatment-seeking, trauma-exposed veteran sample which may not generalize to other populations. Implications concerning the shared somatic complaints and psychological distress in the comorbidity of PTSD and MDD are discussed. Published by Elsevier B.V.

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

    Science.gov (United States)

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

    2015-05-07

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

  6. Emotional intelligence in patients with posttraumatic stress disorder, borderline personality disorder and healthy controls.

    Science.gov (United States)

    Janke, Katrin; Driessen, Martin; Behnia, Behnoush; Wingenfeld, Katja; Roepke, Stefan

    2018-06-01

    Emotional intelligence as a part of social cognition has, to our knowledge, never been investigated in patients with Posttraumatic Stress Disorder (PTSD), though the disorder is characterized by aspects of emotional dysfunctioning. PTSD often occurs with Borderline Personality Disorder (BPD) as a common comorbidity. Studies about social cognition and emotional intelligence in patients with BPD propose aberrant social cognition, but produced inconsistent results regarding emotional intelligence. The present study aims to assess emotional intelligence in patients with PTSD without comorbid BPD, PTSD with comorbid BPD, and BPD patients without comorbid PTSD, as well as in healthy controls. 71 patients with PTSD (41 patients with PTSD without comorbid BPD, 30 patients with PTSD with comorbid BPD), 56 patients with BPD without PTSD, and 63 healthy controls filled in the Test of Emotional Intelligence (TEMINT). Patients with PTSD without comorbid BPD showed impairments in emotional intelligence compared to patients with BPD without PTSD, and compared to healthy controls. These impairments were not restricted to specific emotions. Patients with BPD did not differ significantly from healthy controls. This study provides evidence for an impaired emotional intelligence in PTSD without comorbid BPD compared to BPD and healthy controls, affecting a wide range of emotions. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. The potential of epigenetics in stress-enhanced fear learning models of PTSD.

    Science.gov (United States)

    Blouin, Ashley M; Sillivan, Stephanie E; Joseph, Nadine F; Miller, Courtney A

    2016-10-01

    Prolonged distress and dysregulated memory processes are the core features of post-traumatic stress disorder (PTSD) and represent the debilitating, persistent nature of the illness. However, the neurobiological mechanisms underlying the expression of these symptoms are challenging to study in human patients. Stress-enhanced fear learning (SEFL) paradigms, which encompass both stress and memory components in rodents, are emerging as valuable preclinical models of PTSD. Rodent models designed to study the long-term mechanisms of either stress or fear memory alone have identified a critical role for numerous epigenetic modifications to DNA and histone proteins. However, the epigenetic modifications underlying SEFL remain largely unknown. This review will provide a brief overview of the epigenetic modifications implicated in stress and fear memory independently, followed by a description of existing SEFL models and the few epigenetic mechanisms found to date to underlie SEFL. The results of the animal studies discussed here highlight neuroepigenetics as an essential area for future research in the context of PTSD through SEFL studies, because of its potential to identify novel candidates for neurotherapeutics targeting stress-induced pathogenic memories. © 2016 Blouin et al.; Published by Cold Spring Harbor Laboratory Press.

  8. Cortisol stress response in post-traumatic stress disorder, panic disorder, and major depressive disorder patients.

    Science.gov (United States)

    Wichmann, Susann; Kirschbaum, Clemens; Böhme, Carsten; Petrowski, Katja

    2017-09-01

    Previous research has focussed extensively on the distinction of HPA-axis functioning between patient groups and healthy volunteers, with relatively little emphasis on a direct comparison of patient groups. The current study's aim was to analyse differences in the cortisol stress response as a function of primary diagnosis of panic disorder (PD), post-traumatic stress disorder (PTSD), and major depressive disorder (MDD). A total of n=30 PD (mean age±SD: 36.07±12.56), n=23 PTSD (41.22±10.17), n=18 MDD patients (39.00±14.93) and n=47 healthy control (HC) individuals (35.51±13.15) participated in this study. All the study participants were female. The Trier Social Stress Test (TSST) was used for reliable laboratory stress induction. Blood sampling accompanied the TSST for cortisol and ACTH assessment. Panic-related, PTSD-specific questionnaires and the Beck Depression Inventory II were handed out for the characterisation of the study groups. Repeated measure ANCOVAs were conducted to test for main effects of time or group and for interaction effects. Regression analyses were conducted to take comorbid depression into account. 26.7% of the PD patients, 43.5% of the PTSD patients, 72.2% of the MDD patients and 80.6% of the HC participants showed a cortisol stress response upon the TSST. ANCOVA revealed a cortisol hypo-responsiveness both in PD and PTSD patients, while no significant group differences were seen in the ACTH concentrations. Additional analyses showed no impact of comorbid depressiveness on the cortisol stress response. MDD patients did not differ in the hormonal stress response neither compared to the HC participants nor to the PD and PTSD patients. Our main findings provide evidence of a dissociation between the cortisol and ACTH concentrations in response to the TSST in PTSD and in PD patients, independent of comorbid depression. Our results further support overall research findings of a cortisol hypo-responsiveness in PD patients. A hypo

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  10. PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation.

    Science.gov (United States)

    Mitchell, Karen S; Wolf, Erika J

    2016-09-30

    Posttraumatic stress disorder (PTSD) has been associated with eating disorders (EDs) and addictive behaviors, including the relatively new construct food addiction. However, few studies have investigated mechanisms that account for these associations, and men are underrepresented in studies of EDs and food addiction. We examined whether lifetime PTSD symptoms were associated with current food addiction and ED symptoms, and whether emotion regulation (expressive suppression and cognitive reappraisal), which has been associated with both PTSD and EDs, mediated these relations, in a sample of trauma-exposed, male (n=642) and female (n=55) veterans. Participants were recruited from the Knowledge Networks-GfK Research Panel and completed an online questionnaire. Structural equation modeling revealed that PTSD was directly associated with ED symptoms, food addiction, expressive suppression, and cognitive reappraisal in the full sample and with all constructs except cognitive reappraisal in the male subsample. Expressive suppression was significantly associated with ED symptoms and mediated the PTSD-ED relation. These results highlight the importance of investigating PTSD as a risk factor for food addiction and ED symptoms and the potential mediating role of emotion regulation in the development of PTSD and EDs in order to identify targets for treatments. Published by Elsevier Ireland Ltd.

  11. From Soldiers to Children: Developmental Sciences Transform the Construct of Posttraumatic Stress Disorder

    Science.gov (United States)

    Franks, Bridget A.

    2014-01-01

    Posttraumatic stress disorder (PTSD) was first included in the American Psychiatric Association's "Diagnostic and statistical manual of mental disorders" in 1980. Long used to describe the reactions of soldiers affected by stress in combat situations, PTSD is now recognised as a disorder affecting abused and neglected infants and…

  12. A Double-Blind Randomized Controlled Pilot Trial of N-Acetylcysteine in Veterans with PTSD and Substance Use Disorders

    Science.gov (United States)

    Back, Sudie E.; McCauley, Jenna L.; Korte, Kristina J.; Gros, Daniel F.; Leavitt, Virginia; Gray, Kevin M.; Hamner, Mark B.; DeSantis, Stacia M.; Malcolm, Robert; Brady, Kathleen T.; Kalivas, Peter W.

    2016-01-01

    Objective The antioxidant N-Acetylcysteine (NAC) is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders. Preclinical and clinical findings suggest that NAC normalizes extracellular glutamate by restoring the activity of glutamate transporters and antiporters in the nucleus accumbens. This study explored the efficacy of NAC in the treatment of post-traumatic stress disorder (PTSD), which frequently co-occurs with substance use disorders (SUD) and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. Method Veterans with current PTSD and SUD (N=35) were randomly assigned to receive a double-blind, 8-week course of NAC (2400 mg/day) or placebo plus outpatient group cognitive-behavioral therapy for SUD. Primary outcome measures included PTSD symptoms (Clinician Administered PTSD Scale, PTSD Checklist-Military) and craving (Visual Analogue Scale). Depression (Beck Depression Inventory-II) and substance use (Timeline Follow Back, urine drug screens) were also assessed. Results Participants treated with NAC, as compared to placebo, evidenced significant improvements in PTSD symptoms, craving, and depression. Substance use at the start of treatment was low for both the NAC and placebo groups and no significant between-group differences were observed. NAC was well tolerated and retention was high. Conclusions This is the first randomized controlled trial to investigate NAC as a pharmacological treatment for PTSD. The findings show a significant treatment effect on symptoms of PTSD and drug craving, and provide initial support for the use of NAC in combination with cognitive-behavioral therapy among individuals with co-occurring PTSD and SUD. PMID:27736051

  13. Electrocardiographic features of patients with earthquake related posttraumatic stress disorder

    OpenAIRE

    İlhan, Erkan; Kaplan, Abdullah; Güvenç, Tolga Sinan; Biteker, Murat; Karabulut, Evindar; Işıklı, Serhan

    2013-01-01

    AIM: To analyze electrocardiographic features of patients diagnosed with posttraumatic stress disorder (PTSD) after the Van-Erciş earthquake, with a shock measuring 7.2 on the Richter scale that took place in Turkey in October 2011.

  14. Post-traumatic stress disorder and exposure to violence among ...

    African Journals Online (AJOL)

    traumatic stress disorder (PTSD) symptoms was investigated in the second place, as well as the question whether a difference existed between the two ethnic groups in respect of this relationship. The participants were comprised of 186 Venda and ...

  15. Intranasal Oxytocin Normalizes Amygdala Functional Connectivity in Posttraumatic Stress Disorder

    NARCIS (Netherlands)

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

    2016-01-01

    The neuropeptide oxytocin (OT) has been suggested as a promising pharmacological agent for medication-enhanced psychotherapy in posttraumatic stress disorder (PTSD) because of its anxiolytic and prosocial properties. We therefore investigated the behavioral and neurobiological effects of a single

  16. Diagnosing and treating post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Buhmann, Cæcilie Böck; Andersen, Henrik Steen

    2017-01-01

    The post-traumatic stress disorder (PTSD) diagnosis has undergone large developments. With the changes in DSM-5 and the proposed changes in ICD-11, the two systems move in different directions. Treatment for PTSD is developing, but the evidence for the effect is lacking behind. Trauma...

  17. Posttraumatic Stress Disorder Among Bereaved Relatives of Cancer Patients

    DEFF Research Database (Denmark)

    Elklit, Ask; Reinholt, N.; Nielsen, Louise Hjort

    2010-01-01

    The aim of this study was to assess post-traumatic stress disorder (PTSD) and predictors of PTSD in individuals who experienced the loss of a close relative to cancer. A total of 251 bereaved relatives ages 14 to 76 (M = 41.3, SD = 16.8) were recruited at a counseling service for cancer patients...

  18. Posttraumatic stress disorder in parents following infant death

    DEFF Research Database (Denmark)

    Christiansen, Dorte M.

    2017-01-01

    Parents who have lost an infant prior to, during, or following birth often interpret the event as highly traumatic. The present systematic review included 46 articles based on 31 different studies of posttraumatic stress disorder (PTSD) in parents bereaved by infant death. The PTSD prevalence...

  19. Posttraumatic Stress Disorder in Children: What Elementary Teachers Should Know

    Science.gov (United States)

    Ray, Jan

    2014-01-01

    Posttraumatic stress disorder (PTSD) is not limited to the men and women who have been exposed to the horrors of war through military service. Children who are exposed to traumatic and life-threatening events, such as school shootings, physical and sexual abuse, and community violence, also can suffer from PTSD. This article explores the causes,…

  20. Prevalence and correlates of posttraumatic stress disorder among ...

    African Journals Online (AJOL)

    Context: Posttraumatic stress disorder (PTSD) is the most common consequence of traumatic experiences. The North Central Nigeria to which Plateau State belongs has witnessed many ethno‑religious crises. While previous studies suggested a high prevalence of PTSD among students, to the best of our knowledge, ...

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

    African Journals Online (AJOL)

    Objective: Post Traumatic Stress Disorder (PTSD) is a diagnostic category used to describe symptoms arising from emotionally traumatic experience(s). Research suggests that PTSD may be under- diagnosed when trauma is not the presenting problem or when not the focus of clinical intervention. There is a dearth of South ...

  2. Understanding HIV-related posttraumatic stress disorder in South ...

    African Journals Online (AJOL)

    A number of epidemiological studies have attempted to measure the prevalence of HIV-related posttraumatic stress disorder (PTSD) in sub-Saharan Africa. A systematic review of the literature identified eight relevant studies that put current estimates of the prevalence of HIV-related PTSD between 4.2% and 40%. Even the ...

  3. Posttraumatic Stress Disorder and Autobiographical Memories in Everyday Life.

    Science.gov (United States)

    Schönfeld, Sabine; Ehlers, Anke

    2017-03-01

    Evidence from self-reports and laboratory studies suggests that recall of nontrauma autobiographical memories may be disturbed in posttraumatic stress disorder (PTSD), but investigations in everyday life are sparse. This study investigated unintentional nontrauma and trauma memories in trauma survivors with and without PTSD ( N = 52), who kept an autobiographical memory diary for a week. We investigated whether unintentional nontrauma memories show an overgeneral memory bias and further memory abnormalities in people with PTSD, and whether unintentional trauma memories show distinct features. Compared to the no-PTSD group, the PTSD group recorded fewer nontrauma memories, which were more overgeneral, more often from before the trauma or related to the trauma, were perceived as distant, and led to greater dwelling. Trauma memories were more vivid, recurrent, and present and led to greater suppression and dwelling. Within the PTSD group, the same features distinguished trauma and nontrauma memories. Results are discussed regarding theories of autobiographical memory and PTSD.

  4. Posttraumatic Stress Disorder Disturbs Coronary Tone and Its Regulatory Mechanisms.

    Science.gov (United States)

    Lazuko, Svetlana S; Kuzhel, Olga P; Belyaeva, Lyudmila E; Manukhina, Eugenia B; Fred Downey, H; Tseilikman, Olga B; Komelkova, Maria V; Tseilikman, Vadim E

    2018-01-01

    Posttraumatic stress disorder (PTSD) is associated with myocardial injury, but changes in coronary regulatory mechanisms in PTSD have not been investigated. This study evaluated the effect of PTSD-inducing stress on coronary tone and its regulation by nitric oxide (NO) and voltage-gated K + channels. PTSD was induced by exposing rats to predator stress, 15 min daily for 10 days, followed by 14 stress-free days. Presence of PTSD was confirmed by the elevated plus-maze test. Coronary tone was evaluated from changes in coronary perfusion pressure of Langendorff isolated hearts. Predator stress induced significant decreases in coronary tone of isolated hearts and in blood pressure of intact rats. L-NAME, a non-selective NO synthase (NOS) inhibitor, but not S-MT, a selective iNOS inhibitor, and increased coronary tone of control rats. In PTSD rats, both L-NAME and S-MT increased coronary tone. Therefore, the stress-induced coronary vasodilation resulted from NO overproduction by both iNOS and eNOS. NOS induction was apparently due to systemic inflammation as evidenced by increased serum interleukin-1β and C-reactive protein in PTSD rats. Decreased corticosterone in PTSD rats may have contributed to inflammation and its effect on coronary tone. PTSD was also associated with voltage-gated K + channel dysfunction, which would have also reduced coronary tone.

  5. Gene and stress history interplay in emergence of PTSD-like features.

    Science.gov (United States)

    Chakraborty, Nabarun; Meyerhoff, James; Gautam, Aarti; Muhie, Seid; Jibitu, Meskerem; De Lima, Thereza C M; Hammamieh, Rasha; Jett, Marti

    2015-10-01

    Systematically distinguishing genetic liability from other contributing factors is critical for designing a preventive strategy for post-traumatic stress disorder (PTSD). To address this issue, we investigated a murine model exposing C57BL/6j, DBA/2j and BALB/cj mice to repeated stress via exposure to conspecific aggressors (Agg-E). Naïve mice from each strain were subjected to the proximity of aggressor (Agg) mice for 6h using a 'cage-within-a-cage' paradigm, which was repeated for 5 or 10 days with intermittent and unpredictable direct contact with Agg mice. During the Agg-E stress, DBA/2j developed a different strategy to evade Agg mice, which potentially contributed to its phenotypic resilience to Agg-E stress. Although Agg mice inflicted C57BL/6j and BALB/cj with equivalent numbers of strikes, BALB/cj displayed a distinct behavioral phenotype with delayed exhibition of a number of PTSD-like features. By contrast, C57BL/6j mice displayed unique vulnerability to Agg-E stress induced myocardopathy, possibly attributable to their particular susceptibility to hypoxia. A group of genes (Bdnf, Ngf, Zwint, Cckbr, Slc6a4, Fkbp5) linked to PTSD and synaptic plasticity were significantly altered in C57BL/6j and BALB/cj Agg-E mice. Contributions of Agg-E stress history and genotypic heterogeneity emerged as the key mediators of PTSD-like features. Linking genetic components to specific phenotypic and pathological features could have potential clinical implications. Copyright © 2015 Elsevier B.V. All rights reserved.

  6. Posttraumatic Stress Disorder after Vaginal Delivery at Primiparous Women.

    Science.gov (United States)

    Milosavljevic, Maja; Lecic Tosevski, Dusica; Soldatovic, Ivan; Vukovic, Olivera; Miljevic, Cedo; Peljto, Amir; Kostic, Milutin; Olff, Miranda

    2016-06-08

    Although severe gynaecological pathology during delivery and negative outcome have been shown to be related with posttraumatic stress disorder (PTSD) little is known about traumatic experiences following regular delivery, at the expected time and with a healthy child. The objective of our study was to determine the prevalence of PTSD during postpartum period after vaginal delivery and its risk factors. The sample included 126 primiparous women. Monthly, for the next three months, the women were assessed for PTSD using the gold standard interview for PTSD, Clinician-Administered PTSD Scale (CAPS). Risk factors were assessed including sociodemographic variables, personal medical history and clinical variables. After the first month, 2.4% women had acute full PTSD and another 9.5% had clinically significant level of PTSD symptoms. Following the second and the third month, partial PTSD was found in 5.9% and 1.3% of the women, respectively, and none of participants had full PTSD. Obstetrical interventions were the only significant risk factor for the development of PTSD. Symptoms of postpartum PTSD are not rare after a traumatic delivery, and associated with specific obstetrical risk factors. Awareness of these risk factors may stimulate interventions to prevent this important and neglected postpartum disorder.

  7. Gender differences in trauma and posttraumatic stress disorder.

    Science.gov (United States)

    Breslau, Naomi

    2002-01-01

    Research on posttraumatic stress disorder (PTSD) has focused primarily on Vietnam War veterans. A handful of recent studies have been conducted on samples of the general population. We sought to examine gender differences in exposure to traumatic events and in the emergence of PTSD following exposure in the general population. A representative sample of 2181 persons in the Detroit metropolitan area, ages 18-45 years. Subjects were interviewed to assess history of traumatic events and PTSD using Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. The risk of PTSD was assessed in relation to a representative sample of traumas experienced in the population. Lifetime prevalence of traumatic events was slightly higher in men than in women. The risk for PTSD following traumatic experiences was twofold higher in women than in men. This gender difference was primarily due to women's greater risk of PTSD following events that involved assaultive violence. The probability of PTSD in women versus men exposed to assaultive violence was 36% versus 6%. Prior exposure to assaultive violence was associated with an increased risk of PTSD from a subsequent trauma; the gender difference in the vulnerability for PTSD is not explained by prior exposure. Duration of PTSD was longer in women than in men. The burden of PTSD in U.S. communities is greater in women than in men, chiefly due to the greater effect of assaultive violence on women.

  8. 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.

  9. Predator-based psychosocial stress animal model of PTSD: Preclinical assessment of traumatic stress at cognitive, hormonal, pharmacological, cardiovascular and epigenetic levels of analysis.

    Science.gov (United States)

    Zoladz, Phillip R; Diamond, David M

    2016-10-01

    Research on post-traumatic stress disorder (PTSD) is faced with the challenge of understanding how a traumatic experience produces long-lasting detrimental effects on behavior and brain functioning, and more globally, how stress exacerbates somatic disorders, including cardiovascular disease. Moreover, the design of translational research needs to link animal models of PTSD to clinically relevant risk factors which address why only a subset of traumatized individuals develop persistent psychopathology. In this review, we have summarized our psychosocial stress rodent model of PTSD which is based on well-described PTSD-inducing risk factors, including a life-threatening experience, a sense of horror and uncontrollability, and insufficient social support. Specifically, our animal model of PTSD integrates acute episodes of inescapable exposure of immobilized rats to a predator with chronic daily social instability. This stress regimen produces PTSD-like effects in rats at behavioral, cognitive, physiological, pharmacological and epigenetic levels of analysis. We have discussed a recent extension of our animal model of PTSD in which stress exacerbated coronary pathology following an ischemic event, assessed in vitro. In addition, we have reviewed our research investigating pharmacological and non-pharmacological therapeutic strategies which may have value in clinical approaches toward the treatment of traumatized people. Overall, our translational approach bridges the gap between human and animal PTSD research to create a framework with which to enhance our understanding of the biological basis of trauma-induced pathology and to assess therapeutic approaches in the treatment of psychopathology. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Harm expectancy violation during exposure therapy for posttraumatic stress disorder.

    Science.gov (United States)

    de Kleine, Rianne A; Hendriks, Lotte; Becker, Eni S; Broekman, Theo G; van Minnen, Agnes

    2017-06-01

    Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of harm expectancies is a crucial mechanism of action in exposure therapy. But to date, changes in harm expectancies have not been examined during exposure therapy in PTSD. The goal of the current study was to examine harm expectancy violation as mechanism of change in exposure therapy for posttraumatic stress disorder (PTSD). Patients (N=50, 44 female) with a primary diagnosis of chronic PTSD received intensive exposure therapy. Harm expectancies, harm experiences and subjective units of distress (SUDs) were assessed at each imaginal exposure session, and PTSD symptoms were assessed pre- and posttreatment with the Clinician Administered PTSD Scale (CAPS). Results showed that harm expectancies were violated within and strongly declined in-between exposure therapy sessions. However, expectancy violation was not related to PTSD symptom change. Fear habituation measures were moderately related to PTSD symptom reductions. In line with theory, exposure therapy promotes expectancy violation in PTSD patients, but this is not related to exposure therapy outcome. More work is warranted to investigate mechanisms of change during exposure therapy in PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. Biomarkers of PTSD: military applications and considerations

    OpenAIRE

    Amy Lehrner; Rachel Yehuda

    2014-01-01

    Background: Although there are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk fo...

  12. EMDR for Syrian refugees with posttraumatic stress disorder symptoms:results of a pilot randomized controlled trial

    NARCIS (Netherlands)

    Acarturk, C.; Konuk, E.; Cetinkaya, M.; Senay, I.; Sijbrandij, M.; Cuijpers, P.; Aker, T.

    2015-01-01

    Background: The most common mental health problems among refugees are depression and posttraumatic stress disorder (PTSD). Eye movement desensitization and reprocessing (EMDR) is an effective treatment for PTSD. However, no previous randomized controlled trial (RCT) has been published on treating

  13. An overview of posttraumatic stress disorder genetic studies by analyzing and integrating genetic data into genetic database PTSDgene

    NARCIS (Netherlands)

    Zhang, Kunlin; Qu, Susu; Chang, Suhua; Li, Gen; Cao, Chengqi; Fang, Kechi; Olff, Miranda; Wang, Li; Wang, Jing

    2017-01-01

    Posttraumatic stress disorder (PTSD) is a debilitating psychiatric syndrome with complex etiology. Studies aiming to explore genetic susceptibility and environmental triggers of PTSD have been increasing. However, the results are limited and highly heterogeneous. To understand the genetic study

  14. Posttraumatic stress disorder is associated with emotional eating.

    Science.gov (United States)

    Talbot, Lisa S; Maguen, Shira; Epel, Elissa S; Metzler, Thomas J; Neylan, Thomas C

    2013-08-01

    The present study investigated the relationship between posttraumatic stress disorder (PTSD) and emotional eating in a sample of medically healthy and medication-free adults. Participants with PTSD (n = 44) and control participants free of lifetime psychiatric history (n = 49) completed a measure of emotional eating. Emotional eating is the tendency to eat or overeat in response to negative emotions. PTSD participants exhibited greater emotional eating than control participants (η(2)  = .20) and emotional eating increased with higher PTSD symptom severity (R(2)  = .11). Results supported the stress-eating-obesity model whereby emotional eating is a maladaptive response to stressors. Over time, this could lead to weight gain, particularly abdominal stores, and contribute to higher risk for comorbid medical disorders. Findings suggest the importance of future longitudinal research to understand whether emotional eating contributes to the high rates of obesity, diabetes, and heart disease in PTSD. Copyright © 2013 International Society for Traumatic Stress Studies.

  15. PTSD and Comorbid Disorders in a Representative Sample of Adolescents: The Risk Associated with Multiple Exposures to Potentially Traumatic Events

    Science.gov (United States)

    Macdonald, Alexandra; Danielson, Carla Kmett; Resnick, Heidi S.; Saunders, Benjamin E.; Kilpatrick, Dean G.

    2010-01-01

    Objective: This study compared the impact of multiple exposures to potentially traumatic events (PTEs), including sexual victimization, physical victimization, and witnessed violence, on posttraumatic stress disorder (PTSD) and comorbid conditions (i.e., major depressive episode [MDE], and substance use [SUD]). Methods: Participants were a…

  16. Systems Biology Approach to Understanding Post-traumatic Stress Disorder

    Science.gov (United States)

    2015-01-14

    Post - traumatic stress disorder ( PTSD ) is a psychological disorder a???ecting individuals that have experienced life-changing... post - traumatic stress disorder 5a. CONTRACT NUMBER W911NF-10-2-0111 & USAMRMC 09284002 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...challenges As stated in the Introduction, post - traumatic stress disorder is the only psychological disorder for which the onset of the

  17. Predicting the Transition From Acute Stress Disorder to Posttraumatic Stress Disorder in Children With Severe Injuries.

    Science.gov (United States)

    Brown, Ruth C; Nugent, Nicole R; Hawn, Sage E; Koenen, Karestan C; Miller, Alisa; Amstadter, Ananda B; Saxe, Glenn

    The purpose of this study was to examine predictors of risk for and the transition between acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) in a longitudinal sample of youth with severe injuries admitted to the hospital. These data would assist with treatment and discharge planning. Youth were assessed for ASD during the initial hospital stay and were followed-up over an 18-month period for PTSD (n = 151). Youth were classified into four groups, including Resilient (ASD-, PTSD-), ASD Only (ASD+, PTSD-), PTSD Only (ASD-, PTSD+), and Chronic (ASD+, PTSD+). Demographic, psychiatric, social context, and injury-related factors were examined as predictors of diagnostic transition. The results of multivariate analysis of variance and pairwise comparisons found that peritraumatic dissociation, gender, and socioeconomic status were significant predictors after controlling for multiple testing. Results suggest that both within-child and contextual factors contribute to the longitudinal response to trauma in children. Clinicians should consider early screening and discharge planning, particularly for children most at risk. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  18. Posttraumatic Stress Disorder obesity and weight loss

    DEFF Research Database (Denmark)

    Johannessen, Kim Berg; Berntsen, Dorthe

    Posttraumatic Stress Disorder (PTSD) has frequently been found to have a significant impact on the development of obesity. Yet, while a reciprocal relationship has been found between obesity and depression, the relationship between past traumatic episodes and obesity is usually thought of as uni...

  19. Posttraumatic stress disorder among black Vietnam veterans.

    Science.gov (United States)

    Allen, I M

    1986-01-01

    Because of racism in the military and racial and social upheaval in the United States during the Vietnam War years, as well as limited opportunities for blacks in the postwar period, black veterans of the Vietnam War often harbor conflicting feelings about their wartime experiences and have difficulty rationalizing brutality against the Vietnamese. As a result, black veterans suffer from posttraumatic stress disorder (PTSD) at a higher rate than white veterans. Diagnosis and treatment of PTSD in black veterans is complicated by the tendency to misdiagnose black patients, by the varied manifestations of PTSD, and by patients' frequent alcohol and drug abuse and medical, legal, personality, and vocational problems. The author presents his and others' recommendations about ways to treat black veterans with PTSD.

  20. Posttraumatic Stress Disorder and Orofacial Pain

    Directory of Open Access Journals (Sweden)

    Natalija Prica

    2015-01-01

    Full Text Available Chronic orofacial pain occurs frequently in patients with posttraumatic stress disorder (PTSD and at the same time any pathological process involving orofacial area can be reflected in emotional interpretation of pain and can trigger a series of reactions associated with the PTSD group of symptoms in patients with PTSD. Painful stimuli caused in this way may occur after the primary cause ceased, and because of convergence can cause referred pain outside of the anatomical site where the primary injury occurred. Chronic orofacial pain and PTSD are diagnosed on the basis of subjective testimony and this regularly occurs in the context of social interaction between patients, doctors, medical staff or researchers making it difficult to standardize the results and introduces many cultural phenomena.

  1. Symptom Differences in Acute and Chronic Presentation of Childhood Post-Traumatic Stress Disorder.

    Science.gov (United States)

    Famularo, Richard; And Others

    1990-01-01

    Twenty-four child abuse victims, age 5-13, were diagnosed with posttraumatic stress disorder (PTSD). Children with the acute form of PTSD exhibited such symptoms as difficulty falling asleep, hypervigilance, nightmares, and generalized anxiety. Children exhibiting chronic PTSD exhibited increased detachment, restricted range of affect,…

  2. Gender Differences in the Maintenance of Response to Cognitive Behavior Therapy for Posttraumatic Stress Disorder

    Science.gov (United States)

    Felmingham, Kim L.; Bryant, Richard A.

    2012-01-01

    Objective: To examine potential differential responses in men and women to cognitive behavior therapy for posttraumatic stress disorder (PTSD). Method: Fifty-two men and 56 women diagnosed with PTSD participated in randomized controlled trials of cognitive behavior therapy for PTSD. Participants were randomly allocated to either (a) exposure-only…

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

    NARCIS (Netherlands)

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

    2017-01-01

    OBJECTIVES: Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of

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

    Science.gov (United States)

    Moore, Nykeisha; Wadsworth, John; Cory, James

    2009-01-01

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

  5. Gender Differences in Animal Models of Posttraumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Hagit Cohen

    2011-01-01

    Full Text Available Epidemiological studies report higher prevalence rates of stress-related disorders such as acute stress disorder and post-traumatic stress disorder (PTSD in women than in men following exposure to trauma. It is still not clear whether this greater prevalence in woman reflects a greater vulnerability to stress-related psychopathology. A number of individual and trauma-related characteristics have been hypothesized to contribute to these gender differences in physiological and psychological responses to trauma, differences in appraisal, interpretation or experience of threat, coping style or social support. In this context, the use of an animal model for PTSD to analyze some of these gender-related differences may be of particular utility. Animal models of PTSD offer the opportunity to distinguish between biological and socio-cultural factors, which so often enter the discussion about gender differences in PTSD prevalence.

  6. Posttraumatic stress disorder: a state-of-the-science review.

    Science.gov (United States)

    Nemeroff, Charles B; Bremner, J Douglas; Foa, Edna B; Mayberg, Helen S; North, Carol S; Stein, Murray B

    2006-02-01

    This article reviews the state-of-the-art research in posttraumatic stress disorder (PTSD) from several perspectives: (1) Sex differences: PTSD is more frequent among women, who tend to have different types of precipitating traumas and higher rates of comorbid panic disorder and agoraphobia than do men. (2) Risk and resilience: The presence of Group C symptoms after exposure to a disaster or act of terrorism may predict the development of PTSD as well as comorbid diagnoses. (3) Impact of trauma in early life: Persistent increases in CRF concentration are associated with early life trauma and PTSD, and may be reversed with paroxetine treatment. (4) Imaging studies: Intriguing findings in treated and untreated depressed patients may serve as a paradigm of failed brain adaptation to chronic emotional stress and anxiety disorders. (5) Neural circuits and memory: Hippocampal volume appears to be selectively decreased and hippocampal function impaired among PTSD patients. (6) Cognitive behavioral approaches: Prolonged exposure therapy, a readily disseminated treatment modality, is effective in modifying the negative cognitions that are frequent among PTSD patients. In the future, it would be useful to assess the validity of the PTSD construct, elucidate genetic and experiential contributing factors (and their complex interrelationships), clarify the mechanisms of action for different treatments used in PTSD, discover ways to predict which treatments (or treatment combinations) will be successful for a given individual, develop an operational definition of remission in PTSD, and explore ways to disseminate effective evidence-based treatments for this condition.

  7. 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

  8. Post-traumatic psychiatric disorders: PTSD is not the only diagnosis.

    Science.gov (United States)

    Auxéméry, Yann

    2018-05-01

    Traumatic events and their consequences are often hidden or minimised by patients for reasons linked to the post-traumatic stress disorder itself (inexpressibility, shame, depressive thoughts, fear of stigmatisation, etc.). Although post-traumatic stress disorder (PTSD) remains the most widely known disorder, chronic post-traumatic psychiatric disorders are many and varied. After a trauma, the practitioner has to check for the different clinical forms of post-traumatic psychological consequences: PTSD is not the only diagnosis. Based on our own clinical experience compared to the international literature, we think necessary to build a didactic classification describing chronic post-traumatic symptoms and syndromes. Post traumatic depressions and bereavement lead to high risk of suicidal crisis and self-harm behaviours. Re-experiencing are felt with anxiety, hyper arousal increases anxious reactivity, and avoidance strategies increase anticipatory anxiety, indicating post-traumatic anxiety disorders (agoraphobia, specific phobia, obsessive compulsive disorder, separation anxiety, social phobia). Characterising an often-severe clinical picture, the co-occurrence of post-traumatic and chronic psychotic symptoms is not unusual (post-traumatic schizophrenia, post-traumatic depression with mood-congruent psychotic features, non-schizophrenic post-traumatic psychotic disorder, and bipolar reaction to trauma). A physical injury occurring at the same time as a traumatic exposure increases the risk of developing post-traumatic stress disorder later which, in turn, afflicts the subjective perception of the physical health (development of somatoform and psychosomatic disorders, comorbidity with a post-concussion syndrome). The trauma may cause a rupture in the biography of a person, also in his/her internal physiological functioning as in his/her social activities (impacts of instinctive functions and behaviours, personality changes, and adjustment difficulties on professional

  9. The stressor criterion for posttraumatic stress disorder: Does it matter?

    Science.gov (United States)

    Roberts, Andrea L.; Dohrenwend, Bruce P.; Aiello, Allison; Wright, Rosalind J.; Maercker, Andreas; Galea, Sandro; Koenen, Karestan C.

    2013-01-01

    Objective The definition of the stressor criterion for posttraumatic stress disorder (“Criterion A1”) is hotly debated with major revisions being considered for DSM-V. We examine whether symptoms, course, and consequences of PTSD vary predictably with the type of stressful event that precipitates symptoms. Method We used data from the 2009 PTSD diagnostic subsample (N=3,013) of the Nurses Health Study II. We asked respondents about exposure to stressful events qualifying under 1) DSM-III, 2) DSM-IV, or 3) not qualifying under DSM Criterion A1. Respondents selected the event they considered worst and reported subsequent PTSD symptoms. Among participants who met all other DSM-IV PTSD criteria, we compared distress, symptom severity, duration, impairment, receipt of professional help, and nine physical, behavioral, and psychiatric sequelae (e.g. physical functioning, unemployment, depression) by precipitating event group. Various assessment tools were used to determine fulfillment of PTSD Criteria B through F and to assess these 14 outcomes. Results Participants with PTSD from DSM-III events reported on average 1 more symptom (DSM-III mean=11.8 symptoms, DSM-IV=10.7, non-DSM=10.9) and more often reported symptoms lasted one year or longer compared to participants with PTSD from other groups. However, sequelae of PTSD did not vary systematically with precipitating event type. Conclusions Results indicate the stressor criterion as defined by the DSM may not be informative in characterizing PTSD symptoms and sequelae. In the context of ongoing DSM-V revision, these results suggest that Criterion A1 could be expanded in DSM-V without much consequence for our understanding of PTSD phenomenology. Events not considered qualifying stressors under the DSM produced PTSD as consequential as PTSD following DSM-III events, suggesting PTSD may be an aberrantly severe but nonspecific stress response syndrome. PMID:22401487

  10. Posttraumatic stress disorder related to postpartum haemorrhage: A systematic review.

    Science.gov (United States)

    Zaat, Tjitske R; van Steijn, Minouk E; de Haan-Jebbink, Jiska M; Olff, Miranda; Stramrood, Claire A I; van Pampus, Mariëlle G

    2018-06-01

    In some cases childbirth leads to negative psychological responses such as posttraumatic stress disorder (PTSD). Postpartum hemorrhage (PPH) is a common and major complication of childbirth, which occasionally requires emergency hysterectomy in severe cases. Patients often describe these complications as a traumatic experience. It is unknown whether PPH is a risk factor for developing PTSD. In this systematic review we summarize the current knowledge about the association between PPH with or without emergency hysterectomy and posttraumatic stress symptoms or PTSD. If PPH is a risk factor for PTSD, this will allow adequate preventive measures with the aim to reduce the long-term effects and socioeconomic problems associated with PTSD. To conduct this review MEDLINE, EMBASE, Web of Science, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Cochrane Library and PsycINFO databases were searched for publications between January 1986 and October 2017. Manuscripts evaluating the association between PPH and peripartum emergency hysterectomy and PTSD or posttraumatic stress symptoms were included. Fifty-two articles met the criteria for full-text review. Seven articles were included in this review. Five studies focused on the association between PPH and PTSD and two studies evaluated the association between emergency hysterectomy and PTSD. Three studies found no association between PPH and PTSD. Two studies reported a higher risk of developing PTSD or posttraumatic stress symptoms after PPH. Two studies reported a higher risk of developing PTSD after emergency hysterectomy. Meta-analysis was not possible due to the heterogeneity of these studies. Based on the results of these studies there may be an association between PPH and PTSD. Secondly, it seems likely that an association exists between emergency postpartum hysterectomy and PTSD, but the strength of this conclusion is limited by the small amount of studies included. Copyright © 2018 Elsevier B

  11. The prevalence of common mental disorders and PTSD in the UK military: using data from a clinical interview-based study

    OpenAIRE

    Iversen, Amy C; van Staden, Lauren; Hughes, Jamie Hacker; Browne, Tess; Hull, Lisa; Hall, John; Greenberg, Neil; Rona, Roberto J; Hotopf, Matthew; Wessely, Simon; Fear, Nicola T

    2009-01-01

    Abstract Background The mental health of the Armed Forces is an important issue of both academic and public interest. The aims of this study are to: a) assess the prevalence and risk factors for common mental disorders and post traumatic stress disorder (PTSD) symptoms, during the main fighting period of the Iraq War (TELIC 1) and later deployments to Iraq or elsewhere and enlistment status (regular or reserve), and b) compare the prevalence of depression, PTSD symptoms and suicidal ideation ...

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

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2015-03-01

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

  13. Stroop-interference effect in post-traumatic stress disorder.

    Science.gov (United States)

    Cui, Hong; Chen, Guoliang; Liu, Xiaohui; Shan, Moshui; Jia, Yanyan

    2014-12-01

    To investigate the conflict processing in posttraumatic stress disorder (PTSD) patients, we conducted the classical Stroop task by recording event-related potentials. Although the reaction time was overall slower for PTSD patients than healthy age-matched control group, the Stroop-interference effect of reaction time did not differ between the two groups. Compared with normal controls, the interference effects of N 2 and N 450 components were larger and the interference effect of slow potential component disappeared in PTSD. These data indicated the dysfunction of conflict processing in individuals with PTSD.

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

    Directory of Open Access Journals (Sweden)

    SONAL eGOSWAMI

    2013-05-01

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

  15. Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in DSM-5 and ICD-11: Clinical and Behavioral Correlates.

    Science.gov (United States)

    Hyland, Philip; Shevlin, Mark; Fyvie, Claire; Karatzias, Thanos

    2018-04-01

    The American Psychiatric Association and the World Health Organization provide distinct trauma-based diagnoses in the fifth edition of the Diagnostic and Statistical Manual (DSM-5), and the forthcoming 11th version of the International Classification of Diseases (ICD-11), respectively. The DSM-5 conceptualizes posttraumatic stress disorder (PTSD) as a single, broad diagnosis, whereas the ICD-11 proposes two "sibling" disorders: PTSD and complex PTSD (CPTSD). The objectives of the current study were to: (a) compare prevalence rates of PTSD/CPTSD based on each diagnostic system; (b) identify clinical and behavioral variables that distinguish ICD-11 CPTSD and PTSD diagnoses; and (c) examine the diagnostic associations for ICD-11 CPTSD and DSM-5 PTSD. Participants in a predominately female clinical sample (N = 106) completed self-report scales to measure ICD-11 PTSD and CPTSD, DSM-5 PTSD, and depression, anxiety, borderline personality disorder, dissociation, destructive behaviors, and suicidal ideation and self-harm. Significantly more people were diagnosed with PTSD according to the DSM-5 criteria (90.4%) compared to those diagnosed with PTSD and CPTSD according to the ICD-11 guidelines (79.8%). An ICD-11 CPTSD diagnosis was distinguished from an ICD-11 PTSD diagnosis by higher levels of dissociation (d = 1.01), depression (d = 0.63), and borderline personality disorder (d = 0.55). Diagnostic associations with depression, anxiety, and suicidal ideation and self-harm were higher for ICD-11 CPTSD compared to DSM-5 PTSD (by 10.7%, 4.0%, and 7.0%, respectively). These results have implications for differential diagnosis and for the development of targeted treatments for CPTSD. Copyright © 2018 International Society for Traumatic Stress Studies.

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

    OpenAIRE

    Flory, Janine D.; Yehuda, Rachel; Passarelli, Vincent; Siever, Larry J.

    2012-01-01

    Objective. Childhood maltreatment and familial psychopathology both lead to an increased risk of the development of posttraumatic stress disorder (PTSD) in adulthood. While family history of psychopathology has traditionally been viewed as a proxy for genetic predisposition, such pathology can also contribute to a stress-laden environment for the child. Method. Analyses were conducted to evaluate the joint effect of childhood abuse and a family history of major depressive disorder (MDD) on di...

  17. Serum Lipid Concentrations in Croatian Veterans with Post-traumatic Stress Disorder, Post-traumatic Stress Disorder Comorbid with Major Depressive Disorder, or Major Depressive Disorder

    OpenAIRE

    Karlovi?, Dalibor; Buljan, Danijel; Martinac, Marko; Mar?inko, Darko

    2004-01-01

    The aim of this study was to assess eventual differences in serum cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, LDL-C/HDL-C ratio between veterans with combat-related posttraumatic stress disorder (PTSD) only or comorbid with major depressive disorder (MDD), veterans with combat experiences with MDD, and healthy control group. PTSD and/ or MDD were diagnose according to structured clinical interview based on DSM-IV crite...

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

    Science.gov (United States)

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

    2017-03-01

    Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p disorder predicted poor treatment response and explained 39% of the variance between individuals. Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments

  19. Brain stimulation in posttraumatic stress disorder

    Directory of Open Access Journals (Sweden)

    Vladan Novakovic

    2011-10-01

    Full Text Available Posttraumatic stress disorder (PTSD is a complex, heterogeneous disorder that develops following trauma and often includes perceptual, cognitive, affective, physiological, and psychological features. PTSD is characterized by hyperarousal, intrusive thoughts, exaggerated startle response, flashbacks, nightmares, sleep disturbances, emotional numbness, and persistent avoidance of trauma-associated stimuli. The efficacy of available treatments for PTSD may result in part from relief of associated depressive and anxiety-related symptoms in addition to treatment of core symptoms that derive from reexperiencing, numbing, and hyperarousal. Diverse, heterogeneous mechanisms of action and the ability to act broadly or very locally may enable brain stimulation devices to address PTSD core symptoms in more targeted ways. To achieve this goal, specific theoretical bases derived from novel, well-designed research protocols will be necessary. Brain stimulation devices include both long-used and new electrical and magnetic devices. Electroconvulsive therapy (ECT and Cranial electrotherapy stimulation (CES have both been in use for decades; transcranial magnetic stimulation (TMS, magnetic seizure therapy (MST, deep brain stimulation (DBS, transcranial Direct Current Stimulation (tDCS, and vagus nerve stimulation (VNS have been developed recently, over approximately the past twenty years. The efficacy of brain stimulation has been demonstrated as a treatment for psychiatric and neurological disorders such as anxiety (CES, depression (ECT, CES, rTMS, VNS, DBS, obsessive-compulsive disorder (OCD (DBS, essential tremor, dystonia (DBS, epilepsy (DBS, VNS, Parkinson Disease (DBS, pain (CES, and insomnia (CES. To date, limited data on brain stimulation for PTSD offer only modest guidance. ECT has shown some efficacy in reducing comorbid depression in PTSD patients but has not been demonstrated to improve most core PTSD symptoms. CES and VNS have shown some efficacy in

  20. Early intervention for post-traumatic stress disorder.

    Science.gov (United States)

    Bryant, Richard A

    2007-02-01

    The potentially debilitating effect of posttraumatic stress disorder (PTSD) has created much interest in early intervention strategies that can reduce PTSD. This review critiques the evidence for psychological debriefing approaches and alternate early intervention strategies. The review critiques the randomized controlled trials of psychological debriefing, and early provision of cognitive behavior therapy. The latter approach involves therapy attention on acutely traumatized individuals who are high risk for PTSD development, and particularly in people with acute stress disorder (ASD). Psychological debriefing does not prevent PTSD. Cognitive behaviour therapy strategies have proven efficacy in reducing subsequent PTSD in ASD populations. Despite the promising evidence for early provision of CBT, many people do not benefit from CBT. This review concludes with consideration of major challenges facing early intervention approaches in the context of terrorist attacks and mass disasters.

  1. Embitterment in War Veterans with Posttraumatic Stress Disorder.

    Science.gov (United States)

    Sabic, Dzevad; Sabic, Adela; Batic-Mujanovic, Olivera

    2018-04-01

    The aim of this study was to analyze frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD). It was analyzed 174 subjects (from Health Center Zivinice/ Mental Health Center) through a survey conducted in the period from March 2015 to June 2016, of witch 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the Clinician-Administered PTSD Scale - V (CAPS), the PTSD CheckList (PCL), the Combat Exposure Scale (CES), the Hamilton Depression Rating Scale (HAM-D), the Hamilton Anxiety Rating Scale (HAM-A) and the World Health Organization Quality of Life Scale ( WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52·78 ± 5·99. In the control group average age was 51·42 ± 5·98. Statistical data were analyzed in SPSS statistical program. Comparing the results, t tests revealed significant difference between group veterans with PTSD and control group (t=-21·216, p<0·0001). War veterans group with PTSD (X= 51·41 SD= 8·91), war veterans without PTSD (X=14·39, SD=13·61). Embitterment is frequent in war veterans with PTSD.

  2. Treatment of Posttraumatic Stress Disorder in Rape Victims: A Comparison between Cognitive-Behavioral Procedures and Counseling.

    Science.gov (United States)

    Foa, Edna B.; And Others

    1991-01-01

    Assigned 45 rape victims with posttraumatic stress disorder (PTSD) to stress inoculation training (SIT), prolonged exposure (PE), supportive counseling, or wait-list. All conditions produced improvements on PTSD symptoms, rape-related distress, general anxiety, and depression. SIT produced significantly more improvement on PTSD symptoms than did…

  3. Distinctive cardiac autonomic dysfunction following stress exposure in both sexes in an animal model of PTSD.

    Science.gov (United States)

    Koresh, Ori; Kaplan, Zeev; Zohar, Joseph; Matar, Michael A; Geva, Amir B; Cohen, Hagit

    2016-07-15

    It is unclear whether the poor autonomic flexibility or dysregulation observed in patients with posttraumatic stress disorder (PTSD) represents a pre-trauma vulnerability factor or results from exposure to trauma. We used an animal model of PTSD to assess the association between the behavioral response to predator scent stress (PSS) and the cardiac autonomic modulation in male and female rats. The rats were surgically implanted with radiotelemetry devices to measure their electrocardiograms and locomotor activity (LMA). Following baseline telemetric monitoring, the animals were exposed to PSS or sham-PSS. Continuous telemetric monitoring (24h/day sampling) was performed over the course of 7days. The electrocardiographic recordings were analyzed using the time- and frequency-domain indexes of heart rate variability (HRV). The behavioral response patterns were assessed using the elevated plus maze and acoustic startle response paradigms for the retrospective classification of individuals according to the PTSD-related cut-off behavioral criteria. During resting conditions, the male rats had significantly higher heart rates (HR) and lower HRV parameters than the female rats during both the active and inactive phases of the daily cycle. Immediately after PSS exposure, both the female and male rats demonstrated a robust increase in HR and a marked drop in HRV parameters, with a shift of sympathovagal balance towards sympathetic predominance. In both sexes, autonomic system habituation and recovery were selectively inhibited in the rats whose behavior was extremely disrupted after exposure to PSS. However, in the female rats, exposure to the PSS produced fewer EBR rats, with a more rapid recovery curve than that of the male rats. PSS did not induce changes to the circadian rhythm of the LMA. According to our results, PTSD can be conceptualized as a disorder that is related to failure-of-recovery mechanisms that impede the restitution of physiological homeostasis

  4. 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.

  5. 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.

  6. Interactions between disordered sleep, post-traumatic stress disorder, and substance use disorders.

    Science.gov (United States)

    Vandrey, Ryan; Babson, Kimberly A; Herrmann, Evan S; Bonn-Miller, Marcel O

    2014-04-01

    Disordered sleep is associated with a number of adverse health consequences and is an integral component of many psychiatric disorders. Rates of substance use disorders (SUDs) are markedly higher among individuals with post-traumatic stress disorder (PTSD), and this relationship may be partly mediated by disturbed sleep. Sleep disturbances (e.g. insomnia, daytime sleepiness, vivid nightmares) are hallmark features of PTSD and there is evidence that individuals with PTSD engage in substance use as a means of coping with these symptoms. However, prolonged substance use can lead to more severe sleep disturbances due to the development of tolerance and withdrawal. Behavioural or pharmacological treatment of disordered sleep is associated with improved daytime symptoms and psychosocial functioning among individuals who have developed PTSD. Initial research also suggests that improving sleep could be similarly beneficial in reducing coping oriented substance use and preventing relapse among those seeking treatment for SUDs. Together, these findings suggest that ameliorating sleep disturbance among at-risk individuals would be a viable target for the prevention and treatment of PTSD and associated SUDs, but prospective research is needed to examine this hypothesis. Enhanced understanding of the interrelation between sleep, PTSD, and SUDs may yield novel prevention and intervention approaches for these costly, prevalent and frequently co-occurring disorders.

  7. Alcohol Use Disorder History Moderates the Relationship Between Avoidance Coping and Posttraumatic Stress Symptoms

    OpenAIRE

    Hruska, Bryce; Fallon, William; Spoonster, Eileen; Sledjeski, Eve M.; Delahanty, Douglas L.

    2011-01-01

    Avoidance coping (AVC) is common in individuals with posttraumatic stress disorder (PTSD) and in individuals with alcohol use disorder (AUD). Given that PTSD and AUD commonly co-occur, AVC may represent a risk factor for the development of comorbid post-traumatic stress and alcohol use. In this study, the relationship between AVC and PTSD symptoms (PTSS) was examined in individuals with versus without AUDs. Motor vehicle accident (MVA) victims were assessed 6-weeks post accident for AUD histo...

  8. Major depressive disorder, panic disorder, and post-traumatic stress disorder in Korean subway drivers.

    Science.gov (United States)

    Kim, Hyoung-Ryoul; Yim, Hyeon Woo; Jo, Sun-Jin; Choi, Bongkyoo; Jeong, Seung Hee; Lee, Kang Sook; Park, Jong-Ik; Chang, Sung Man

    2013-05-01

    The purposes of this study are to investigate the prevalence of major depressive disorder, panic disorder, and post-traumatic stress disorder (PTSD) in Korean subway drivers, and find the association between these disorders and the drivers' person-under-train (PUT) experiences. A total of 826 subway drivers who participated in a cross-sectional work and health survey were included for this study. The Korean version of the Composite International Diagnostic Interview 2.1 was applied to assess major depressive disorder, panic disorder, and PTSD. The date of PUT, whether victim died, and how many PUTs the drivers experienced were asked using a structured questionnaire. The standardized prevalence ratios (SPRs) for lifetime prevalence of panic disorder and PTSD in subway drivers were 13.3 (95 % confidence interval [CI] 6.6-22.4) and 2.1 (95 % CI 1.1-3.4), respectively. In lifetime prevalence, after adjusting for age, education, income, and working career, the drivers who experienced PUT had significantly higher risks for panic disorder (odds ratio [OR] = 4.2, 95 % CI 1.2-16.6) and PTSD (OR = 4.4, 95 % CI 1.3-16.4). In 1-year prevalence, the drivers who experienced PUT had a significantly higher risk for PTSD (OR = 11.7, 95 % CI 1.9-225.8). There was no significant value of SPR and OR in major depressive disorder. This study suggests that Korean subway drivers are at higher risk for panic disorder and PTSD compared to the general population, and PUT experience is associated with panic disorder and PTSD. Drivers who have experienced PUT should be treated quickly, sympathetically, and sensitively by a psychological professional and their colleagues, so they can return to work soon.

  9. ICD-11 Prevalence Rates of Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in a German Nationwide Sample.

    Science.gov (United States)

    Maercker, Andreas; Hecker, Tobias; Augsburger, Mareike; Kliem, Sören

    2018-04-01

    Prevalence rates are still lacking for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) diagnoses based on the new ICD-11 criteria. In a nationwide representative German sample (N = 2524; 14-99 years), exposure to traumatic events and symptoms of PTSD or CPTSD were assessed with the International Trauma Questionnaire. A clinical variant of CPTSD with a lower threshold for core PTSD symptoms was also calculated, in addition to conditional prevalence rates dependent on trauma type and differential predictors. One-month prevalence rates were as follows: PTSD, 1.5%; CPTSD, 0.5%; and CPTSD variant, 0.7%. For PTSD, the highest conditional prevalence was associated with kidnapping or rape, and the highest CPTSD rates were associated with sexual childhood abuse or rape. PTSD and CPTSD were best differentiated by sexual violence. Combined PTSD and CPTSD (ICD-11) rates were in the range of previously reported prevalences for unified PTSD (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; ICD-10). Evidence on differential predictors of PTSD and CPTSD is still preliminary.

  10. Mother-Infant Attachment and the Intergenerational Transmission of Posttraumatic Stress Disorder

    OpenAIRE

    Enlow, Michelle Bosquet; Egeland, Byron; Carlson, Elizabeth; Blood, Emily; Wright, Rosalind J.

    2013-01-01

    Evidence for the intergenerational transmission of posttraumatic stress disorder (PTSD) is documented in the literature, though the underlying mechanisms are poorly understood. Attachment theory provides a framework for elucidating the ways in which maternal PTSD may increase offspring PTSD vulnerability. The current study utilized two independent prospective datasets to test the hypotheses that (a) maternal PTSD increases the probability of developing an insecure mother-infant attachment rel...

  11. Genetics of Post-Traumatic Stress Disorder: Informing Clinical Conceptualizations and Promoting Future Research

    Science.gov (United States)

    Nugent, Nicole R.; Amstadter, Ananda B.; Koenen, Karestan C.

    2009-01-01

    The purpose of this article is to provide an overview of genetic research involving post-traumatic stress disorder (PTSD). First, we summarize evidence for genetic influences on PTSD from family investigations. Second, we discuss the distinct contributions to our understanding of the genetics of PTSD permitted by twin studies. Finally, we summarize findings from molecular genetic studies, which have the potential to inform our understanding of underlying biological mechanisms for the development of PTSD. PMID:18412098

  12. Biological Studies of Posttraumatic Stress Disorder

    Science.gov (United States)

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

    2016-01-01

    Preface Posttraumatic stress disorder (PTSD) is the only major mental disorder for which a cause is considered to be known, viz., an event that involves threat to the physical integrity of oneself or others and induces a response of intense fear, helplessness, or horror. Although PTSD is still largely regarded as a psychological phenomenon, over the past three decades the growth of the biological PTSD literature has been explosive, and thousands of references now exist. Ultimately, the impact of an environmental event, such as a psychological trauma, must be understood at organic, cellular, and molecular levels. The present review attempts to present the current state of this understanding, based upon psychophysiological, structural and functional neuroimaging, endocrinological, genetic, and molecular biological studies in humans and in animal models. PMID:23047775

  13. 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...

  14. Post-traumatic Stress Disorder and Cardiovascular Disease.

    Science.gov (United States)

    Burg, Matthew M; Soufer, Robert

    2016-10-01

    Post-traumatic stress disorder (PTSD) is a disabling condition that develops consequent to trauma exposure such as natural disasters, sexual assault, automobile accidents, and combat that independently increases risk for early incident cardiovascular disease (CVD) and cardiovascular (CV) mortality by over 50 % and incident hypertension risk by over 30 %. While the majority of research on PTSD and CVD has concerned initially healthy civilian and military veteran samples, emerging research is also demonstrating that PTSD consequent to the trauma of an acute cardiac event significantly increases risk for early recurrence and mortality and that patient experiences in the clinical pathway that are related to the emergency department environment may provide an opportunity to prevent PTSD onset and thus improve outcomes. Future directions for clinical and implementation science concern broad PTSD and trauma screening in the context of primary care medical environments and the testing of PTSD treatments with CVD-related surrogates and endpoints.

  15. Post traumatic stress disorder and the forensic radiographer

    International Nuclear Information System (INIS)

    Glaysher, E.; Vallis, J.; Reeves, P.

    2016-01-01

    The term post traumatic stress disorder (PTSD) is used to describe the psychological issues resulting from any traumatic event. An individual's ability to function is impaired by experiencing emotional responses to a traumatic event. Forensic radiographers need to be aware of the potential debilitating effects of this condition and those writing forensic protocols must take the condition into account and build in safeguards and welfare strategies. This narrative review looks at the origins of the term PTSD and highlights those who may be at increased risk of developing the condition including, in particular, forensic radiographers involved in mass fatality work. Signs, symptoms and possible treatments are also reviewed. - Highlights: • Presents a summary of PTSD for those working in forensic radiography. • Outlines signs & symptoms of PTSD. • Discusses treatment & prognosis of PTSD. • Suggests ways of managing factors which may predispose to PTSD.

  16. Body piercings and posttraumatic stress disorder symptoms in young adults.

    Science.gov (United States)

    Bui, Eric; Rodgers, Rachel; Simon, Naomi M; Jehel, Louis; Metcalf, Christina A; Birmes, Philippe; Schmitt, Laurent

    2013-02-01

    Body piercing, which is prevalent in young adults, has been suggested to be associated with features usually related to posttraumatic stress disorder (PTSD) such as high-risk behaviours and psychopathological symptoms and might be motivated by a wish to deal with prior traumatic experiences. However, to date, no research has investigated the relationship between this practice and PTSD symptoms. The present research aims to investigate the possible relationship between body piercing and PTSD symptoms in French-speaking young adults. According to our results, having two or more body piercings was associated with a twofold increased risk for scoring above the cut-off score for PTSD on the PTSD checklist. Our findings suggest that two or more body piercings might serve as an identifiable marker for PTSD symptoms and may have important implications for clinical screening. Copyright © 2012 John Wiley & Sons, Ltd.

  17. Personality predictors of injury-related posttraumatic stress disorder.

    Science.gov (United States)

    Fauerbach, J A; Lawrence, J W; Schmidt, C W; Munster, A M; Costa, P T

    2000-08-01

    This longitudinal, cohort study examined the effect of personality traits on the emergence of posttraumatic stress disorder (PTSD) in a recently traumatized, civilian, mixed-gender sample with significant injuries. Burn survivors (N = 70) were administered the NEO-Personality Inventory (NEO-PI) and the Structured Clinical Interview for DSM III-R (SCID) at hospital discharge and readministered the SCID 4 and 12 months later. Overall, the sample of burn survivors scored significantly higher on neuroticism and extraversion and lower on openness, agreeableness, and conscientiousness relative to a normative national sample. Furthermore, multivariate analysis of variance revealed that PTSD symptom severity groups (i.e., single symptom, multiple symptoms, subthreshold PTSD, PTSD) were differentially related to neuroticism and extraversion. Planned comparisons indicated that neuroticism was higher and extraversion was lower in those who developed PTSD compared with those who did not develop PTSD.

  18. Hair cortisol concentrations and cortisol stress reactivity predict PTSD symptom increase after trauma exposure during military deployment.

    Science.gov (United States)

    Steudte-Schmiedgen, Susann; Stalder, Tobias; Schönfeld, Sabine; Wittchen, Hans-Ulrich; Trautmann, Sebastian; Alexander, Nina; Miller, Robert; Kirschbaum, Clemens

    2015-09-01

    Previous evidence on endocrine risk markers for posttraumatic stress disorder (PTSD) has been inconclusive. Here, we report results of the first prospective study to investigate whether long-term hair cortisol levels and experimentally-induced cortisol stress reactivity are predictive of the development of PTSD symptomatology in response to trauma during military deployment. Male soldiers were examined before deployment to Afghanistan and at a 12-month post-deployment follow-up using dimensional measures for psychopathological symptoms. The predictive value of baseline (i) hair cortisol concentrations (HCC, N=90) and (ii) salivary cortisol stress reactivity (measured by the Trier Social Stress Test, N=80) for the development of PTSD symptomatology after being exposed to new-onset traumatic events was analyzed. Baseline cortisol activity significantly predicted PTSD symptom change from baseline to follow-up upon trauma exposure. Specifically, our results consistently revealed that lower HCC and lower cortisol stress reactivity were predictive of a greater increase in PTSD symptomatology in soldiers who had experienced new-onset traumatic events (explaining 5% and 10.3% of variance, respectively). Longitudinal analyses revealed an increase in HCC from baseline to follow-up and a trend for a negative relationship between HCC changes and the number of new-onset traumatic events. Additional pre-deployment analyses revealed that trauma history was reflected in lower HCC (at trend level) and that HCC were negatively related to stressful load. Our data indicate that attenuated cortisol secretion is a risk marker for subsequent development of PTSD symptomatology upon trauma exposure. Future studies are needed to confirm our findings in other samples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  19. Sleep Disorders in Patients with Post-Traumatic Stress Disorder.

    Science.gov (United States)

    El-Solh, Ali A; Riaz, Usman; Roberts, Jasmine

    2018-04-20

    A growing body of evidence supports a bidirectional relationship between post-traumatic stress disorder (PTSD) and sleep disturbances. Fragmented sleep induced by sleep-related breathing disorders, insomnia, and nightmares impacts recovery and treatment outcomes and worsens PTSD symptoms. Despite recent attention, management of these disorders has been unrewarding in the setting of PTSD. This review summarizes the evidence for empirically supported treatments of these sleep ailments as it relates to PTSD including psychotherapeutic and pharmacologic interventions. Recent advances in positive airway pressure technology have made treatment of OSA more acceptable however adherence to CPAP represents a significant challenge. The presence of concomitant insomnia, which engenders psychiatric and medical conditions including depression, suicide, alcohol and substance abuse, can be managed with cognitive behavioral therapy (CBT). Hypnotic agents are considered an alternative therapy but concerns about adverse events and lack of high level evidence supporting their efficacy in PTSD have limited their use to resistant cases or as adjunct to behavioral therapy when the response is less than desirable. Intrusion of nightmares can complicate PTSD treatment and exert serious strain on social, occupational and marital relations. Image rehearsal therapy has shown significant reduction in nightmares intensity and frequency. The success of noradrenergic blocking agents has not been consistent among studies with half reporting treatment failure. An integrated stepped care approach that includes components of both behavioral and pharmacologic interventions customized to patients sleep maladaptive behaviors may offer a solution to delivering accessible, effective, and efficient services for individuals with PTSD. Copyright © 2018. Published by Elsevier Inc.

  20. A Randomized Controlled Trial for Veterans with PTSD and Substance Use Disorder: Creating Change versus Seeking Safety.

    Science.gov (United States)

    Najavits, Lisa M; Krinsley, Karen; Waring, Molly E; Gallagher, Matthew W; Skidmore, Christopher

    2018-02-20

    Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) co-occur in military veterans and other populations. To conduct a randomized controlled trial to compare a new past-focused treatment (Creating Change; CC), to a well-established, evidence-based present-focused treatment for PTSD/SUD (Seeking Safety; SS), on symptoms of both disorders. CC guides patients to process the past through exploration of PTSD/SUD life themes and memories whereas SS focuses on coping skills in the present. Fifty-two male and female veterans with current PTSD/SUD were randomized (n = 26 per treatment) and assessed at baseline, end-of-treatment and 3-month follow-up. They received 17 individual one-hour sessions. Intent-to-treat analyses indicated that both conditions improved over time, with no difference between conditions, on PTSD, alcohol use, and drug use (our primary outcomes) as well as mental health symptoms, quality of life, self-efficacy, and SUD cognitions. Effect sizes were medium except for alcohol use, which was large. Change over time reflected improvement from baseline to end-of-treatment, with gains sustained at follow-up, although alcohol use showed continued improvement from end-of-treatment to follow-up. Both treatments evidenced a strong safety profile; and attendance, alliance, and treatment satisfaction were also very strong. Conclusions/importance: CC has promise as a PTSD/SUD therapy with strong public health relevance and the potential to fill important gaps in the field. We used minimal exclusionary criteria to obtain a real-world sample, which was severe-predominantly substance-dependent with chronic PTSD and additional psychiatric diagnoses. Future research is warranted, especially on nonveteran samples and treatment mechanisms of action.

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

    Directory of Open Access Journals (Sweden)

    Janine D. Flory

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Carmassi C

    2016-02-01

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

  3. Comorbidity in illness-induced posttraumatic stress disorder versus posttraumatic stress disorder due to external events in a nationally representative study.

    Science.gov (United States)

    Sommer, Jordana L; Mota, Natalie; Edmondson, Donald; El-Gabalawy, Renée

    2018-05-10

    The current study compared physical and mental health characteristics and quality of life of illness-induced posttraumatic stress disorder (PTSD) versus those with PTSD due to external traumatic events in a population-based sample. PTSD was assessed with the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS-5) using DSM-5 criteria in the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions. Participants with past-year PTSD (n = 1779) were categorized into two groups: illness-induced (6.5%) and other trauma-induced PTSD (92.9%) based on index trauma. Group differences in physical health, mental health, and quality of life were estimated using multiple logistic and linear regressions with adjustment for demographics and medical morbidity. Compared to PTSD due to external events, illness-induced PTSD had higher rates of life-threatening illness in the past year. Illness-induced PTSD compared to PTSD due to external events was associated with reduced odds of depressive/bipolar disorders and antisocial personality disorder, but increased odds of cannabis use disorder. The groups did not differ on quality of life after accounting for medical morbidity. Illness-induced PTSD is common among American adults and has a similar impact on quality of life as PTSD due to external events, but may have distinct mental health correlates. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Validating the Primary Care Posttraumatic Stress Disorder Screen and the Posttraumatic Stress Disorder Checklist with Soldiers Returning from Combat

    Science.gov (United States)

    Bliese, Paul D.; Wright, Kathleen M.; Adler, Amy B.; Cabrera, Oscar; Castro, Carl A.; Hoge, Charles W.

    2008-01-01

    The purpose of the research was to assess the diagnostic efficiency of the Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) and the Posttraumatic Stress Disorder Checklist (PCL) as clinical screening tools for active duty soldiers recently returned from a combat deployment. A secondary goal was to examine the item-level characteristics…

  5. Traumatic dissociation as a predictor of posttraumatic stress disorder in South African female rape survivors.

    Science.gov (United States)

    Nöthling, Jani; Lammers, Kees; Martin, Lindi; Seedat, Soraya

    2015-04-01

    Women survivors of rape are at an increased risk for posttraumatic stress disorder (PTSD). Traumatic dissociation has been identified as a precursor of PTSD. This study assessed the predictive potential of traumatic dissociation in PTSD and depression development.The study followed a longitudinal, prospective design. Ninety-seven female rape survivors were recruited from 2 clinics in Cape Town, South Africa. Clinical interviews and symptom status assessments of the participants were completed to measure dissociation, childhood traumas, resilience, depression, and PTSD.Traumatic dissociation was a significant predictor of PTSD and depression. The linear combination of prior dissociation, current dissociation, and resilience significantly explained 20.7% of the variance in PTSD. Dissociation mediated the relationship between resilience and PTSD.As traumatic dissociation significantly predicts PTSD, its early identification and management may reduce the risk of developing PTSD. Interventions focused on promoting resilience may also be successful in reducing the risk of dissociation following rape.

  6. Traumatic Dissociation as a Predictor of Posttraumatic Stress Disorder in South African Female Rape Survivors

    Science.gov (United States)

    Nöthling, Jani; Lammers, Kees; Martin, Lindi; Seedat, Soraya

    2015-01-01

    Abstract Women survivors of rape are at an increased risk for posttraumatic stress disorder (PTSD). Traumatic dissociation has been identified as a precursor of PTSD. This study assessed the predictive potential of traumatic dissociation in PTSD and depression development. The study followed a longitudinal, prospective design. Ninety-seven female rape survivors were recruited from 2 clinics in Cape Town, South Africa. Clinical interviews and symptom status assessments of the participants were completed to measure dissociation, childhood traumas, resilience, depression, and PTSD. Traumatic dissociation was a significant predictor of PTSD and depression. The linear combination of prior dissociation, current dissociation, and resilience significantly explained 20.7% of the variance in PTSD. Dissociation mediated the relationship between resilience and PTSD. As traumatic dissociation significantly predicts PTSD, its early identification and management may reduce the risk of developing PTSD. Interventions focused on promoting resilience may also be successful in reducing the risk of dissociation following rape. PMID:25906104

  7. Post-traumatic stress disorder, social anxiety disorder, and depression in survivors of the Kosovo War: experiential avoidance as a contributor to distress and quality of life

    NARCIS (Netherlands)

    Kashdan, T.B.; Morina, N.; Priebe, S.

    2009-01-01

    Few studies have been conducted on psychological disorders other than post-traumatic stress disorder (PTSD) in war survivors. The aim of this study was to examine PTSD, social anxiety disorder (SAD), and major depressive disorder (MDD) and their associations with distress and quality of life in 174

  8. Post traumatic stress disorder: undiagnosed cases in a tertiary ...

    African Journals Online (AJOL)

    Objective: Post traumatic stress disorder (PTSD) is a common, debilitating anxiety disorder characterized by emotional and physical symptoms that may occur after exposure to a severely traumatic event. Since it occurs commonly as a comorbid diagnosis with other mood- and anxiety disorders, we postulated that this ...

  9. 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.

  10. Feature: Post Traumatic Stres Disorder PTSD: NIH Research to Results

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Feature PTSD NIH Research to Results Past Issues / Winter 2009 ... be a key to a better understanding of PTSD and early identification of those at risk. Early ...

  11. Complex PTSD as proposed for ICD-11: validation of a new disorder in children and adolescents and their response to Trauma-Focused Cognitive Behavioral Therapy.

    Science.gov (United States)

    Sachser, Cedric; Keller, Ferdinand; Goldbeck, Lutz

    2017-02-01

    To evaluate whether the symptoms of children and adolescents with clinically significant posttraumatic stress symptoms (PTSS) form classes consistent with the diagnostic criteria of complex PTSD (CPTSD) as proposed for the ICD-11, and to relate the emerging classes with treatment outcome of Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). Latent classes analysis (LCA) was used to explore the symptom profiles of the clinical baseline assessment of N = 155 children and adolescents participating in a randomized controlled trial of TF-CBT. The treatment outcomes of patients with posttraumatic stress disorder (PTSD) and of patients with CPTSD were compared by a t-test for depended samples and a repeated-measures ANOVA. The LCA revealed two distinct classes: a PTSD class characterized by elevated core symptoms of PTSD (n = 62) and low symptoms of disturbances in self-organization versus a complex PTSD class with elevated PTSD core symptoms and elevated symptoms of disturbances in self-organization (n = 93). The Group × Time interaction regarding posttraumatic stress symptoms was not significant. Pre-post effect sizes regarding posttraumatic stress symptoms were large for both groups (PTSD: d = 2.81; CPTSD: d = 1.37). For disturbances in self-organization in the CPTSD class, we found medium to large effect sizes (d = 0.40-1.16) after treatment with TF-CBT. The results provide empirical evidence of the ICD-11 CPTSD and PTSD distinction in a clinical sample of children and adolescents. In terms of relative improvement from their respective baseline posttraumatic stress symptoms, patients with PTSD and CPTSD responded equally to TF-CBT; however, those with CPTSD ended treatment with clinically and statistically greater symptoms than those with PTSD. © 2016 Association for Child and Adolescent Mental Health.

  12. Biomarkers for PTSD

    Science.gov (United States)

    2011-07-01

    Intern Med 167, 476-82 (2007). 5 P. B. Watson and B. Daniels, Follow up of post - traumatic stress disorder symptoms in Australian servicemen...for DOD and VA as objective indicators of PTSD for use in post - deployment medical screening, treatment selection, treatment outcome monitoring...mitigating the associations between war zone-related PTSD and physical health problems, including cardiovascular and metabolic disorders 6-10. In

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  14. Beyond war and PTSD: The crucial role of transition stress in the lives of military veterans.

    Science.gov (United States)

    Mobbs, Meaghan C; Bonanno, George A

    2018-02-01

    Although only a relatively small minority of military veterans develop Posttraumatic Stress Disorder (PTSD), mental health theory and research with military veterans has focused primarily on PTSD and its treatment. By contrast, many and by some accounts most veterans experience high levels of stress during the transition to civilian life, however transition stress has received scant attention. In this paper we attempt to address this deficit by reviewing the wider range of challenges, rewards, successes, and failures that transitioning veterans might experience, as well as the factors that might moderate these experiences. To illuminate this argument, we briefly consider what it means to become a soldier (i.e., what is required to transition into military service) and more crucially what kind of stressors veterans might experience when they attempt to shed that identity (i.e., what is required to transition out of military service). We end by suggesting how an expanded research program on veteran transition stress might move forward. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Evidence for smaller right amygdala volumes in posttraumatic stress disorder following childhood trauma

    NARCIS (Netherlands)

    Veer, I.M.; Oei, N.Y.L.; van Buchem, M.A.; Spinhoven, Ph.; Elzinga, B.M.; Rombouts, S.A.R.B.

    2015-01-01

    Hippocampus and amygdala volumes in posttraumatic stress disorder (PTSD) related to childhood trauma are relatively understudied, albeit the potential importance to the disorder. Whereas some studies reported smaller hippocampal volumes, little evidence was found for abnormal amygdala volumes. Here

  16. Food addiction as a proxy for eating disorder and obesity severity, trauma history, PTSD symptoms, and comorbidity.

    Science.gov (United States)

    Brewerton, Timothy D

    2017-06-01

    Food addiction (FA) is a newly defined yet still controversial condition that has important etiological, developmental, treatment, prevention, and social policy implications. In this review, the case is made that FA (or high scores on the Yale Food Addiction Scale) may be used as a proxy measure for a matrix of interrelated clinical features, including greater eating disorder severity, greater obesity severity, more severe trauma histories, greater symptoms of posttraumatic stress disorder (PTSD), greater psychiatric comorbidity, as well as greater medical morbidity and mortality. A Medline search was undertaken using the following terms: food addiction cross-referenced with eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and binge eating), obesity, trauma, posttraumatic stress disorder, and comorbidity. The thesis is that the identification and acknowledgment of the concept of FA, when integrated into an overall, trauma-focused and transdiagnostic treatment approach, are supported and can be useful in understanding clinically the "big picture." Food addiction (FA) may be used as a proxy for (1) bulimic eating disorder severity, (2) complex trauma histories, (3) severity of PTSD and PTSD symptoms, (4) intensity of psychiatric comorbidity, (5) severity of obesity, as well as (6) their combination. Implications for developing treatment strategies are discussed. The case for a comprehensive management that requires careful attention to medical and psychiatric assessment and integrated care that incorporates trauma-focused treatment is made.

  17. Conduct disorder, war zone stress, and war-related posttraumatic stress disorder symptoms in American Indian Vietnam veterans.

    Science.gov (United States)

    Dillard, Denise; Jacobsen, Clemma; Ramsey, Scott; Manson, Spero

    2007-02-01

    This study examined whether conduct disorder (CD) was associated with war zone stress and war-related post-traumatic stress disorder (PTSD) symptoms in American Indian (AI) Vietnam veterans. Cross-sectional lay-interview data was analyzed for 591 male participants from the American Indian Vietnam Veterans Project. Logistic regression evaluated the association of CD with odds of high war zone stress and linear regression evaluated the association of CD and PTSD symptom severity. Childhood CD was not associated with increased odds of high war zone stress. Conduct disorder was associated with elevated war-related PTSD symptoms among male AI Vietnam Veterans independent of war zone stress level and other mediators. Future efforts should examine reasons for this association and if the association exists in other AI populations.

  18. The prevalence of common mental disorders and PTSD in the UK military: using data from a clinical interview-based study

    Directory of Open Access Journals (Sweden)

    Hotopf Matthew

    2009-10-01

    Full Text Available Abstract Background The mental health of the Armed Forces is an important issue of both academic and public interest. The aims of this study are to: a assess the prevalence and risk factors for common mental disorders and post traumatic stress disorder (PTSD symptoms, during the main fighting period of the Iraq War (TELIC 1 and later deployments to Iraq or elsewhere and enlistment status (regular or reserve, and b compare the prevalence of depression, PTSD symptoms and suicidal ideation in regular and reserve UK Army personnel who deployed to Iraq with their US counterparts. Methods Participants were drawn from a large UK military health study using a standard two phase survey technique stratified by deployment status and engagement type. Participants undertook a structured telephone interview including the Patient Health Questionnaire (PHQ and a short measure of PTSD (Primary Care PTSD, PC-PTSD. The response rate was 76% (821 participants. Results The weighted prevalence of common mental disorders and PTSD symptoms was 27.2% and 4.8%, respectively. The most common diagnoses were alcohol abuse (18.0% and neurotic disorders (13.5%. There was no health effect of deploying for regular personnel, but an increased risk of PTSD for reservists who deployed to Iraq and other recent deployments compared to reservists who did not deploy. The prevalence of depression, PTSD symptoms and subjective poor health were similar between regular US and UK Iraq combatants. Conclusion The most common mental disorders in the UK military are alcohol abuse and neurotic disorders. The prevalence of PTSD symptoms remains low in the UK military, but reservists are at greater risk of psychiatric injury than regular personnel.

  19. Sleep diaries of Vietnam War veterans with chronic PTSD: the relationships among insomnia symptoms, psychosocial stress, and nightmares.

    Science.gov (United States)

    Gehrman, Philip R; Harb, Gerlinde C; Cook, Joan M; Barilla, Holly; Ross, Richard J

    2015-01-01

    Impaired sleep and nightmares are known symptoms of posttraumatic stress disorder (PTSD) in the veteran population. In order to assess prospectively the sleep disturbances in this population, sleep diaries are an effective way to obtain information over an extended period of time. In this investigation, a sample of veterans (N = 105) completed daily sleep diaries for a 6-week period. Greater PTSD severity and nightmare-related distress were correlated with more awakenings, shorter duration of sleep, longer sleep latency, and greater frequency of nightmares. Perceived frequency of daytime stressors was associated with an increased number of nightmares, nightmare-related distress, and longer sleep latency. The use of sleep diaries in future investigations may allow targeted treatments for veteran populations with PTSD and sleep disturbances.

  20. Why clinicians do not implement integrated treatment for comorbid substance use disorder and posttraumatic stress disorder: a qualitative study

    Directory of Open Access Journals (Sweden)

    Nele Gielen

    2014-02-01

    Full Text Available Background: Healthcare providers working in addiction facilities do not often implement integrated treatment of comorbid substance use disorder (SUD and posttraumatic stress disorder (PTSD while there is empirical evidence to do so. Objective: This study aims to get insight into the views of clinicians with regard to the diagnosis and treatment of PTSD in SUD patients. Method: A qualitative research method was chosen. Fourteen treatment staff members of different wards of an addiction care facility were interviewed by an independent interviewer. Results: Despite acknowledging adverse consequences of trauma exposure on SUD, severe underdiagnosis of PTSD was mentioned and treatment of PTSD during SUD treatment was not supported. Obstacles related to the underestimation of PTSD among SUD patients and to the perceptions of SUD clinicians concerning the treatment of comorbid SUD/PTSD were reported. Conclusions: It is concluded that SUD facilities should train their clinicians to enable them to provide for integrated treatment of SUD/PTSD.

  1. 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

  2. Intergenerational transmission of post-traumatic stress disorder in Australian Vietnam veterans' families.

    Science.gov (United States)

    O'Toole, B I; Burton, M J; Rothwell, A; Outram, S; Dadds, M; Catts, S V

    2017-05-01

    To assess the association between parental post-traumatic stress disorder (PTSD) and offspring PTSD and its specificity for other disorders in a non-clinical epidemiological cohort of Australian Vietnam veterans, their partners and their sons and daughters. Veterans were interviewed twice, in 1992-1994 and 2005-2006; partners were interviewed in 2006-2007, and their offspring in 2012-2014. A total of 125 sons and 168 daughters were interviewed from 197 families, 137 of which also included partners who were the mothers of the children. Statistical analysis used multi-level modelling to compute odds ratios and 95% confidence intervals while controlling for clustering effects within families. Parent PTSD diagnoses were examined for associations with offspring trauma exposure, PTSD and other psychiatric diagnoses. Veteran PTSD increased the risk of PTSD and no other disorder in both sons and daughters; partner PTSD did not. Veteran depression was also a risk factor for sons' PTSD, and alcohol disorder was linked to alcohol dependence in sons and PTSD in daughters, but not when controlling for veteran PTSD. We conclude that PTSD in a Vietnam veteran father increases the risk specifically for PTSD in his sons and daughters. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. 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…

  4. The role of early pharmacotherapy in the development of posttraumatic stress disorder symptoms after traumatic injury : an observational cohort study in consecutive patients

    NARCIS (Netherlands)

    Mouthaan, Joanne; Sijbrandij, Marit; Reitsma, Johannes B; Luitse, Jan S K; Goslings, J Carel; Gersons, Berthold P R; Olff, Miranda

    OBJECTIVE: Pharmacological intervention during traumatic memory consolidation has been suggested to prevent posttraumatic stress disorder (PTSD). The aim of this study was to examine the association between prescription of early pharmacotherapy and the risk of developing PTSD symptoms following

  5. The role of early pharmacotherapy in the development of posttraumatic stress disorder symptoms after traumatic injury: an observational cohort study in consecutive patients

    NARCIS (Netherlands)

    Mouthaan, Joanne; Sijbrandij, Marit; Reitsma, Johannes B.; Luitse, Jan S. K.; Goslings, J. Carel; Gersons, Berthold P. R.; Olff, Miranda

    2015-01-01

    Pharmacological intervention during traumatic memory consolidation has been suggested to prevent posttraumatic stress disorder (PTSD). The aim of this study was to examine the association between prescription of early pharmacotherapy and the risk of developing PTSD symptoms following traumatic

  6. Mindfulness-Based Stress Reduction for Low-Income, Predominantly African American Women with PTSD and a History of Intimate Partner Violence

    Science.gov (United States)

    Dutton, Mary Ann; Bermudez, Diana; Matas, Armely; Majid, Haseeb; Myers, Neely L.

    2013-01-01

    In this article, we consider the use of Mindfulness-Based Stress Reduction (MBSR; Kabat-Zinn, 1991) as a community-based intervention for posttraumatic stress disorder (PTSD) among low-income, predominantly African American women with a history of intimate partner violence (IPV). The results of a pilot randomized clinical trial (RCT) of MBSR as an…

  7. Decreased Somatosensory Activity to Non-threatening Touch in Combat Veterans with Posttraumatic Stress Disorder

    OpenAIRE

    Badura-Brack, Amy S.; Becker, Katherine M.; McDermott, Timothy J.; Ryan, Tara J.; Becker, Madelyn M.; Hearley, Allison R.; Heinrichs-Graham, Elizabeth; Wilson, Tony W.

    2015-01-01

    Posttraumatic stress disorder (PTSD) is a severe psychiatric disorder prevalent in combat veterans. Previous neuroimaging studies have demonstrated that patients with PTSD exhibit abnormal responses to non-threatening visual and auditory stimuli, but have not examined somatosensory processing. Thirty male combat veterans, 16 with PTSD and 14 without, completed a tactile stimulation task during a 306-sensor magnetoencephalography (MEG) recording. Significant oscillatory neural responses were i...

  8. Construct Validity of the Posttraumatic Stress Disorder Checklist in Cancer Survivors: Analyses Based on Two Samples

    Science.gov (United States)

    DuHamel, Katherine N.; Ostrof, Jamie; Ashman, Teresa; Winkel, Gary; Mundy, Elizabeth A.; Keane, Terence M.; Morasco, Benjamin J.; Vickberg, Suzanne M. J.; Hurley, Karen; Chhabra, Rosy; Scigliano, Eileen; Papadopoulos, Esperanza; Moskowitz, Craig; Redd, William

    2004-01-01

    The measurement of posttraumatic stress disorder (PTSD) is critically important for the identification and treatment of this disorder. The PTSD Checklist (PCL; F. W. Weathers & J. Ford, 1996) is a self-report measure that is increasingly used. In this study, the authors investigated the factorial validity of the PCL with data from 236 cancer…

  9. Victimization, Posttraumatic Stress Disorder Symptomatology, and Later Nonsuicidal Self-Harm in a Birth Cohort

    Science.gov (United States)

    Nada-Raja, Shyamala; Skegg, Keren

    2011-01-01

    This longitudinal population-based study examined pathways to nonsuicidal self-harm (NSSH) in relation to childhood sexual abuse (CSA), assault victimization in early adulthood, posttraumatic stress disorder symptomatology (PTSD), and other mental disorders. At age 21, 476 men and 455 women completed interviews on assault victimization, PTSD, and…

  10. Prevalence and predictors of stress disorders following two earthquakes.

    Science.gov (United States)

    Yuan, Kang Chuan; Ruo Yao, Zhao; Zhen Yu, Shi; Xu Dong, Zhao; Jian Zhong, Yang; Edwards, Jason Glen; Edwards, Glen David

    2013-09-01

    Studies about stress disorders following a disaster have mainly been based on single-event trauma with little emphasis on multiple traumas. This study investigated the prevalence and predictors of stress disorders following two earthquakes in China. Subjects were randomly sampled from 11 villages in rural China. A total of 624 subjects were administered with the 12-item General Health Questionnaire (GHQ-12), Symptom Checklist -90-R (SCL-90-R), Coping Style Scale and Social Support Rating Scale. This was followed by a structural clinical interview using the Chinese translation of the Structured Clinical Interview for Diagnostic and Statistical Manual (DSM)-IV-TR axis 1 disorders (SCID-I-P) for acute stress disorder (ASD) and post-traumatic stress disorder (PTSD). The prevalence of ASD and PTSD was 15% and 29%, respectively. Regression analysis indicated that high intensity of trauma exposure, lower educational level, subjective feeling of economic status and psychological stress after the first earthquake significantly predicted the outcome of PTSD. The study suggested that the prevalence of stress disorders in two earthquakes were higher than that experienced in a single disaster. The intensity of trauma exposure, low educational level, bad subjective feeling of economic status, and psychological stress after the first earthquake could be used to identify survivors at risk of developing PTSD in two earthquakes.

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  12. Stress and PTSD Mechanisms as Targets for Pharmacotherapy of Alcohol Abuse, Addiction and Relapse

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-13-1-0126 TITLE: Stress and PTSD Mechanisms as Targets for Pharmacotherapy of Alcohol Abuse, Addiction and Relapse PRINCIPAL...10/27/2017 2. REPORT TYPE Annual 3. DATES COVERED 30 Sep 2016 — 29 Sep 2017 4. TITLE AND SUBTITLE Stress and PTSD Mechanisms as Targets for...insights into mechanism; (2) suppression of noradrenergic signaling decreases alcohol drinking in rats with a history of traumatic stress , but not in

  13. The Role of Generalized Explicit and Implicit Guilt and Shame in Interpersonal Traumatization and Posttraumatic Stress Disorder.

    Science.gov (United States)

    Bockers, Estelle; Roepke, Stefan; Michael, Lars; Renneberg, Babette; Knaevelsrud, Christine

    2016-02-01

    Posttraumatic stress disorder (PTSD) and interpersonal traumatization are frequently associated with trauma-related guilt and shame. However, research on generalized guilt and shame in PTSD is lacking. The aim of this study was to investigate generalized explicit and implicit guilt and shame in interpersonal traumatization and PTSD. Interpersonally traumatized women either with PTSD (n = 28) or without PTSD (n = 32) and 32 nontraumatized women completed the Test of Self-Conscious Affect-3 and the Implicit Association Test to measure explicit and implicit guilt and shame. Explicit guilt and shame were significantly higher in women with PTSD than in traumatized women without PTSD. Traumatized women without PTSD showed significantly higher levels of explicit guilt and shame than nontraumatized women did. PTSD was associated with implicit guilt but not implicit shame. In addition to trauma-related guilt and shame, generalized explicit guilt and shame and implicit guilt seem to play a crucial role in PTSD.

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

    Science.gov (United States)

    Gupta, Madhulika A

    2013-02-01

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

  15. The Influence of Posttraumatic Stress Disorder on Treatment Outcomes of Patients With Borderline Personality Disorder.

    Science.gov (United States)

    Boritz, Tali; Barnhart, Ryan; McMain, Shelley F

    2016-06-01

    The aim of this study was to determine the influence of posttraumatic stress disorder (PTSD) on treatment outcomes in patients with borderline personality disorder (BPD). Participants were 180 individuals diagnosed with BPD enrolled in a randomized controlled trial that compared the clinical and cost effectiveness of dialectical behavior therapy (DBT) and general psychiatric management (GPM). Multilevel linear models and generalized linear models were used to compare clinical outcomes of BPD patients with and without PTSD. BPD patients with comorbid PTSD reported significantly higher levels of global psychological distress at baseline and end of treatment compared to their non-PTSD counterparts. Both groups evidenced comparable rates of change on suicide attempts and non-suicidal self-injury (NSSI), global psychological distress, and BPD symptoms over the course of treatment and post-treatment follow-up. DBT and GPM were effective for BPD patients with and without PTSD across a broad range of outcomes.

  16. Locus of control among spinal cord injury patients with different levels of posttraumatic stress disorder.

    Science.gov (United States)

    Chung, Man Cheung; Preveza, Eleni; Papandreou, Konstantinos; Prevezas, Nikolaos

    2007-08-30

    Two hypotheses were investigated in the present study: 1) Patients with full posttraumatic stress symptoms following spinal cord injury (SCI) would experience more general health problems than those with partial posttraumatic stress disorder (PTSD), with no-PTSD and the control group; 2) Patients with full PTSD would endorse the external locus of control more than those with partial PTSD, no-PTSD and the control group. Sixty-two patients were recruited from a specialized rehabilitation clinic for spinal cord injury. The control group comprised 60 participants without SCI. Patients with SCI were assessed using the Posttraumatic Stress Disorder Checklist, the General Health Questionnaire-28 (GHQ-28) and the Multidimensional Health Locus of Control (MHLC). The control group was assessed using the GHQ-28 and the MHLC. The full PTSD group experienced more somatic problems, anxiety, social dysfunction and depression than the partial PTSD, the no-PTSD and the control groups. The results also showed that the full PTSD group endorsed significantly more external health locus of control than the control group. However, no significant differences were found between the three patient groups in health locus of control. The three PTSD sub-scales were positively correlated with general health problems. Further analyses showed that partial PTSD patients with paraplegia and partial PTSD patients whose SCI had a medically related cause were more likely to report less internal locus of control than other patients. Patients who suffered from full PTSD experienced more general health problems than those with fewer PTSD symptoms and those without SCI. External locus of control was a distinctive strategy that SCI-PTSD patients used in coping with the effects of SCI-PTSD.

  17. The Dissociative Subtype of Post-traumatic Stress Disorder: Research Update on Clinical and Neurobiological Features.

    Science.gov (United States)

    van Huijstee, Jytte; Vermetten, Eric

    2017-10-21

    Recently, a dissociative subtype of post-traumatic stress disorder (PTSD) has been included in the DSM-5. This review focuses on the clinical and neurobiological features that distinguish the dissociative subtype of PTSD from non-dissociative PTSD. Clinically, the dissociative subtype of PTSD is associated with high PTSD severity, predominance of derealization and depersonalization symptoms, a more significant history of early life trauma, and higher levels of comorbid psychiatric disorders. Furthermore, PTSD patients with dissociative symptoms exhibit different psychophysiological and neural responses to the recall of traumatic memories. While individuals with non-dissociative PTSD exhibit an increased heart rate, decreased activation of prefrontal regions, and increased activation of the amygdala in response to traumatic reminders, individuals with the dissociative subtype of PTSD show an opposite pattern. It has been proposed that dissociation is a regulatory strategy to restrain extreme arousal in PTSD through hyperinhibition of limbic regions. In this research update, promises and pitfalls in current research studies on the dissociative subtype of PTSD are listed. Inclusion of the dissociative subtype of PTSD in the DSM-5 stimulates research on the prevalence, symptomatology, and neurobiology of the dissociative subtype of PTSD and poses a challenge to improve treatment outcome in PTSD patients with dissociative symptoms.

  18. Screening for HIV-related PTSD: sensitivity and specificity of the 17-item Posttraumatic Stress Diagnostic Scale (PDS) in identifying HIV-related PTSD among a South African sample.

    Science.gov (United States)

    Martin, L; Fincham, D; Kagee, A

    2009-11-01

    The identification of HIV-positive patients who exhibit criteria for Posttraumatic Stress Disorder (PTSD) and related trauma symptomatology is of clinical importance in the maintenance of their overall wellbeing. This study assessed the sensitivity and specificity of the 17-item Posttraumatic Stress Diagnostic Scale (PDS), a self-report instrument, in the detection of HIV-related PTSD. An adapted version of the PTSD module of the Composite International Diagnostic Interview (CIDI) served as the gold standard. 85 HIV-positive patients diagnosed with HIV within the year preceding data collection were recruited by means of convenience sampling from three HIV clinics within primary health care facilities in the Boland region of South Africa. A significant association was found between the 17-item PDS and the adapted PTSD module of the CIDI. A ROC curve analysis indicated that the 17-item PDS correctly discriminated between PTSD caseness and non-caseness 74.9% of the time. Moreover, a PDS cut-off point of > or = 15 yielded adequate sensitivity (68%) and 1-specificity (65%). The 17-item PDS demonstrated a PPV of 76.0% and a NPV of 56.7%. The 17-item PDS can be used as a brief screening measure for the detection of HIV-related PTSD among HIV-positive patients in South Africa.

  19. Post-Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    ... the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere ... excess drinking or drug use Lacking a good support system of family and ... with a weapon An accident Many other traumatic events also can lead to ...

  20. Post-Traumatic Stress Disorder (PTSD)

    Science.gov (United States)

    ... least a year. The research builds on past animal studies that indicated retrieval or reactivation of an emotional memory opens a window of opportunity in which a training procedure can alter it. Learning not to fear, a process called fear extinction, appears to depend on a specific type of ...

  1. 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 ...

  2. Posttraumatic stress disorder in abused and neglected children grown up.

    Science.gov (United States)

    Widom, C S

    1999-08-01

    The purpose of this study was to describe the extent to which childhood abuse and neglect increase a person's risk for subsequent posttraumatic stress disorder (PTSD) and to determine whether the relationship to PTSD persists despite controls for family, individual, and lifestyle characteristics associated with both childhood victimization and PTSD. Victims of substantiated child abuse and neglect from 1967 to 1971 in a Midwestern metropolitan county area were matched on the basis of age, race, sex, and approximate family socioeconomic class with a group of nonabused and nonneglected children and followed prospectively into young adulthood. Subjects (N = 1,196) were located and administered a 2-hour interview that included the National Institute of Mental Health Diagnostic Interview Schedule to assess PTSD. Childhood victimization was associated with increased risk for lifetime and current PTSD. Slightly more than a third of the childhood victims of sexual abuse (37.5%), 32.7% of those physically abused, and 30.6% of victims of childhood neglect met DSM-III-R criteria for lifetime PTSD. The relationship between childhood victimization and number of PTSD symptoms persisted despite the introduction of covariates associated with risk for both. Victims of child abuse (sexual and physical) and neglect are at increased risk for developing PTSD, but childhood victimization is not a sufficient condition. Family, individual, and lifestyle variables also place individuals at risk and contribute to the symptoms of PTSD.

  3. Relations between anger and DSM-5 posttraumatic stress disorder symptoms.

    Science.gov (United States)

    Durham, Tory A; Byllesby, Brianna M; Armour, Cherie; Forbes, David; Elhai, Jon D

    2016-10-30

    The present study investigated the relationship between posttraumatic stress disorder (PTSD) and anger. Anger co-occurring with PTSD is found to have a severe effect across a wide range of traumatic experiences, making this an important relationship to examine. The present study utilized data regarding dimensions of PTSD symptoms and anger collected from a non-clinical sample of 247 trauma-exposed participants. Confirmatory factor analysis (CFA) was used to determine the underlying factor structure of both PTSD and anger by examining anger in the context of three models of PTSD. Results indicate that a five-factor representation of PTSD and one-factor representation of anger fit the data best. Additionally, anger demonstrated a strong relationship with the dysphoric arousal and negative alterations in cognitions and mood (NACM) factors; and dysphoric arousal was differentially related to anger. Clinical implications include potential need to reevaluate PTSD's diagnostic symptom structure and highlight the potential need to target and treat comorbid anger in individuals with PTSD. In regard to research, these results support the heterogeneity of PTSD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Anger, hostility, and aggression among Iraq and Afghanistan War veterans reporting PTSD and subthreshold PTSD.

    Science.gov (United States)

    Jakupcak, Matthew; Conybeare, Daniel; Phelps, Lori; Hunt, Stephen; Holmes, Hollie A; Felker, Bradford; Klevens, Michele; McFall, Miles E

    2007-12-01

    Iraq and Afghanistan War veterans were grouped by level of posttraumatic stress disorder (PTSD) symptomatology and compared on self-report measures of trait anger, hostility, and aggression. Veterans who screened positive for PTSD reported significantly greater anger and hostility than those in the subthreshold-PTSD and non-PTSD groups. Veterans in the subthreshold-PTSD group reported significantly greater anger and hostility than those in the non-PTSD group. The PTSD and subthreshold-PTSD groups did not differ with respect to aggression, though both groups were significantly more likely to have endorsed aggression than the non-PTSD group. These findings suggest that providers should screen for anger and aggression among Iraq and Afghanistan War veterans who exhibit symptoms of PTSD and incorporate relevant anger treatments into early intervention strategies.

  5. Longitudinal Associations Among Pain, Posttraumatic Stress Disorder Symptoms, and Stress Appraisals.

    Science.gov (United States)

    Vaughan, Christine A; Miles, Jeremy N V; Eisenman, David P; Meredith, Lisa S

    2016-04-01

    Comorbidity of posttraumatic stress disorder (PTSD) and pain is well documented, but the mechanisms underlying their comorbidity are not well understood. Cross-lagged regression models were estimated with 3 waves of longitudinal data to examine the reciprocal associations between PTSD symptom severity, as measured by the Clinician-Administered PTSD Scale (CAPS), and pain, as measured by a brief self-report measure of pain called the PEG (pain intensity [P], interference with enjoyment of life [E], and interference with general activity [G]). We evaluated stress appraisals as a mediator of these associations in a sample of low-income, underserved patients with PTSD (N = 355) at federally qualified health centers in a northeastern metropolitan area. Increases in PTSD symptom severity between baseline and 6-month and 6- and 12-month assessments were independently predicted by higher levels of pain (β = .14 for both lags) and appraisals of life stress as uncontrollable (β = .15 for both lags). Stress appraisals, however, did not mediate these associations, and PTSD symptom severity did not predict change in pain. Thus, the results did not support the role of stress appraisals as a mechanism underlying the associations between pain and PTSD. Copyright © 2016 International Society for Traumatic Stress Studies.

  6. Diagnosing and treating post-traumatic stress disorder

    DEFF Research Database (Denmark)

    Buhmann, Cæcilie Böck; Andersen, Henrik Steen

    2017-01-01

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

  7. Post traumatic stress disorder and resilience in veterans who served ...

    African Journals Online (AJOL)

    current PTSD from 2.2% to 15.2%.5,11,12,13-15 Data from the Gulf and Iraqi Wars, found a PTSD prevalence between 2 and. 12%16-21,22 while combat veterans of the Yom Kippur War of. 1973 in ..... (p.330) The protective role of social support for both prisoners of .... Posttraumatic stress disorder and among U.S. army.

  8. Information Processing Bias in Post-traumatic Stress Disorder

    OpenAIRE

    Weber, Darren L

    2008-01-01

    This review considers theory and evidence for abnormal information processing in post-traumatic stress disorder (PTSD). Cognitive studies have indicated sensitivity in PTSD for traumatic information, more so than general emotional information. These findings were supported by neuroimaging studies that identify increased brain activity during traumatic cognition, especially in affective networks (including the amygdala, orbitofrontal and anterior cingulate cortex). In theory, it is proposed th...

  9. Cognitive processes in post-traumatic stress disorder

    OpenAIRE

    Yıldırımlı, Gamze; Tosun, Ahmet

    2012-01-01

    Post-Traumatic Stress Disorder (PTSD) consists of a pattern of symptoms that include cognitive, affective, sensory and behavioral systems. In PTSD, the individual experiences disturbing emotions and sensations such as anxiety, panic, depression, anger, tension, high startle response and hyper-vigilance as a result of re-experiencing traumatic memories, flashbacks, attention difficulties, memory loss, nightmares and intrusive thoughts. To get rid of these emotions, he avoids all stimuli that r...

  10. Posttraumatic Stress Disorder after Vaginal Delivery at Primiparous Women

    OpenAIRE

    Maja Milosavljevic; Dusica Lecic Tosevski; Ivan Soldatovic; Olivera Vukovic; Cedo Miljevic; Amir Peljto; Milutin Kostic; Miranda Olff

    2016-01-01

    Although severe gynaecological pathology during delivery and negative outcome have been shown to be related with posttraumatic stress disorder (PTSD) little is known about traumatic experiences following regular delivery, at the expected time and with a healthy child. The objective of our study was to determine the prevalence of PTSD during postpartum period after vaginal delivery and its risk factors. The sample included 126 primiparous women. Monthly, for the next three months, the women we...

  11. Management of trauma and PTSD

    African Journals Online (AJOL)

    of post-traumatic stress disorder (PTSD). [1]. In the USA, the National .... Recent work suggests that an alternative approach could .... and the National Institute of Clinical. Excellence ..... American Psychiatric Association. Diagnostic and ...

  12. Posttraumatic stress disorder: a serious post-earthquake complication.

    Science.gov (United States)

    Farooqui, Mudassir; Quadri, Syed A; Suriya, Sajid S; Khan, Muhammad Adnan; Ovais, Muhammad; Sohail, Zohaib; Shoaib, Samra; Tohid, Hassaan; Hassan, Muhammad

    2017-01-01

    Earthquakes are unpredictable and devastating natural disasters. They can cause massive destruction and loss of life and survivors may suffer psychological symptoms of severe intensity. Our goal in this article is to review studies published in the last 20 years to compile what is known about posttraumatic stress disorder (PTSD) occurring after earthquakes. The review also describes other psychiatric complications that can be associated with earthquakes, to provide readers with better overall understanding, and discusses several sociodemographic factors that can be associated with post-earthquake PTSD. A search for literature was conducted on major databases such as MEDLINE, PubMed, EMBASE, and PsycINFO and in neurology and psychiatry journals, and many other medical journals. Terms used for electronic searches included, but were not limited to, posttraumatic stress disorder (PTSD), posttraumatic symptoms, anxiety, depression, major depressive disorder, earthquake, and natural disaster. The relevant information was then utilized to determine the relationships between earthquakes and posttraumatic stress symptoms. It was found that PTSD is the most commonly occurring mental health condition among earthquake survivors. Major depressive disorder, generalized anxiety disorder, obsessive compulsive disorder, social phobia, and specific phobias were also listed. The PTSD prevalence rate varied widely. It was dependent on multiple risk factors in target populations and also on the interval of time that had elapsed between the exposure to the deadly incident and measurement. Females seemed to be the most widely-affected group, while elderly people and young children exhibit considerable psychosocial impact.

  13. Posttraumatic stress disorder: a serious post-earthquake complication

    Directory of Open Access Journals (Sweden)

    Mudassir Farooqui

    Full Text Available Abstract Objectives Earthquakes are unpredictable and devastating natural disasters. They can cause massive destruction and loss of life and survivors may suffer psychological symptoms of severe intensity. Our goal in this article is to review studies published in the last 20 years to compile what is known about posttraumatic stress disorder (PTSD occurring after earthquakes. The review also describes other psychiatric complications that can be associated with earthquakes, to provide readers with better overall understanding, and discusses several sociodemographic factors that can be associated with post-earthquake PTSD Method A search for literature was conducted on major databases such as MEDLINE, PubMed, EMBASE, and PsycINFO and in neurology and psychiatry journals, and many other medical journals. Terms used for electronic searches included, but were not limited to, posttraumatic stress disorder (PTSD, posttraumatic symptoms, anxiety, depression, major depressive disorder, earthquake, and natural disaster. The relevant information was then utilized to determine the relationships between earthquakes and posttraumatic stress symptoms. Results It was found that PTSD is the most commonly occurring mental health condition among earthquake survivors. Major depressive disorder, generalized anxiety disorder, obsessive compulsive disorder, social phobia, and specific phobias were also listed. Conclusion The PTSD prevalence rate varied widely. It was dependent on multiple risk factors in target populations and also on the interval of time that had elapsed between the exposure to the deadly incident and measurement. Females seemed to be the most widely-affected group, while elderly people and young children exhibit considerable psychosocial impact.

  14. Alexithymia and posttraumatic stress disorder following asthma attack.

    Science.gov (United States)

    Chung, Man Cheung; Wall, Natalie

    2013-09-01

    This study examined the levels of posttraumatic stress disorder (PTSD) following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity among college students. It also investigated the association between these variables and alexithymia. One hundred and six college students participated in the study and completed an on-line survey comprising the Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28 and Toronto Alexithymia Scale. Ninety-one students without asthma and major illness formed the control group. 2 % met the diagnostic criteria for full-PTSD, while 42 and 56 % met the partial and no-PTSD criteria respectively. Compared with the control, the asthma group reported significantly more somatic problems, social dysfunction and depression and was five times more likely to have an elevated risk of developing a general psychiatric disorder. After adjusting age, marital status, asthma experience and symptoms, alexithymia did not predict PTSD, while difficulty identifying feelings predicted psychiatric co-morbidity. Mediational analyses showed that asthma symptoms partially mediated the link between difficulty identifying feelings and psychiatric co-morbidity. People can develop PTSD symptoms and other psychological difficulties following asthma attack. Alexithymia influenced general psychological difficulties independently of PTSD symptoms.

  15. Abnormal Functional Connectivity Density in Post-traumatic Stress Disorder.

    Science.gov (United States)

    Zhang, Youxue; Xie, Bing; Chen, Heng; Li, Meiling; Liu, Feng; Chen, Huafu

    2016-05-01

    Post-traumatic stress disorder (PTSD) is a psychiatric disorder that occurs in individuals who have experienced life-threatening mental traumas. Previous neuroimaging studies have indicated that the pathology of PTSD may be associated with the abnormal functional integration among brain regions. In the current study, we used functional connectivity density (FCD) mapping, a novel voxel-wise data-driven approach based on graph theory, to explore aberrant FC through the resting-state functional magnetic resonance imaging of the PTSD. We calculated both short- and long-range FCD in PTSD patients and healthy controls (HCs). Compared with HCs, PTSD patients showed significantly increased long-range FCD in the left dorsolateral prefrontal cortex (DLPFC), but no abnormal short-range FCD was found in PTSD. Furthermore, seed-based FC analysis of the left DLPFC showed increased connectivity in the left superior parietal lobe and visual cortex of PTSD patients. The results suggested that PTSD patients experienced a disruption of intrinsic long-range functional connections in the fronto-parietal network and visual cortex, which are associated with attention control and visual information processing.

  16. [Does mobbing cause posttraumatic stress disorder? Impact of coping and personality].

    Science.gov (United States)

    Kreiner, Barbara; Sulyok, Christoph; Rothenhäusler, Hans-Bernd

    2008-01-01

    Previous research has documented that a variety of anxiety, depressive, and psychosomatic symptoms are present in a substantial portion of mobbing victims. This study aimed to explore the frequency of posttraumatic stress disorder (PTSD) among mobbing victims, and to investigate how PTSD was linked to pertinent psychometric scales. We recruited 20 mobbing victims and conducted the Structural Clinical Interview (SCID) to assess PTSD according to DSM-IV criteria. The trauma criterion was homogeneously defined as mobbing. 55% of our entire sample had a current PTSD, and 70% suffered from severe posttraumatic stress symptoms according to the Impact of Event Scale. Using multivariate analysis of variance (MANOVA), we found that mobbing victims with a current PTSD tended to demonstrate higher levels of stress and depressive symptoms, and less quality of life (SF 36 Short-Form Health Survey), especially in terms of bodily pain, compared with those without a PTSD diagnosis. No significant differences in personality factors (Freiburg Personality Inventory) between mobbing-victims with and without PTSD were evident by multivariate analysis. Univariate statistics, however, revealed that mobbing-related PTSD showed a trend towards higher scores in social orientation and somatic complaints. There was no general evidence that mobbing victims with a PTSD used more often negative and positive coping strategies (SVF - Stress Coping Questionnaire). However, they showed a tendency to employ control strategies, avoidance, social withdrawal, and cognitive preoccupation. Posttraumatic stress disorder subsequent to mobbing can occur frequently. PTSD therefore should be specifically considered in routine care.

  17. 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

  18. COMORBID INTERMITTENT EXPLOSIVE DISORDER AND POSTTRAUMATIC STRESS DISORDER: CLINICAL CORRELATES AND RELATIONSHIP TO SUICIDAL BEHAVIOR

    Science.gov (United States)

    Fanning, Jennifer R.; Lee, Royce; Coccaro, Emil F.

    2016-01-01

    Objective Posttraumatic stress disorder (PTSD) is associated with both aggressive and suicidal behavior. Recent research suggests that the diagnosis of Intermittent Explosive Disorder (IED), an impulse-control disorder characterized by repeated impulsive aggressive behavior, may help to identify individuals at risk for attempting suicide. Given the relationship between anger and PTSD, there is likely to be an increased prevalence of IED among individuals with PTSD; however, little is known about the overlap in these two disorders, including how individuals with comorbid IED and PTSD may differ from those with either disorder alone. The purpose of this study is to examine the clinical correlates of comorbid IED and PTSD and the contribution of these two disorders (among others) to lifetime suicide attempt and characteristics of suicidal behavior. Method In a large sample of community research volunteers (N=1460), we compared individuals with PTSD, IED, and comorbid PTSD and IED on measures of current mood, trait aggression, and trait impulsivity. We also examined the contributions of PTSD, IED, and other syndromal and personality disorders to the prediction of lifetime aggression and lifetime suicide attempt, and their relationship to characteristics of suicide attempts, including level of intent, use of violent versus non-violent means, and the medical seriousness of the attempt. Results Comorbid PTSD and IED was associated with significantly elevated levels of depression, anxiety, anger, aggression, and impulsivity, as well as with high rates of comorbidity with other psychiatric disorders. IED (β=.56, psuicide attempt in multivariate analysis (ORs: 1.6 and 1.6, pssuicide attempt (41.4% in this sample). Conclusion These findings add support to the notion that the diagnosis of IED may aid in identifying individuals at risk for aggressive and suicidal behavior. PMID:27624432

  19. Mechanisms of Sex Differences in Fear and Posttraumatic Stress Disorder.

    Science.gov (United States)

    Ramikie, Teniel Sonya; Ressler, Kerry J

    2018-05-15

    Following sexual maturity, females disproportionately have higher rates of posttraumatic stress disorder (PTSD) and experience greater symptom severity and chronicity as compared with males. This observation has led many to examine sex differences in PTSD risk factors. Though relatively few, these studies reveal that the root causes of PTSD sex differences are complex, and partly represent interactions between sex-specific nonbiological and biological risk factors, which differentially shape PTSD vulnerability. Moreover, these studies suggest that sex-specific PTSD vulnerability is partly regulated by sex differences in fear systems. Fear, which represents a highly conserved adaptive response to threatening environmental stimuli, becomes pathological in trauma- and stress-based psychiatric syndromes, such as PTSD. Over the last 30 years, considerable progress has been made in understanding normal and pathological molecular and behavioral fear processes in humans and animal models. Thus, fear mechanisms represent a tractable PTSD biomarker in the study of sex differences in fear. In this review, we discuss studies that examine nonbiological and biological sex differences that contribute to normal and pathological fear behaviors in humans and animal models. This, we hope, will shed greater light on the potential mechanisms that contribute to increased PTSD vulnerability in females. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  20. Similar cortical but not subcortical gray matter abnormalities in women with posttraumatic stress disorder with versus without dissociative identity disorder.

    Science.gov (United States)

    Chalavi, Sima; Vissia, Eline M; Giesen, Mechteld E; Nijenhuis, Ellert R S; Draijer, Nel; Barker, Gareth J; Veltman, Dick J; Reinders, Antje A T S

    2015-03-30

    Neuroanatomical evidence on the relationship between posttraumatic stress disorder (PTSD) and dissociative disorders is still lacking. We acquired brain structural magnetic resonance imaging (MRI) scans from 17 patients with dissociative identity disorder (DID) and co-morbid PTSD (DID-PTSD) and 16 patients with PTSD but without DID (PTSD-only), and 32 healthy controls (HC), and compared their whole-brain cortical and subcortical gray matter (GM) morphological measurements. Associations between GM measurements and severity of dissociative and depersonalization/derealization symptoms or lifetime traumatizing events were evaluated in the patient groups. DID-PTSD and PTSD-only patients, compared with HC, had similarly smaller cortical GM volumes of the whole brain and of frontal, temporal and insular cortices. DID-PTSD patients additionally showed smaller hippocampal and larger pallidum volumes relative to HC, and larger putamen and pallidum volumes relative to PTSD-only. Severity of lifetime traumatizing events and volume of the hippocampus were negatively correlated. Severity of dissociative and depersonalization/derealization symptoms correlated positively with volume of the putamen and pallidum, and negatively with volume of the inferior parietal cortex. Shared abnormal brain structures in DID-PTSD and PTSD-only, small hippocampal volume in DID-PTSD, more severe lifetime traumatizing events in DID-PTSD compared with PTSD-only, and negative correlations between lifetime traumatizing events and hippocampal volume suggest a trauma-related etiology for DID. Our results provide neurobiological evidence for the side-by-side nosological classification of PTSD and DID in the DSM-5. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Posttraumatic stress disorder in callers to the Anxiety Disorders Association of America.

    Science.gov (United States)

    Zhang, Wei; Ross, Jerilyn; Davidson, Jonathan R T

    2004-01-01

    We surveyed callers to the Anxiety Disorders Association of America (ADAA) with posttraumatic stress disorder (PTSD) and subthreshold PTSD (SPTSD). Most subjects heard about ADAA through media referrals and were satisfied with the service given by the association. The most frequent requests were for written information, learning how to cope with anxiety, and access to a local support group. Among callers, rates of PTSD (n=80) and SPTSD (n=111) were 8.0% and 11.1%, respectively. PTSD or SPTSD subjects were more likely to be younger, female, and with lower income than their no-Axis I psychiatric disorder controls (NAC) who had been exposed to trauma. In addition, they presented with more history of trauma, especially violent trauma, psychiatric comorbidity, recent psychotropic use, and side effects. More medical comorbidity, increased health service use, and reduced work productivity were also found among the PTSD and SPTSD subjects. SPTSD subjects were comparable to PTSD subjects on most of the measures with a few exceptions (more likely to be married, to have less psychiatric comorbidity, less medication use for mood and social fear, and fewer sedation and sexual side effects, and to have less health service use and work impairment). In conclusion, callers to ADAA with PTSD were particularly impaired and used the health care system extensively. Although the SPTSD subjects were not as impaired as those with PTSD, they were disadvantaged in many ways. Copyright 2004 Wiley-Liss, Inc.

  2. Diagnosis of Posttraumatic Stress Disorder in Preschool Children

    Science.gov (United States)

    De Young, Alexandra C.; Kenardy, Justin A.; Cobham, Vanessa E.

    2011-01-01

    This study investigated the existing diagnostic algorithms for posttraumatic stress disorder (PTSD) to determine the most developmentally sensitive and valid approach for diagnosing this disorder in preschoolers. Participants were 130 parents of unintentionally burned children (1-6 years). Diagnostic interviews were conducted with parents to…

  3. Gender-specific predictors of posttraumatic stress disorder in adolescents

    DEFF Research Database (Denmark)

    Donbaek, Dagmar Feddern; Elklit, Ask

    2015-01-01

    Gender is an important risk factor for both posttraumatic stress disorder (PTSD) and substance use disorders (SUD) in adolescents; however, little is known about the influence of gender when considering their common co-occurrence. This study examined whether problematic substance use, attachment...

  4. A Virtual Agent for Post-Traumatic Stress Disorder Treatment

    NARCIS (Netherlands)

    Tielman, M.L.

    2018-01-01

    Post-traumatic stress disorder (PTSD) is a mental disorder with a high impact on quality of life, and despite the existence of treatment, barriers still stop many people from receiving the care they need. An e-mental health system for home use might remove some of these barriers, as it provides a

  5. Immediate ketamine treatment does not prevent posttraumatic stress responses in an animal model for PTSD.

    Science.gov (United States)

    Juven-Wetzler, Alzbeta; Cohen, Hagit; Kaplan, Zeev; Kohen, Avi; Porat, Oren; Zohar, Joseph

    2014-03-01

    Clinical studies suggest that administration of ketamine hydrochloride-an antagonist at the N-methyl-d-aspartate ionophore-provides short-term amelioration for depressive symptoms. The effects of a brief course of ketamine given immediately following exposure to psychogenic stress on the behavioral stress responses were assessed in an animal model of posttraumatic stress disorder. Animals exposed to stress were treated 1h later with ketamine (0.5, 5, and 15 mg/kg) or vehicle for three days (N = 107). Outcome measures included behavior in the elevated plus maze (EPM) and acoustic startle response (ASR) tests 30 days after initial exposure and freezing behavior upon exposure to a trauma-cue on day 31. Pre-set cut-off behavioral criteria classified exposed animals according to their EPM and ASR response-patterns into "extreme," "minimal," or "partial" behavioral response for analysis of prevalence rates of "PTSD-like behavior." Circulating corticosterone levels were assessed 20 min after injection of ketamine in exposed and unexposed animals (N = 62). The dexamethasone suppression test was used to assess negative feedback inhibition of the HPA axis. Prevalence rates of extremely-, partially-, or minimally-disrupted behavior demonstrated that ketamine administered immediately following stress exposure was ineffective in alleviating "PTSD-like behavior" at day 30 after exposure. Administration of ketamine was associated with increase in freezing behavior after exposure to a trauma-cue on day 31. Corticosterone levels were significantly suppressed by ketamine only in the exposed animals. Administration of ketamine immediately following trauma-exposure may not only be ineffective but actually detrimental in the long term. A disruption of the post-stress HPA-response has been raised as a contributing factor. © 2013 Published by Elsevier B.V. and ECNP.

  6. The Comparative Effectiveness of Levels of Training and Years of Work Experience in Firefighters as Determining Factors in the Development of Posttraumatic Stress Disorder

    Science.gov (United States)

    Turner, Melva W.

    2011-01-01

    Posttraumatic Stress Disorder (PTSD) has been known by other names and not well studied prior to returning Vietnam veterans who suffered psychological dysfunction. However, the term PTSD became part of the Diagnostic and Statistical Manual for Mental Disorders in 1981. Since that time PTSD has been researched extensively in veterans. However,…

  7. Discriminating Malingered from Genuine Civilian Posttraumatic Stress Disorder: A Validation of Three MMPI-2 Infrequency Scales (F, Fp, and Fptsd)

    Science.gov (United States)

    Elhai, Jon D.; Naifeh, James A.; Zucker, Irene S.; Gold, Steven N.; Deitsch, Sarah E.; Frueh, B. Christopher

    2004-01-01

    The Infrequency-Posttraumatic Stress Disorder scale (Fptsd), recently created for the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), has demonstrated incremental validity over other MMPI-2 scales in malingered posttraumatic stress disorder (PTSD) detection. Fptsd was developed with combat-exposed PTSD patients, potentially limiting its…

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

    Directory of Open Access Journals (Sweden)

    Janet C'de Baca

    2014-03-01

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

  9. The neural correlates of emotional memory in posttraumatic stress disorder.

    Science.gov (United States)

    Brohawn, Kathryn Handwerger; Offringa, Reid; Pfaff, Danielle L; Hughes, Katherine C; Shin, Lisa M

    2010-12-01

    Posttraumatic stress disorder (PTSD) is marked by intrusive, chronic, and distressing memories of highly emotional events. Previous research has highlighted the role of the amygdala and its interactions with the hippocampus in mediating the effect of enhanced memory for emotional information in healthy individuals. As the functional integrity of these regions may be compromised in PTSD, the current study examined the neural correlates of emotional memory in PTSD. We used functional magnetic resonance imaging and an event-related subsequent memory recognition paradigm to study amygdala and hippocampus activation in 18 individuals with PTSD and 18 trauma-exposed non-PTSD control participants. Memory enhancement for negative, relative to neutral, pictures was found across all subjects, without significant differences between groups. Relative to the trauma-exposed non-PTSD group, the PTSD group showed exaggerated amygdala activation during the encoding of negative versus neutral pictures. This effect was even more pronounced when the analysis included data from only pictures that were subsequently remembered 1 week later. In the PTSD group, degree of amygdala activation during the encoding of negative versus neutral pictures was positively correlated with hippocampal activation and current PTSD symptom severity. The PTSD group also showed exaggerated hippocampal activation in response to negative pictures that were remembered versus forgotten. Finally, hippocampal activation associated with the successful encoding of negative relative to neutral pictures was significantly greater in the PTSD group. Exaggerated amygdala activation during the encoding of emotionally negative stimuli in PTSD is related to symptom severity and to hippocampal activation. Copyright © 2010 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Longitudinal Associations between Posttraumatic Stress Disorder and Metabolic Syndrome Severity

    Science.gov (United States)

    Wolf, Erika J.; Bovin, Michelle J.; Green, Jonathan D.; Mitchell, Karen S.; Stoop, Tawni B.; Barretto, Kenneth M.; Jackson, Colleen E.; Lee, Lewina O.; Fang, Shona C.; Trachtenberg, Felicia; Rosen, Raymond C.; Keane, Terence M.; Marx, Brian P.

    2016-01-01

    Background Posttraumatic stress disorder (PTSD) is associated with elevated risk for metabolic syndrome (MetS). However, the direction of this association is not yet established, as most prior studies employed cross-sectional designs. The primary goal of this study was to evaluate bidirectional associations between PTSD and MetS using a longitudinal design. Methods 1,355 male and female veterans of the conflicts in Iraq and Afghanistan underwent PTSD diagnostic assessments and their biometric profiles pertaining to MetS were extracted from the electronic medical record at two time points (spanning ~2.5 years, n = 971 at time 2). Results The prevalence of MetS among veterans with PTSD was just under 40% at both time points and was significantly greater than that for veterans without PTSD; the prevalence of MetS among those with PTSD was also elevated relative to age-matched population estimates. Cross-lagged panel models revealed that PTSD severity predicted subsequent increases in MetS severity (β = .08, p = .002), after controlling for initial MetS severity, but MetS did not predict later PTSD symptoms. Logistic regression results suggested that for every 10 PTSD symptoms endorsed at time 1, the odds of a subsequent MetS diagnosis increased by 56%. Conclusions Results highlight the substantial cardiometabolic concerns of young veterans with PTSD and raise the possibility that PTSD may predispose individuals to accelerated aging, in part, manifested clinically as MetS. This demonstrates the need to identify those with PTSD at greatest risk for MetS and to develop interventions that improve both conditions. PMID:27087657

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

    Science.gov (United States)

    Bae, Sung-Man; Hyun, Myoung-Ho

    2014-01-01

    Objective Differential diagnosis between post-traumatic stress disorder (PTSD) and adjustment disorder (AD) is rather difficult, but very important to the assignment of appropriate treatment and prognosis. This study investigated methods to differentiate PTSD and AD. Methods Twenty-five people with PTSD and 24 people with AD were recruited. Memory tests, the Minnesota Multiphasic Personality Inventory 2 (MMPI-2), and Beck's Depression Inventory were administered. Results There were significant decreases in immediate verbal recall and delayed verbal recognition in the participants with PTSD. The reduced memory functions of participants with PTSD were significantly influenced by depressive symptoms. Hypochondriasis, hysteria, psychopathic deviate, paranoia, schizophrenia, post-traumatic stress disorder scale of MMPI-2 classified significantly PTSD and AD group. Conclusion Our results suggest that verbal memory assessments and the MMPI-2 could be useful for discriminating between PTSD and AD. PMID:24851120

  12. Neurofeedback Treatment and Posttraumatic Stress Disorder: Effectiveness of Neurofeedback on Posttraumatic Stress Disorder and the Optimal Choice of Protocol.

    Science.gov (United States)

    Reiter, Karen; Andersen, Søren Bo; Carlsson, Jessica

    2016-02-01

    Neurofeedback is an alternative, noninvasive approach used in the treatment of a wide range of neuropsychiatric disorders, including posttraumatic stress disorder (PTSD). Many different neurofeedback protocols and methods exist. Likewise, PTSD is a heterogeneous disorder. To review the evidence on effectiveness and preferred protocol when using neurofeedback treatment on PTSD, a systematic search of PubMed, PsychInfo, Embase, and Cochrane databases was undertaken. Five studies were included in this review. Neurofeedback had a statistically significant effect in three studies. Neurobiological changes were reported in three studies. Interpretation of results is, however, limited by differences between the studies and several issues regarding design. The optimistic results presented here qualify neurofeedback as probably efficacious for PTSD treatment.

  13. Germ Cell Origins of Posttraumatic Stress Disorder Risk: The Transgenerational Impact of Parental Stress Experience.

    Science.gov (United States)

    Rodgers, Ali B; Bale, Tracy L

    2015-09-01

    Altered stress reactivity is a predominant feature of posttraumatic stress disorder (PTSD) and may reflect disease vulnerability, increasing the probability that an individual will develop PTSD following trauma exposure. Environmental factors, particularly prior stress history, contribute to the developmental programming of the hypothalamic-pituitary-adrenal stress axis. Critically, the consequences of stress experiences are transgenerational, with parental stress exposure impacting stress reactivity and PTSD risk in subsequent generations. Potential molecular mechanisms underlying this transmission have been explored in rodent models that specifically examine the paternal lineage, identifying epigenetic signatures in male germ cells as possible substrates of transgenerational programming. Here, we review the role of these germ cell epigenetic marks, including posttranslational histone modifications, DNA methylation, and populations of small noncoding RNAs, in the development of offspring stress axis sensitivity and disease risk. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  14. Smaller Hippocampal Volume in Posttraumatic Stress Disorder : A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia

    NARCIS (Netherlands)

    Logue, Mark W.; van Rooij, Sanne J H; Dennis, Emily L.; Davis, Sarah L.; Hayes, Jasmeet P.; Stevens, Jennifer S.; Densmore, Maria; Haswell, Courtney C.; Ipser, Jonathan; Koch, Saskia B.J.; Korgaonkar, Mayuresh; Lebois, Lauren A.M.; Peverill, Matthew; Baker, Justin T.; Boedhoe, Premika S W; Frijling, Jessie L.; Gruber, Staci A.; Harpaz-Rotem, Ilan; Jahanshad, Neda; Koopowitz, Sheri; Levy, Ifat; Nawijn, Laura; O'Connor, Lauren; Olff, Miranda; Salat, David H.; Sheridan, Margaret A.; Spielberg, Jeffrey M.; van Zuiden, Mirjam; Winternitz, Sherry R.; Wolff, Jonathan D.; Wolf, Erika J.; Wang, Xin; Wrocklage, Kristen; Abdallah, Chadi G.; Bryant, Richard A.; Geuze, Elbert; Jovanovic, Tanja; Kaufman, Milissa L.; King, Anthony P.; Krystal, John H.; Lagopoulos, Jim; Bennett, Maxwell; Lanius, Ruth; Liberzon, Israel; McGlinchey, Regina E.; McLaughlin, Katie A.; Milberg, William P.; Miller, Mark W.; Ressler, Kerry J; Veltman, Dick J.; Stein, Dan J; Thomaes, Kathleen; Thompson, Paul M.; Morey, Rajendra A.

    2018-01-01

    Background Many studies report smaller hippocampal and amygdala volumes in posttraumatic stress disorder (PTSD), but findings have not always been consistent. Here, we present the results of a large-scale neuroimaging consortium study on PTSD conducted by the Psychiatric Genomics Consortium

  15. Long-term trajectories of posttraumatic stress disorder in veterans

    DEFF Research Database (Denmark)

    Karstoft, Karen-Inge; Armour, Cherie; Elklit, Ask

    2013-01-01

    OBJECTIVE: To (1) identify long-term trajectories of combat-induced posttraumatic stress disorder (PTSD) symptoms over a 20-year period from 1983 to 2002 in veterans with and without combat stress reaction (CSR) and (2) identify social predictors of these trajectories. METHOD: A latent growth...

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

    Directory of Open Access Journals (Sweden)

    Heloisa de Souza Dantas

    2008-01-01

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

  17. 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...

  18. Trends in Opioid Use Disorder Diagnoses and Medication Treatment Among Veterans With Posttraumatic Stress Disorder.

    Science.gov (United States)

    Shiner, Brian; Leonard Westgate, Christine; Bernardy, Nancy C; Schnurr, Paula P; Watts, Bradley V

    2017-01-01

    Despite long-standing interest in posttraumatic stress disorder (PTSD) and opioid use disorder comorbidity, there is a paucity of data on the prevalence of opioid use disorder in patients with PTSD. Therefore, there is limited understanding of the use of medications for opioid use disorder in this population. We determined the prevalence of diagnosed opioid use disorder and use of medications for opioid use disorder in a large cohort of patients with PTSD. We obtained administrative and pharmacy data for veterans who initiated PTSD treatment in the Department of Veterans Affairs (VA) between 2004 and 2013 (N = 731,520). We identified those with a comorbid opioid use disorder diagnosis (2.7%; n = 19,998) and determined whether they received a medication for opioid use disorder in the year following their initial clinical PTSD diagnosis (29.6%; n = 5,913). Using logistic regression, we determined the predictors of receipt of opioid use disorder medications. Comorbid opioid use disorder diagnoses increased from 2.5% in 2004 to 3.4% in 2013. Patients with comorbid opioid use disorder used more health services and had more comorbidities than other patients with PTSD. Among patients with PTSD and comorbid opioid use disorder, use of medications for opioid use disorder increased from 22.6% to 35.1% during the same time period. Growth in the use of buprenorphine (2.0% to 22.7%) was accompanied by relative decline in use of methadone (19.3% to 12.7%). Patients who received buprenorphine were younger and more likely to be rural, White, and married. Patients who received methadone were older, urban, unmarried, from racial and ethnic minorities, and more likely to see substance abuse specialists. While use of naltrexone increased (2.8% to 8.6%), most (87%) patients who received naltrexone also had an alcohol use disorder. Controlling for patient factors, there was a substantial increase in the use of buprenorphine, a substantial decrease in the use of methadone, and no change

  19. Application of Short Screening Tools for Post-Traumatic Stress Disorder in the Korean Elderly Population

    Science.gov (United States)

    Jang, Yu Jin; Chung, Hae Gyung; Choi, Jin Hee; Kim, Tae Yong; So, Hyung Seok

    2016-01-01

    Objective Post-traumatic stress disorder (PTSD) is often missed or incorrectly diagnosed in primary care settings. Although brief screening instruments may be useful in detecting PTSD, an adequate validation study has not been conducted with older adults. This study aimed to evaluate the reliability and validity of the Korean version of the primary care PTSD screen (PC-PTSD) and single-item PTSD screener (SIPS) in elderly veterans. Methods The PC-PTSD and SIPS assessments were translated into Korean, with a back-translation to the original language to verify accuracy. Vietnamese war veterans [separated into a PTSD group (n=41) and a non-PTSD group (n=99)] participated in several psychometric assessments, including the Korean versions of the PC-PTSD (PC-PTSD-K), SIPS (SIPS-K), a structured clinical interview from the Diagnostic and Statistical Manual of Mental Disorders-IV(SCID), and PTSD checklist(PCL). Results The PC-PTSD-K showed high internal consistency (Cronbach α=0.76), and the test-retest reliability of the PC-PTSD-K and SIPS-K were also high (r=0.97 and r=0.91, respectively). A total score of 3 from the PC-PTSD-K yielded the highest diagnostic efficiency, with sensitivity and specificity values of 0.90 and 0.86, respectively. The 'bothered a lot' response level from the SIPS-K showed the highest diagnostic efficiency, with sensitivity and specificity values of 0.85 and 0.89, respectively. Conclusion Our findings suggest that both PC-PTSD-K and SIPS-K have good psychometric properties with high validity and reliability for detecting PTSD symptoms in elderly Korean veterans. However, further research will be necessary to increase our understanding of PTSD characteristics in diverse groups with different types of trauma. PMID:27482241

  20. 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...

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

    Directory of Open Access Journals (Sweden)

    Dzenana Kartal

    2016-02-01

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

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

    Science.gov (United States)

    Kartal, Dzenana; Kiropoulos, Litza

    2016-01-01

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

  3. The Many Presentations of Posttraumatic Stress Disorder

    Directory of Open Access Journals (Sweden)

    Edward J. Hickling

    2013-02-01

    Full Text Available Posttraumatic stress disorder (PTSD has been a controversial diagnosis, with concerns including the sheer number of possible minimal diagnostic combinations (1,750, increasing to >10,000 theoretical possibilities in Diagnostic and Statistical Manual of Mental Disorders (5th ed. proposals. This study examined whether the theoretical combinations postulated actually occur in a large sample of military personnel. The design of the study was a retrospective examination of PTSD checklists from 3,810 participants who, based on scores, endorsed symptoms consistent with probable PTSD. Combinations of PTSD Checklist–Civilian Version (PCL-C symptom clusters were identified using data from active-duty military personnel who completed the 2005 and the 2008 Department of Defense (DoD Health Related Behaviors Among Active Duty Military Personnel Survey. The study examined (a occurrence of combinations, (b unique minimum combinations, (c most frequent combinations, and (d replication of symptom combinations and clusters. The PCL-C scores showed 1,837 unique scoring combinations, 83.5% (1,533/1,837 of the observed unique scoring combinations occurred just once. The most frequently occurring combination (17/17 endorsed accounted for 955 participants (25.1%, the second most frequent (16/17 endorsed accounted for 75 participants (2.0%. PTSD most often presented as a unique constellation of symptom clusters, either capturing symptoms while allowing for considerable variability in its presentation, reflecting different severities of the disorder, or raising concerns about the classification itself, and any future classification that Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V might develop.

  4. Fluoxetine treatment is effective in a rat model of childhood-induced post-traumatic stress disorder

    OpenAIRE

    Ariel, Lior; Inbar, Sapir; Edut, Schachaf; Richter-Levin, Gal

    2017-01-01

    Although selective serotonin reuptake inhibitors (SSRIs) are first-line treatment for post-traumatic stress disorder (PTSD) patients, their therapeutic efficacy is limited. Childhood adversities are considered a risk factor for developing PTSD in adulthood but may trigger PTSD without additional trauma in some individuals. Nevertheless, just as childhood is considered a vulnerable period it may also be an effective period for preventive treatment. Using a rat model of childhood-induced PTSD, ...

  5. Investigating the pathogenesis of posttraumatic stress disorder with neuroimaging.

    Science.gov (United States)

    Pitman, R K; Shin, L M; Rauch, S L

    2001-01-01

    Rapidly evolving brain neuroimaging techniques such as magnetic resonance imaging (MRI) and positron emission tomography (PET) are proving fruitful in exploring the pathogenesis and pathophysiology of posttraumatic stress disorder (PTSD). Structural abnormalities in PTSD found with MRI include nonspecific white matter lesions and decreased hippocampal volume. These abnormalities may reflect pretrauma vulnerability to develop PTSD, or they may be a consequence of traumatic exposure, PTSD, and/or PTSD sequelae. Functional neuroimaging symptom provocation and cognitive activation paradigms using PET measurement of regional cerebral blood flow have revealed greater activation of the amygdala and anterior paralimbic structures (which are known to be involved in processing negative emotions such as fear), greater deactivation of Broca's region (motor speech) and other nonlimbic cortical regions, and failure of activation of the cingulate cortex (which possibly plays an inhibitory role) in response to trauma-related stimuli in individuals with PTSD. Functional MRI research has shown the amygdala to be hyperresponsive to fear-related stimuli in this disorder. Research with PET suggests that cortical, notably hippocampal, metabolism is suppressed to a greater extent by pharmacologic stimulation of the noradrenergic system in persons with PTSD. The growth of knowledge concerning the anatomical and neurochemical basis of this important mental disorder will hopefully eventually lead to rational psychological and pharmacologic treatments.

  6. EFFICACY AND LONG-TERM CLINICAL OUTCOME OF COMORBID POSTTRAUMATIC STRESS DISORDER AND MAJOR DEPRESSIVE DISORDER AFTER ELECTROCONVULSIVE THERAPY.

    Science.gov (United States)

    Ahmadi, Naser; Moss, Lori; Simon, Edwin; Nemeroff, Charles B; Atre-Vaidya, Nutan

    2016-07-01

    Many patients fulfill criteria for both posttraumatic stress disorder (PTSD) and major depressive disorder (MDD). Electroconvulsive therapy (ECT) is generally acknowledged to be the most-effective treatment for refractory MDD. This study investigated the efficacy of ECT on long-term clinical outcome of comorbid PTSD and MDD. This retrospective nested matched case-control study is inclusive of 22,164 subjects [3,485 with comorbid MDD and PTSD (92 with ECT and 3,393 without ECT) and 18,679 without MDD and PTSD]. Using the clinical global impression scale (CGI) to assess efficacy, more-robust improvement of PTSD and MDD symptoms was observed with ECT (90%), compared to antidepressant-treatment alone(50%) (P = 0.001). During the median of 8 years of follow-up, the death-rate was 8% in subjects without PTSD and MDD, 9.7% in PTSD and MDD treated with ECT and 18% in PTSD and MDD without ECT (P 0.05). The relative risk of suicidality, all-cause, and cardiovascular mortality was reduced 64, 65, and 46% in MDD and PTSD patients treated with ECT, compared to those without ECT (P < 0.05). ECT is associated with a significant reduction of symptoms of PTSD and MDD, as well as reduction in risk of suicidality, cardiovascular, and all-cause mortality in MDD and PTSD, an effect more robust than antidepressant-therapy alone. © 2015 Wiley Periodicals, Inc.

  7. The prevalence of post traumatic stress disorder in an army unit and its relationship with functional gastrointestinal disorders

    Directory of Open Access Journals (Sweden)

    Qian WANG

    2018-04-01

    Full Text Available Objective To determine the prevalence of post traumatic stress disorder (PTSD in the army officers and soldiers (AOSs, and identify its relationship with functional gastrointestinal disorders (FGIDs. Methods PTSD and FGIDs were diagnosed based on the PTSD checklist-civilian (PCL-C and Rome Ⅲ Modular Questionnaire respectively, the overlaps of PTSD and FGIDs and their correlation were diagnosed. The correlation of PTSD with traumatic and stressful events was investigated using Trauma History and Stressful Event Screening Questionnaire. The coexistence and relationship of PTSD and FGIDs were analyzed. Results Of 927 AOSs, 33 were diagnosed with PTSD. The prevalence of PTSD was 3.56%. FGIDs were identified in 435 subjects and the incidence of FGIDs was 46.93%. Among 33 AOSs with PTSD, 28 were diagnosed as having FGIDs and the prevalence of FGIDs was 84.85%, which was significantly higher than that of non-PTSD group (45.53%, P<0.05. Moreover, the FGIDs group had a higher prevalence of PTSD, compared with the non-FGID group (6.43% vs. 1.02%, P<0.05. Cyclic vomiting syndrome (CVS, 33.33%, unspecified functional bowel disorder (24.24%, functional bloating (18.18% and functional anorectal pain (18.18% were the four most frequent FGIDs in PTSD AOSs. Multiple regression analysis showed PTSD was the risk factor for CVS (OR=9.118, functional anorectal pain (OR=3.373, functional bloating (OR=4.772, irritable bowel syndrome (OR=3.438, rumination syndrome (OR=16.033, functional vomiting (OR=10.329, functional dysphagia (OR=9.891(P<0.05. CVS (OR=4.063, the number of traumatic (OR=1.159 and stress events (OR=1.401 were the risk factors for PTSD in AOSs (P<0.05. Conclusions PTSD and FGID interact as risk factor each other. The prevalence of PTSD differs significantly in different FGIDs. CVS is the most frequent FGID in PTSD AOSs and risk factor for PTSD, which deserves more concerns. DOI: 10.11855/j.issn.0577-7402.2018.02.14

  8. The dissociative subtype of posttraumatic stress disorder: rationale, clinical and neurobiological evidence, and implications.

    Science.gov (United States)

    Lanius, Ruth A; Brand, Bethany; Vermetten, Eric; Frewen, Paul A; Spiegel, David

    2012-08-01

    Clinical and neurobiological evidence for a dissociative subtype of posttraumatic stress disorder (PTSD) has recently been documented. A dissociative subtype of PTSD is being considered for inclusion in the forthcoming Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) to address the symptoms of depersonalization and derealization found among a subset of patients with PTSD. This article reviews research related to the dissociative subtype including antecedent, concurrent, and predictive validators as well as the rationale for recommending the dissociative subtype. The relevant literature pertaining to the dissociative subtype of PTSD was reviewed. Latent class analyses point toward a specific subtype of PTSD consisting of symptoms of depersonalization and derealization in both veteran and civilian samples of PTSD. Compared to individuals with PTSD, those with the dissociative subtype of PTSD also exhibit a different pattern of neurobiological response to symptom provocation as well as a differential response to current cognitive behavioral treatment designed for PTSD. We recommend that consideration be given to adding a dissociative subtype of PTSD in the revision of the DSM. This facilitates more accurate analysis of different phenotypes of PTSD, assist in treatment planning that is informed by considering the degree of patients' dissociativity, will improve treatment outcome, and will lead to much-needed research about the prevalence, symptomatology, neurobiology, and treatment of individuals with the dissociative subtype of PTSD. © 2012 Wiley Periodicals, Inc.

  9. Resting-State Neurophysiological Abnormalities in Posttraumatic Stress Disorder: A Magnetoencephalography Study

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    Amy S. Badura-Brack

    2017-04-01

    Full Text Available Posttraumatic stress disorder (PTSD is a debilitating psychiatric condition that is common in veterans returning from combat operations. While the symptoms of PTSD have been extensively characterized, the neural mechanisms that underlie PTSD are only vaguely understood. In this study, we examined the neurophysiology of PTSD using magnetoencephalography (MEG in a sample of veterans with and without PTSD. Our primary hypothesis was that veterans with PTSD would exhibit aberrant activity across multiple brain networks, especially those involving medial temporal and frontal regions. To this end, we examined a total of 51 USA combat veterans with a battery of clinical interviews and tests. Thirty-one of the combat veterans met diagnostic criteria for PTSD and the remaining 20 did not have PTSD. All participants then underwent high-density MEG during an eyes-closed resting-state task, and the resulting data were analyzed using a Bayesian image reconstruction method. Our results indicated that veterans with PTSD had significantly stronger neural activity in prefrontal, sensorimotor and temporal areas compared to those without PTSD. Veterans with PTSD also exhibited significantly stronger activity in the bilateral amygdalae, parahippocampal and hippocampal regions. Conversely, healthy veterans had stronger neural activity in the bilateral occipital cortices relative to veterans with PTSD. In conclusion, these data suggest that veterans with PTSD exhibit aberrant neural activation in multiple cortical areas, as well as medial temporal structures implicated in affective processing.

  10. Post-traumatic stress disorder and beyond: an overview of rodent stress models.

    Science.gov (United States)

    Schöner, Johanna; Heinz, Andreas; Endres, Matthias; Gertz, Karen; Kronenberg, Golo

    2017-10-01

    Post-traumatic stress disorder (PTSD) is a psychiatric disorder of high prevalence and major socioeconomic impact. Patients suffering from PTSD typically present intrusion and avoidance symptoms and alterations in arousal, mood and cognition that last for more than 1 month. Animal models are an indispensable tool to investigate underlying pathophysiological pathways and, in particular, the complex interplay of neuroendocrine, genetic and environmental factors that may be responsible for PTSD induction. Since the 1960s, numerous stress paradigms in rodents have been developed, based largely on Seligman's seminal formulation of 'learned helplessness' in canines. Rodent stress models make use of physiological or psychological stressors such as foot shock, underwater trauma, social defeat, early life stress or predator-based stress. Apart from the brief exposure to an acute stressor, chronic stress models combining a succession of different stressors for a period of several weeks have also been developed. Chronic stress models in rats and mice may elicit characteristic PTSD-like symptoms alongside, more broadly, depressive-like behaviours. In this review, the major existing rodent models of PTSD are reviewed in terms of validity, advantages and limitations; moreover, significant results and implications for future research-such as the role of FKBP5, a mediator of the glucocorticoid stress response and promising target for therapeutic interventions-are discussed. © 2017 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  11. Autonomic and inflammatory consequences of posttraumatic stress disorder and the link to cardiovascular disease.

    Science.gov (United States)

    Brudey, Chevelle; Park, Jeanie; Wiaderkiewicz, Jan; Kobayashi, Ihori; Mellman, Thomas A; Marvar, Paul J

    2015-08-15

    Stress- and anxiety-related disorders are on the rise in both military and general populations. Over the next decade, it is predicted that treatment of these conditions, in particular, posttraumatic stress disorder (PTSD), along with its associated long-term comorbidities, will challenge the health care system. Multiple organ systems are adversely affected by PTSD, and PTSD is linked to cancer, arthritis, digestive disease, and cardiovascular disease. Evidence for a strong link between PTSD and cardiovascular disease is compelling, and this review describes current clinical data linking PTSD to cardiovascular disease, via inflammation, autonomic dysfunction, and the renin-angiotensin system. Recent clinical and preclinical evidence regarding the role of the renin-angiotensin system in the extinction of fear memory and relevance in PTSD-related immune and autonomic dysfunction is also addressed. Copyright © 2015 the American Physiological Society.

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

    Science.gov (United States)

    Roque, Autumn Pearl

    2015-01-01

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

  13. A memory-based model of posttraumatic stress disorder

    DEFF Research Database (Denmark)

    Rubin, David C.; Berntsen, Dorthe; Johansen, Marlene Klindt

    2008-01-01

    In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed......., text rev.; American Psychiatric Association, 2000). The model accounts for important and reliable findings that are often inconsistent with the current diagnostic view and that have been neglected by theoretical accounts of the disorder, including the following observations. The diagnosis needs...

  14. Improvement in cerebral function with treatment of posttraumatic stress disorder.

    Science.gov (United States)

    Roy, Michael J; Francis, Jennifer; Friedlander, Joshua; Banks-Williams, Lisa; Lande, Raymond G; Taylor, Patricia; Blair, James; McLellan, Jennifer; Law, Wendy; Tarpley, Vanita; Patt, Ivy; Yu, Henry; Mallinger, Alan; Difede, Joann; Rizzo, Albert; Rothbaum, Barbara

    2010-10-01

    Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are signature illnesses of the Iraq and Afghanistan wars, but current diagnostic and therapeutic measures for these conditions are suboptimal. In our study, functional magnetic resonance imaging (fMRI) is used to try to differentiate military service members with: PTSD and mTBI, PTSD alone, mTBI alone, and neither PTSD nor mTBI. Those with PTSD are then randomized to virtual reality exposure therapy or imaginal exposure. fMRI is repeated after treatment and along with the Clinician-Administered PTSD Scale (CAPS) and Clinical Global Impression (CGI) scores to compare with baseline. Twenty subjects have completed baseline fMRI scans, including four controls and one mTBI only; of 15 treated for PTSD, eight completed posttreatment scans. Most subjects have been male (93%) and Caucasian (83%), with a mean age of 34. Significant improvements are evident on fMRI scans, and corroborated by CGI scores, but CAPS scores improvements are modest. In conclusion, CGI scores and fMRI scans indicate significant improvement in PTSD in both treatment arms, though CAPS score improvements are less robust. © 2010 Association for Research in Nervous and Mental Disease.

  15. Intranasal Oxytocin Normalizes Amygdala Functional Connectivity in Posttraumatic Stress Disorder.

    Science.gov (United States)

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

    2016-07-01

    The neuropeptide oxytocin (OT) has been suggested as a promising pharmacological agent for medication-enhanced psychotherapy in posttraumatic stress disorder (PTSD) because of its anxiolytic and prosocial properties. We therefore investigated the behavioral and neurobiological effects of a single intranasal OT administration (40 IU) in PTSD patients. We conducted a randomized, placebo-controlled, cross-over resting-state fMRI study in male and female police officers with (n=37, 21 males) and without PTSD (n=40, 20 males). We investigated OT administration effects on subjective anxiety and functional connectivity of basolateral (BLA) and centromedial (CeM) amygdala subregions with prefrontal and salience processing areas. In PTSD patients, OT administration resulted in decreased subjective anxiety and nervousness. Under placebo, male PTSD patients showed diminished right CeM to left ventromedial prefrontal cortex (vmPFC) connectivity compared with male trauma-exposed controls, which was reinstated after OT administration. Additionally, female PTSD patients showed enhanced right BLA to bilateral dorsal anterior cingulate cortex (dACC) connectivity compared with female trauma-exposed controls, which was dampened after OT administration. Although caution is warranted, our findings tentatively suggest that OT has the potential to diminish anxiety and fear expression of the amygdala in PTSD, either via increased control of the vmPFC over the CeM (males) or via decreased salience processing of the dACC and BLA (females). Our findings add to accumulating evidence that OT administration could potentially enhance treatment response in PTSD.

  16. Personality Disorders, Coping Strategies, and Posttraumatic Stress Disorder in Women with Histories of Childhood Sexual Abuse

    Science.gov (United States)

    Johnson, Dawn M.; Sheahan, Timothy C.; Chard, Kathleen M.

    2003-01-01

    Using a treatment-seeking sample of adult female survivors of childhood sexual abuse, the relationships between coping strategies, personality disorders (PD) and Posttraumatic Stress Disorder (PTSD) were explored. A variety of PDs were found to exist in this population, with avoidant, antisocial, dependent PDs having higher frequencies than…

  17. Associations between Prolonged Grief Disorder, Depression, Posttraumatic Stress Disorder, and Anxiety in Rwandan Genocide Survivors

    Science.gov (United States)

    Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas

    2012-01-01

    A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed…

  18. An examination of the structure of posttraumatic stress disorder in relation to the anxiety and depressive disorders.

    Science.gov (United States)

    Forbes, David; Lockwood, Emma; Elhai, Jon D; Creamer, Mark; O'Donnell, Meaghan; Bryant, Richard; McFarlane, Alexander; Silove, Derrick

    2011-07-01

    The nature and structure of posttraumatic stress disorder (PTSD) has been the subject of much interest in recent times. This research has been represented by two streams, the first representing a substantive body of work which focuses specifically on the factor structure of PTSD and the second exploring PTSD's relationship with other mood and anxiety disorders. The present study attempted to bring these two streams together by examining structural models of PTSD and their relationship with dimensions underlying other mood and anxiety disorders. PTSD, anxiety and mood disorder data from 989 injury survivors interviewed 3-months following their injury were analyzed using a series of confirmatory factor analyses (CFA) to identify the optimal structural model. CFA analyses indicated that the best fitting model included PTSD's re-experiencing (B1-5), active avoidance (C1-2), and hypervigilance and startle (D4-5) loading onto a Fear factor (represented by panic disorder, agoraphobia and social phobia) and the PTSD dysphoria symptoms (numbing symptoms C3-7 and hyperarousal symptoms D1-3) loading onto an Anxious Misery/Distress factor (represented by depression, generalized anxiety disorder and obsessive compulsive disorder). The findings have implications for informing potential revisions to the structure of the diagnosis of PTSD and the diagnostic algorithm to be applied, with the aim of enhancing diagnostic specificity. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Post-Traumatic Stress Disorder in Kosovo Veterans

    Directory of Open Access Journals (Sweden)

    Mimoza Shahini

    2016-03-01

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

  20. Feasibility and Efficacy of Prolonged Exposure for PTSD among Individuals with a Psychotic Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Anouk L. Grubaugh

    2017-06-01

    Full Text Available Objective: Few empirical studies have examined the feasibility of trauma-focused treatment among individuals with schizophrenia. This lack of research is important given the substantial overlap of trauma exposure and subsequent PTSD with psychotic spectrum disorders, and the potential for PTSD to complicate the course and prognosis of schizophrenia and other variants of severe mental illness.Method: As part of a larger study, 14 veterans with a psychotic spectrum disorder were enrolled to receive prolonged exposure (PE for PTSD within a single arm open trial study design. Patient reactions and responses to PE were examined using feasibility indices such as attrition, survey reactions, and treatment expectancy; pre and post-changes in PTSD severity and diagnostic status; and thematic interviews conducted post-intervention.Results: Quantitative and qualitative data indicate that implementation of PE is feasible, subjectively well-tolerated, and may result in clinically significant reductions in PTSD symptoms in patients with psychotic spectrum disorders.Conclusion: Consistent with treatment outcome data in clinical populations with a broader range of severe mental illnesses, the current results support the use of PTSD exposure-based interventions, such as PE, for individuals with psychotic spectrum disorders.

  1. Post-traumatic stress disorder following myocardial infarction: prevalence and risk factors.

    Science.gov (United States)

    Roberge, Marie-Anne; Dupuis, Gilles; Marchand, André

    2010-05-01

    Post-traumatic stress disorder (PTSD) is associated with negative impacts on physical health. Victims of a myocardial infarction (MI) who develop PTSD may be particularly affected by these impacts due to their cardiovascular vulnerability. Post-traumatic reactions in this population are not well known. To examine the prevalence of PTSD after MI and its risk factors, and to validate a prediction model for PTSD symptoms. Patients hospitalized for MI (n=477) were recruited in three hospitals. The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and questionnaires concerning PTSD symptoms and general measures were administered to patients during hospitalization and at one-month follow-up. Four per cent of the patients had PTSD and 12% had partial PTSD. The perception of a threat to life, the intensity of acute stress disorder and depression symptoms several days after the MI, a history of referral to a psychologist or psychiatrist, and female sex were risk factors for the intensity of PTSD symptoms in a sequential multiple regression analysis (R=0.634). The prediction model was validated by applying the regression equation to 48 participants who were not included in the initial regression (R=0.633). The risk factors for development of PTSD symptoms identified in the present study could be used to facilitate the detection of patients at risk for developing PTSD symptoms so they can later be offered psychological interventions as needed.

  2. Written Disclosure Treatment for Posttraumatic Stress Disorder in Substance Use Disorder Inpatients

    Science.gov (United States)

    Bragdon, Rodney A.; Lombardo, Thomas W.

    2012-01-01

    Comprehensive exposure-based approaches to treating posttraumatic stress disorder (PTSD) are effective, but they are time intensive and not widely used because of factors such as client noncompliance and fears of iatrogenic effects. Exposure by writing disclosure (WD), modeled after Pennebaker's brief stress-reduction procedure, may circumvent…

  3. Posttraumatic stress disorder in the World Mental Health Surveys.

    Science.gov (United States)

    Koenen, K C; Ratanatharathorn, A; Ng, L; McLaughlin, K A; Bromet, E J; Stein, D J; Karam, E G; Meron Ruscio, A; Benjet, C; Scott, K; Atwoli, L; Petukhova, M; Lim, C C W; Aguilar-Gaxiola, S; Al-Hamzawi, A; Alonso, J; Bunting, B; Ciutan, M; de Girolamo, G; Degenhardt, L; Gureje, O; Haro, J M; Huang, Y; Kawakami, N; Lee, S; Navarro-Mateu, F; Pennell, B-E; Piazza, M; Sampson, N; Ten Have, M; Torres, Y; Viana, M C; Williams, D; Xavier, M; Kessler, R C

    2017-10-01

    Traumatic events are common globally; however, comprehensive population-based cross-national data on the epidemiology of posttraumatic stress disorder (PTSD), the paradigmatic trauma-related mental disorder, are lacking. Data were analyzed from 26 population surveys in the World Health Organization World Mental Health Surveys. A total of 71 083 respondents ages 18+ participated. The Composite International Diagnostic Interview assessed exposure to traumatic events as well as 30-day, 12-month, and lifetime PTSD. Respondents were also assessed for treatment in the 12 months preceding the survey. Age of onset distributions were examined by country income level. Associations of PTSD were examined with country income, world region, and respondent demographics. The cross-national lifetime prevalence of PTSD was 3.9% in the total sample and 5.6% among the trauma exposed. Half of respondents with PTSD reported persistent symptoms. Treatment seeking in high-income countries (53.5%) was roughly double that in low-lower middle income (22.8%) and upper-middle income (28.7%) countries. Social disadvantage, including younger age, female sex, being unmarried, being less educated, having lower household income, and being unemployed, was associated with increased risk of lifetime PTSD among the trauma exposed. PTSD is prevalent cross-nationally, with half of all global cases being persistent. Only half of those with severe PTSD report receiving any treatment and only a minority receive specialty mental health care. Striking disparities in PTSD treatment exist by country income level. Increasing access to effective treatment, especially in low- and middle-income countries, remains critical for reducing the population burden of PTSD.

  4. Altered Pituitary Gland Structure and Function in Posttraumatic Stress Disorder.

    Science.gov (United States)

    Cooper, Odelia; Bonert, Vivien; Moser, Franklin; Mirocha, James; Melmed, Shlomo

    2017-06-01

    Posttraumatic stress disorder (PTSD) is associated with hypothalamus-pituitary-adrenal (HPA) axis response to stressors, but links to neurophysiological and neuroanatomical changes are unclear. The purpose of this study was to determine whether stress-induced cortisol alters negative feedback on pituitary corticotroph function and pituitary volume. Prospective controlled study in an outpatient clinic. Subjects with PTSD and matched control subjects underwent pituitary volume measurement on magnetic resonance imaging, with pituitary function assessed by 24-hour urine free cortisol (UFC), 8:00 am cortisol, and adrenocorticotropic hormone (ACTH) levels, and ACTH levels after 2-day dexamethasone/corticotropin-releasing hormone test. Primary outcome was pituitary volume; secondary outcomes were ACTH area under the curve (AUC) and 24-hour UFC. Thirty-nine subjects were screened and 10 subjects with PTSD were matched with 10 healthy control subjects by sex and age. Mean pituitary volume was 729.7 mm 3 [standard deviation (SD), 227.3 mm 3 ] in PTSD subjects vs 835.2 mm 3 (SD, 302.8 mm 3 ) in control subjects. ACTH AUC was 262.5 pg/mL (SD, 133.3 pg/mL) L in PTSD vs 244.0 pg/mL (SD, 158.3 pg/mL) in control subjects ( P = 0.80). In PTSD subjects, UFC levels and pituitary volume inversely correlated with PTSD duration; pituitary volume correlated with ACTH AUC in control subjects (Pearson correlation coefficient, 0.88, P = 0.0009) but not in PTSD subjects. The HPA axis may be downregulated and dysregulated in people with PTSD, as demonstrated by discordant pituitary corticotroph function and pituitary volume vs intact HPA feedback and correlation of pituitary volume with ACTH levels in healthy control subjects. The results suggest a link between pituitary structure and function in PTSD, which may point to endocrine targeted therapeutic approaches.

  5. Altered Pituitary Gland Structure and Function in Posttraumatic Stress Disorder

    Science.gov (United States)

    Bonert, Vivien; Moser, Franklin; Mirocha, James; Melmed, Shlomo

    2017-01-01

    Objectives: Posttraumatic stress disorder (PTSD) is associated with hypothalamus-pituitary-adrenal (HPA) axis response to stressors, but links to neurophysiological and neuroanatomical changes are unclear. The purpose of this study was to determine whether stress-induced cortisol alters negative feedback on pituitary corticotroph function and pituitary volume. Design: Prospective controlled study in an outpatient clinic. Methods: Subjects with PTSD and matched control subjects underwent pituitary volume measurement on magnetic resonance imaging, with pituitary function assessed by 24-hour urine free cortisol (UFC), 8:00 am cortisol, and adrenocorticotropic hormone (ACTH) levels, and ACTH levels after 2-day dexamethasone/corticotropin-releasing hormone test. Primary outcome was pituitary volume; secondary outcomes were ACTH area under the curve (AUC) and 24-hour UFC. Results: Thirty-nine subjects were screened and 10 subjects with PTSD were matched with 10 healthy control subjects by sex and age. Mean pituitary volume was 729.7 mm3 [standard deviation (SD), 227.3 mm3] in PTSD subjects vs 835.2 mm3 (SD, 302.8 mm3) in control subjects. ACTH AUC was 262.5 pg/mL (SD, 133.3 pg/mL) L in PTSD vs 244.0 pg/mL (SD, 158.3 pg/mL) in control subjects (P = 0.80). In PTSD subjects, UFC levels and pituitary volume inversely correlated with PTSD duration; pituitary volume correlated with ACTH AUC in control subjects (Pearson correlation coefficient, 0.88, P = 0.0009) but not in PTSD subjects. Conclusions: The HPA axis may be downregulated and dysregulated in people with PTSD, as demonstrated by discordant pituitary corticotroph function and pituitary volume vs intact HPA feedback and correlation of pituitary volume with ACTH levels in healthy control subjects. The results suggest a link between pituitary structure and function in PTSD, which may point to endocrine targeted therapeutic approaches. PMID:29264511

  6. Traumatic Dissociation as a Predictor of Posttraumatic Stress Disorder in South African Female Rape Survivors

    OpenAIRE

    Nöthling, Jani; Lammers, Kees; Martin, Lindi; Seedat, Soraya

    2015-01-01

    Abstract Women survivors of rape are at an increased risk for posttraumatic stress disorder (PTSD). Traumatic dissociation has been identified as a precursor of PTSD. This study assessed the predictive potential of traumatic dissociation in PTSD and depression development. The study followed a longitudinal, prospective design. Ninety-seven female rape survivors were recruited from 2 clinics in Cape Town, South Africa. Clinical interviews and symptom status assessments of the participants were...

  7. Post-traumatic Stress Disorder Symptoms Among People Living with HIV/AIDS in Rural China

    OpenAIRE

    Luo, S; Lin, C; Ji, G; Li, L

    2017-01-01

    Among people living with HIV/AIDS (PLHA), the occurrence of post-traumatic stress disorder (PTSD) symptoms associated with HIV diagnosis is a common problem. This study examined HIV diagnosis-related PTSD symptoms and its associated factors among PLHA in rural China. We used baseline data from a randomized controlled trial conducted in Anhui Province, China. Surveys of 522 PLHA were conducted via computer-assisted personal interview method. PTSD symptoms were measured based on re-experiencing...

  8. Sleep Difficulties and Alcohol Use Motives in Female Rape Victims With Posttraumatic Stress Disorder

    OpenAIRE

    Nishith, Pallavi; Resick, Patricia A.; Mueser, Kim T.

    2001-01-01

    The purpose of this study was to assess the relationship between sleep difficulties and drinking motives in female rape victims with posttraumatic stress disorder (PTSD). Seventy-four participants were assessed for PTSD symptoms, depression, sleep difficulties, and drinking motives. Results demonstrated that neither PTSD symptoms nor depression were related to any motives for using alcohol. On the other hand, after controlling for education, sleep difficulties were significantly related to dr...

  9. Eyeblink Classical Conditioning and Post-Traumatic Stress Disorder ? A Model Systems Approach

    OpenAIRE

    Schreurs, Bernard G.; Burhans, Lauren B.

    2015-01-01

    Not everyone exposed to trauma suffers flashbacks, bad dreams, numbing, fear, anxiety, sleeplessness, hyper-vigilance, hyperarousal, or an inability to cope, but those who do may suffer from post-traumatic stress disorder (PTSD). PTSD is a major physical and mental health problem for military personnel and civilians exposed to trauma. There is still debate about the incidence and prevalence of PTSD especially among the military, but for those who are diagnosed, behavioral therapy and drug tre...

  10. Gender Differences in Sleep During the Aftermath of Trauma and the Development of Posttraumatic Stress Disorder

    OpenAIRE

    Kobayashi, Ihori; Mellman, Thomas A.

    2012-01-01

    Women have a greater risk of developing posttraumatic stress disorder (PTSD) after exposure to trauma. Although sleep abnormalities have been implicated in the development of PTSD, gender differences in sleep soon after a traumatic event have not been investigated. This secondary analysis examined sleep characteristics using polysomnography in 13 female and 22 male trauma patients within a month of their traumatic injuries and assessed PTSD symptoms at 2-months post-injury. Results revealed m...

  11. Emergence Delirium With Post-traumatic Stress Disorder Among Military Veterans

    OpenAIRE

    Nguyen, Son; Pak, Mila; Paoli, Daniel; Neff, Donna F

    2016-01-01

    The clinical characteristics of emergence delirium (ED) associated with post-traumatic stress disorder (PTSD) among military veterans encompass transient agitation, restlessness, disorientation, and violent verbal and physical behaviors?due to?re-experiencing of PTSD-related incidents. Two cases of?ED after general anesthesia associated with PTSD are presented. Different?anesthesia methods were applied for the?two cases.?A traditional medical approach appeared not to prevent the incidence of ...

  12. Posttraumatic stress disorder: a special case of emergence delirium and anesthetic alternatives.

    Science.gov (United States)

    Shoum, Steven M

    2014-09-01

    Two anesthesia cases are presented involving patients with a history of posttraumatic stress disorder (PTSD). The first patient experienced a prolonged dangerous flashback during emergence. In the second patient, after a thorough review of PTSD and the anesthesia literature, emergence was uneventful. A history of PTSD should be considered a risk factor in the assessment of every patient and anesthetic management designed to best avoid serious and potentially harmful reactions.

  13. 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…

  14. Post-traumatic stress disorder symptoms, underlying affective vulnerabilities, and smoking for affect regulation.

    Science.gov (United States)

    Mathew, Amanda R; Cook, Jessica W; Japuntich, Sandra J; Leventhal, Adam M

    2015-01-01

    Post-traumatic stress disorder (PTSD) is overrepresented among cigarette smokers. It has been hypothesized that those with PTSD smoke to alleviate negative affect and counteract deficient positive affect commonly associated with the disorder; however, limited research has examined associations between PTSD symptoms, smoking motives, and affective vulnerability factors. In the current study, we examined (1) whether PTSD symptoms were associated with positive reinforcement and negative reinforcement smoking motives; and (2) whether two affective vulnerability factors implicated in PTSD-anxiety sensitivity and anhedonia-mediated relationships between PTSD symptoms and smoking motives. Data were drawn from a community sample of non-treatment-seeking smokers recruited without regard for trauma history (N = 342; 10+ cig/day). We used the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C) to assess overall PTSD symptom severity as well as individual PTSD subfactors. Overall, PTSD symptom severity was significantly associated with negative reinforcement, but not positive reinforcement, smoking motives. Variation in anxiety sensitivity significantly mediated the relation between PTSD symptom severity and negative reinforcement smoking motives, whereas anhedonia did not. Regarding PTSD subfactors, emotional numbing was the only PTSD subfactor associated with smoking rate, while re-experiencing symptoms were uniquely associated with both positive reinforcement and negative reinforcement smoking motives. Findings suggest that anxiety sensitivity may be an important feature associated with PTSD that enhances motivation to smoke for negative reinforcement purposes. Smoking cessation interventions that alleviate anxiety sensitivity and enhance coping with negative affect may be useful for smokers with elevated PTSD symptoms. © American Academy of Addiction Psychiatry.

  15. intimate partner violence and post-traumatic stress disorder

    African Journals Online (AJOL)

    Enrique

    In this article we will focus on the association between IPV and PTSD and discuss implications for diagnosis and management at a primary care level. WHAT IS PTSD? PTSD is an anxiety disorder resulting from exposure to traumatic events.

  16. Posttraumatic Stress Disorder and Stressful Life Events Among Rural Women With HIV Disease.

    Science.gov (United States)

    Kemppainen, Jeanne K; MacKain, Sally; Alexander, Melissa; Reid, Paula; Jackson, Morgan Parks

    Posttraumatic stress disorder (PTSD) and stressful life events are frequent and distressing problems for women living with HIV (WLWH). Studies have independently focused on the impact of these problems, but little work has examined the relationship between PTSD and stressful life events. Our cross-sectional study examined relationships between PTSD and recent stressful life events in WLWH. A sample of 60 women recruited through HIV community agencies in southeastern North Carolina completed the Stressful Life Events Questionnaire and the PTSD Checklist-Civilian Version (PCL-C). PTSD prevalence was high (43.2%). Two-thirds (66%) reported three or more recent life stressors. Women who experienced a higher number of recent life stressors scored higher on the PCL-C than those with fewer life stressors (p stressful life events may accelerate PTSD symptoms. Findings underscore the importance of addressing mental health issues in HIV treatment settings. Implications for nursing practice are provided. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

  17. The relations between posttraumatic stress disorder symptoms and disorder of extreme stress (not otherwise specified) symptoms following war captivity.

    Science.gov (United States)

    Zerach, Gadi; Solomon, Zahava

    2013-01-01

    War captivity is a recognized pathogenic agent for both posttraumatic stress disorder (PTSD) symptoms and disorder of extreme stress not otherwise specified (DESNOS) symptoms, also known as Complex PTSD. However, the relationship between the two disorders remains unclear. While some scholars assume that the two diagnoses are overlapping and share the same predictors, others believe that the two diagnoses are relatively independent and differ in phenomenology and functional impairment. This study aims to assess both PTSD and DESNOS symptoms and their inter-relations among ex-prisoners of war (ex-POWs) and matched controls, 35 years after the end of the war. The sample included two groups of male Israeli veterans from the 1973 Yom Kippur War: ex-POWs (n = 176) and comparable veterans who had not been held captive (n = 118). PTSD and DESNOS symptoms, battlefield and captivity stressors, and ways of coping in captivity were assessed using self-report questionnaires in 2008. Ex-POWs reported a higher number of PTSD symptoms and higher rates of PTSD symptoms that fill criteria for the diagnosis of PTSD than controls. Furthermore, ex-POWs reported a higher number of DESNOS symptom clusters and higher rates of DESNOS symptoms that fill criteria for the diagnosis of DESNOS. Moreover, we found positive relationships between PTSD symptom clusters and DESNOS symptom clusters. Finally, weight loss and mental suffering in captivity, loss of emotional control and total number of DESNOS symptoms predicted total number of PTSD symptoms. However, only the total number of PTSD symptoms predicted the total number of DESNOS symptoms. This study demonstrated the heavy and extensive toll of war captivity, three decades after the ex-POWs' release from captivity. Importantly, approaching the publication of DSM-5, this study depicts both the high number of DESNOS symptom clusters alongside PTSD symptoms and highlights the complex relationship between the two diagnostic entities. Thus

  18. Posttraumatic Stress Disorder in Institutionalized World War II Veterans.

    Science.gov (United States)

    Herrmann, Nathan; Eryavec, Goran

    1994-01-01

    Relatively little is known about posttraumatic stress disorder (PTSD) in World War II (WWII) veterans, despite the significant number of studies on this problem in Vietnam veterans. The authors document the prevalence of PTSD and other psychiatric disorders and investigate the etiological correlates of the syndrome in elderly, institutionalized WWII veterans. Sixty-two cognitively intact subjects (mean age 74.2 years), residents in a veterans' long-term care facility, were assessed for past and present psychopathology. A second investigator, blind to patients' psychiatric status, determined the degree of combat exposure and administered a checklist of pre-war and wartime variables. The lifetime prevalence of PTSD was 23%. Of those veterans with PTSD, 57% experienced chronic symptoms. The lifetime prevalence of other diagnoses was also high, including 3 7% for major depression and 53% for alcohol abuse. There was a strong correlation between the severity of the combat stressor and the development of PTSD. Significant correlations between PTSD and some pre-war variables were also found: more family histories of alcohol abuse, more deaths of close family members in early life, and less likelihood of having held a job for more than 1 year prior to the war. PTSD in elderly, institutionalized WWII veterans is a common, serious problem that is often unrecognized. Copyright © 1994 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. Dissociative features in posttraumatic stress disorder: A latent profile analysis.

    Science.gov (United States)

    Műllerová, Jana; Hansen, Maj; Contractor, Ateka A; Elhai, Jon D; Armour, Cherie

    2016-09-01

    The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) characterizes the dissociative subtype of posttraumatic stress disorder (PTSD) in terms of the individual meeting the criteria for PTSD and additionally reporting symptoms of depersonalization and/or derealization. The current study aimed to examine whether a dissociative PTSD profile may include alternative features of dissociation and whether it could be differentiated from a nondissociative PTSD profile on certain psychopathologies and demographics. Data from 309 trauma-exposed participants, collected through Amazon Mechanical Turk, were subjected to latent profile analysis. Regression analyses were used to examine the predictors of latent classes. Three discrete profiles named Baseline, PTSD, and Dissociative profile were uncovered. All examined features of dissociation were significantly elevated in the Dissociative profile. Anxiety, male sex, being employed, and having a minority racial background significantly predicted the Dissociative profile relative to the PTSD profile. The study points to the importance of alternative symptoms of dissociation in the dissociative PTSD subtype beyond the symptoms of depersonalization and derealization. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Predictive factors for acute stress disorder and posttraumatic stress disorder after motor vehicle accidents.

    Science.gov (United States)

    Yaşan, Aziz; Guzel, Aslan; Tamam, Yusuf; Ozkan, Mustafa

    2009-01-01

    Since traffic accidents are more common in developing countries than in developed countries, we aimed to investigate the association of several factors with the development and persistence of posttraumatic stress disorder (PTSD) after traffic accidents. In the study,95 participants with injuries from traffic accidents were evaluated at 4 different times: in the beginning, and after 3, 6 and 12 months. During the first evaluation, 41.1% (39) of our participants had acute stress disorder (ASD). It was found that lower perceived social support (OR = 0.0908, 95% CI = 0.834-0.989, p = 0.027) and higher peritraumatic dissociative experience scores (OR = 1.332, 95% CI = 1.170-1.516, p accident, we found PTSD affected 29.8, 23.1 and 17.9% of the participants, respectively. Although limitations at work and in social life after a traffic accident were not related to PTSD at 3 months (OR = 122.43, 95% CI = 0.000, p = 0.999) or at 6 months (OR = 63.438, 95% CI = 0.529-76.059, p = 0.089), limitations at work and in social life were predictors of PTSD at 12 months (OR = 155.514, 95% CI = 2.321-104.22, p = 0.019). The persistence of PTSD at the 12-month evaluation is related to ASD, limitations in work and social life, and lower social support scores. In developing countries like Turkey, long-term PTSD is commonly seen after traffic accidents. 2009 S. Karger AG, Basel.

  1. Acute episodes of predator exposure in conjunction with chronic social instability as an animal model of post-traumatic stress disorder

    OpenAIRE

    Zoladz, Phillip R.; Conrad, Cheryl D.; Fleshner, Monika; Diamond, David M.

    2008-01-01

    People who are exposed to horrific, life-threatening experiences are at risk for developing post-traumatic stress disorder (PTSD). Some of the symptoms of PTSD include persistent anxiety, exaggerated startle, cognitive impairments and increased sensitivity to yohimbine, an α2-adrenergic receptor antagonist. We have taken into account the conditions known to induce PTSD, as well as factors responsible for long-term maintenance of the disorder, to develop an animal model of PTSD. Adult male Spr...

  2. Assessing the role of attention-deficit/hyperactivity disorder symptoms in smokers with and without posttraumatic stress disorder.

    Science.gov (United States)

    Mitchell, John T; Van Voorhees, Elizabeth E; Dennis, Michelle F; McClernon, F Joseph; Calhoun, Patrick S; Kollins, Scott H; Beckham, Jean C

    2012-08-01

    Smoking prevalence among individuals with posttraumatic stress disorder (PTSD) is elevated relative to non-PTSD smokers, and there is evidence to suggest that affect regulation may be a motivation for smoking among those with this disorder. Previous studies have also indicated that (a) PTSD is frequently comorbid with attention-deficit/hyperactivity disorder (ADHD), (b) individuals with ADHD smoke at significantly higher rates than the general population, (c) subclinical ADHD symptoms are a risk factor for smoking, and (d) affect regulation is a motivation for smoking in ADHD. The goal of this study was to assess the degree to which ADHD symptoms were uniquely associated with smoking-related affective functioning (SRAF) variables above and beyond the variance already explained by PTSD symptoms. Smokers with (n = 55) and without PTSD (n = 68) completed measures assessing PTSD symptoms, ADHD symptoms, and SRAF. The PTSD group endorsed significantly more severe levels of DSM-IV inattentive and hyperactive-impulsive ADHD symptoms. A series of hierarchical regressions among the entire sample indicated that, after accounting for PTSD symptoms, ADHD symptoms were associated with lower positive affect, higher negative affect, higher emotion dysregulation, higher anxiety sensitivity, and higher urges to smoke to increase positive affect. Taken together, these findings suggest that ADHD symptoms may increase affective dysregulation difficulties already faced by smokers, particularly those with PTSD, which may, in turn, confer increased risk for smoking relapse in those with higher levels of symptomatology of both disorders.

  3. Return to work: a case of PTSD, dissociative identity disorder, and satanic ritual abuse.

    Science.gov (United States)

    Precin, Patricia

    2011-01-01

    This case study investigated an intervention that enabled an individual with Posttraumatic Stress Disorder (PTSD), Dissociative Identity Disorder (DID), and satanic ritual abuse to return to work after discharge from psychiatric inpatient treatment. The Occupational Questionnaire [88] revealed past difficulties in organization, awareness of time, communication, cooperation, frustration tolerance, competition, stress management, goal setting, and amnesia resulting in incomplete tasks and sporadic attendance at work. The Role Checklist [72] identified alters valuing work and employed in the past. The Modified Interest Checklist [70] identified running as an interest that 24 alters shared. Based on the initial evaluations, three times a week treadmill running was used as an intervention that built work skills (as measured by the Clerical Work Sample of the Valpar Component Work Sample Series [97]) necessary to sustain gainful employment upon discharge. After intervention, this individual improved in awareness of time, stress management, and goal setting abilities and was less amnestic as per the Occupational Questionnaire [88] and four additional alters expressed an interest in work according to the Modified Interest Checklist [70].

  4. A case of enterobiasis presenting as post-traumatic-stress-disorder ...

    African Journals Online (AJOL)

    A case of enterobiasis presenting as post-traumatic-stress-disorder (PTSD): a curious case of the infection with predominant mental health symptoms, presenting for the first time in the settings of a refugee camp.

  5. Trait Resilience Moderates the Longitudinal Linkage between Adolescent Posttraumatic Stress Disorder Symptoms and Posttraumatic Growth

    Science.gov (United States)

    Ying, Liuhua; Wang, Yanli; Lin, Chongde; Chen, Chuansheng

    2016-01-01

    The current study examined the longitudinal association between posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) as well as the moderating role of trait resilience in that association. Participants completed measures of PTSD symptoms, PTG, and trait resilience at 12, 18, and 24 months after the Wenchuan earthquake.…

  6. Cognitive ability and risk of post-traumatic stress disorder after military deployment

    DEFF Research Database (Denmark)

    Nissen, Lars R.; Karstoft, Karen-Inge; Vedtofte, Mia S.

    2017-01-01

    Background: Studies of the association between pre-deployment cognitive ability and post-deployment post-traumatic stress disorder (PTSD) have shown mixed results. Aims: To study the influence of pre-deployment cognitive ability on PTSD symptoms 6-8 months post-deployment in a large population...

  7. Posttraumatic Stress Disorder in Maltreated Youth: A Review of Contemporary Research and Thought

    Science.gov (United States)

    Kearney, Christopher A.; Wechsler, Adrianna; Kaur, Harpreet; Lemos-Miller, Amie

    2010-01-01

    Youths who have been maltreated often experience symptoms of posttraumatic stress disorder (PTSD), and this special population has received increased attention from researchers. Pathways toward maladaptive effects of maltreatment and PTSD are remarkably similar and reflect specific biological diatheses and psychological vulnerabilities that…

  8. Posttraumatic Stress Disorder, Traumatic Brain Injury, and Suicide Attempt History among Veterans Receiving Mental Health Services

    Science.gov (United States)

    Brenner, Lisa A.; Betthauser, Lisa M.; Homaifar, Beeta Y.; Villarreal, Edgar; Harwood, Jeri E. F.; Staves, Pamela J.; Huggins, Joseph A.

    2011-01-01

    History of posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI) has been found to increase risk of suicidal behavior. The association between suicide attempt history among veterans with PTSD and/or TBI was explored. Cases (N = 81) and 2:1 matched controls (N = 160) were randomly selected from a Veterans Affairs Medical Center…

  9. Characteristics of polytrauma patients with posttraumatic stress disorder in a level 1 trauma center

    NARCIS (Netherlands)

    B.E. Kreis; N.J.Y. Castano; W.E. Tuinebreijer (Wim); L.C.A. Hoogenboom; S.A.G. Meylaerts (Sven); S. Rhemrev (Steven)

    2011-01-01

    textabstractAims: The aims of this study were to determine if the severity of injury is related to the prevalence of posttraumatic stress disorder (PTSD) in polytrauma patients and to review the personality traits of patients with PTSD. Methods: During 2006 and 2007, 252 polytrauma patients were

  10. Posttraumatic Stress Disorder's Frequency and Intensity Ratings Are Associated with Factor Structure Differences in Military Veterans

    Science.gov (United States)

    Elhai, Jon D.; Palmieri, Patrick A.; Biehn, Tracey L.; Frueh, B. Christopher; Magruder, Kathryn M.

    2010-01-01

    We examined possible differences in the factor structure of posttraumatic stress disorder (PTSD) on the basis of whether frequency or intensity symptom response formats were used to assess PTSD. Participants included 669 veterans recruited from an epidemiological study of four Veterans Affairs Medical Centers' primary care clinics in the…

  11. Meta-Analysis of Dropout in Treatments for Posttraumatic Stress Disorder

    Science.gov (United States)

    Imel, Zac E.; Laska, Kevin; Jakupcak, Matthew; Simpson, Tracy L.

    2013-01-01

    Objective: Many patients drop out of treatments for posttraumatic stress disorder (PTSD); some clinicians believe that trauma-focused treatments increase dropout. Method: We conducted a meta-analysis of dropout among active treatments in clinical trials for PTSD (42 studies; 17 direct comparisons). Results: The average dropout rate was 18%, but it…

  12. The Monsters in My Head: Posttraumatic Stress Disorder and the Child Survivor of Sexual Abuse

    Science.gov (United States)

    Putman, Stacie E.

    2009-01-01

    Posttraumatic stress disorder (PTSD) is 1 of several possible outcomes of child sexual victimization. There is a growing body of literature regarding the prevalence of PTSD among children who have been sexually victimized. Using specific case examples, this article looks at the nature and scope of the problem, diagnostic criteria according to the…

  13. Relationship between Type of Trauma Exposure and Posttraumatic Stress Disorder among Urban Children and Adolescents

    Science.gov (United States)

    Luthra, Rohini; Abramovitz, Robert; Greenberg, Rick; Schoor, Alan; Newcorn, Jeffrey; Schmeidler, James; Levine, Paul; Nomura, Yoko; Chemtob, Claude M.

    2009-01-01

    This study examines the association between trauma exposure and posttraumatic stress disorder (PTSD) among 157 help-seeking children (aged 8-17). Structured clinical interviews are carried out, and linear and logistic regression analyses are conducted to examine the relationship between PTSD and type of trauma exposure controlling for age, gender,…

  14. Impact of Posttraumatic Stress Disorder and Injury Severity on Recovery in Children with Traumatic Brain Injury

    Science.gov (United States)

    Kenardy, Justin; Le Brocque, Robyne; Hendrikz, Joan; Iselin, Greg; Anderson, Vicki; McKinlay, Lynne

    2012-01-01

    The adverse impact on recovery of posttraumatic stress disorder (PTSD) in mild traumatic brain injury (TBI) has been demonstrated in returned veterans. The study assessed this effect in children's health outcomes following TBI and extended previous work by including a full range of TBI severity, and improved assessment of PTSD within a…

  15. Cognitive Change Predicts Symptom Reduction with Cognitive Therapy for Posttraumatic Stress Disorder

    Science.gov (United States)

    Kleim, Birgit; Grey, Nick; Wild, Jennifer; Nussbeck, Fridtjof W.; Stott, Richard; Hackmann, Ann; Clark, David M.; Ehlers, Anke

    2013-01-01

    Objective: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in…

  16. Internet-Based Early Intervention to Prevent Posttraumatic Stress Disorder in Injury Patients: Randomized Controlled Trial

    NARCIS (Netherlands)

    Mouthaan, Joanne; Sijbrandij, Marit; de Vries, Giel-Jan; Reitsma, Johannes B.; van de Schoot, Rens; Goslings, J. Carel; Luitse, Jan S. K.; Bakker, Fred C.; Gersons, Berthold P. R.; Olff, Miranda

    2013-01-01

    Background: Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. Objective: To determine

  17. Internet-based early intervention to prevent poststraumatic stress disorder in injury patients: Randomized controlled trial.

    NARCIS (Netherlands)

    Mouthaan, J.; Sijbrandij, M.; de Vries, G.J.; Reitsma, J.B.; van de Schoot, R.; Goslings, J.C.; Luitse, J.S.K.; Bakker, F.C.; Gersons, B.P.R.; Olff, M.

    2013-01-01

    Background: Posttraumatic stress disorder (PTSD) develops in 10-20% of injury patients. We developed a novel, self-guided Internet-based intervention (called Trauma TIPS) based on techniques from cognitive behavioral therapy (CBT) to prevent the onset of PTSD symptoms. Objective: To determine

  18. Treatment of acute posttraumatic stress disorder with brief cognitive behavioral therapy: a randomized controlled trial

    NARCIS (Netherlands)

    Sijbrandij, Marit; Olff, Miranda; Reitsma, Johannes B.; Carlier, Ingrid V. E.; de Vries, Mirjam H.; Gersons, Berthold P. R.

    2007-01-01

    OBJECTIVE: The purpose of this study was to evaluate the efficacy of brief cognitive behavioral therapy for patients with acute posttraumatic stress disorder (PTSD) resulting from various types of psychological trauma. METHOD: The authors randomly assigned 143 patients with acute PTSD (irrespective

  19. Avoidant Coping and Treatment Outcome in Rape-Related Posttraumatic Stress Disorder

    Science.gov (United States)

    Leiner, Amy S.; Kearns, Megan C.; Jackson, Joan L.; Astin, Millie C.; Rothbaum, Barbara O.

    2012-01-01

    Objective: This study investigated the impact of avoidant coping on treatment outcome in rape-related posttraumatic stress disorder (PTSD). Method: Adult women with rape-related PTSD (N = 62) received 9 sessions of prolonged exposure (PE) or eye movement desensitization and reprocessing (EMDR). The mean age for the sample was 34.7 years, and race…

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  1. The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

    Science.gov (United States)

    Armour, Cherie

    2015-01-01

    There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the "correct" constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist.

  2. The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

    Science.gov (United States)

    Armour, Cherie

    2015-01-01

    There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD) best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994) to the fifth (DSM-5, 2013) edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the “correct” constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist. PMID:25994027

  3. The underlying dimensionality of PTSD in the diagnostic and statistical manual of mental disorders: where are we going?

    Directory of Open Access Journals (Sweden)

    Cherie Armour

    2015-05-01

    Full Text Available There has been a substantial body of literature devoted to answering one question: Which latent model of posttraumatic stress disorder (PTSD best represents PTSD's underlying dimensionality? This research summary will, therefore, focus on the literature pertaining to PTSD's latent structure as represented in the fourth (DSM-IV, 1994 to the fifth (DSM-5, 2013 edition of the DSM. This article will begin by providing a clear rationale as to why this is a pertinent research area, then the body of literature pertaining to the DSM-IV and DSM-IV-TR will be summarised, and this will be followed by a summary of the literature pertaining to the recently published DSM-5. To conclude, there will be a discussion with recommendations for future research directions, namely that researchers must investigate the applicability of the new DSM-5 criteria and the newly created DSM-5 symptom sets to trauma survivors. In addition, researchers must continue to endeavour to identify the “correct” constellations of symptoms within symptom sets to ensure that diagnostic algorithms are appropriate and aid in the development of targeted treatment approaches and interventions. In particular, the newly proposed DSM-5 anhedonia model, externalising behaviours model, and hybrid models must be further investigated. It is also important that researchers follow up on the idea that a more parsimonious latent structure of PTSD may exist.

  4. Animal Models of Post-Traumatic Stress Disorder and Recent Neurobiological Insights

    Science.gov (United States)

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

    2014-01-01

    Post-traumatic stress disorder (PTSD) is a complex psychiatric disorder characterized by the intrusive re-experiencing of past trauma, avoidant behavior, enhanced fear, and hyperarousal following a traumatic event in vulnerable populations. Preclinical animal models do not replicate the human condition in its entirety, but seek to mimic symptoms or endophenotypes associated with PTSD. Although many models of traumatic stress exist, few adequately capture the complex nature of the disorder and the observed individual variability in susceptibility of humans to develop PTSD. In addition, various types of stressors may produce different molecular neuroadaptations that likely contribute to the various behavioral disruptions produced by each model, although certain consistent neurobiological themes related to PTSD have emerged. For example, animal models report traumatic stress- and trauma reminder-induced alterations in neuronal activity in the amygdala and prefrontal cortex, in agreement with the human PTSD literature. Models have also provided a conceptual framework for the often observed combination of PTSD and co-morbid conditions such as alcohol use disorder (AUD). Future studies will continue to refine preclinical PTSD models in hopes of capitalizing on their potential to deliver new and more efficacious treatments for PTSD and associated psychiatric disorders. PMID:25083568

  5. A family study of chronic post-traumatic stress disorder following rape trauma.

    Science.gov (United States)

    Davidson, J R; Tupler, L A; Wilson, W H; Connor, K M

    1998-01-01

    There is evidence that familial factors serve as determinants of risk for post-traumatic stress disorder (PTSD), especially familial anxiety. This study investigates the relationship between chronic PTSD and family psychiatric morbidity. The sample was drawn from 81 female rape survivors with or without lifetime PTSD, 31 major depressive disorder controls, 20 anxiety disorder controls and 39 healthy controls. First-degree family members were directly interviewed (n = 285) and diagnoses assigned of major depressive, anxiety and alcohol or substance use disorder. Information was also available by family history for 639 relatives. In the directly interviewed sample, no consistently increased morbidity risk was observed for anxiety, PTSD, or alcohol/substance abuse in the rape survivor groups, but there was an increase in depression relative to the anxiety in healthy control groups. When comorbid depression in rape survivor probands was taken into account post hoc, an increased risk for depression was noted in family members of PTSD probands with depression, but not in relatives of PTSD probands without lifetime depression. Among rape survivor probands with non-comorbid PTSD, rates by history of familial anxiety and depression were negligible. In a logistic regression analysis, individual vulnerability to depression served as an independent predictor of chronic PTSD, along with specific trauma-related variables. In the family history group, results were consistent with those obtained from the directly interviewed group. Our findings clearly support the view that PTSD following rape is associated with familial vulnerability to major depression, which may thus serve as a risk factor for developing PTSD. The exact nature of this predisposition calls for further inquiry and there is a need to expand this study to include other PTSD populations. PTSD may on occasion represent a form of depression which is induced and/or modified neurobiologically and phenomenologically by

  6. The wake-promoting drug modafinil stimulates specific hypothalamic circuits to promote adaptive stress responses in an animal model of PTSD.

    Science.gov (United States)

    Cohen, S; Ifergane, G; Vainer, E; Matar, M A; Kaplan, Z; Zohar, J; Mathé, A A; Cohen, H

    2016-10-11

    Pharmacotherapeutic intervention during traumatic memory consolidation has been suggested to alleviate or even prevent the development of posttraumatic stress disorder (PTSD). We recently reported that, in a controlled, prospective animal model, depriving rats of sleep following stress exposure prevents the development of a PTSD-like phenotype. Here, we report that administering the wake-promoting drug modafinil to rats in the aftermath of a stressogenic experience has a similar prophylactic effect, as it significantly reduces the prevalence of PTSD-like phenotype. Moreover, we show that the therapeutic value of modafinil appears to stem from its ability to stimulate a specific circuit within the hypothalamus, which ties together the neuropeptide Y, the orexin system and the HPA axis, to promote adaptive stress responses. The study not only confirms the value of sleep prevention and identifies the mechanism of action of a potential prophylactic treatment after traumatic exposure, but also contributes to understanding mechanisms underlying the shift towards adaptive behavioral response.

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

    NARCIS (Netherlands)

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

    2016-01-01

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

  8. Interactive effects of stress and individual differences on alcohol use and posttraumatic stress disorder among personnel deployed to Guantanamo Bay.

    Science.gov (United States)

    De La Rosa, Gabriel M; Delaney, Eileen M; Webb-Murphy, Jennifer A; Johnston, Scott L

    2015-11-01

    This study examines the role of factors such as perceived stress, neuroticism, beliefs in psychotherapy stigma, resilience, and demographics in understanding posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) among deployed military personnel. Results show that personnel who screened positive for PTSD were more likely to screen positive for AUD (versus those who did not screen positive for PTSD). Perceived stress, neuroticism, and psychotherapy stigma all have direct multivariate relationships with PTSD symptoms. Moderated regression analyses show that the positive relationship between perceived stress and PTSD symptoms is significantly stronger among those scoring high on neuroticism and psychotherapy stigma. The positive relationship between perceived stress and AUD symptoms is only significant among those scoring high on psychotherapy stigma. Given the moderating role of psychotherapy stigma in the relationship between perceived stress and PTSD symptoms and the relationship between perceived stress and AUD symptoms efforts to reduce the stigma associated with mental health care in the military should be expanded. Also, the current research adds to the literature highlighting the role of neuroticism as a key variable in understanding PTSD. Copyright © 2015. Published by Elsevier Ltd.

  9. Post-traumatic stress disorder--best practice GP guidelines.

    Science.gov (United States)

    Forbes, David; Wolfgang, Bronwyn; Cooper, John; Creamer, Mark; Barton, David

    2009-03-01

    Approximately 50-65% of Australians are exposed to a traumatic event during their lifetime. Approximately 250 000 Australians suffer from post-traumatic stress disorder (PTSD) at any given time, making it one of the most common anxiety disorders. In May 2007, the Australian guidelines for the treatment of adults with acute stress disorder and posttraumatic stress disorder was published. In order to facilitate translation of evidence regarding PTSD into busy clinical practice, and particularly for general practitioners, a more succinct version of the guidelines has been developed. This article describes a brief algorithm based on the Australian guidelines and outlines key recommendations. General practitioners are often the first point of contact with the health care system for someone who has experienced a traumatic event. Patients experiencing trauma within the past 2 weeks require psychological first aid, and monitoring and assessment for the development of acute stress disorder and symptoms of PTSD. If the patient wishes to talk about the event with you, support them in doing so. However, it is important not to push those who prefer not to talk about the event. Trauma focused psychological treatment is the first line of treatment for PTSD, although antidepressant medication may have an adjuvant role in some patients or in those with comorbidities.

  10. Chronic obstructive lung disease and posttraumatic stress disorder: current perspectives

    Directory of Open Access Journals (Sweden)

    Abrams TE

    2015-10-01

    Full Text Available Thad E Abrams,1,2 Amy Blevins,1,3 Mark W Vander Weg1,2,4 1Department of Internal Medicine, University of Iowa, 2Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Health Care System, 3Hardin Health Sciences Library, 4Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA Background: Several studies have reported on the co-occurrence of chronic obstructive pulmonary disease (COPD and psychiatric conditions, with the most robust evidence base demonstrating an impact of comorbid anxiety and depression on COPD-related outcomes. In recent years, research has sought to determine if there is a co-occurrence between COPD and posttraumatic stress disorder (PTSD as well as for associations between PTSD and COPD-related outcomes. To date, there have been no published reviews summarizing this emerging literature.Objectives: The primary objective of this review was to determine if there is adequate evidence to support a co-occurrence between PTSD and COPD. Secondary objectives were to: 1 determine if there are important clinical considerations regarding the impact of PTSD on COPD management, and 2 identify targeted areas for further research.Methods: A structured review was performed using a systematic search strategy limited to studies in English, addressing adults, and to articles that examined: 1 the co-occurrence of COPD and PTSD and 2 the impact of PTSD on COPD-related outcomes. To be included, articles must have addressed some type of nonreversible obstructive lung pathology.Results: A total of 598 articles were identified for initial review. Upon applying the inclusion and exclusion criteria, n=19 articles or abstracts addressed our stated objectives. Overall, there is inconclusive evidence to support the co-occurrence between PTSD and COPD. Studies finding a significant co-occurrence generally had inferior methods of identifying COPD; in contrast, studies that utilized more robust COPD

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

    Science.gov (United States)

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

    2012-05-09

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

  12. Post-traumatic Stress Disorder Symptoms Among People Living with HIV/AIDS in Rural China.

    Science.gov (United States)

    Luo, Sitong; Lin, Chunqing; Ji, Guoping; Li, Li

    2017-11-01

    Among people living with HIV/AIDS (PLHA), the occurrence of post-traumatic stress disorder (PTSD) symptoms associated with HIV diagnosis is a common problem. This study examined HIV diagnosis-related PTSD symptoms and its associated factors among PLHA in rural China. We used baseline data from a randomized controlled trial conducted in Anhui Province, China. Surveys of 522 PLHA were conducted via computer-assisted personal interview method. PTSD symptoms were measured based on re-experiencing, avoidance and arousal of the day of HIV diagnosis. Association between PTSD symptoms and demographic characteristics, physical and social functioning were assessed by multiple regression analysis and structural equation modeling. Social functioning exhibited a direct association with HIV diagnosis-related PTSD symptoms, and also mediated the association between PTSD symptoms and age, family income, and physical functioning. The study findings underscore the importance of developing interventions that alleviate PTSD symptoms and improve social functioning among PLHA in rural China.

  13. Disability from posttraumatic headache is compounded by coexisting posttraumatic stress disorder.

    Science.gov (United States)

    Roper, Louise S; Nightingale, Peter; Su, Zhangjie; Mitchell, James L; Belli, Antonio; Sinclair, Alexandra J

    2017-01-01

    Posttraumatic headache (PTH) occurs in up to 82% of patients with traumatic brain injury (TBI). Posttraumatic stress disorder (PTSD) occurs in 39% of those with PTH. This study evaluates whether PTSD affects PTH disability. Eighty-six patients with TBI were prospectively evaluated in a secondary care trauma center. Headache disability was assessed using the Headache Impact Test version 6 and signs indicative of PTSD using the PTSD Check List Civilian version. Increased PTSD-type symptoms were significantly associated with increased headache disability ( p headache disability (Spearman's correlation rho=0.361, p =0.001). Increased severity of PTSD-type symptoms is significantly associated with increased headache disability in patients with chronic PTH. Managing PTSD symptoms in patients with chronic PTH may facilitate headache management.

  14. Effects of Estradiol on Post-Traumatic Stress Disorder Symptoms

    Science.gov (United States)

    2010-03-01

    Directed By: T. John Wu, Ph.D. Associate Professor, Department of Obstetrics and Gynecology Post-traumatic stress disorder (PTSD) is a complex...Preventing post-traumatic stress disorder after mass exposure to violence . Biosecur Bioterror 2005;3:154-63; discussion 64-5. 16. Baker DG...John Wu* Affiliations: *Program in Neuroscience and § Program in Molecular and Cellular Biology, Department of Obstetrics and Gynecology Uniformed

  15. Prolonged Exposure Therapy For Post Traumatic Stress Disorder

    OpenAIRE

    Levent SÜTÇÝGÝL; Selçuk ASLAN

    2012-01-01

    Post-traumatic Stress Disorder (PTSD) is a psychiatric illness that usually develops after an event that threatens one’s life and body integrity and it affects quality of life and impairs social functioning significantly. Many studies have shown therapeutic effect of cognitive behavioral therapies on posttraumatic stress disorder, so that these therapies take part in the first step of treatment guides. Exposure is a practice that is generally used to reduce pathological fear and related ...

  16. Correlation of sleep disturbances, anxiety and depression in Croatian war veterans with posttraumatic stress disorder.

    Science.gov (United States)

    Jevtović, Sasa; Gregurek, Rudolf; Kalenić, Barbara; Brajković, Lovorka; Bras, Marijana; Loncar, Mladen; Germain, Anne

    2011-01-01

    The aim of the study was to examine the relationships between global sleep quality and its specific components and Posttraumatic Stress Disorder (PTSD) symptom severity questionnaire. We also researched whether sleep quality and sleep disturbances differed among groups of PTSD based on symptom severity categories. This study was conducted on the sample of 120 Croatian war veterans with PTSD. The following self-report instruments were used: Pittsburgh Sleep Quality Index, the Pittsburgh Sleep Quality Index Addendum for PTSD, the Mississippi Scale for Combat-Related PTSD, the Spielberger State and Trait Anxiety Inventory and the Beck Depression Inventory. There were statistically significant differences between the three PTSD severity groups on general nervousness (PSQI-A variable), where patients with extremely severe PTSD have more symptoms of general nervousness than groups with severe or moderate PTSD. Differences were found between PTSD severity groups in episodes of terror and acting-out dreams, where patients with extremely severe PTSD have more symptoms of episodes of terror and acting-out dreams than groups with severe or moderate PTSD. Sleep quality was significantly correlated with state anxiety, trait anxiety, and depression, indicating that with decrease of anxiety and depression, sleep quality improves. Sleep latency was positively correlated with both state and trait anxiety. There wasn't any significant correlation between sleep latency and depression. Study suggests that sleep disturbances are equally severe across groups of veterans based on PTSD severity and that the severity of sleep disturbances is significantly related to severity of anxiety and depression symptoms.

  17. Symptom structure of PTSD following breast cancer.

    Science.gov (United States)

    Cordova, M J; Studts, J L; Hann, D M; Jacobsen, P B; Andrykowski, M A

    2000-04-01

    Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.

  18. [Violence and post-traumatic stress disorder in childhood].

    Science.gov (United States)

    Ximenes, Liana Furtado; de Oliveira, Raquel de Vasconcelos Carvalhães; de Assis, Simone Gonçalves

    2009-01-01

    This study presents the prevalence of symptoms of Posttraumatic Stress Disorder (PTSD) in 500 schoolchildren (6-13 years old) in São Gonçalo, Rio de Janeiro. It also investigates the association between PTSD, violence and other adverse events in the lives of these children. The multi-stage cluster sampling strategy involved three selection stages. Parents were interviewed about their children's behavior. The instrument used to screen symptoms of PTSD was the Child Behavior Checklist-Posttraumatic Stress Disorder Scale (CBCL-PTSD). Conflict Tactics Scales (CTS) were applied to evaluate family violence and other scales to investigate the socioeconomic profile, familiar relationship, characteristics and adverse events in the lives of the children. Multivariate analysis was performed using a hierarchical model with a significance level of 5%. The prevalence of clinical symptoms of PTSD was of 6.5%. The multivariate analysis suggested an explanation model of PTSD characterized by 18 variables, such as the child's characteristics; specific life events; family violence; and other family factors. The results reveal that it is necessary to work with the child in particularly difficult moments of his/her life in order to prevent or minimize the impact of adverse events on their mental and social functioning.

  19. Increased prevalence of posttraumatic stress disorder in CRPS.

    Science.gov (United States)

    Speck, V; Schlereth, T; Birklein, F; Maihöfner, C

    2017-03-01

    Although specific psychological disorders in complex regional pain syndrome (CRPS) have not been identified, studies suggest that CRPS patients may have increased rates of traumatic life events. Because these events do not always lead to apparent psychological symptoms, we systematically screened CRPS patients for posttraumatic stress disorder (PTSD) to determine if PTSD could be a risk factor for CRPS. Consecutive CRPS patients referred to two university hospital centres (University of Erlangen, UMC Mainz) between December 2011 and April 2013 were prospectively examined using a diagnostic PTSD instrument (Post-traumatic Stress Diagnostic Scale (PDS). We also tested maladaptive coping strategies (brief-COPE inventory) and the PDS severity score as predictors for CRPS. Patients with non-CRPS extremity pain and healthy individuals were used as control groups. We collected data from 152 patients with CRPS, 55 control patients and 55 age- and sex-matched healthy individuals. Fifty-eight CRPS patients (38%), six non-CRPS pain patients (10%) and two healthy individuals (4%) met diagnostic criteria for PTSD. Initial PTSD symptom onset was prior to CRPS in 50 CRPS patients (86%) and during the course of CRPS in eight patients. Results of a logistic regression revealed that the PTSD severity score was associated with CRPS (p CRPS than it is in the general population. Research has not yet provided support for specific psychological predictors for CRPS. © 2016 European Pain Federation - EFIC®.

  20. A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5.

    Science.gov (United States)

    Armour, Cherie; Műllerová, Jana; Elhai, Jon D

    2016-03-01

    The factor structure of posttraumatic stress disorder (PTSD) has been widely researched, but consensus regarding the exact number and nature of factors is yet to be reached. The aim of the current study was to systematically review the extant literature on PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to identify the best-fitting model. One hundred and twelve research papers published after 1994 using confirmatory factor analysis and DSM-based measures of PTSD were included in the review. In the DSM-IV literature, four-factor models received substantial support, but the five-factor Dysphoric arousal model demonstrated the best fit, regardless of gender, measurement instrument or trauma type. The recently proposed DSM-5 PTSD model was found to be a good representation of PTSD's latent structure, but studies analysing the six- and seven-factor models suggest that the DSM-5 PTSD factor structure may need further alterations. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Ethy Dorrepaal

    2013-11-01

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

  2. Patients with Posttraumatic Stress Disorder with Comorbid Major Depressive Disorder Require a Higher Dose of Psychotropic Drugs.

    Science.gov (United States)

    Chiba, Hiromi; Oe, Misari; Uchimura, Naohisa

    2016-01-01

    Major depressive disorder (MDD) has been associated with stressful life events and with posttraumatic stress disorder (PTSD). PTSD and MDD comorbidity was also reported to be associated with greater symptom severity and lower levels of functioning. However, the characteristics of pharmacotherapy for PTSD with MDD are not fully understood. To understand this relationship, we conducted a retrospective review using medical charts at the Department of Neuropsychiatry, Kurume University Hospital. Information from 55 patients with PTSD was analyzed. Five cases were excluded after re-evaluation of the PTSD diagnosis. A higher rate of type II trauma was observed in the PTSD with MDD group (50.0%) than in the PTSD-only group [13.6%; χ(2) (1, n =50) = 7.26, p<0.01]. Patients with comorbid MDD were significantly older, had more severe PTSD symptomatology, and a longer duration of treatment. They also received higher doses of psychotropic drugs, regardless of the type (antidepressants, antipsychotics, benzodiazepines), than the PTSD-only group. Our results showed that comorbid MDD is associated with higher doses of psychotropic drugs, suggesting difficulties in treatment.

  3. Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study.

    Science.gov (United States)

    Atwoli, Lukoye; Stein, Dan J; Williams, David R; Mclaughlin, Katie A; Petukhova, Maria; Kessler, Ronald C; Koenen, Karestan C

    2013-07-03

    South Africa's unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population. The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO's Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental disorders. The most common traumatic events were the unexpected death of a loved one and witnessing trauma occurring to others. Lifetime and 12-month prevalence rates of PTSD were 2.3% and 0.7% respectively, while the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk after trauma exposure and probability of chronicity after PTSD onset were both highest for witnessing trauma. Socio-demographic factors such as sex, age and education were largely unrelated to PTSD risk. The occurrence of trauma and PTSD in South Africa is not distributed according to the socio-demographic factors or trauma types observed in other countries. The dominant role of witnessing in contributing to PTSD may reflect the public settings of trauma exposure in South Africa and highlight the importance of political and social context in shaping the epidemiology of PTSD.

  4. Ketamine as a Rapid Treatment for Post-Traumatic Stress Disorder

    Science.gov (United States)

    2011-10-01

    Post - traumatic stress disorder ( PTSD ) is a debilitating anxiety disorder characterized by intrusive re-experiences of the traumatic events...08-1-0602 TITLE: Ketamine as a Rapid Treatment for Post - Traumatic Stress Disorder PRINCIPAL INVESTIGATOR: Dennis Charney...dissociative effects of ketamine but not have any sustained anxiolytic and antidepressant effects. Forty individuals diagnosed with post - traumatic

  5. Post-traumatic stress disorder risk and brain-derived neurotrophic factor Val66Met

    Science.gov (United States)

    Zhang, Lei; Li, Xiao-Xia; Hu, Xian-Zhang

    2016-01-01

    Brain-derived neurotrophic factor (BDNF), which regulates neuronal survival, growth differentiation, and synapse formation, is known to be associated with depression and post-traumatic stress disorder (PTSD). However, the molecular mechanism for those mental disorders remains unknown. Studies have shown that BDNF is associated with PTSD risk and exaggerated startle reaction (a major arousal manifestation of PTSD) in United States military service members who were deployed during the wars in Iraq and Afghanistan. The frequency of the Met/Met in BDNF gene was greater among those with PTSD than those without PTSD. Among individuals who experienced fewer lifetime stressful events, the Met carriers have significantly higher total and startle scores on the PTSD Checklist than the Val/Val carriers. In addition, subjects with PTSD showed higher levels of BDNF in their peripheral blood plasma than the non-probable-PTSD controls. Increased BDNF levels and startle response were observed in both blood plasma and brain hippocampus by inescapable tail shock in rats. In this paper, we reviewed these data to discuss BDNF as a potential biomarker for PTSD risk and its possible roles in the onset of PTSD. PMID:27014593

  6. Postanesthesia emergence in patients with post-traumatic stress disorder.

    Science.gov (United States)

    Umholtz, Matthew; Cilnyk, John; Wang, Christopher K; Porhomayon, Jahan; Pourafkari, Leili; Nader, Nader D

    2016-11-01

    Recovery from anesthesia may be complicated with development of severe panic symptoms and anxiety. Preexisting anxiety disorder has been reported as a risk factor for development of these symptoms. We aimed to examine the frequency of emergence delirium (EDL) among veterans diagnosed with posttraumatic stress disorders (PTSDs). Retrospective cohort. Postoperative recovery area. Perioperative information of 1763 consecutive patients who underwent a surgical procedure requiring general anesthesia were collected. The patients were grouped on the basis of previous diagnosis of PTSD. A total of 317 patients were identified with a positive history of PTSD and were compared to 1446 patients without such a history for the occurrence of EDL in the postanesthesia care unit (PACU) as the primary endpoint. Duration of stay in PACU in minutes and the frequency of hospital admission were the secondary endpoints. Multivariate binary logistic regression analysis was performed to identify the predictors of EDL among the veteran population. Emergence delirium was reported in 37 cases (2.1%) after general anesthesia. Fifteen (4.7%) of 317 patients with PTSD and 22 (1.5%) of 1446 patients without history of PTSD demonstrated symptoms related to EDL in the PACU (P=.002). After propensity matching, there were 8 patients with EDL in the PTSD group whereas there were only 2 patients with EDL among controls. Posttraumatic stress disorder was also an independent predictor of EDL in multivariate analysis with an odds ratio of 6.66 and a 95% confidence interval of 2.04 to 21.72 (P=.002). Posttraumatic stress disorder independently predicted the frequency of EDL even after correcting for preexisting depression and anxiety disorders. A relatively longer duration of PACU stay in PTSD patients may reflect raised awareness of the health care workers about this debilitating mental disorder. Published by Elsevier Inc.

  7. Stress-induced neuroplasticity: (mal)adaptation to adverse life events in patients with PTSD--a critical overview.

    Science.gov (United States)

    Deppermann, S; Storchak, H; Fallgatter, A J; Ehlis, A-C

    2014-12-26

    Stress is an adaptive response to demands of the environment and thus essential for survival. Exposure to stress triggers hypothalamic-pituitary-adrenocortical (HPA) axis activation and associated neurochemical reactions, following glucocorticoid release from the adrenal glands, accompanied by rapid physiological responses. Stimulation of this pathway results in the activation of specific brain regions, including the hippocampus, amygdala and prefrontal cortex which are enriched with glucocorticoid receptors (GRs). Recent findings indicate that the activation of GRs mediates the regulation of the brain-derived neurotrophic factor (BDNF). BDNF is crucial for neural plasticity, as it promotes cellular growth and synaptic changes. Hence stress-induced activation of these pathways leads to neuroplastic changes, including the formation of long-lasting memories of the experiences. As a consequence, organisms can learn from stressful events and respond in an adaptive manner to similar demands in the future. Whereas an optimal stress level leads to enhancement of memory performance, the exposure to extreme, traumatic or chronic stressors is a risk factor for psychopathologies which are associated with memory impairment and cognitive deficits such as posttraumatic stress disorder (PTSD). In this review article, we will outline the implications of stress exposure on memory formation involving the role of glucocorticoids and BDNF. Within this context, potential adverse effects of neuroplastic alterations will be discussed using the example of PTSD. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  8. Comparison of eye movement desensitization and reprocessing therapy, cognitive behavioral writing therapy, and wait-list in pediatric posttraumatic stress disorder following single-incident trauma : a multicenter randomized clinical trial

    NARCIS (Netherlands)

    de Roos, C.; van der Oord, S.; Zijlstra, B.; Lucassen, S.; Perrin, S.; Emmelkamp, P.; de Jongh, A.

    2017-01-01

    Background: Practice guidelines for childhood posttraumatic stress disorder (PTSD) recommend trauma-focused psychotherapies, mainly cognitive behavioral therapy (CBT). Eye movement desensitization and reprocessing (EMDR) therapy is a brief trauma-focused, evidence-based treatment for PTSD in adults,

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

    Science.gov (United States)

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

    2017-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Derrick Silove

    2017-05-01

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

  11. A novel locus in the oxidative stress-related gene ALOX12 moderates the association between PTSD and thickness of the prefrontal cortex.

    Science.gov (United States)

    Miller, Mark W; Wolf, Erika J; Sadeh, Naomi; Logue, Mark; Spielberg, Jeffrey M; Hayes, Jasmeet P; Sperbeck, Emily; Schichman, Steven A; Stone, Angie; Carter, Weleetka C; Humphries, Donald E; Milberg, William; McGlinchey, Regina

    2015-12-01

    Oxidative stress has been implicated in many common age-related diseases and is hypothesized to play a role in posttraumatic stress disorder (PTSD)-related neurodegeneration (Miller and Sadeh, 2014). This study examined the influence of the oxidative stress-related genes ALOX 12 and ALOX 15 on the association between PTSD and cortical thickness. Factor analyses were used to identify