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Liberati AS, Perrotta G. Neuroanatomical and functional correlates in post-traumatic stress disorder: A narrative review. IBRAIN 2024; 10:46-58. [PMID: 38682011 PMCID: PMC11045199 DOI: 10.1002/ibra.12147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 12/27/2023] [Accepted: 01/03/2024] [Indexed: 05/01/2024]
Abstract
Post-traumatic stress disorder (PTSD), currently included by the Diagnostic and Statistical of Mental Disorders, Fifth Edition, Text Revision in the macro-category "disorders related to traumatic and stressful events", is a severe mental distress that arises acutely as a result of direct or indirect exposure to severely stressful and traumatic events. A large body of literature is available on the psychological and behavioral manifestations of PTSD; however, with regard to the more purely neuropsychological aspects of the disorder, they are still the subject of research and need greater clarity, although the roles of the thalamus, hypothalamus, amygdala, cingulate gyrus, cerebellum, locus coeruleus, and hippocampus in the onset of the disorder's characteristic symptoms have already been elucidated.
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Affiliation(s)
- Anna S. Liberati
- Faculty of PsychologyInternational Telematic University “Uninettuno”RomeItaly
- Department of the Psychological SciencesForensic Science Academy (F.S.A.)SalernoItaly
| | - Giulio Perrotta
- Department of the Psychological SciencesForensic Science Academy (F.S.A.)SalernoItaly
- Department of the Strategic PsychotherapyInstitute for the Study of Psychotherapies (I.S.P.)RomeItaly
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2
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Zaks I, Dekel R, Zuckerman YS, Horesh D. Study protocol: A multimethod psychophysiological randomized controlled trial of a couple therapy for post-traumatic stress disorder. Contemp Clin Trials 2023; 132:107280. [PMID: 37419309 DOI: 10.1016/j.cct.2023.107280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/25/2023] [Accepted: 07/03/2023] [Indexed: 07/09/2023]
Abstract
Posttraumatic stress disorder (PTSD) sequelae often have ripple effects on victims' families and spouses. Yet there has been a lag in the development and study of couple therapy for PTSD. To fill this gap, we present here a protocol for a study examining the efficacy of Cognitive Behavioral Conjoint Therapy (CBCT), a 15- session couple therapy protocol meant to alleviate PTSD and improve relationship satisfaction, in the Israeli context. The study will be a randomized controlled trial examining outcomes and processes of change via self-report questionnaires, qualitative interviews, and physiological measures (e.g., both partners' heart rate variability and electrodermal activity). We will employ a modified remote treatment protocol via video conferencing. The study will examine whether there is a reduction in couples' levels of symptomatic, emotional, and behavioral difficulties following CBCT and whether relationship satisfaction and couples' physiological synchrony increases. The study will also examine physiological and psychological change mechanisms in CBCT. Sixty Israeli couples (n = 120) will be randomly assigned to either a CBCT group or a wait-list control group. Outcomes will be assessed at four timepoints: before treatment, during treatment, post-treatment, and four months after treatment. The proposed study has the potential to shed light on the unique psychological and physiological mechanisms underlying CBCT and will be the first RCT study to employ this unique methodology in CBCT research, particularly in a video conferencing setting. This study may increase our ability to offer effective, cost-efficient, and attainable treatments for patients with PTSD and their spouses.
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Affiliation(s)
- Ilil Zaks
- Bar-Ilan University, Department of Psychology, Ramat Gan 590002, Israel.
| | - Rachel Dekel
- Bar-Ilan University School of Social Work, Ramat Gan 590002, Israel.
| | | | - Danny Horesh
- Bar-Ilan University, Department of Psychology, Ramat Gan 590002, Israel; Grossman School of Medicine, Department of Psychiatry, New York University, 550 First Avenue, New York, NY 10016, USA.
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3
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Smiley CE, Wood SK. Stress- and drug-induced neuroimmune signaling as a therapeutic target for comorbid anxiety and substance use disorders. Pharmacol Ther 2022; 239:108212. [PMID: 35580690 DOI: 10.1016/j.pharmthera.2022.108212] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 05/10/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
Stress and substance use disorders remain two of the most highly prevalent psychiatric conditions and are often comorbid. While individually these conditions have a debilitating impact on the patient and a high cost to society, the symptomology and treatment outcomes are further exacerbated when they occur together. As such, there are few effective treatment options for these patients, and recent investigation has sought to determine the neural processes underlying the co-occurrence of these disorders to identify novel treatment targets. One such mechanism that has been linked to stress- and addiction-related conditions is neuroimmune signaling. Increases in inflammatory factors across the brain have been heavily implicated in the etiology of these disorders, and this review seeks to determine the nature of this relationship. According to the "dual-hit" hypothesis, also referred to as neuroimmune priming, prior exposure to either stress or drugs of abuse can sensitize the neuroimmune system to be hyperresponsive when exposed to these insults in the future. This review completes an examination of the literature surrounding stress-induced increases in inflammation across clinical and preclinical studies along with a summarization of the evidence regarding drug-induced alterations in inflammatory factors. These changes in neuroimmune profiles are also discussed within the context of their impact on the neural circuitry responsible for stress responsiveness and addictive behaviors. Further, this review explores the connection between neuroimmune signaling and susceptibility to these conditions and highlights the anti-inflammatory pharmacotherapies that may be used for the treatment of stress and substance use disorders.
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Affiliation(s)
- Cora E Smiley
- Department of Pharmacology, Physiology, and Neuroscience; University of South Carolina School of Medicine, Columbia, SC 29209, United States of America; WJB Dorn Veterans Administration Medical Center, Columbia, SC 29209, United States of America.
| | - Susan K Wood
- Department of Pharmacology, Physiology, and Neuroscience; University of South Carolina School of Medicine, Columbia, SC 29209, United States of America; WJB Dorn Veterans Administration Medical Center, Columbia, SC 29209, United States of America.
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Muacevic A, Adler JR, Natarajan B, Mitra S, Tango T, Ahmed A, Bansode S, Almushawah AA. Current Treatments of Post-traumatic Stress Disorder and Amygdala Ablation as a Potential Cutting-Edge Therapy in Its Refractory Cases. Cureus 2022; 14:e31943. [PMID: 36582576 PMCID: PMC9794924 DOI: 10.7759/cureus.31943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 11/29/2022] Open
Abstract
Post-traumatic stress disorder (PTSD)is a very common psychiatric disorder occurring in an individual of any age, gender, or race who underwent trauma, with women being twice more at risk than men. It is generally seen more in American Indians, United States Latinos, and African American ethnic groups. A patient is diagnosed with PTSD if the symptoms of intrusion, avoidance, changes in cognition and emotions, arousal, and mood reactivity changes persist for more than a month and cause the individual severe difficulty in their everyday cognitive and psychological functioning. The psychological treatment includes numerous therapies including trauma-focused therapies such as cognitive behavioral therapy, cognitive processing therapy, prolonged exposure therapy, eye movement desensitization and reprocessing, and non-trauma-focused therapies such as relaxation techniques, interpersonal therapy, and mindfulness. Various pharmacological measures have also been tried with mixed results such as selective serotonin reuptake inhibitors, benzodiazepines, adrenergic drugs, atypical antipsychotics, and mood stabilizers like lithium and valproate. As numerous studies have proven, PTSD is linked with right-side stimulation of the amygdala. The purpose of this article is to highlight the use of extremely selective laser ablation of the amygdala-hippocampal unit as a successful surgical intervention for medically unresponsive PTSD and as a revolutionary solution and prospective cutting-edge therapy in the near future.
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Mottershead R. The social prescribing of psychosocial interventions in the treatment of addictions and substance use disorders with military veterans: a reclamation of identity and belonging. F1000Res 2022; 11:944. [PMID: 36203746 PMCID: PMC9513413 DOI: 10.12688/f1000research.124768.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/21/2022] [Indexed: 01/13/2023] Open
Abstract
Social prescribing is a way of connecting individuals to a source of support within the community to help improve their health and well-being. Social prescribing programmes are being widely promoted within the United Kingdom (UK) and United States as non-pharmaceutical interventions for those living with addiction and substance misuse needs. These needs have been exasperated by the recent COVID-19 pandemic and global economic crisis, with emerging research indicating short-term and long-term detrimental effects on physical and mental health due to substance misuse and addictions. Psychosocial interventions utilize psychological or social factors rather than an overreliance on biological interventions to treat the health impacts of mental illnesses such as addictions and substance use disorder. In this paper, I will discuss the associated determinants of addictions and substance for the military veteran population, as well as how the social prescribing of psychosocial interventions could be used to reaffirm participant's identity and enhance their sense of belonging for military veterans, using a real-world example in Wales, UK.
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Affiliation(s)
- Richard Mottershead
- RAK College of Nursing, Ras al Khaimah Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates,
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Neuroinflammation in Post-Traumatic Stress Disorder. Biomedicines 2022; 10:biomedicines10050953. [PMID: 35625690 PMCID: PMC9138406 DOI: 10.3390/biomedicines10050953] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/07/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a well-known mental illness, which is caused by various stressors, including memories of past physical assaults and psychological pressure. It is diagnosed as a mental and behavioral disorder, but increasing evidence is linking it to the immune system and inflammatory response. Studies on the relationship between inflammation and PTSD revealed that patients with PTSD had increased levels of inflammatory cytokine biomarkers, such as interleukin-1, interleukin-6, tumor necrosis factor-α, nuclear factor-κB, and C-reactive protein, compared with healthy controls. In addition, animal model experiments imitating PTSD patients suggested the role of inflammation in the pathogenesis and pathophysiology of PTSD. In this review, we summarize the definition of PTSD and its association with increased inflammation, its mechanisms, and future predictable diseases and treatment possibilities. We also discuss anti-inflammatory treatments to address inflammation in PTSD.
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Gran-Ruaz SM, Taylor RJ, Jacob G, Williams MT. Lifetime Trauma Exposure and Posttraumatic Stress Disorder Among African Americans and Black Caribbeans by Sex and Ethnicity. Front Psychiatry 2022; 13:889060. [PMID: 35800025 PMCID: PMC9253828 DOI: 10.3389/fpsyt.2022.889060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is a debilitating disorder requiring timely diagnosis and treatment, with special attention needed for Black populations in the U.S. Yet, stakeholders often fail to recognize Black communities' heterogeneous ethnic composition, thus not allowing diverse sociocultural realities to inform PTSD interventions. This study aims to characterize sex and ethnic differences in lifetime trauma exposure, lifetime PTSD diagnosis and symptoms, and help-seeking among the African Americans and Black Caribbeans in the U.S. METHOD This study relied on data from the National Survey of American Life 2001-2003 (NSAL) to investigate the lifetime exposure to traumatic events and prevalence of a clinical PTSD diagnosis based on the DSM-IV among African American (n = 3,570) and Black Caribbean (n = 1,623) adults. 44.5% of respondents were men and 55.5% were women. Logistic regression was utilized to investigate the impact of traumatic events on PTSD. RESULTS Several ethnic and sex differences in exposure to potentially traumatic events were identified. African American respondents were more likely to experience spousal abuse and toxin exposure than their Black Caribbean counterparts. Black Caribbeans reported higher lifetime exposure to muggings, natural disasters, harsh parental discipline, being a civilian living in terror and/or being a refugee than African American respondents. Specific to sex, Black men reported more events of combat, a peacekeeper/relief worker, being mugged, toxin exposure, seeing atrocities, and/or injuring someone. Black women were more likely to have been rape/sexual assault and/or intimate partner violence victims. The assaultive violence trauma type was most predictive of lifetime PTSD diagnosis among Black Americans. African American women were more likely to report PTSD symptoms than men, with almost no significant differences in Black Caribbean men and women. Approximately half of Black Americans sought help for their worst traumatic event, commonly engaging family/friends, psychiatrists, and mental health professionals. Further, there were almost no ethnic and sex differences related to professional and non-professional help sought. CONCLUSION Future PTSD-related research should aim to characterize the heterogenous experiences of potentially traumatic events within different Black communities. Clinicians working with Black clients should strive to understand the limitations within their tools/interventions in meeting the needs of diverse groups.
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Affiliation(s)
| | | | - Grace Jacob
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Monnica T Williams
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.,School of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
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Wolde A, Dessalegn N. Posttraumatic Stress Disorder, Suicidal Behavior, Substance Use, and Sexual Victimization Among Adolescent Girls Aged 10-19 Years Living Under Ethnic-Based Civil War in Ethiopia. Neuropsychiatr Dis Treat 2022; 18:2239-2250. [PMID: 36254143 PMCID: PMC9569158 DOI: 10.2147/ndt.s381461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/01/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a chronic, impairing mental disorder that develops after exposure to a traumatic event. Despite many factors putting adolescent girls at risk of PTSD, little is known about the prevalence and how adolescent girls cope with the PTSD burden. So, this study aimed to investigate the prevalence of PTSD and associated factors among adolescent girls in three selected towns in Southwest Ethiopia. METHODS A community-based cross-sectional study was conducted among 397 adolescent girls from May 27 to July 27, 2021. The participants were selected by a systematic random sampling method. PTSD and substance use disorder were assessed by DSM V criteria for mental disorders. The data was entered into Epi Data Manager Version 4.0.2 before being exported to SPSS Version 25 for analysis. A logistic regression model was used, and variables with a p-value less than 0.05 in the final fitting model were stated as independent predictors of PTSD. RESULTS The prevalence of PTSD among the adolescent girls was 22%, and about three in four (72.7%) of the adolescent girls developed PTSD after exposure to sexual violence. Furthermore, PTSD was associated with Khat use disorder (AOR, 95% CI: 2.79 (1.47-5.30), alcohol use disorder (AOR, 95% CI: 5.27 (2.21-12.60), and suicidal behavior (AOR, 95% CI: 2.12 (1.20-3.74)). CONCLUSION The prevalence of PTSD was high among adolescent girls, and suicidal ideation or attempt, khat use disorder, and alcohol use disorder were risk factors for PTSD. Therefore, early screening for PTSD and comorbid risk factors among this particular age group and managing accordingly is warranted.
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Affiliation(s)
- Asrat Wolde
- Department of Psychiatry, School of Medicine, Mizan Tepi University, Mizan Aman, Ethiopia
| | - Nigatu Dessalegn
- Department of Pediatric Health Nursing, Mizan Tepi University, Mizan Aman, Ethiopia
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Sayers B, Wijeyesekera A, Gibson G. Exploring the potential of prebiotic and polyphenol-based dietary interventions for the alleviation of cognitive and gastrointestinal perturbations associated with military specific stressors. J Funct Foods 2021. [DOI: 10.1016/j.jff.2021.104753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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10
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Mottershead R, Ghisoni M. Horticultural therapy, nutrition and post-traumatic stress disorder in post-military veterans: developing non-pharmaceutical interventions to complement existing therapeutic approaches. F1000Res 2021; 10:885. [PMID: 34621518 PMCID: PMC8456374 DOI: 10.12688/f1000research.70643.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2021] [Indexed: 12/12/2022] Open
Abstract
Non-pharmaceutical interventions for veterans living with post-traumatic stress disorder are becoming a more popular way to address some of the social and personal needs identified by this group. Horticultural therapy or growing and eating food together provides several ways to increase mood, improve nutritional status, reduce loneliness and reduce the physical health impacts of mental illnesses such as post-traumatic stress disorder. In this paper we will discuss some of the issues people living with post-traumatic stress disorder might face. We will also provide an overview of the therapeutic effects of these approaches and how they will be applied in a locally identified group.
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Affiliation(s)
- Richard Mottershead
- Ras Al Khaimah College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah, P.O.Box 11172, United Arab Emirates
| | - Marjorie Ghisoni
- School of Medical and Health Sciences, Bangor University, Bangor, Wales, LL57 2DG, UK
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11
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Sekoni O, Mall S, Christofides N. Prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria: a cross-sectional study. BMC Public Health 2021; 21:1546. [PMID: 34384401 PMCID: PMC8359091 DOI: 10.1186/s12889-021-11508-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 07/19/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Little is known about the prevalence of and factors associated with PTSD among adult females in Nigeria, particularly those who live in slums. PTSD is a mental health condition that develops among some individuals who experience or witness a traumatic event. Several other factors could place individuals at heightened risk of PTSD including stress and comorbid mental disorders. Therefore, this study aimed to examine the prevalence and factors associated with PTSD among female urban slum dwellers in Ibadan, Nigeria. METHODS We conducted a cross sectional survey using multistage sampling of 550 women aged 18 and above from selected slums. Interviewer administered questionnaires were used to elicit information on experience of childhood trauma, recent stressors, intimate partner violence, other mental disorders, sociodemographic characteristics and PTSD. PTSD was measured using the Harvard Trauma Questionnaire (HTQ) which is based on DSM IV. A multivariable linear regression model was built to test associations between PTSD and independent variables. RESULTS The prevalence for PTSD was found to be 4.18% and the mean PTSD score was 5.80 ± 7.11. Sexual abuse in childhood, past year intimate partner violence and anxiety were significantly associated with higher PTSD scores. PTSD was not significantly associated with a history of recent stressors. Education, employment and marital status were not associated with PTSD however, age and wealth index showed marginal association with PTSD. CONCLUSION The prevalence of PTSD among women living in Ibadan slums was relatively low. Both child sexual abuse and intimate partner violence can be prevented. We also recommend longitudinal studies to better understand risk and protective factors.
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Affiliation(s)
- Olutoyin Sekoni
- Department of Community Medicine, College of Medicine, University of Ibadan, Queen Elizabeth Road, Ibadan, Nigeria.
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, 2193, South Africa.
| | - Sumaya Mall
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, 2193, South Africa
| | - Nicola Christofides
- School of Public Health, University of the Witwatersrand, 27 St Andrews Road, Parktown, 2193, South Africa
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Johnson A, Weeks M, Loewen B, Byrd M, Ryan GA. Training Considerations and Recommendations for Tactical Professionals With Posttraumatic Stress Disorder. Strength Cond J 2021. [DOI: 10.1519/ssc.0000000000000591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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13
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Mordeno IG, Gallemit IMJS, Ferolino MAL, Sinday JV. DSM-5-Based ASD Models: Assessing the Latent Structural Relations with Functionality in War-Exposed Individuals. Psychiatr Q 2021; 92:347-362. [PMID: 32748123 DOI: 10.1007/s11126-020-09804-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
There is a dearth of studies investigating the latent structure of Acute Stress Disorder (ASD) following the changes in the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5). To date, there is no consensus on the best representation of ASD. This study addressed this gap by examining four latent ASD models in a sample of war-exposed individuals (N = 424). Investigation on the relationship of the best-fitting model to functionality in the latent level was also conducted. The five-factor model, composed of intrusion, avoidance, numbing, dysphoric arousal, and anxious arousal factors, yielded the best-fitting model. Latent associations between the factors of the model and functionality suggest that symptoms of functionality do not significantly affect the factor structure of ASD. These findings have implications for understanding the underlying mechanism of ASD and can inform the development of more nuanced trauma-related interventions, particularly addressing ASD symptoms and functionality separately.
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Affiliation(s)
- Imelu G Mordeno
- Department of Professional Education, Mindanao State University - Iligan Institute of Technology, Andres Bonifacio Ave., Tibanga, 9200, Iligan City, Philippines.
| | - I Marie Joy S Gallemit
- School of Graduate Studies, College of Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Michelle Anne L Ferolino
- School of Graduate Studies, College of Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
| | - Jonahliza V Sinday
- School of Graduate Studies, College of Education, Mindanao State University - Iligan Institute of Technology, Iligan City, Philippines
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Nebbitt V, Lombe M, Pitzer KA, Foell A, Enelamah N, Chu Y, Yu M, Newransky C, Gaylord-Harden N. Exposure to Violence and Posttraumatic Stress Among Youth in Public Housing: Do Community, Family, and Peers Matter? J Racial Ethn Health Disparities 2021; 8:264-274. [PMID: 32519280 DOI: 10.1007/s40615-020-00780-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022]
Abstract
This study examines the mediating roles of neighborhood risk factors, parental behaviors, and peers on the relationship between community violence exposure and posttraumatic stress in a sample of urban youth in low-income public housing communities. Data are from 320 African-American youth living in public housing in a northeastern city in the USA. Structural equation modeling was utilized to examine the stated relationships. Study results point to significant effects of violence exposure on posttraumatic stress in urban youth. While findings indicated indirect effects of neighborhood risk, parenting practices, and exposure to delinquent peers on posttraumatic stress, each of these paths operates through their relationship with violence exposure, with exposure to delinquent peers having the strongest mediating effect. Exposure to delinquent peers mediates the effects of neighborhood risks and parental behaviors on exposure to community violence, representing one potential intervention point to disrupt the deleterious effects of exposure to violence among youth. Our findings suggest interventions that address peer influence, and group norms may serve as protective factors against the risk of youth violence exposure. Overall, results highlight the co-occurring socioecological context of community violence exposure for youth living in public housing.
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Affiliation(s)
- Von Nebbitt
- The Brown School, Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA.
| | - Margaret Lombe
- School of Social Work, Boston College, 140 Commonwealth Avenue, McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Kyle A Pitzer
- The Brown School, Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Andrew Foell
- The Brown School, Washington University in St. Louis, 1 Brookings Dr., St. Louis, MO, 63130, USA
| | - Ngozi Enelamah
- School of Social Work, Boston College, 140 Commonwealth Avenue, McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Yoosun Chu
- School of Social Work, Boston College, 140 Commonwealth Avenue, McGuinn Hall, Chestnut Hill, MA, 02467, USA
| | - Mansoo Yu
- School of Social Work, Department of Public Health, University of Missouri, 720 Clark Hall, Columbia, MO, 65211, USA
| | - Chrisann Newransky
- School of Social Work, Adelphi University, Social Work Building Room 309, One South Avenue, Garden City, NY, 11530, USA
| | - Noni Gaylord-Harden
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL, 60660, USA
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Agarwal TM, Muneer M, Asim M, Awad M, Afzal Y, Al-Thani H, Alhassan A, Mollazehi M, El-Menyar A. Psychological trauma in different mechanisms of traumatic injury: A hospital-based cross-sectional study. PLoS One 2020; 15:e0242849. [PMID: 33253298 PMCID: PMC7703890 DOI: 10.1371/journal.pone.0242849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psychological distress following traumatic injury can influence the patient health, well-being and quality of life; however, this impact may partly vary according to the type and severity of injury. We aimed to study the predominant distress causing cluster and individual symptoms of Post-Traumatic Stress Disorders (PTSD) at the clinical and subthreshold level in patients with traumatic injuries, based on the mechanism of injury (MOI). METHODS A hospital based cross-sectional study was conducted at a Level 1 Trauma Center utilizing PTSD Checklist to diagnose PTSD after one month of the traumatic event. All patients suffering from psychological distresses were assessed by a clinical psychologist in the trauma section. PTSD diagnostic criteria from DSM-5 were used to classify the patients. The inclusion criteria comprised of adult trauma patients who were directly involved in traumatic injuries and admitted under the Trauma Surgery services for a minimum of one day; have ability to provide written informed consent and can be assessed with the PCL-5 checklist after 4 weeks post-injury. RESULTS Two hundred patients completed PCL-5 checklist, of them 26 (13.0%) were positive for PTSD and 174 (87%) had subthreshold scores. The mean age of participants was 34.4±11.8 years and males constituted 90.5%. Road traffic injury (RTI) was most the frequent injury mechanism (59%). PTSD positive patients with RTI, fall of heavy objects, pedestrian injury and assaults had highest average scores on clusters of negative alterations in mood and cognitions (16.9, 18.0, 18.5, 17.0 respectively), followed by hyperarousal. Symptom of always being on the guard and having repeated unwanted or disturbing memories of the incident, was reported by nearly 100% PTSD positive patients. Patients with subthreshold scores also reported distressing symptoms on all four clusters of PTSD. CONCLUSIONS Patients with different MOI showed a broad range of psychological problems with respect to symptom clusters. Negative alteration in mood and cognition followed by hyperarousal caused higher level of distress in patients post traumatic injuries. Subthreshold symptoms of PTSD are more common and deserve more attention.
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Affiliation(s)
| | - Mohammed Muneer
- Department of Surgery, Plastic Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Asim
- Clinical Research, Trauma & Vascular Surgery, Department of Surgery, Hamad General Hospital, Doha, Qatar
| | - Malaz Awad
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Yousra Afzal
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ahmed Alhassan
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - Monira Mollazehi
- Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ayman El-Menyar
- Clinical Research, Trauma & Vascular Surgery, Department of Surgery, Hamad General Hospital, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medical School, Doha, Qatar
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Uncovering Physical and Attitudinal Barriers to Adherence to Precautions for Preventing the Transmission of COVID-19 and Anxiety Level of People in Wuhan: 2 Months After the Lockdown. J Acad Consult Liaison Psychiatry 2020; 62:201-210. [PMID: 33183846 PMCID: PMC7506304 DOI: 10.1016/j.psym.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/15/2020] [Accepted: 09/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Wuhan, the epicenter of the coronavirus disease 2019 outbreak, was locked down on January 23, 2020. We aimed to investigate the barriers to the physical prevention, negative attitudes, and anxiety levels. METHODS A online cross-sectional survey was conducted with the people living in Wuhan between March 12th and 23rd, 2020. RESULTS Of a total of 2411 complete responses, the mean and standard deviation for the total physical prevention barriers score was 19.73 (standard deviation ± 5.3; range 12-45) out of a possible score of 48. Using a cut-off score of 44 for the State-Trait Inventory score, 79.9% (95% confidence interval [CI]: 78.2-81.5) of the participants reported moderate to severe anxiety during the early phase of the outbreak, and 51.3% (95% CI 49.2-53.3) reported moderate to severe anxiety after the peak of coronavirus disease 2019 was over (during the study period). Comparing anxiety levels in the early phase of the outbreak and after the peak of the outbreak, 58.5% (95% CI 56.5-60.5) recorded a decreased anxiety. Females reported a higher likelihood of having decreased levels of anxiety than males (odds ratio = 1.78, 95% CI 1.48-2.14). Low negative attitudes score were associated with a higher decrease in anxiety (odds ratio = 1.59, 95% CI 1.33-1.89). CONCLUSIONS The attitudinal barriers to prevention of transmission of coronavirus disease 2019 are more prominent than physical prevention barriers after the peak of coronavirus disease 2019. High anxiety levels even after the peak warrant serious attention.
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Neurophysiology and Psychopathology Underlying PTSD and Recent Insights into the PTSD Therapies-A Comprehensive Review. J Clin Med 2020; 9:jcm9092951. [PMID: 32932645 PMCID: PMC7565106 DOI: 10.3390/jcm9092951] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 12/21/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a well-known psychiatric disorder that affects millions of people worldwide. Pharmacodynamic and cognitive-behavioral therapies (CBT) have been used to treat patients with PTSD. However, it remains unclear whether there are concurrent changes in psychopathological and neurophysiological factors associated with PTSD patients. Past reports described those PTSD patients with efficient fatty acid metabolism, neurogenesis, mitochondrial energy balance could improve ability to cope against the conditioned fear responses and traumatic memories. Furthermore, cognitive, behavioral, cellular, and molecular evidence can be combined to create personalized therapies for PTSD sufferers either with or without comorbidities such as depression or memory impairment. Unfortunately, there is still evidence lacking to establish a full understanding of the underlying neurophysiological and psychopathological aspects associated with PTSD. This review has extensively discussed the single nucleotide polymorphism (SNPs) of genetic factors to cause PTSD, the implications of inflammation, neurotransmitter genomics, metabolic alterations, neuroendocrine disturbance (hypothalamus-pituitary-adrenal (HPA) axis), mitochondrial dynamics, neurogenesis, and premature aging related to PTSD-induced psychopathology and neurophysiology. In addition, the review delineated the importance of CBT and several pharmacodynamic therapies to mitigate symptomatology of PTSD.
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Zhang X, Zou R, Liao X, Bernardo ABI, Du H, Wang Z, Cheng Y, He Y. Perceived Stress, Hope, and Health Outcomes Among Medical Staff in China During the COVID-19 Pandemic. Front Psychiatry 2020; 11:588008. [PMID: 33584363 PMCID: PMC7873910 DOI: 10.3389/fpsyt.2020.588008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/24/2020] [Indexed: 11/13/2022] Open
Abstract
This study investigated the buffering role of hope between perceived stress and health outcomes among front-line medical staff treating patients with suspected COVID-19 infection in Shenzhen, China. In the cross-sectional study with online questionnaires, medical staff's perceived stress, anxiety, depression, sleep quality, and hope were measured by the 10-item Chinese Perceived Stress Scale, Hospital Anxiety and Depression Scale, the Pittsburgh Sleep Quality Index, and the Locus-of-Hope Scale, respectively. A total of 319 eligible front-line medical staff participated. The prevalence of anxiety (29.70%), depression (28.80%), poor sleep quality (38.90%) indicated that a considerable proportion of medical staff experienced mood and sleep disturbances during the COVID-19 pandemic. Internal locus-of-hope significantly moderated the effects of stress on anxiety, depression, and sleep quality. Moreover, external family locus-of-hope and external peer locus-of-hope significantly moderated the association between perceived stress and depression. The prevalence of symptoms indicates that both mental and physical health outcomes of front-line medical staff deserve more attention. Internal and external locus-of-hope functioned differently as protective factors for medical staffs' health and might be promising targets for intervention.
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Affiliation(s)
- Xin Zhang
- Department of Medical Humanities, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | - Rong Zou
- Hubei Key Laboratory of Sport Training and Monitoring, Department of Psychology, College of Health Science, Wuhan Sports University, Wuhan, China
| | - Xiaoxing Liao
- The Emergency and Disaster Rescue Medical Center, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
| | | | - Hongfei Du
- Institute of Advanced Studies in Humanities and Social Sciences, Beijing Normal University at Zhuhai, Zhuhai, China
| | - Zhechen Wang
- Department of Psychology, School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Yu Cheng
- Department of Medical Humanities, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China.,Department of Anthropology, School of Sociology and Anthropology, Sun Yat-sen University, Guangzhou, China
| | - Yulong He
- Center for Digestive Disease, The Seventh Affiliated Hospital of Sun Yat-sen University, Shenzhen, China
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Pathania S, Slater LZ, Vose C, Navarra AM. Music Therapy and Pain Management in Patients with End-Stage Liver Disease: An Evidence-Based Practice Quality Improvement Project. Pain Manag Nurs 2018; 20:10-16. [PMID: 30448441 DOI: 10.1016/j.pmn.2018.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Revised: 02/23/2018] [Accepted: 07/16/2018] [Indexed: 01/27/2023]
Abstract
BACKGROUND Pain can negatively affect the inpatient hospitalization experience; however, in patients with compromised metabolic pathways who are more vulnerable to medication side effects, pain control becomes even more challenging. AIMS This evidence-based practice quality improvement project explored the feasibility of implementing a music therapy intervention for improved pain management (pain intensity, analgesic volume) and patient satisfaction among patients with a diagnosis of cirrhotic end-stage liver disease in the acute care setting. DESIGN The plan-do-check-act cycle served as the implementation framework. Four nurse champions were trained to implement a 30-minute music intervention. Self-selected musical selections were delivered via unit-based iPads with earbud headphones during 3 consecutive days. METHODS Data collection was performed using unit-based measures for pain and patient satisfaction and an investigator-developed audit tool. Bivariate analyses and descriptive statistics were used to assess the effect of the intervention on the three outcomes of interest. RESULTS Overall results from data collected with eight participants during a 6-week period indicated a 10% reduction in pain intensity and a 30% improvement in patient satisfaction with pain management care. CONCLUSIONS Findings from this evidence-based practice quality improvement project provide support for the effectiveness of music therapy as an adjunct to traditional pharmacologic modalities for pain management of the end-stage liver disease patient population.
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Affiliation(s)
- Sonia Pathania
- New York University Rory Meyers College of Nursing, New York, New York.
| | - Larry Z Slater
- New York University Rory Meyers College of Nursing, New York, New York
| | - Courtney Vose
- New York University Rory Meyers College of Nursing, New York, New York
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Violanti JM, Ma CC, Mnatsakanova A, Fekedulegn D, Hartley TA, Gu JK, Andrew ME. Associations Between Police Work Stressors and Posttraumatic Stress Disorder Symptoms: Examining the Moderating Effects of Coping. JOURNAL OF POLICE AND CRIMINAL PSYCHOLOGY 2018; 33:271-282. [PMID: 31024192 PMCID: PMC6477685 DOI: 10.1007/s11896-018-9276-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The role of coping in the association between stress and posttraumatic stress disorder (PTSD) is not clear. We investigated the effects of active and passive coping strategies on the associations between police stress (administrative and organization pressure, physical and psychological threats, and lack of support) and PTSD symptoms in 342 police officers. Linear regression model was used in the analyses. The association between physical and psychological stress and PTSD symptoms was stronger in officers who used lower active coping (B = 4.34, p <0.001) compared to those who utilized higher active coping (p -interaction = 0.027) (B =1.79, p ≤ 0.003). A similar result was found between lack of support and PTSD symptoms (p -interaction = 0.016) (lower active coping, B = 5.70, p < 0.001; higher active coping, B = 3.33, p <0.001), but was not significantly different comparing the two groups regarding the association between administrative and organizational pressure and PTSD symptoms (p -interaction = 0.376). Associations of total stress, administrative and organizational pressure, and physical and psychological stressors with PTSD symptoms were significantly stronger in officers who utilized higher passive coping (p -interaction = 0.011, 0.030, and 0.023, respectively). In conclusion, low active or high passive coping methods may exacerbate the effect of work stress on PTSD symptoms.
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Affiliation(s)
- John M. Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, 270 Farber Hall, Buffalo, NY, USA
| | - Claudia C. Ma
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown,WV, USA
| | - Anna Mnatsakanova
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown,WV, USA
| | - Desta Fekedulegn
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown,WV, USA
| | - Tara A. Hartley
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown,WV, USA
| | - Ja Kook Gu
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown,WV, USA
| | - Michael E. Andrew
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown,WV, USA
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Jacob L, Haro JM, Koyanagi A. Post-traumatic stress symptoms are associated with physical multimorbidity: Findings from the Adult Psychiatric Morbidity Survey 2007. J Affect Disord 2018. [PMID: 29522958 DOI: 10.1016/j.jad.2018.02.063] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Studies on the association between symptoms of post-traumatic stress disorder (PTSD) and physical multimorbidity (i.e., ≥2 chronic conditions) are lacking. Thus, we assessed the association between PTSD symptoms and physical multimorbidity using nationally representative, community-based data of the UK adult population. METHODS Data from the 2007 Adult Psychiatric Morbidity Survey were analyzed. PTSD symptoms were assessed using the 10-item Trauma Screening Questionnaire (TSQ). A total score of ≥6 points indicated a probable PTSD. Information was collected on 20 doctor/other health professional diagnosed physical health conditions that were present in the past 12 months. Multimorbidity was defined as ≥2 physical diseases. Multivariable logistic regression and mediation analyses were conducted to analyze the association between PTSD and physical multimorbidity, and the influence of behavioral and psychological factors in this association. RESULTS Among 7403 individuals aged ≥16 years [mean age (SD) = 46.3 (18.6) years; 51.5% females], the prevalence of PTSD increased from 2.1% in individuals with no physical conditions to 5.4% in those with ≥4 physical conditions. After adjustment for sociodemographic factors and lifetime occurrence of a traumatic event, PTSD was associated with higher odds for physical multimorbidity (Odds Ratio [OR] = 2.47; 95% Confidence Interval [CI]: 1.71-3.56). Anxiety, depression, and disordered eating explained 35%, 21%, and 8% of the PTSD-multimorbidity association, respectively. LIMITATIONS Causality or temporal associations cannot be established due to the cross-sectional nature of the study. In addition, PTSD and physical conditions were assessed using self-reports. CONCLUSIONS PTSD symptoms may be risk factors for physical multimorbidity. Anxiety and depressive symptoms might play an important role in this association. Screening for chronic physical conditions among individuals with PTSD and treating them simultaneously may lead to better clinical outcomes.
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Affiliation(s)
- Louis Jacob
- Faculty of Medicine, University of Paris 5, 15 rue de l'École de Médecine, Paris 75006, France.
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, Barcelona 08830, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Monforte de Lemos 3-5 Pabellón 11, Madrid 28029, Spain
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22
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Alzoubi KH, Rababa'h AM, Al Yacoub ON. Tempol prevents post-traumatic stress disorder induced memory impairment. Physiol Behav 2018; 184:189-195. [PMID: 29217357 DOI: 10.1016/j.physbeh.2017.12.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 10/14/2017] [Accepted: 12/02/2017] [Indexed: 12/14/2022]
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23
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Kopacz MS, Ames D, Koenig HG. Association Between Trust and Mental, Social, and Physical Health Outcomes in Veterans and Active Duty Service Members With Combat-Related PTSD Symptomatology. Front Psychiatry 2018; 9:408. [PMID: 30233429 PMCID: PMC6131606 DOI: 10.3389/fpsyt.2018.00408] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/13/2018] [Indexed: 11/25/2022] Open
Abstract
Background: Trust represents a complex emotion and interpersonal concept which assumes abandoning control over a given situation or set of circumstances, in turn yielding such control to another party. Advances in our knowledge of post-traumatic stress disorder and moral injury have underscored the need to more closely examine how trust stands to impact health outcomes in these disorders. The aim of the present study is to examine and identify relationships linking general trust with select health outcomes in a mixed sample of Veterans and Service members with a self-reported history of deployment to a combat theater and PTSD symptomatology. Methods: This study applied a cross-sectional methodology, surveying n = 427 participants recruited across six sites. This included 373 Veterans and 54 active duty Service members in the United States. Measures included demographic characteristics, combat exposure, general trust, post-traumatic stress disorder symptomatology, depressive/anxiety symptomatology, alcohol use, social involvement, religiosity, and physical health. Data were analyzed descriptively as well as using Pearson correlations, Student's t-test, and multivariate regression. Results: Several significant relationships were identified, indicating an inverse relationship between trust and PTSD, depressive, and anxiety symptomatology. Greater levels of trust were also significantly associated with increased social interaction and religiosity. Lastly, no significant associations were identified with either physical functioning or pain level. Conclusion: The findings suggest that trust is correlated with a variety of health outcomes in Veterans and Service members affected by combat-related PTSD. Additional, hypothesis-driven research, informed by longitudinal data, is needed to better understand how trust stands to impact health outcomes, including the development of strategies and intervention options for repairing trust.
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Affiliation(s)
- Marek S Kopacz
- VISN 2 Center of Excellence for Suicide Prevention, U.S. Department of Veterans Affairs, Canandaigua, NY, United States.,Mental Health and Chaplaincy, U.S. Department of Veterans Affairs, Durham, NC, United States
| | - Donna Ames
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States.,David Geffen School of Medicine, University of California, Los Angeles Los Angeles, CA, United States
| | - Harold G Koenig
- Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.,Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.,School of Public Health, Ningxia Medical University, Yinchuan, China
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25
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Poor tap water quality experiences and poor sleep quality during the Flint, Michigan Municipal Water Crisis. Sleep Health 2017; 3:241-243. [DOI: 10.1016/j.sleh.2017.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/13/2017] [Accepted: 05/17/2017] [Indexed: 11/21/2022]
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26
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Tahmasian M, Jamalabadi H, Abedini M, Ghadami MR, Sepehry AA, Knight DC, Khazaie H. Differentiation chronic post traumatic stress disorder patients from healthy subjects using objective and subjective sleep-related parameters. Neurosci Lett 2017; 650:174-179. [DOI: 10.1016/j.neulet.2017.04.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2016] [Revised: 04/20/2017] [Accepted: 04/21/2017] [Indexed: 12/15/2022]
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27
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Maxwell PC. Betrayal Trauma and Covenant: Theologically Understanding Abuse Trauma and Traumatically Reforming Theological Understanding. JOURNAL OF SPIRITUALITY IN MENTAL HEALTH 2016. [DOI: 10.1080/19349637.2016.1260514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Paul C. Maxwell
- Trinity Evangelical Divinity School, Deerfield, Illinois, USA
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28
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Reisman M. PTSD Treatment for Veterans: What's Working, What's New, and What's Next. P & T : A PEER-REVIEWED JOURNAL FOR FORMULARY MANAGEMENT 2016; 41:623-634. [PMID: 27757001 PMCID: PMC5047000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
More than a decade of war in the Middle East has pushed post-traumatic stress disorder (PTSD) to the forefront of public health concerns. The author defines the disorder and discusses risk factors, treatments, and the barriers to effective care.
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Horn SR, Charney DS, Feder A. Understanding resilience: New approaches for preventing and treating PTSD. Exp Neurol 2016; 284:119-132. [PMID: 27417856 DOI: 10.1016/j.expneurol.2016.07.002] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 06/24/2016] [Accepted: 07/08/2016] [Indexed: 12/29/2022]
Abstract
All individuals experience stressful life events, and up to 84% of the general population will experience at least one potentially traumatic event. In some cases, acute or chronic stressors lead to the development of posttraumatic stress disorder (PTSD) or other psychopathology; however, the majority of people are resilient to such effects. Resilience is the ability to adapt successfully in the face of stress and adversity. A wealth of research has begun to identify the genetic, epigenetic, neural, and environmental underpinnings of resilience, and has indicated that resilience is mediated by adaptive changes encompassing several environmental factors, neural circuits, numerous neurotransmitters, and molecular pathways. The first part of this review focuses on recent findings regarding the genetic, epigenetic, developmental, psychosocial, and neurochemical factors as well as neural circuits and molecular pathways that underlie the development of resilience. Emerging and exciting areas of research and novel methodological approaches, including genome-wide gene expression studies, immune, endocannabinoid, oxytocin, and glutamatergic systems, are explored to help delineate innovative mechanisms that may contribute to resilience. The second part reviews several interventions and preventative approaches designed to enhance resilience in both developmental and adult populations. Specifically, the review will delineate approaches aimed to bolster resilience in individuals with PTSD. Furthermore, we discuss novel pharmacologic approaches, including the N-methyl-d-aspartate (NMDA) receptor ketamine and neuropeptide Y (NPY), as exciting new prospects for not only the treatment of PTSD but as new targets to enhance resilience. Our growing understanding of resilience and interventions will hopefully lead to the development of new strategies for not just treating PTSD but also screening and early identification of at-risk youth and adults. Taken together, efforts aimed at dissemination and implementation of novel interventions to enhance resilience will have to keep pace with the growth of new preventive and treatment strategies.
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Affiliation(s)
- Sarah R Horn
- Department of Psychiatry, Icahn School of Medicine, New York, NY, USA
| | - Dennis S Charney
- Department of Psychiatry, Icahn School of Medicine, New York, NY, USA; Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pharmacology and Systems Therapeutics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Adriana Feder
- Department of Psychiatry, Icahn School of Medicine, New York, NY, USA.
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Houston JB, Spialek ML, Perreault MF. Coverage of Posttraumatic Stress Disorder in the New York Times, 1950-2012. JOURNAL OF HEALTH COMMUNICATION 2015; 21:240-248. [PMID: 26166398 DOI: 10.1080/10810730.2015.1058441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a mental health disorder that occurs for some individuals following a traumatic experience and that can cause significant health, mental health, and functioning problems. The concept of PTSD has multiple components (cause, reactions, and treatment), which provides for great variety in the experience of an individual with PTSD. Given this complexity, the news media's construction of PTSD is likely an important influence in determining how the public understands PTSD, but research has yet to investigate how the news media depict PTSD. This study addresses that gap in the literature by examining New York Times coverage of PTSD from 1950 to 2012. Results indicate that the number of PTSD articles during this time period increased, with coverage spikes related to U.S. military conflicts and the September 11, 2001, terrorist attacks. Almost half (49.14%) of all PTSD articles included military service as a PTSD cause. Military PTSD articles were more likely than civilian PTSD articles to depict the disorder as causing anger/irritability/rage, homicide/violence/rape, suicide, substance abuse, and home/work/relationship problems. PTSD news stories were almost always (94.8%) situated in the current time and most frequently (46.6%) used a community frame. Implications for public understanding of PTSD are discussed.
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Affiliation(s)
- J Brian Houston
- a Department of Communication , University of Missouri , Columbia , Missouri , USA
- b Disaster and Community Crisis Center , University of Missouri , Columbia , Missouri , USA
| | - Matthew L Spialek
- a Department of Communication , University of Missouri , Columbia , Missouri , USA
- b Disaster and Community Crisis Center , University of Missouri , Columbia , Missouri , USA
| | - Mildred F Perreault
- b Disaster and Community Crisis Center , University of Missouri , Columbia , Missouri , USA
- c School of Journalism , University of Missouri , Columbia , Missouri , USA
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Vicarious social defeat stress: Bridging the gap between physical and emotional stress. J Neurosci Methods 2015; 258:94-103. [PMID: 26545443 DOI: 10.1016/j.jneumeth.2015.10.012] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/15/2015] [Accepted: 10/27/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND Animal models capable of differentiating the neurobiological intricacies between physical and emotional stress are scarce. Current models rely primarily on physical stressors (e.g., chronic unpredictable or mild stress, social defeat, learned helplessness), and neglect the impact of psychological stress alone. This is surprising given extensive evidence that a traumatic event needs not be directly experienced to produce enduring perturbations on an individual's health and psychological well-being. Post-traumatic stress disorder (PTSD), a highly debilitating neuropsychiatric disorder characterized by intense fear of trauma-related stimuli, often occurs in individuals that have only witnessed a traumatic event. NEW METHOD By modifying the chronic social defeat stress (CSDS) paradigm to include a witness component (witnessing the social defeat of another mouse), we demonstrate a novel behavioral paradigm capable of inducing a robust behavioral syndrome reminiscent of PTSD in emotionally stressed adult mice. RESULTS We describe the vicarious social defeat stress (VSDS) model that is capable of inducing a host of behavioral deficits that include social avoidance and other depressive- and anxiety-like phenotypes in adult male mice. VSDS exposure induces weight loss and spike in serum corticosterone (CORT) levels. A month after stress, these mice retain the social avoidant phenotype and have an increased CORT response when exposed to subsequent stress. COMPARISON WITH EXISTING METHOD(S) The VSDS is a novel paradigm capable of inducing emotional stress by isolating physical stress/confrontation in mice. CONCLUSIONS The VSDS model can be used to study the short- and long-term neurobiological consequences of exposure to emotional stress in mice.
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Bolton AJ, Dorstyn DS. Telepsychology for Posttraumatic Stress Disorder: A systematic review. J Telemed Telecare 2015; 21:254-67. [DOI: 10.1177/1357633x15571996] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2014] [Indexed: 11/16/2022]
Abstract
Summary The effectiveness of psychological services provided remotely, telepsychology, for the management of Posttraumatic Stress Disorder (PTSD) was evaluated. Eleven studies ( n = 472 participants) were identified from electronic database searches. Study quality was assessed, with studies characterised by small and underpowered samples. Effect sizes and associated confidence intervals (CIs) were calculated to determine the direction and magnitude of treatment change. Short-term treatment gains were reported for internet and video-based interventions. This included significant medium to large improvements ( d range = 0.66–3.22) in cognitive and behavioural symptoms of depression, generalised anxiety and posttraumatic stress. However, the equivalence of telepsychology and face-to-face psychotherapy could not be determined, with few comparative studies available. Both treatment gains and deterioration were noted 1 to 6 months following treatment cessation, although this was based on limited follow-up data. Further larger scale and longitudinal research will help to ascertain the minimum requirements for the management and treatment of PTSD in a technology-supported environment.
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Affiliation(s)
- AJ Bolton
- School of Psychology, University of Adelaide, Adelaide, South Australia 5005
| | - DS Dorstyn
- School of Psychology, University of Adelaide, Adelaide, South Australia 5005
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Vagharseyyedin SA. Experiences of Wives of Iranian War Veterans with Posttraumatic Stress Disorder Regarding Social Relationships. Public Health Nurs 2014; 32:122-31. [DOI: 10.1111/phn.12118] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Post-traumatic stress disorder and vision. ACTA ACUST UNITED AC 2010; 81:240-52. [DOI: 10.1016/j.optm.2009.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2009] [Revised: 04/02/2009] [Accepted: 07/30/2009] [Indexed: 12/19/2022]
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Brown TE, Wilson AR, Cocking DL, Sorg BA. Inhibition of matrix metalloproteinase activity disrupts reconsolidation but not consolidation of a fear memory. Neurobiol Learn Mem 2008; 91:66-72. [PMID: 18824238 DOI: 10.1016/j.nlm.2008.09.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2008] [Revised: 09/08/2008] [Accepted: 09/09/2008] [Indexed: 01/18/2023]
Abstract
The reconsolidation hypothesis posits that memories that have been reactivated can be either enhanced or disrupted by pharmacological manipulation. Synaptic plasticity is presumed to underlie the reconsolidation process. Matrix metalloproteinases are proteins that regulate the extracellular matrix involved in plasticity events, and these proteins have recently been shown to influence learning and memory. However, all studies on the role of matrix metalloproteinases in learning and memory have employed tasks that rely on contextual cues. The goal of this study was to determine the extent to which FN-439 would disrupt the consolidation and/or reconsolidation of a fear memory associated with a conditioned stimulus that signaled tone-shock pairings and that was independent of contextual cues. Male Sprague-Dawley rats were given infusions of FN-439 (35 microg intracerebroventricular) 30 min prior to conditioning (tone-shock paired association) or 30 min prior to a single reactivation session given 24h after conditioning. Administration of FN-439 did not disrupt consolidation of the freezing response when the tone (conditioned stimulus) was presented. In contrast, FN-439 infusion disrupted reconsolidation of the fear memory in a reactivation-dependent manner. The reduced freezing behavior was not due to a decrease in general anxiety levels, since FN-439 had no effect on the percent of open-arm time or open-arm entries in an elevated-plus maze task. Thus, we demonstrated for the first time that matrix metalloproteinase inhibition in the brain is capable of disrupting the reconsolidation of a tone-shock association memory that does not depend on contextual cues. The finding that a fear response to a previously paired conditioned stimulus can be disrupted by treatment with an MMP inhibitor during a single reactivation session suggests that this class of compounds may have therapeutic potential for posttraumatic stress disorder and/or simple phobias.
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Affiliation(s)
- Travis E Brown
- Alcohol and Drug Abuse Research Program and Program in Neuroscience, Department of Veterinary and Comparative Anatomy, Pharmacology and Physiology, Washington State University, Stadium Way, Pullman, WA 99164-6520, USA
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Hankey A. CAM and Post-Traumatic Stress Disorder. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2007; 4:131-2. [PMID: 17342251 PMCID: PMC1810367 DOI: 10.1093/ecam/nel041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2006] [Accepted: 05/26/2006] [Indexed: 11/17/2022]
Abstract
In the form of the Transcendental Meditation program CAM offers a method of eliminating deep-rooted stress, the efficacy of which has been demonstrated in several related studies. Any discussion of CAM and post-traumatic stress disorder should include a study of its application to Vietnam War Veterans in which improvements were observed on all variables, and several participants were able to return to work after several years of being unable to hold a job. The intervention has been studied for its impact on brain and autonomic nervous system function. It has been found to be highly effective against other stress-related conditions such as hypertension, and to improve brain coherence-a measure of effective brain function. It should be considered a possible 'new and improved mode of treatment' for PTSD, and further studies of its application made.
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Affiliation(s)
- Alex Hankey
- Health Sciences, University of Pune Maharashtra, India
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Wang L, Muxin G, Nishida H, Shirakawa C, Sato S, Konishi T. Psychological stress-induced oxidative stress as a model of sub-healthy condition and the effect of TCM. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2006; 4:195-202. [PMID: 17549236 PMCID: PMC1876613 DOI: 10.1093/ecam/nel080] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2006] [Accepted: 09/25/2006] [Indexed: 11/24/2022]
Abstract
Distress-mediated tissue oxidative stress was examined as a model of sub-healthy condition defined in traditional Chinese medicine theory. Mice were subjected to psychologically stressful conditions by whiskers removal. Under this condition, spontaneous locomotive activity was significantly enhanced in the dark (P < 0.05 versus the control mice in three different movements), and granulocytes/lymphocytes balance shifted to granulocytes. At the same time, peroxynitrite level in blood plasma increased to ∼180% from that of the control mice at 6 h after removal of the whiskers (P < 0.01), and was maintained even after 12 h. Both protein carbonyl formation and lipid peroxidation were significantly increased under this condition in brain, heart, liver and spleen at 6 h after removal of whiskers (P < 0.05 or P < 0.01), and these levels were maximized after 12 h (increased to 120–160%, P < 0.05 or P < 0.01). The oxidative tissue injuries observed at 12 h after the removal of the whiskers were effectively prevented by two traditional Chinese medicine formula: Shengmai San (SMS) and Ling Gui Zhu Gan Tang (LGZGT), when administered for 5 days before the removal of the whiskers. Therefore, this stress model is considered useful in assessing the preventive potential of antioxidants and antioxidant-based herbal mixtures in treating the pathophysiology associated with psychological or emotional distress.
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Affiliation(s)
- Lei Wang
- Niigata University of Pharmacy and Applied Life Sciences Niigata 950-2081,, Niigata College of Medical Technology, Niigata 950-2076, Japan and School of Traditional Chinese Medicine, Capital Medical University Beijing, China
| | - Gong Muxin
- Niigata University of Pharmacy and Applied Life Sciences Niigata 950-2081,, Niigata College of Medical Technology, Niigata 950-2076, Japan and School of Traditional Chinese Medicine, Capital Medical University Beijing, China
| | - Hiroshi Nishida
- Niigata University of Pharmacy and Applied Life Sciences Niigata 950-2081,, Niigata College of Medical Technology, Niigata 950-2076, Japan and School of Traditional Chinese Medicine, Capital Medical University Beijing, China
| | - Chieko Shirakawa
- Niigata University of Pharmacy and Applied Life Sciences Niigata 950-2081,, Niigata College of Medical Technology, Niigata 950-2076, Japan and School of Traditional Chinese Medicine, Capital Medical University Beijing, China
| | - Shinji Sato
- Niigata University of Pharmacy and Applied Life Sciences Niigata 950-2081,, Niigata College of Medical Technology, Niigata 950-2076, Japan and School of Traditional Chinese Medicine, Capital Medical University Beijing, China
| | - Tetsuya Konishi
- Niigata University of Pharmacy and Applied Life Sciences Niigata 950-2081,, Niigata College of Medical Technology, Niigata 950-2076, Japan and School of Traditional Chinese Medicine, Capital Medical University Beijing, China
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38
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Schiff E, Gurgevich S, Caspi O. Potential synergism between hypnosis and acupuncture—is the whole more than the sum of its parts? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2006; 4:233-40. [PMID: 17549241 PMCID: PMC1876614 DOI: 10.1093/ecam/nel069] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2006] [Accepted: 09/14/2006] [Indexed: 11/13/2022]
Abstract
Both hypnosis and acupuncture have gained credibility over the years in their effectiveness for treating various health conditions. Currently, each of these treatments is administered in distinct settings and separate times. That is, even if patients receive both treatments as part of a multidimensional therapeutic program, they would typically receive them separately rather than simultaneously at the same session. This separation however might be undesirable since, at least theoretically, hypnosis and acupuncture could potentially augment each other if administered concomitantly. In this article we outline the rationale for this hypothesis and discuss the potential ramifications of its implementation.
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Affiliation(s)
- Elad Schiff
- Bnai Zion Medical Center, Internal Medicine Division Haifa, Israel.
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