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Pulver A, Kiive E, Harro J. Reward sensitivity, affective neuroscience personality, symptoms of attention-deficit/hyperactivity disorder, and TPH2-703G/T (rs4570625) genotype. Acta Neuropsychiatr 2020; 32:247-56. [PMID: 32338242 DOI: 10.1017/neu.2020.18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Reward sensitivity is an increasingly used construct in psychiatry, yet its possible inner structure and relationship with other affective variables are not well known. METHODS A reward sensitivity measurement scale was constructed on the basis of large item pool collected from birth cohort representative samples (the Estonian Children Personality Behaviour and Health Study; original n = 1238). Affective Neuroscience Personality Scale (ANPS) and the Adult Attention deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS) were administered in young adulthood. A variant (rs4570625) of the gene encoding tryptophan hydroxylase 2 (TPH2) that is responsible for the synthesis of central serotonin was genotyped. RESULTS Reward sensitivity consisted of two orthogonal components, operationally defined as Openness to Rewards and Insatiability by Reward, that respectively characterise the striving towards multiple rewards and the strong pursuit and fixation to a particular reward. While SEEKING and PLAY (and to lower extent CARE) of the ANPS co-varied with Openness to Rewards, FEAR, SADNESS, and ANGER were related to Insatiability by Reward. The total score of ASRS was moderately correlated with Insatiability by Reward, while the association with Openness to Rewards was negligible. However, ASRS Inattention had some negative relationship with the Social Experience facet of Openness to Rewards. The T/T homozygotes for the TPH2 promoter polymorphism had lower Insatiability by Reward but not Openness to Rewards. CONCLUSIONS Behaviours sensitive to rewards are separable to the components of variability and fixation, and these components are differentially related to affective aspects of personality, attention, and hyperactivity as well as to TPH2 genotype.
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Brown LA, Chen S, Narine K, Contractor AA, Oslin D. DSM-5 PTSD symptom clusters and suicidal ideation in veterans. Psychiatry Res 2020; 288:112942. [PMID: 32315877 DOI: 10.1016/j.psychres.2020.112942] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/16/2020] [Accepted: 03/23/2020] [Indexed: 12/23/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with significantly greater risk for suicidal ideation (SI). In civilians, the negative alterations in cognitions and mood (NACM) and alterations in arousal and reactivity (AAR) clusters are most strongly associated with SI. This study sought to examine the association between PTSD symptom clusters and SI in a large sample of veterans. Veterans (n = 1,789) completed the PTSD Checklist for DSM-5 and the Patient Health Questionnaire (PHQ) during primary care visits. Wald chi-square tests of parameter constraints were computed to test hypothesized relations between PTSD factors and the PHQ-9 suicidal ideation item. Each of the PTSD symptom clusters were significantly associated with SI. The NACM cluster was more strongly associated with SI than AAR and marginally more strongly associated with SI than the avoidance symptom clusters. In a restricted sample of only veterans with PTSD, NACM remained more strongly associated with SI than avoidance. Each of the NACM symptoms were significantly associated with SI. Changes in cognitions and mood were most strongly associated with SI in this large sample of veterans. These findings suggest that directly targeting the NACM symptom cluster may be an important goal for suicide prevention efforts among veterans with PTSD.
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Affiliation(s)
- Lily A Brown
- University of Pennsylvania, Department of Psychiatry, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA.
| | - Shirley Chen
- Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center and Center of Excellence for Substance Abuse Treatment and Evaluation Corporal Michael J. Crescenz VA Medical Center, 21 S University Ave, Philadelphia, PA 19104, Philadelphia, PA, USA
| | - Kevin Narine
- University of Pennsylvania, Department of Psychiatry, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA
| | - Ateka A Contractor
- University of North Texas, 1155 Union Cir, Denton, TX 76203, Denton, TX, USA
| | - David Oslin
- University of Pennsylvania, Department of Psychiatry, 3535 Market Street Suite 600N, Philadelphia, PA 19104, USA; Mental Illness Research, Education, and Clinical Center at the Philadelphia VA Medical Center and Center of Excellence for Substance Abuse Treatment and Evaluation Corporal Michael J. Crescenz VA Medical Center, 21 S University Ave, Philadelphia, PA 19104, Philadelphia, PA, USA
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McCall CE, Rodriguez KE, Wadsworth SMM, Meis LA, O'Haire ME. "A Part of Our Family"? Effects of Psychiatric Service Dogs on Quality of Life and Relationship Functioning in Military-Connected Couples. Mil Behav Health 2020; 8:410-423. [PMID: 35316935 DOI: 10.1080/21635781.2020.1825243] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Posttraumatic stress disorder (PTSD) can have corrosive impacts on family relationships and individual functioning. Emerging evidence has shown that psychiatric service dogs may be an effective complementary treatment for military veterans with PTSD, benefiting veterans' mental and social health. However, few studies have examined the effects of psychiatric service dogs on the family members of veterans, specifically their partners. Mixed-methods data from 60 veteran-partner dyads examined individual and relationship functioning among partners of veterans paired with a service dog (service dog group; n = 37) and those awaiting placement (waitlist group; n = 23). While there were no statistically significant differences across groups, the effect sizes for group differences suggested that partners in the service dog group (relative to those on the waitlist) may experience higher levels of resilience and companionship, and lower levels of anger, social isolation, and work impairment. A topical survey of partner qualitative data within the service dog group indicated that service dogs provided more benefits than challenges. Partners reported improvements in veteran functioning, family relationships, and partners' quality of life. Results, although preliminary, suggest that psychiatric service dogs may provide modest positive experiences for some veteran family systems.
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Affiliation(s)
- Christine E McCall
- Military Family Research Institute, Department of Human Development and Family Studies, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana
| | - Kerri E Rodriguez
- Center for the Human-Animal Bond, Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
| | - Shelley M MacDermid Wadsworth
- Military Family Research Institute, Department of Human Development and Family Studies, College of Health and Human Sciences, Purdue University, West Lafayette, Indiana
| | - Laura A Meis
- Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System, Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Marguerite E O'Haire
- Center for the Human-Animal Bond, Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana
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Campbell SB, Renshaw KD. Posttraumatic stress disorder and relationship functioning: A comprehensive review and organizational framework. Clin Psychol Rev 2018; 65:152-62. [PMID: 30205286 DOI: 10.1016/j.cpr.2018.08.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 01/02/2023]
Abstract
Posttraumatic stress disorder (PTSD) is associated with impairments in relationship functioning. Beyond the abundance of research that has demonstrated this basic link, more recent research has begun to explore possible mediators and moderators of this association. The present paper reviews and synthesizes existing literature in the context of an overarching organizational framework of potential ways in which PTSD impacts relationship functioning. The framework organizes findings in terms of specific elements of PTSD and comorbid conditions, mediators (factors that are posited to explain or account for the association), and moderators (factors that are posited to alter the strength of the association). Specific symptoms of PTSD, comorbid symptoms, and many of the potential mediators explored have extensive overlap, raising questions of possible tautology and redundancy in findings. Some findings suggest that non-specific symptoms, such as depression or anger, account for more variance in relationship impairments than trauma-specific symptoms, such as re-experiencing. Moderators, which are characterized as individual, relational, or environmental in nature, have been the subject of far less research in comparison to other factors. Recommendations for future research and clinical implications of the findings reviewed are also presented.
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Lester P, Rauch P, Loucks L, Sornborger J, Ohye B, Karnik NS. Posttraumatic Stress Disorder and Military-Connected Families: The Relevance of a Family-Centered Approach. Focus (Am Psychiatr Publ) 2017; 15:420-428. [PMID: 31975873 DOI: 10.1176/appi.focus.20170027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Since the September 11, 2001, terrorist attacks, military service in the United States has been linked to a range of behavioral health and physical injuries in a significant number of the almost three million service members who have returned from wartime deployment. These injuries have occurred in the larger context of wartime military service, which is characterized by an array of stressors that have been associated with increased risk for behavioral health problems not only for service members but also for their family members. For the past 15 years, military-connected (defined as active-duty, reserve component, and veteran) family members have shared their own experiences of military service, including multiple deployments in the context of danger, high operational stress within their communities, and living with the physical and behavioral health injuries and ongoing care needs of a loved one. This article provides an overview of the evolving research on the specific impact of posttraumatic stress disorder (PTSD) and other war zone-related behavioral health problems among families in the context of contemporary warfare, as well as research on the impact of family adjustment on veteran recovery and care. We propose an empirically supported, family-centered framework to inform a continuum of prevention and care for veterans with PTSD and their families. Gaps in the current continuum of behavioral health services for veterans with PTSD are identified, as well as efforts underway to develop trauma-informed, family-centered screening, prevention, and treatment approaches. Future research recommendations are provided.
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Affiliation(s)
- Patricia Lester
- Dr. Lester is with the Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Dr. Rauch is with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Loucks is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta. Dr. Sornborger is with Operation Mend, UCLA Health. Dr. Ohye is with the Massachusetts General Hospital Program, Harvard Medical School, Boston. Dr. Karnik is with the Department of Psychiatry, Rush University Medical Center, Chicago
| | - Paula Rauch
- Dr. Lester is with the Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Dr. Rauch is with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Loucks is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta. Dr. Sornborger is with Operation Mend, UCLA Health. Dr. Ohye is with the Massachusetts General Hospital Program, Harvard Medical School, Boston. Dr. Karnik is with the Department of Psychiatry, Rush University Medical Center, Chicago
| | - Laura Loucks
- Dr. Lester is with the Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Dr. Rauch is with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Loucks is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta. Dr. Sornborger is with Operation Mend, UCLA Health. Dr. Ohye is with the Massachusetts General Hospital Program, Harvard Medical School, Boston. Dr. Karnik is with the Department of Psychiatry, Rush University Medical Center, Chicago
| | - Jo Sornborger
- Dr. Lester is with the Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Dr. Rauch is with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Loucks is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta. Dr. Sornborger is with Operation Mend, UCLA Health. Dr. Ohye is with the Massachusetts General Hospital Program, Harvard Medical School, Boston. Dr. Karnik is with the Department of Psychiatry, Rush University Medical Center, Chicago
| | - Bonnie Ohye
- Dr. Lester is with the Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Dr. Rauch is with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Loucks is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta. Dr. Sornborger is with Operation Mend, UCLA Health. Dr. Ohye is with the Massachusetts General Hospital Program, Harvard Medical School, Boston. Dr. Karnik is with the Department of Psychiatry, Rush University Medical Center, Chicago
| | - Niranjin S Karnik
- Dr. Lester is with the Nathanson Family Resilience Center, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles (UCLA). Dr. Rauch is with the Department of Psychiatry, Massachusetts General Hospital, Boston. Dr. Loucks is with the Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta. Dr. Sornborger is with Operation Mend, UCLA Health. Dr. Ohye is with the Massachusetts General Hospital Program, Harvard Medical School, Boston. Dr. Karnik is with the Department of Psychiatry, Rush University Medical Center, Chicago
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