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Smeltz AM, Wicker AB, Belliston-Fowkes DJ, Tran LN, Smith EJ, An X, Lin BI, Teeter EG. Relationship Between Computed Tomography-Derived Left Bronchial Diameter and Double- Lumen Endotracheal Tube Size Selection. J Cardiothorac Vasc Anesth 2024; 38:1286-1287. [PMID: 38458827 DOI: 10.1053/j.jvca.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Alan M Smeltz
- University of North Carolina School of Medicine, Chapel Hill, NC.
| | - Ashley B Wicker
- University of North Carolina School of Medicine, Chapel Hill, NC
| | | | - Linh N Tran
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - Emmaline J Smith
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - Xinming An
- University of North Carolina School of Medicine, Chapel Hill, NC
| | - Bridget I Lin
- University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Emily G Teeter
- University of North Carolina School of Medicine, Chapel Hill, NC
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2
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Borst B, Jovanovic T, House SL, Bruce SE, Harnett NG, Roeckner AR, Ely TD, Lebois LAM, Young D, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Pearson C, Peak DA, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Harte SE, Koenen KC, Kessler RC, McLean SA, Ressler KJ, Stevens JS, van Rooij SJH. Sex differences in response inhibition-related neural predictors of PTSD in recent trauma-exposed civilians. Biol Psychiatry Cogn Neurosci Neuroimaging 2024:S2451-9022(24)00080-6. [PMID: 38522649 DOI: 10.1016/j.bpsc.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Females are more likely to develop posttraumatic stress disorder (PTSD) than males. Impaired inhibition has been identified as mechanism for PTSD development, but studies on the potential sex differences of this neurobiological mechanism and how it relates to PTSD severity and progression are sparse. Here we examined sex differences in neural activation during response inhibition and PTSD following recent trauma. METHODS Participants (N= 205, 138 female sex assigned at birth) were recruited from emergency departments within 72 hours of a traumatic event. PTSD symptoms were assessed 2-weeks and 6-months post-trauma. A Go/NoGo task was performed 2-weeks post-trauma in a 3T MRI scanner to measure neural activity during response inhibition in the ventromedial prefrontal cortex (vmPFC), right inferior frontal gyrus (rIFG), and the bilateral hippocampus. General Linear models were used to examine the interaction effect of sex on the relationship between our regions of interest (ROIs) and the whole brain, and PTSD symptoms at 6-months, and symptom progression between 2-weeks and 6-months. RESULTS Lower response-inhibition-related vmPFC activation 2-weeks post-trauma predicted more PTSD symptoms at 6-months in females but not in males, while greater response-inhibition-related rIFG activation predicted lower PTSD symptom progression in males but not females. Whole brain interaction effects were observed in the medial temporal gyrus and left precentral gyrus. CONCLUSIONS There are sex differences in the relationship between inhibition-related brain activation and PTSD symptom severity and progression. These findings suggest that sex differences should be assessed in future PTSD studies and reveal potential targets for sex-specific interventions.
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Affiliation(s)
- Bibian Borst
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA; Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Alyssa R Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Dmitri Young
- University of California San Francisco, San Francisco, CA, USA
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, RI, USA; Department of Emergency Medicine, Brown University, Providence, RI
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; The Many Brains Project, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott L Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA; Ohio State University College of Nursing, Columbus, OH, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J Seamon
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth M Datner
- Department of Emergency Medicine, Jefferson Einstein hospital, Jefferson Health, Philadelphia, PA, USA; Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
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Jiang D, An X, Xu Q, Mo G, Ling W, Ji C, Wang Z, Wang X, Sun Q, Kang B. Effects of ferritin heavy chain on oxidative stress, cell proliferation and apoptosis in geese follicular granulosa cells. Br Poult Sci 2024:1-10. [PMID: 38456722 DOI: 10.1080/00071668.2024.2315086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 12/02/2023] [Indexed: 03/09/2024]
Abstract
1. The ferritin heavy chain (FHC) has a vital impact on follicular development in geese, due to its ability to regulate apoptosis of granulosa cells (GCs) and follicular atresia. However, its specific regulatory mechanisms remain unclear. The present study characterised how FHC regulates oxidative stress, cell proliferation and apoptosis in goose GCs by interfering with and overexpressing the FHC gene.2. After 72 h of interference with FHC expression, the activity of GCs decreased remarkably (p < 0.05), reactive oxygen species (ROS) levels and the expression levels of antioxidant enzyme genes catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) increased significantly (p < 0.05). The overexpression of FHC for 72 h was found to significantly reduce the expression of CAT and SOD genes (p < 0.05).3. Interfering with FHC expression revealed that the expression levels of the cell proliferation gene Aurora kinase A (AURORA-A) were significantly decreased (p < 0.05), while the expression levels of the apoptosis genes B-cell lymphoma-2 (BCL-2) and cysteine aspartate-specific protease 8 (CASPASE 8) increased (p < 0.05). Further research has shown that, when interfering with FHC expression for 72 h, apoptosis rate increased by 1.19-fold (p < 0.05), but the current data showed a lower apoptosis rate after FHC overexpression by 59.41%, 63.39%, and 52.31% at three different treatment times (p < 0.05).4. In conclusion, FHC improved the antioxidant capacity of GCs, promotes GCs proliferation, and inhibits GCs apoptosis of ovarian follicles in Sichuan white geese.
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Affiliation(s)
- D Jiang
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - X An
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - Q Xu
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - G Mo
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - W Ling
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - C Ji
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - Z Wang
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - X Wang
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - Q Sun
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
| | - B Kang
- State Key Laboratory of Swine and Poultry Breeding Industry,College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
- Key Laboratory of Livestock and Poultry Multi-omics, Ministry of Agriculture and Rural Affairs, College of Animal Science and Technology, Sichuan Agricultural University, Chengdu, P. R. China
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Sendi M, Fu Z, Harnett N, van Rooij S, Vergara V, Pizzagalli D, Daskalakis N, House S, Beaudoin F, An X, Neylan T, Clifford G, Jovanovic T, Linnstaedt S, Germine L, Bollen K, Rauch S, Haran J, Storrow A, Lewandowski C, Musey P, Hendry P, Sheikh S, Jones C, Punches B, Swor R, Gentile N, Murty V, Hudak L, Pascual J, Seamon M, Harris E, Chang A, Pearson C, Peak D, Merchant R, Domeier R, Rathlev N, O'Neil B, Sergot P, Sanchez L, Bruce S, Sheridan J, Harte S, Kessler R, Koenen K, McLean S, Stevens J, Calhoun V, Ressler K. Brain dynamics reflecting an intra-network brain state is associated with increased posttraumatic stress symptoms in the early aftermath of trauma. Res Sq 2024:rs.3.rs-4004473. [PMID: 38496567 PMCID: PMC10942549 DOI: 10.21203/rs.3.rs-4004473/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
This study examines the association between brain dynamic functional network connectivity (dFNC) and current/future posttraumatic stress (PTS) symptom severity, and the impact of sex on this relationship. By analyzing 275 participants' dFNC data obtained ~2 weeks after trauma exposure, we noted that brain dynamics of an inter-network brain state link negatively with current (r=-0.179, pcorrected= 0.021) and future (r=-0.166, pcorrected= 0.029) PTS symptom severity. Also, dynamics of an intra-network brain state correlated with future symptom intensity (r = 0.192, pcorrected = 0.021). We additionally observed that the association between the network dynamics of the inter-network brain state with symptom severity is more pronounced in females (r=-0.244, pcorrected = 0.014). Our findings highlight a potential link between brain network dynamics in the aftermath of trauma with current and future PTSD outcomes, with a stronger protective effect of inter-network brain states against symptom severity in females, underscoring the importance of sex differences.
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Affiliation(s)
| | - Zening Fu
- d Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University
| | | | | | | | | | | | | | - Francesca Beaudoin
- The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital
| | - Xinming An
- University of North Carolina at Chapel Hill
| | - Thomas Neylan
- San Francisco VA Healthcare System; University of California San Francisco
| | - Gari Clifford
- Emory University School of Medicine; Georgia Institute of Technology
| | | | | | | | | | | | - John Haran
- University of Massachusetts Medical School
| | | | | | | | | | | | | | - Brittany Punches
- University of Cincinnati College of Medicine & University of Cincinnati College of Nursing
| | | | | | | | | | - Jose Pascual
- Perelman School of Medicine at the University of Pennsylvania
| | | | | | | | | | | | | | | | | | | | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth
| | | | | | | | | | | | | | | | | | - Vince Calhoun
- Georgia Institute of Technology, Emory University and Georgia State University
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5
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Garrison-Desany HM, Meyers JL, Linnstaedt SD, House SL, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Jovanovic T, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, Gentile NT, Hudak LA, Pascual JL, Seamon MJ, Harris E, Pearson C, Peak DA, Domeier RM, Rathlev NK, O’Neil BJ, Sergot P, Sanchez LD, Bruce SE, Joormann J, Harte SE, McLean SA, Koenen KC, Denckla CA. Post-traumatic stress and future substance use outcomes: leveraging antecedent factors to stratify risk. Front Psychiatry 2024; 15:1249382. [PMID: 38525258 PMCID: PMC10957776 DOI: 10.3389/fpsyt.2024.1249382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/10/2024] [Indexed: 03/26/2024] Open
Abstract
Background Post-traumatic stress disorder (PTSD) and substance use (tobacco, alcohol, and cannabis) are highly comorbid. Many factors affect this relationship, including sociodemographic and psychosocial characteristics, other prior traumas, and physical health. However, few prior studies have investigated this prospectively, examining new substance use and the extent to which a wide range of factors may modify the relationship to PTSD. Methods The Advancing Understanding of RecOvery afteR traumA (AURORA) study is a prospective cohort of adults presenting at emergency departments (N = 2,943). Participants self-reported PTSD symptoms and the frequency and quantity of tobacco, alcohol, and cannabis use at six total timepoints. We assessed the associations of PTSD and future substance use, lagged by one timepoint, using the Poisson generalized estimating equations. We also stratified by incident and prevalent substance use and generated causal forests to identify the most important effect modifiers of this relationship out of 128 potential variables. Results At baseline, 37.3% (N = 1,099) of participants reported likely PTSD. PTSD was associated with tobacco frequency (incidence rate ratio (IRR): 1.003, 95% CI: 1.00, 1.01, p = 0.02) and quantity (IRR: 1.01, 95% CI: 1.001, 1.01, p = 0.01), and alcohol frequency (IRR: 1.002, 95% CI: 1.00, 1.004, p = 0.03) and quantity (IRR: 1.003, 95% CI: 1.001, 1.01, p = 0.001), but not with cannabis use. There were slight differences in incident compared to prevalent tobacco frequency and quantity of use; prevalent tobacco frequency and quantity were associated with PTSD symptoms, while incident tobacco frequency and quantity were not. Using causal forests, lifetime worst use of cigarettes, overall self-rated physical health, and prior childhood trauma were major moderators of the relationship between PTSD symptoms and the three substances investigated. Conclusion PTSD symptoms were highly associated with tobacco and alcohol use, while the association with prospective cannabis use is not clear. Findings suggest that understanding the different risk stratification that occurs can aid in tailoring interventions to populations at greatest risk to best mitigate the comorbidity between PTSD symptoms and future substance use outcomes. We demonstrate that this is particularly salient for tobacco use and, to some extent, alcohol use, while cannabis is less likely to be impacted by PTSD symptoms across the strata.
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Affiliation(s)
- Henri M. Garrison-Desany
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Jacquelyn L. Meyers
- Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, New York City, NY, United States
| | - Sarah D. Linnstaedt
- Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - Francesca L. Beaudoin
- Department of Epidemiology, Brown University, Providence, RI, United States
- Department of Emergency Medicine, Brown University, Providence, RI, United States
| | - Xinming An
- Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Thomas C. Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, United States
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
| | - Laura T. Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, United States
- The Many Brains Project, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Kenneth A. Bollen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Scott L. Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, United States
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, McLean Hospital, Belmont, MA, United States
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Alan B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, United States
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, United States
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, United States
| | - Brittany E. Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, United States
| | - Robert A. Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, United States
| | - Nina T. Gentile
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States
| | - Jose L. Pascual
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, United States
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, United States
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Mark J. Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Erica Harris
- Department of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, United States
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, United States
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Robert M. Domeier
- Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, MI, United States
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, United States
| | - Brian J. O’Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, United States
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at The University of Texas Health Science Center, Houston, TX, United States
| | - Leon D. Sanchez
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, United States
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, United States
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, United States
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, United States
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Samuel A. McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Christy A. Denckla
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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6
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Hinojosa CA, Liew A, An X, Stevens JS, Basu A, van Rooij SJH, House SL, Beaudoin FL, Zeng D, Neylan TC, Clifford GD, Jovanovic T, Linnstaedt SD, Germine LT, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Swor RA, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, Sergot P, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Pizzagalli DA, Sheridan JF, Harte SE, Elliott JM, Kessler RC, Koenen KC, McLean SA, Ressler KJ, Fani N. Associations of alcohol and cannabis use with change in posttraumatic stress disorder and depression symptoms over time in recently trauma-exposed individuals. Psychol Med 2024; 54:338-349. [PMID: 37309917 PMCID: PMC10716364 DOI: 10.1017/s0033291723001642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Several hypotheses may explain the association between substance use, posttraumatic stress disorder (PTSD), and depression. However, few studies have utilized a large multisite dataset to understand this complex relationship. Our study assessed the relationship between alcohol and cannabis use trajectories and PTSD and depression symptoms across 3 months in recently trauma-exposed civilians. METHODS In total, 1618 (1037 female) participants provided self-report data on past 30-day alcohol and cannabis use and PTSD and depression symptoms during their emergency department (baseline) visit. We reassessed participant's substance use and clinical symptoms 2, 8, and 12 weeks posttrauma. Latent class mixture modeling determined alcohol and cannabis use trajectories in the sample. Changes in PTSD and depression symptoms were assessed across alcohol and cannabis use trajectories via a mixed-model repeated-measures analysis of variance. RESULTS Three trajectory classes (low, high, increasing use) provided the best model fit for alcohol and cannabis use. The low alcohol use class exhibited lower PTSD symptoms at baseline than the high use class; the low cannabis use class exhibited lower PTSD and depression symptoms at baseline than the high and increasing use classes; these symptoms greatly increased at week 8 and declined at week 12. Participants who already use alcohol and cannabis exhibited greater PTSD and depression symptoms at baseline that increased at week 8 with a decrease in symptoms at week 12. CONCLUSIONS Our findings suggest that alcohol and cannabis use trajectories are associated with the intensity of posttrauma psychopathology. These findings could potentially inform the timing of therapeutic strategies.
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Affiliation(s)
- Cecilia A. Hinojosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Amanda Liew
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Archana Basu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Sanne J H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L. Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C. Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Sarah D. Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T. Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- The Many Brains Project, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Scott L. Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Alan B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E. Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA
- Ohio State University College of Nursing, Columbus, OH, USA
| | - Michael C. Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, USA
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, USA
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A. Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L. Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J. Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth M. Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, PA, USA
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Anna M. Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roland C. Merchant
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Robert M. Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, USA
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - Leon D. Sanchez
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Mark W. Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Robert H. Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - John F. Sheridan
- Division of Biosciences, Ohio State University College of Dentistry, Columbus, OH, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, USA
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M. Elliott
- Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Samuel A. McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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7
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Wrobel JR, Magin JC, Williams D, An X, Acton JD, Doyal AS, Jia S, Krakowski JC, Serrano R, Grant SA, Flynn DN, McLean DJ. Comparing preoperative fasting and ultrasound-measured intravascular volume status in elective surgery, enhanced recovery patients versus inpatient, urgent surgery patients and the ability of IVC collapsibility to predict post-induction hypotension. J Perioper Pract 2023:17504589231215932. [PMID: 38149485 DOI: 10.1177/17504589231215932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Hypotension following induction of general anaesthesia has been shown to result in increased complications and mortality postoperatively. Patients admitted to the hospital undergoing urgent surgery are often fasted from fluids for significant periods compared to elective patients subject to Enhanced Recovery After Surgery protocols despite guidelines stating that a two-hour fast is sufficient. The aim of this prospective, observational study was to compare fasting times and intravascular volume status between elective surgery patients subject to enhanced recovery protocols and inpatient, urgent surgery patients and to assess differences in the incidence of post-induction hypotension. Fasting data was obtained by questionnaire in the preoperative area in addition to inferior vena cava collapsibility index, a non-invasive measure of intravascular volume. Blood pressure readings and drug administration for the ten minutes following induction were obtained from patients' charts. Inpatients undergoing urgent surgery were fasted significantly longer than enhanced recovery patients and had lower intravascular volume. However, no difference was found in the incidence of post-induction hypotension.
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Affiliation(s)
| | | | | | - Xinming An
- UNC School of Medicine, Chapel Hill, NC, USA
| | | | | | - Shawn Jia
- UNC School of Medicine, Chapel Hill, NC, USA
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8
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Wong SA, Lebois LAM, Ely TD, van Rooij SJH, Bruce SE, Murty VP, Jovanovic T, House SL, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Swor RA, Hudak LA, Pascual JL, Seamon MJ, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Harte SE, Elliott JM, Kessler RC, Koenen KC, McLean SA, Ressler KJ, Stevens JS, Harnett NG. Internal capsule microstructure mediates the relationship between childhood maltreatment and PTSD following adulthood trauma exposure. Mol Psychiatry 2023; 28:5140-5149. [PMID: 36932158 PMCID: PMC10505244 DOI: 10.1038/s41380-023-02012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/19/2023]
Abstract
Childhood trauma is a known risk factor for trauma and stress-related disorders in adulthood. However, limited research has investigated the impact of childhood trauma on brain structure linked to later posttraumatic dysfunction. We investigated the effect of childhood trauma on white matter microstructure after recent trauma and its relationship with future posttraumatic dysfunction among trauma-exposed adult participants (n = 202) recruited from emergency departments as part of the AURORA Study. Participants completed self-report scales assessing prior childhood maltreatment within 2-weeks in addition to assessments of PTSD, depression, anxiety, and dissociation symptoms within 6-months of their traumatic event. Fractional anisotropy (FA) obtained from diffusion tensor imaging (DTI) collected at 2-weeks and 6-months was used to index white matter microstructure. Childhood maltreatment load predicted 6-month PTSD symptoms (b = 1.75, SE = 0.78, 95% CI = [0.20, 3.29]) and inversely varied with FA in the bilateral internal capsule (IC) at 2-weeks (p = 0.0294, FDR corrected) and 6-months (p = 0.0238, FDR corrected). We observed a significant indirect effect of childhood maltreatment load on 6-month PTSD symptoms through 2-week IC microstructure (b = 0.37, Boot SE = 0.18, 95% CI = [0.05, 0.76]) that fully mediated the effect of childhood maltreatment load on PCL-5 scores (b = 1.37, SE = 0.79, 95% CI = [-0.18, 2.93]). IC microstructure did not mediate relationships between childhood maltreatment and depressive, anxiety, or dissociative symptomatology. Our findings suggest a unique role for IC microstructure as a stable neural pathway between childhood trauma and future PTSD symptoms following recent trauma. Notably, our work did not support roles of white matter tracts previously found to vary with PTSD symptoms and childhood trauma exposure, including the cingulum bundle, uncinate fasciculus, and corpus callosum. Given the IC contains sensory fibers linked to perception and motor control, childhood maltreatment might impact the neural circuits that relay and process threat-related inputs and responses to trauma.
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Affiliation(s)
- Samantha A Wong
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, USA
| | - Vishnu P Murty
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, RI, USA
- Department of Emergency Medicine, Brown University, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- The Many Brains Project, Belmont, MA, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA
- Ohio State University College of Nursing, Columbus, OH, USA
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, USA
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, USA
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M Elliott
- Kolling Institute, University of Sydney, St Leonards, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, Camperdown, NSW, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Magin JC, Wrobel JR, An X, Acton J, Doyal A, Jia S, Krakowski JC, Schoenherr J, Serrano R, Flynn D, McLean D, Grant SA. Venous Excess Ultrasound (VExUS Grading to Assess Perioperative Fluid Status for Noncardiac Surgeries: a Prospective Observational Pilot Study. POCUS J 2023; 8:223-229. [PMID: 38099161 PMCID: PMC10721303 DOI: 10.24908/pocus.v8i2.16792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2023]
Abstract
Objectives: Perioperative fluid administration impacts the rate of complications following surgery. VExUS grading system is a standardized point of care ultrasound (POCUS)-based, comprehensive method to assess volume status. VExUS could serve as a tool to guide fluid management, if validated perioperatively. The primary aim was to assess the success rate of obtaining required windows for VExUS grading , as well as the feasibility within a perioperative setting among noncardiac surgery. Further, this study describes the incidence of perioperative venous congestion and associations with 30-day postoperative complications. Methods: This observational study was conducted in non-critically ill adults undergoing noncardiac surgery. Patients were scanned preoperatively, in the post anesthesia care unit (PACU), and 24 hours postoperatively for venous congestion. Researchers retrospectively captured 30-day complications for multivariate analyses. Results: The cohort included 69 participants. Ninety-one percent of scans over all timepoints were successfully completed. Pre-operatively, 57 (83%) scans were Grade 0, and 11 (16%) were Grade 1. Venous congestion was observed in 29 (44%) patients in the PACU (n=66). 22 (33%) patients were Grade 1, while 7 (11%) were Grade 2. At 24 hours (n=63), 31 patients (49%) had venous congestion: 20 (32%) Grade 1 and 11 (17%) Grade 2. Of the pre-operative Grade 0, 28 (50%) had at least one postoperative scan with venous congestion. No patients were Grade 3 at any timepoint. The 30-day complication rate was 32% (n=22). Eleven (16%) patients developed acute kidney injury (AKI). There was no statistically significant association between VExUS grading and all-cause complications or AKI. Conclusion: This study demonstrates that perioperative VExUS scoring is a feasible tool among a variety of noncardiac surgeries. We highlight that venous congestion is common and increases postoperatively within non-ICU populations. Larger studies are needed to assess the relationship between VExUS grading and postoperative complications.
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Affiliation(s)
- Justin C Magin
- University of North Carolina School of MedicineChapel Hill, NCUSA
| | - Jacob R Wrobel
- University of North Carolina School of MedicineChapel Hill, NCUSA
| | - Xinming An
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - Jacob Acton
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - Alexander Doyal
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - Shawn Jia
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - James C Krakowski
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - Jay Schoenherr
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - Ricardo Serrano
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - David Flynn
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - Duncan McLean
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
| | - Stuart A Grant
- Department of Anesthesiology, University of North CarolinaChapel Hill, NCUSA
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10
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Liu T, Zhao Z, Wu C, Lu C, Liu M, An X, Sha Z, Wang X, Luo Z, Chen L, Liu C, Cao P, Zhang D, Jiang R. Impact of COVID-19 infection experience on mental health status of intensive care unit patients' family members: a real-world study. QJM 2023; 116:903-910. [PMID: 37498557 DOI: 10.1093/qjmed/hcad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/05/2023] [Indexed: 07/28/2023] Open
Abstract
PURPOSE Family members of patients hospitalized in intensive care unit (ICU) are susceptible to adverse psychological outcomes. However, there is a paucity of studies specifically examining the mental health symptoms in ICU patients' family members with a prior history of coronavirus disease 2019 (COVID-19) infection. AIM This study aimed to investigate mental health status and its influencing factors of ICU patients' family members with previous COVID-19 infection experience in China. DESIGN Nationwide, cross-sectional cohort of consecutive participants of family members of ICU patients from 10 provinces randomly selected in mainland China conducted between October 2022 and May 2023. METHODS The basic information scale, Self-rating depression scale, Self-rating Anxiety Scale, Impact of Event Scale-Revised, Pittsburgh sleep quality index, Perceived Stress Scale, Connor-Davidson resilience scale, Simplified Coping Style Questionnaire were employed to explore mental health status among participants. RESULTS A total of 463 participants, comprising 156 individuals in Covid-19 family member cohort (infection group) and 307 individuals in control family member cohort (control group), met inclusion criteria. The infection group exhibited significantly higher incidence of composite mental health symptoms compared to control group (P = 0.017). Multivariable logistic regression analysis revealed that being female, engaging in physical/mental labor, residing in rural areas, and having children were identified as risk factors for the development of depression, anxiety, and post-traumatic stress disorder symptoms, while medical history of surgery was protective factor. A predictive model demonstrated a favorable discriminative ability and excellent calibration. CONCLUSION COVID-19 infection experience regarded as new traumatic stressors worsen mental health status of ICU patients' family members.
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Affiliation(s)
- T Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China
| | - Z Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China
| | - C Wu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China
| | - C Lu
- Department of Psychiatry, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, Tianjin, China
| | - M Liu
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China
| | - X An
- Department of Intensive Care Unit, Beijing Tiantan Hospital, Beijing, China
| | - Z Sha
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China
| | - X Wang
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Z Luo
- Department of Neurosurgery, Shandong Provincial Third Hospital, Shandong, China
| | - L Chen
- Department of Intensive Care Unit, Shaoxing People's Hospital, Shaoxing, Zhejiang, China
| | - C Liu
- Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Anhui, China
| | - P Cao
- Department of Intensive Care Unit, The First Affiliated Hospital of Bengbu Medical College, Anhui, China
| | - D Zhang
- Tianjin Neurological Institute, Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, 300052, China
| | - R Jiang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin, China
- Key Laboratory of Post Neuro-Injury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Ministry of Education, Tianjin, China
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11
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Zeamer AL, Salive MC, An X, Beaudoin FL, House SL, Stevens JS, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Rauch SL, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, Hudak LA, Pascual JL, Seamon MJ, Harris E, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Bruce SE, Kessler RC, Koenen KC, McLean SA, Bucci V, Haran JP. Association between microbiome and the development of adverse posttraumatic neuropsychiatric sequelae after traumatic stress exposure. Transl Psychiatry 2023; 13:354. [PMID: 37980332 PMCID: PMC10657470 DOI: 10.1038/s41398-023-02643-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 10/20/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023] Open
Abstract
Patients exposed to trauma often experience high rates of adverse post-traumatic neuropsychiatric sequelae (APNS). The biological mechanisms promoting APNS are currently unknown, but the microbiota-gut-brain axis offers an avenue to understanding mechanisms as well as possibilities for intervention. Microbiome composition after trauma exposure has been poorly examined regarding neuropsychiatric outcomes. We aimed to determine whether the gut microbiomes of trauma-exposed emergency department patients who develop APNS have dysfunctional gut microbiome profiles and discover potential associated mechanisms. We performed metagenomic analysis on stool samples (n = 51) from a subset of adults enrolled in the Advancing Understanding of RecOvery afteR traumA (AURORA) study. Two-, eight- and twelve-week post-trauma outcomes for post-traumatic stress disorder (PTSD) (PTSD checklist for DSM-5), normalized depression scores (PROMIS Depression Short Form 8b) and somatic symptom counts were collected. Generalized linear models were created for each outcome using microbial abundances and relevant demographics. Mixed-effect random forest machine learning models were used to identify associations between APNS outcomes and microbial features and encoded metabolic pathways from stool metagenomics. Microbial species, including Flavonifractor plautii, Ruminococcus gnavus and, Bifidobacterium species, which are prevalent commensal gut microbes, were found to be important in predicting worse APNS outcomes from microbial abundance data. Notably, through APNS outcome modeling using microbial metabolic pathways, worse APNS outcomes were highly predicted by decreased L-arginine related pathway genes and increased citrulline and ornithine pathways. Common commensal microbial species are enriched in individuals who develop APNS. More notably, we identified a biological mechanism through which the gut microbiome reduces global arginine bioavailability, a metabolic change that has also been demonstrated in the plasma of patients with PTSD.
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Affiliation(s)
- Abigail L Zeamer
- Department of Microbiology and Physiologic Systems, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Marie-Claire Salive
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Xinming An
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, RI, USA
- Department of Emergency Medicine, Brown University, Providence, RI, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- The Many Brains Project, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA
- Ohio State University College of Nursing, Columbus, OH, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J Seamon
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Erica Harris
- Department of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | | | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Vanni Bucci
- Department of Microbiology and Physiologic Systems, University of Massachusetts Chan Medical School, Worcester, MA, USA.
- Program in Microbiome Dynamics, University of Massachusetts Chan Medical School, Worcester, MA, USA.
| | - John P Haran
- Department of Microbiology and Physiologic Systems, University of Massachusetts Chan Medical School, Worcester, MA, USA.
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
- Program in Microbiome Dynamics, University of Massachusetts Chan Medical School, Worcester, MA, USA.
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12
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Zannas AS, Linnstaedt SD, An X, Stevens JS, Harnett NG, Roeckner AR, Oliver KI, Rubinow DR, Binder EB, Koenen KC, Ressler KJ, McLean SA. Epigenetic aging and PTSD outcomes in the immediate aftermath of trauma. Psychol Med 2023; 53:7170-7179. [PMID: 36951141 DOI: 10.1017/s0033291723000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
BACKGROUND Psychological trauma exposure and posttraumatic stress disorder (PTSD) have been associated with advanced epigenetic age. However, whether epigenetic aging measured at the time of trauma predicts the subsequent development of PTSD outcomes is unknown. Moreover, the neural substrates underlying posttraumatic outcomes associated with epigenetic aging are unclear. METHODS We examined a multi-ancestry cohort of women and men (n = 289) who presented to the emergency department (ED) after trauma. Blood DNA was collected at ED presentation, and EPIC DNA methylation arrays were used to assess four widely used metrics of epigenetic aging (HorvathAge, HannumAge, PhenoAge, and GrimAge). PTSD symptoms were evaluated longitudinally at the time of ED presentation and over the ensuing 6 months. Structural and functional neuroimaging was performed 2 weeks after trauma. RESULTS After covariate adjustment and correction for multiple comparisons, advanced ED GrimAge predicted increased risk for 6-month probable PTSD diagnosis. Secondary analyses suggested that the prediction of PTSD by GrimAge was driven by worse trajectories for intrusive memories and nightmares. Advanced ED GrimAge was also associated with reduced volume of the whole amygdala and specific amygdala subregions, including the cortico-amygdaloid transition and the cortical and accessory basal nuclei. CONCLUSIONS Our findings shed new light on the relation between biological aging and trauma-related phenotypes, suggesting that GrimAge measured at the time of trauma predicts PTSD trajectories and is associated with relevant brain alterations. Furthering these findings has the potential to enhance early prevention and treatment of posttraumatic psychiatric sequelae.
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Affiliation(s)
- Anthony S Zannas
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Stress Initiative, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Xinming An
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Nathaniel G Harnett
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Alyssa R Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Katelyn I Oliver
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elisabeth B Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Karestan C Koenen
- Department of Epidemiology, Harvard School of Public Health, Harvard University, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Harvard University, Boston, MA, USA
| | - Kerry J Ressler
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Samuel A McLean
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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13
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Rowland GE, Roeckner A, Ely TD, Lebois LAM, van Rooij SJH, Bruce SE, Jovanovic T, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Gentile NT, Hudak LA, Pascual JL, Seamon MJ, Harris E, Pearson C, Merchant RC, Domeier RM, Rathlev NK, Sergot P, Sanchez LD, Miller MW, Pietrzak RH, Joormann J, Pizzagalli DA, Sheridan JF, Smoller JW, Harte SE, Elliott JM, Kessler RC, Koenen KC, McLean SA, Ressler KJ, Stevens JS, Harnett NG. Prior Sexual Trauma Exposure Impacts Posttraumatic Dysfunction and Neural Circuitry Following a Recent Traumatic Event in the AURORA Study. Biol Psychiatry Glob Open Sci 2023; 3:705-715. [PMID: 37881578 PMCID: PMC10593890 DOI: 10.1016/j.bpsgos.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/02/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
Background Prior sexual trauma (ST) is associated with greater risk for posttraumatic stress disorder after a subsequent traumatic event; however, the underlying neurobiological mechanisms remain opaque. We investigated longitudinal posttraumatic dysfunction and amygdala functional dynamics following admission to an emergency department for new primarily nonsexual trauma in participants with and without previous ST. Methods Participants (N = 2178) were recruited following acute trauma exposure (primarily motor vehicle collision). A subset (n = 242) completed magnetic resonance imaging that included a fearful faces task and a resting-state scan 2 weeks after the trauma. We investigated associations between prior ST and several dimensions of posttraumatic symptoms over 6 months. We further assessed amygdala activation and connectivity differences between groups with or without prior ST. Results Prior ST was associated with greater posttraumatic depression (F1,1120 = 28.35, p = 1.22 × 10-7, ηp2 = 0.06), anxiety (F1,1113 = 17.43, p = 3.21 × 10-5, ηp2 = 0.05), and posttraumatic stress disorder (F1,1027 = 11.34, p = 7.85 × 10-4, ηp2 = 0.04) severity and more maladaptive beliefs about pain (F1,1113 = 8.51, p = .004, ηp2 = 0.02) but was not related to amygdala reactivity to fearful versus neutral faces (all ps > .05). A secondary analysis revealed an interaction between ST and lifetime trauma load on the left amygdala to visual cortex connectivity (peak Z value: -4.41, corrected p < .02). Conclusions Findings suggest that prior ST is associated with heightened posttraumatic dysfunction following a new trauma exposure but not increased amygdala activity. In addition, ST may interact with lifetime trauma load to alter neural circuitry in visual processing regions following acute trauma exposure. Further research should probe the relationship between trauma type and visual circuitry in the acute aftermath of trauma.
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Affiliation(s)
- Grace E Rowland
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Alyssa Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, Missouri
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, Rhode Island
- Department of Emergency Medicine, Brown University, Providence, Rhode Island
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Thomas C Neylan
- Department of Psychiatry, University of California, San Francisco, San Francisco, California
- Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
- TheMany Brains Project, Belmont, Massachusetts
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, Ohio
- Ohio State University College of Nursing, Columbus, Ohio
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama
- Division of Acute Care Surgery, Department of Surgery, University of Alabama School of Medicine, Birmingham, Alabama
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama
| | - Nina T Gentile
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jose L Pascual
- Department of Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
- Division of Traumatology, Department of Surgery, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Erica Harris
- Einstein Medical Center, Philadelphia, Pennsylvania
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, Michigan
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, Michigan
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, Connecticut
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - John F Sheridan
- Division of Biosciences, Ohio State University College of Dentistry, Columbus, Ohio
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, Ohio
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, Michigan
| | - James M Elliott
- Kolling Institute, University of Sydney, St. Leonards, New South Wales, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Sydney, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Karestan C Koenen
- Department of Epidemiology, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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14
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Webb EK, Ely TD, Rowland GE, Lebois LAM, van Rooij SJH, Bruce SE, Jovanovic T, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, Pascual JL, Seamon MJ, Datner EM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, Sergot P, Sanchez LD, Kessler RC, Koenen KC, McLean SA, Stevens JS, Ressler KJ, Harnett NG. Neighborhood Disadvantage and Neural Correlates of Threat and Reward Processing in Survivors of Recent Trauma. JAMA Netw Open 2023; 6:e2334483. [PMID: 37721751 PMCID: PMC10507487 DOI: 10.1001/jamanetworkopen.2023.34483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/13/2023] [Indexed: 09/19/2023] Open
Abstract
Importance Differences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry. Objective To investigate associations of neighborhood disadvantage with white and gray matter and neural reactivity to positive and negative stimuli in the context of trauma exposure. Design, Setting, and Participants In this cross-sectional study, survivors of trauma who completed sociodemographic and posttraumatic symptom assessments and neuroimaging were recruited as part of the Advancing Understanding of Recovery After Trauma (AURORA) study between September 2017 and June 2021. Data analysis was performed from October 25, 2022, to February 15, 2023. Exposure Neighborhood disadvantage was measured with the Area Deprivation Index (ADI) for each participant home address. Main Outcomes and Measures Participants completed separate threat and reward tasks during functional magnetic resonance imaging. Diffusion-weighted and high-resolution structural images were also collected. Linear models assessed the association of ADI with reactivity, microstructure, and macrostructure of a priori regions of interest after adjusting for income, lifetime trauma, sex at birth, and age. A moderated-mediation model tested whether ADI was associated with neural activity via microstructural changes and if this was modulated by PTSD symptoms. Results A total of 280 participants (183 females [65.4%]; mean [SD] age, 35.39 [13.29] years) completed the threat task and 244 participants (156 females [63.9%]; mean [SD] age, 35.10 [13.26] years) completed the reward task. Higher ADI (per 1-unit increase) was associated with greater insula (t274 = 3.20; β = 0.20; corrected P = .008) and anterior cingulate cortex (ACC; t274 = 2.56; β = 0.16; corrected P = .04) threat-related activity after considering covariates, but ADI was not associated with reward reactivity. Greater disadvantage was also associated with altered microstructure of the cingulum bundle (t274 = 3.48; β = 0.21; corrected P = .001) and gray matter morphology of the ACC (cortical thickness: t273 = -2.29; β = -0.13; corrected P = .02; surface area: t273 = 2.53; β = 0.13; corrected P = .02). The moderated-mediation model revealed that ADI was associated with ACC threat reactivity via cingulum microstructural changes (index of moderated mediation = -0.02). However, this mediation was only present in individuals with greater PTSD symptom severity (at the mean: β = -0.17; standard error = 0.06, t= -2.28; P = .007; at 1 SD above the mean: β = -0.28; standard error = 0.08; t = -3.35; P < .001). Conclusions and Relevance In this study, neighborhood disadvantage was associated with neurobiology that supports threat processing, revealing associations of neighborhood disadvantage with neural susceptibility for PTSD and suggesting how altered structure-function associations may complicate symptoms. Future work should investigate specific components of neighborhood disadvantage that may be associated with these outcomes.
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Affiliation(s)
- E Kate Webb
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Grace E Rowland
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri-St Louis
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, Rhode Island
- Department of Emergency Medicine, Brown University, Providence, Rhode Island
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill
| | - Thomas C Neylan
- Department of Psychiatry, University of California, San Francisco
- Department Neurology, University of California, San Francisco
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- The Many Brains Project, Belmont, Massachusetts
- Institute for Technology in Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
- Department of Sociology, University of North Carolina at Chapel Hill
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Institute for Technology in Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, Massachusetts
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus
- College of Nursing, Ohio State University, Columbus
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, Michigan
| | - Jose L Pascual
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Mark J Seamon
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, Pennsylvania
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St John Hospital, Detroit, Michigan
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Robert M Domeier
- Department of Emergency Medicine, Trinity Health-Ann Arbor, Ypsilanti, Michigan
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, Texas
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Karestan C Koenen
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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15
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Angelopoulos V, Zhang XJ, Artemyev AV, Mourenas D, Tsai E, Wilkins C, Runov A, Liu J, Turner DL, Li W, Khurana K, Wirz RE, Sergeev VA, Meng X, Wu J, Hartinger MD, Raita T, Shen Y, An X, Shi X, Bashir MF, Shen X, Gan L, Qin M, Capannolo L, Ma Q, Russell CL, Masongsong EV, Caron R, He I, Iglesias L, Jha S, King J, Kumar S, Le K, Mao J, McDermott A, Nguyen K, Norris A, Palla A, Roosnovo A, Tam J, Xie E, Yap RC, Ye S, Young C, Adair LA, Shaffer C, Chung M, Cruce P, Lawson M, Leneman D, Allen M, Anderson M, Arreola-Zamora M, Artinger J, Asher J, Branchevsky D, Cliffe M, Colton K, Costello C, Depe D, Domae BW, Eldin S, Fitzgibbon L, Flemming A, Frederick DM, Gilbert A, Hesford B, Krieger R, Lian K, McKinney E, Miller JP, Pedersen C, Qu Z, Rozario R, Rubly M, Seaton R, Subramanian A, Sundin SR, Tan A, Thomlinson D, Turner W, Wing G, Wong C, Zarifian A. Energetic Electron Precipitation Driven by Electromagnetic Ion Cyclotron Waves from ELFIN's Low Altitude Perspective. Space Sci Rev 2023; 219:37. [PMID: 37448777 PMCID: PMC10335998 DOI: 10.1007/s11214-023-00984-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/28/2023] [Indexed: 07/15/2023]
Abstract
We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data collected by the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at >0.5 MeV which are abrupt (bursty) (lasting ∼17 s, or Δ L ∼ 0.56 ) with significant substructure (occasionally down to sub-second timescale). We attribute the bursty nature of the precipitation to the spatial extent and structuredness of the wave field at the equator. Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Case studies employing conjugate ground-based or equatorial observations of the EMIC waves reveal that the energy of moderate and strong precipitation at ELFIN approximately agrees with theoretical expectations for cyclotron resonant interactions in a cold plasma. Using multiple years of ELFIN data uniformly distributed in local time, we assemble a statistical database of ∼50 events of strong EMIC wave-driven precipitation. Most reside at L ∼ 5 - 7 at dusk, while a smaller subset exists at L ∼ 8 - 12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L -shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of ∼ 1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. It should be noted though that this diffusive treatment likely includes effects from nonlinear resonant interactions (especially at high energies) and nonresonant effects from sharp wave packet edges (at low energies). Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven >1 MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to ∼ 200-300 keV by much less intense higher frequency EMIC waves at dusk (where such waves are most frequent). At ∼100 keV, whistler-mode chorus may be implicated in concurrent precipitation. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation.
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Affiliation(s)
- V. Angelopoulos
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X.-J. Zhang
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: University of Texas at Dallas, Richardson, TX 75080 USA
| | - A. V. Artemyev
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | | | - E. Tsai
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - C. Wilkins
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - A. Runov
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - J. Liu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Atmospheric and Oceanic Sciences Departments, University of California, Los Angeles, CA USA
| | - D. L. Turner
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Johns Hopkins University Applied Physics Laboratory, Laurel, Maryland USA
| | - W. Li
- Atmospheric and Oceanic Sciences Departments, University of California, Los Angeles, CA USA
| | - K. Khurana
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - R. E. Wirz
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: School of Mechanical, Industrial, and Manufacturing Engineering, Oregon State University, Corvallis, OR 97331 USA
| | - V. A. Sergeev
- University of St. Petersburg, St. Petersburg, Russia
| | - X. Meng
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
| | - J. Wu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. D. Hartinger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Space Science Institute, Boulder, CO 80301 USA
| | - T. Raita
- Sodankylä Geophysical Observatory, University of Oulu, Sodankylä, Finland
| | - Y. Shen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. An
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. Shi
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. F. Bashir
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - X. Shen
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - L. Gan
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - M. Qin
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - L. Capannolo
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - Q. Ma
- Department of Astronomy and Center for Space Physics, Boston University, Boston, MA USA
| | - C. L. Russell
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - E. V. Masongsong
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - R. Caron
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - I. He
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - L. Iglesias
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Deloitte Consulting, New York, NY 10112 USA
| | - S. Jha
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
| | - J. King
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. Kumar
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Astronomy and Astrophysics, The University of Chicago, Chicago, IL 60637 USA
| | - K. Le
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - J. Mao
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Raybeam, Inc., Mountain View, CA 94041 USA
| | - A. McDermott
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - K. Nguyen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
| | - A. Norris
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - A. Palla
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Reliable Robotics Corporation, Mountain View, CA 94043 USA
| | - A. Roosnovo
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Los Alamos National Laboratory, Los Alamos, NM 87545 USA
| | - J. Tam
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - E. Xie
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Deloitte Consulting, New York, NY 10112 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R. C. Yap
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, PBC, San Francisco, CA 94107 USA
| | - S. Ye
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - C. Young
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
| | - L. A. Adair
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: KSAT, Inc., Denver, CO 80231 USA
| | - C. Shaffer
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Tyvak Nano-Satellite Systems, Inc., Irvine, CA 92618 USA
| | - M. Chung
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - P. Cruce
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Apple, Cupertino, CA 95014 USA
| | - M. Lawson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - D. Leneman
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - M. Allen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Zipline International, South San Francisco, CA 94080 USA
| | - M. Anderson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Lucid Motors, Newark, CA 94560 USA
| | - M. Arreola-Zamora
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - J. Artinger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: College of Engineering and Computer Science, California State University, Fullerton, Fullerton, CA 92831 USA
| | - J. Asher
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - D. Branchevsky
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - M. Cliffe
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - K. Colton
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mathematics Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Planet Labs, PBC, San Francisco, CA 94107 USA
| | - C. Costello
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Heliogen, Pasadena, CA 91103 USA
| | - D. Depe
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Argo AI, LLC, Pittsburgh, PA 15222 USA
| | - B. W. Domae
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. Eldin
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Microsoft, Redmond, WA 98052 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - L. Fitzgibbon
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Terran Orbital, Irvine, CA 92618 USA
| | - A. Flemming
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
| | - D. M. Frederick
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Millenium Space Systems, El Segundo, CA 90245 USA
| | - A. Gilbert
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Electrical Engineering, Stanford University, Stanford, CA 94305 USA
| | - B. Hesford
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - R. Krieger
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Materials Science and Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Mercedes-Benz Research and Development North America, Long Beach, CA 90810 USA
| | - K. Lian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - E. McKinney
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Geosyntec Consultants, Inc., Costa Mesa, CA 92626 USA
| | - J. P. Miller
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Juniper Networks Sunnyvale, California, 94089 USA
| | - C. Pedersen
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - Z. Qu
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Niantic Inc., San Francisco, CA 94111 USA
| | - R. Rozario
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: SpaceX, Hawthorne, CA 90250 USA
| | - M. Rubly
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Teledyne Scientific and Imaging, Thousand Oaks, CA 91360 USA
| | - R. Seaton
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - A. Subramanian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Present Address: Northrop Grumman Aerospace Systems, Redondo Beach, CA 90278 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
| | - S. R. Sundin
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Naval Surface Warfare Center Corona Division, Norco, CA 92860 USA
| | - A. Tan
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Electrical and Computer Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Epirus Inc., Torrance, CA 90501 USA
| | - D. Thomlinson
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: The Aerospace Corporation, El Segundo, CA 90245 USA
| | - W. Turner
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Astronomy, Ohio State University, Columbus, OH 43210 USA
| | - G. Wing
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Computer Science Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Present Address: Amazon, Seattle, WA 98109 USA
| | - C. Wong
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Physics and Astronomy Department, University of California, Los Angeles, CA 90095 USA
- Present Address: Department of Radiology, University of California, San Francisco, San Francisco, CA 94143 USA
| | - A. Zarifian
- Earth, Planetary, and Space Sciences Department, and Institute of Geophysics and Planetary Physics, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Mechanical and Aerospace Engineering Department, Henry Samueli School of Engineering, University of California, Los Angeles, CA 90095 USA
- Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA
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Harnett NG, Fani N, Carter S, Sanchez LD, Rowland GE, Davie WM, Guzman C, Lebois LAM, Ely TD, van Rooij SJH, Seligowski AV, Winters S, Grasser LR, Musey PI, Seamon MJ, House SL, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, Hudak LA, Pascual JL, Harris E, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Harte SE, Elliott JM, Kessler RC, Koenen KC, McLean SA, Jovanovic T, Stevens JS, Ressler KJ. Structural inequities contribute to racial/ethnic differences in neurophysiological tone, but not threat reactivity, after trauma exposure. Mol Psychiatry 2023; 28:2975-2984. [PMID: 36725899 PMCID: PMC10615735 DOI: 10.1038/s41380-023-01971-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 02/03/2023]
Abstract
Considerable racial/ethnic disparities persist in exposure to life stressors and socioeconomic resources that can directly affect threat neurocircuitry, particularly the amygdala, that partially mediates susceptibility to adverse posttraumatic outcomes. Limited work to date, however, has investigated potential racial/ethnic variability in amygdala reactivity or connectivity that may in turn be related to outcomes such as post-traumatic stress disorder (PTSD). Participants from the AURORA study (n = 283), a multisite longitudinal study of trauma outcomes, completed functional magnetic resonance imaging and psychophysiology within approximately two-weeks of trauma exposure. Seed-based amygdala connectivity and amygdala reactivity during passive viewing of fearful and neutral faces were assessed during fMRI. Physiological activity was assessed during Pavlovian threat conditioning. Participants also reported the severity of posttraumatic symptoms 3 and 6 months after trauma. Black individuals showed lower baseline skin conductance levels and startle compared to White individuals, but no differences were observed in physiological reactions to threat. Further, Hispanic and Black participants showed greater amygdala connectivity to regions including the dorsolateral prefrontal cortex (PFC), dorsal anterior cingulate cortex, insula, and cerebellum compared to White participants. No differences were observed in amygdala reactivity to threat. Amygdala connectivity was associated with 3-month PTSD symptoms, but the associations differed by racial/ethnic group and were partly driven by group differences in structural inequities. The present findings suggest variability in tonic neurophysiological arousal in the early aftermath of trauma between racial/ethnic groups, driven by structural inequality, impacts neural processes that mediate susceptibility to later PTSD symptoms.
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Affiliation(s)
- Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sierra Carter
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Grace E Rowland
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - William M Davie
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Camilo Guzman
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
- Department of Psychiatry, Henry Ford Health System, Detroit, MI, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Antonia V Seligowski
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sterling Winters
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Lana R Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mark J Seamon
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- The Many Brains Project, Belmont, MA, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA
- Ohio State University College of Nursing, Columbus, OH, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M Elliott
- Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, St Leonards, New South Wales, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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17
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Smeltz AM, Farber MA, Parodi FE, An X, Kirsch RJ, Hipp JS, Kumar PA, Arora H. Comparison of Landmark-Guided Versus Fluoroscopy-Guided Cerebrospinal Fluid Drain-Related Complications After Aortic Repairs. J Cardiothorac Vasc Anesth 2023:S1053-0770(23)00358-0. [PMID: 37328307 DOI: 10.1053/j.jvca.2023.05.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 02/24/2023] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Cerebrospinal fluid drains (CSFDs) are efficacious in preventing spinal cord injury after thoracic or thoracoabdominal aortic repair with extensive coverage. Increasingly, fluoroscopy is used to guide placement instead of the traditional landmark-based approach, but it is unknown which approach is associated with fewer complications. DESIGN A retrospective cohort study. SETTING In the operating room. PARTICIPANTS Patients having undergone thoracic or thoracoabdominal aortic repair with a CSFD over a 7-year period at a single center. INTERVENTIONS No intervention. MEASUREMENTS AND MAIN RESULTS Groups were reviewed and statistically compared with respect to baseline characteristics, ease of CSFD placement, and major and minor complications directly related to placement. A total of 150 CSFDs were placed with landmark guidance as opposed to 95 with fluoroscopy guidance. Compared to the landmark group, patients with fluoroscopy-guided CSFDs were older (p < 0.008), had lower American Society of Anesthesiologists physical status scores (p = 0.008), required fewer CSFD placement attempts (p = 0.011), had the CSFD in place for longer duration (p < 0.001), and had a similar incidence of CSFD-related complications (p > 0.999). Composites of both major (4.5% of cases) and minor CSFD-related complications (6.1% of cases), the primary outcomes of the study, occurred with similar incidences between the 2 groups (p > 0.999 for both comparisons) after adjusting potential confounders. CONCLUSIONS In patients undergoing thoracic or thoracoabdominal aortic repairs, there were no significant differences in the risk of major and minor CSFD-related complications between fluoroscopic guidance and the landmark approach. Although the authors' institution is a high-volume center for this type of procedure, the study was limited by a small sample size. Hence, regardless of the technique used for the placement of CSFD, the risks related to the placement should be balanced carefully against the potential benefits resulting from spinal cord injury prevention. Fluoroscopy-aided insertion of CSFD requires fewer attempts and, hence, may be better tolerated by patients.
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Affiliation(s)
- Alan M Smeltz
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Mark A Farber
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - F Ezequiel Parodi
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Xinming An
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Rachel J Kirsch
- Department of Anesthesiology, University of California, San Francisco, CA
| | - John S Hipp
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Priya A Kumar
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC; Outcomes Research Consortium, Cleveland, OH
| | - Harendra Arora
- Outcomes Research Consortium, Cleveland, OH; Department of Anesthesiology, University of Mississippi Medical Center, Jackson, MS
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Entzel P, Nielsen M, Weiss S, Park YA, Lu R, Baskin-Miller J, Hutchinson B, Obioma P, An X, Balfanz G. How do I reduce variation in red blood cell transfusion practices in a large integrated health care system? Transfusion 2023. [PMID: 37190781 DOI: 10.1111/trf.17383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Reducing variation in transfusion practices can prevent unwarranted transfusions, an outcome that improves quality of care and patient safety, while lowering costs and eliminating waste of blood. We developed and assessed a system-wide initiative to reduce variation in red blood cell (RBC) transfusion in terms of both transfusion utilization and the number of units transfused. INTERVENTION DESIGN AND METHODS Our initiative combined a single-unit default order for RBC transfusion in hemodynamically stable, non-bleeding patients with a "Why Give 2 When 1 Will Do?" Choosing Wisely campaign, while also promoting a restrictive hemoglobin threshold (Hb <7 g/dl). This multimodal intervention was implemented across an academic medical center (AMC) with over 950 beds and 10 community hospitals. RESULTS Between our baseline (CY 2020) and intervention period (CY 2021), single-unit orders increased from 57% to 70% of all RBC transfusion orders (p < .001). The greatest change in ordering practices was at community hospitals, where single-unit orders increased from 46% to 65% (p < .001). Over the same time period, the system-wide mean (SD) Hb result prior to transfusion fell from 7.3 (0.05) to 7.2 g/dl (0.04) (p < .05). We estimate this effort saved over 4000 units of blood and over $4 million in direct and indirect costs in its first year. DISCUSSION By combining a single-unit default setting in the RBC order with a restrictive hemoglobin threshold, we significantly reduced variation in ordering practices. This effort demonstrates the value of single-unit policies and "nudges" in system-wide patient blood management initiatives.
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Affiliation(s)
- Pamela Entzel
- Care Redesign Department, UNC Health, Morrisville, North Carolina, USA
| | - Matthew Nielsen
- Department of Urology, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Susan Weiss
- Carolinas Pathology Group, Atrium Health Carolinas Medical Center, Charlotte, North Carolina, USA
| | - Yara A Park
- Department of Pathology and Laboratory Medicine, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Rommel Lu
- UNC Rex Hematology Oncology, Raleigh, North Carolina, USA
| | - Jacquelyn Baskin-Miller
- Department of Pediatrics, Hematology/Oncology, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Blake Hutchinson
- Department of Pathology, UNC Rex Healthcare, Raleigh, North Carolina, USA
| | - Prestige Obioma
- Care Redesign Department, UNC Health, Morrisville, North Carolina, USA
| | - Xinming An
- Department of Anesthesiology, UNC School of Medicine, Chapel Hill, North Carolina, USA
| | - Greg Balfanz
- Department of Anesthesiology, UNC School of Medicine, Chapel Hill, North Carolina, USA
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19
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Ma KD, Zhu CR, An X, Ma XC. [Effects and questions of prone position in novel coronavirus infection]. Zhonghua Nei Ke Za Zhi 2023; 62:568-571. [PMID: 37096288 DOI: 10.3760/cma.j.cn112138-20220512-00363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
Affiliation(s)
- K D Ma
- Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - C R Zhu
- Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - X An
- Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
| | - X C Ma
- Department of Critical Care Medicine, the First Affiliated Hospital of China Medical University, Shenyang 110001, China
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20
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Harnett NG, Dumornay NM, Delity M, Sanchez LD, Mohiuddin K, Musey PI, Seamon MJ, McLean SA, Kessler RC, Koenen KC, Beaudoin FL, Lebois L, van Rooij SJ, Sampson NA, Michopoulos V, Maples-Keller JL, Haran JP, Storrow AB, Lewandowski C, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Swor RA, McGrath ME, Hudak LA, Pascual JL, House SL, An X, Stevens JS, Neylan TC, Jovanovic T, Linnstaedt SD, Germine LT, Datner EM, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O’Neil BJ, Sergot P, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Luna B, Harte SE, Elliott JM, Ressler KJ. Prior differences in previous trauma exposure primarily drive the observed racial/ethnic differences in posttrauma depression and anxiety following a recent trauma. Psychol Med 2023; 53:2553-2562. [PMID: 35094717 PMCID: PMC9339026 DOI: 10.1017/s0033291721004475] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Racial and ethnic groups in the USA differ in the prevalence of posttraumatic stress disorder (PTSD). Recent research however has not observed consistent racial/ethnic differences in posttraumatic stress in the early aftermath of trauma, suggesting that such differences in chronic PTSD rates may be related to differences in recovery over time. METHODS As part of the multisite, longitudinal AURORA study, we investigated racial/ethnic differences in PTSD and related outcomes within 3 months after trauma. Participants (n = 930) were recruited from emergency departments across the USA and provided periodic (2 weeks, 8 weeks, and 3 months after trauma) self-report assessments of PTSD, depression, dissociation, anxiety, and resilience. Linear models were completed to investigate racial/ethnic differences in posttraumatic dysfunction with subsequent follow-up models assessing potential effects of prior life stressors. RESULTS Racial/ethnic groups did not differ in symptoms over time; however, Black participants showed reduced posttraumatic depression and anxiety symptoms overall compared to Hispanic participants and White participants. Racial/ethnic differences were not attenuated after accounting for differences in sociodemographic factors. However, racial/ethnic differences in depression and anxiety were no longer significant after accounting for greater prior trauma exposure and childhood emotional abuse in White participants. CONCLUSIONS The present findings suggest prior differences in previous trauma exposure partially mediate the observed racial/ethnic differences in posttraumatic depression and anxiety symptoms following a recent trauma. Our findings further demonstrate that racial/ethnic groups show similar rates of symptom recovery over time. Future work utilizing longer time-scale data is needed to elucidate potential racial/ethnic differences in long-term symptom trajectories.
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Affiliation(s)
- N. G. Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - N. M. Dumornay
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - M. Delity
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - L. D. Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - K. Mohiuddin
- Department of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, 19141, USA
| | - P. I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - M. J. Seamon
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - S. A. McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - K. C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - F. L. Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, 02930, USA
| | - L. Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - S. J. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30332, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - V. Michopoulos
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30332, USA
| | - J. L. Maples-Keller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30332, USA
| | - J. P. Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - A. B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - C. Lewandowski
- Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, 48202, USA
| | - P. L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - S. Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - C. W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
| | - B. E. Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
- College of Nursing, University of Cincinnati, Cincinnati, OH, 45221, USA
| | - M. C. Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, 35294, USA
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, 35294, USA
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - R. A. Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, 48309, USA
| | - M. E. McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA
| | - L. A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - J. L. Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - S. L. House
- Department of Emergency Medicine,, Washington University School of Medicine,, St. Louis, MO, 63130, USA
| | - X. An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - J. S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - T. C. Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - T. Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | - S. D. Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - L. T. Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
| | - E. M. Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Pennsylvania, PA, 19141, USA
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA, 19107, USA
| | - A. M. Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, 19107, USA
| | - C. Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - D. A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - R. C. Merchant
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - R. M. Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA
| | - N. K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA
| | - B. J. O’Neil
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - P. Sergot
- Department of Emergency Medicine, McGovern Medical School, University of Texas Health, Houston, TX, 77030, USA
| | - S. E. Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA
| | - M. W. Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - R. H. Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, 06510, USA
| | - J. Joormann
- Department of Psychology, Yale University, West Haven, CT, 06520, USA
| | - D. M. Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - D. A. Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - J. F. Sheridan
- Department of Biosciences, OSU Wexner Medical Center, Columbus, OH, 43210, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA
| | - J. W. Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, 02114, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, 02142, USA
| | - B. Luna
- Affiliation Laboratory of Neurocognitive Development, University of Pittsburgh Medical Center- Western Psychiatric Hospital, Pittsburgh, PA, 15213, USA
| | - S. E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - J. M. Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, 2006,, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA
| | - K. J. Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
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21
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Gu Y, Xu W, Liu Y, An X, Li J, Cong L, Zhu L, He X, Wang H, Jiang Y. The feasibility of a novel computer-aided classification system for the characterisation and diagnosis of breast masses on ultrasound: a single-centre preliminary test study. Clin Radiol 2023:S0009-9260(23)00130-7. [PMID: 37069025 DOI: 10.1016/j.crad.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/07/2023] [Accepted: 03/15/2023] [Indexed: 04/19/2023]
Abstract
AIM To introduce a novel computer-aided classification (CAC) system and investigate the feasibility of characterising and diagnosing breast masses on ultrasound (US). MATERIALS AND METHODS A total of 246 breast masses were included. US features and the final assessment categories of the breast masses were analysed by a radiologist and the CAC system according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon. The CAC system evaluated the BI-RADS assessment from the fusion of multi-view and colour Doppler US images without (SmartBreast) or with combining clinical variables (m-CAC system). The diagnostic performance and agreement of US characteristics between the radiologist and the CAC system were compared. RESULTS The agreement between the radiologist and the CAC system was substantial for mass shape (κ = 0.673), orientation (κ = 0.682), margin (κ = 0.622), posterior features (κ = 0.629), calcifications in a mass (κ = 0.709) and vascularity (κ = 0.745), fair for echo pattern (κ = 0.379), and moderate for BI-RADS assessment (κ = 0.575). With BI-RADS 4a as the cut-off value, the specificity (52.5% versus 25%, p<0.0001) and accuracy (73.98% versus 62.6%, p=0.0002) of the m-CAC system were improved without significant loss of sensitivity (94.44% versus 98.41%, p=0.1250) compared with the SmartBreast. The m-CAC system showed similar specificity (52.5% versus 45.83%, p=0.2430) and accuracy (73.98% versus 73.58%, p=1.0000) as the radiologist, but a lower sensitivity (94.44% versus 100%, p=0.0156). CONCLUSION The CAC system showed an acceptable agreement with the radiologist for characterisation of breast lesions. It has the potential to mimic the decision-making behaviour of radiologists for the classification of breast lesions.
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Affiliation(s)
- Y Gu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - W Xu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - Y Liu
- Department of Medical Imaging Advanced Research, Beijing Research Institute, Shenzhen Mindray Bio-Medical Electronics Co., Ltd, Beijing, China
| | - X An
- Department of Medical Imaging Advanced Research, Beijing Research Institute, Shenzhen Mindray Bio-Medical Electronics Co., Ltd, Beijing, China
| | - J Li
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China
| | - L Cong
- Department of Medical Imaging Advanced Research, Beijing Research Institute, Shenzhen Mindray Bio-Medical Electronics Co., Ltd, Beijing, China
| | - L Zhu
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd, Shenzhen, China
| | - X He
- Shenzhen Mindray Bio-Medical Electronics Co., Ltd, Shenzhen, China
| | - H Wang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China.
| | - Y Jiang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai Fu Yuan, Dong Cheng District, Beijing, 100730, China.
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22
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Jones CW, An X, Ji Y, Liu M, Zeng D, House SL, Beaudoin FL, Stevens JS, Neylan TC, Clifford GD, Jovanovic T, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Punches BE, Lyons MS, Kurz MC, Swor RA, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Harris E, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Harte SE, Elliott JM, Koenen KC, Ressler KJ, Kessler RC, McLean SA. Derivation and Validation of a Brief Emergency Department-Based Prediction Tool for Posttraumatic Stress After Motor Vehicle Collision. Ann Emerg Med 2023; 81:249-261. [PMID: 36328855 DOI: 10.1016/j.annemergmed.2022.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/05/2022]
Abstract
STUDY OBJECTIVE To derive and initially validate a brief bedside clinical decision support tool that identifies emergency department (ED) patients at high risk of substantial, persistent posttraumatic stress symptoms after a motor vehicle collision. METHODS Derivation (n=1,282, 19 ED sites) and validation (n=282, 11 separate ED sites) data were obtained from adults prospectively enrolled in the Advancing Understanding of RecOvery afteR traumA study who were discharged from the ED after motor vehicle collision-related trauma. The primary outcome was substantial posttraumatic stress symptoms at 3 months (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders-5 ≥38). Logistic regression derivation models were evaluated for discriminative ability using the area under the curve and the accuracy of predicted risk probabilities (Brier score). Candidate posttraumatic stress predictors assessed in these models (n=265) spanned a range of sociodemographic, baseline health, peritraumatic, and mechanistic domains. The final model selection was based on performance and ease of administration. RESULTS Significant 3-month posttraumatic stress symptoms were common in the derivation (27%) and validation (26%) cohort. The area under the curve and Brier score of the final 8-question tool were 0.82 and 0.14 in the derivation cohort and 0.76 and 0.17 in the validation cohort. CONCLUSION This simple 8-question tool demonstrates promise to risk-stratify individuals with substantial posttraumatic stress symptoms who are discharged to home after a motor vehicle collision. Both external validation of this instrument, and work to further develop more accurate tools, are needed. Such tools might benefit public health by enabling the conduct of preventive intervention trials and assisting the growing number of EDs that provide services to trauma survivors aimed at promoting psychological recovery.
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Affiliation(s)
- Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ
| | - Xinming An
- Department of Anesthesiology, Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yinyao Ji
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Mochuan Liu
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St Louis, MO
| | - Francesca L Beaudoin
- Department of Emergency Medicine and Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Thomas C Neylan
- Department of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine and Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI
| | - Sarah D Linnstaedt
- Department of Anesthesiology, Department of Psychiatry, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA; The Many Brains Project, Belmont, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience and Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Scott L Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychiatry, McLean Hospital, Belmont, MA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Phyllis L Hendry
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL; Department of Emergency Medicine, University of Cincinnati College of Medicine, and College of Nursing, University of Cincinnati, Cincinnati, OH
| | - Brittany E Punches
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL
| | - Michael S Lyons
- College of Nursing, University of Cincinnati, Cincinnati, OH
| | - Michael C Kurz
- Department of Emergency Medicine, Division of Acute Care Surgery, Department of Surgery, University of Alabama School of Medicine, and Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA; Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA; Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA
| | - Mark J Seamon
- Division of Traumatology, Department of Surgery, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, and the Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA
| | | | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St John Hospital, Detroit, MI
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School, University of Texas Health, Houston, TX
| | - Leon D Sanchez
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA; Department of Emergency Medicine, Harvard Medical School, Boston, MA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St Louis, St Louis, MO
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, and Department of Psychiatry, Boston University School of Medicine, Boston, MA; Clinical Neurosciences Division, National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT
| | | | - Jutta Joormann
- Department of Psychology, Yale School of Medicine, New Haven, CT
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, MO
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA
| | - John F Sheridan
- Department of Biosciences, and the Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, and Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA
| | - Steven E Harte
- Department of Anesthesiology, and Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI
| | - James M Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, and Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Australia, and Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T H Chan School of Public Health, Harvard University, Boston, MA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA; Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, MO
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA
| | - Samuel A McLean
- Departments of Emergency Medicine and Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC.
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23
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Straus LD, An X, Ji Y, McLean SA, Neylan TC. Utility of Wrist-Wearable Data for Assessing Pain, Sleep, and Anxiety Outcomes After Traumatic Stress Exposure. JAMA Psychiatry 2023; 80:220-229. [PMID: 36630119 PMCID: PMC9857758 DOI: 10.1001/jamapsychiatry.2022.4533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/09/2022] [Indexed: 01/12/2023]
Abstract
Importance Adverse posttraumatic neuropsychiatric sequelae after traumatic stress exposure are common and have higher incidence among socioeconomically disadvantaged populations. Pain, depression, avoidance of trauma reminders, reexperiencing trauma, anxiety, hyperarousal, sleep disruption, and nightmares have been reported. Wrist-wearable devices with accelerometers capable of assessing 24-hour rest-activity characteristics are prevalent and may have utility in measuring these outcomes. Objective To evaluate whether wrist-wearable devices can provide useful biomarkers for recovery after traumatic stress exposure. Design, Setting, and Participants Data were analyzed from a diverse cohort of individuals seen in the emergency department after experiencing a traumatic stress exposure, as part of the Advancing Understanding of Recovery After Trauma (AURORA) study. Participants recruited from 27 emergency departments wore wrist-wearable devices for 8 weeks, beginning in the emergency department, and completed serial assessments of neuropsychiatric symptoms. A total of 19 019 patients were screened. Of these, 3040 patients met study criteria, provided informed consent, and completed baseline assessments. A total of 2021 provided data from wrist-wearable devices, completed the 8-week assessment, and were included in this analysis. The data were randomly divided into 2 equal parts (n = 1010) for biomarker identification and validation. Data were collected from September 2017 to January 2020, and data were analyzed from May 2020 to November 2022. Exposures Participants were recruited for the study after experiencing a traumatic stress exposure (most commonly motor vehicle collision). Main Outcomes and Measures Rest-activity characteristics were derived and validated from wrist-wearable devices associated with specific self-reported symptom domains at a point in time and changes in symptom severity over time. Results Of 2021 included patients, 1257 (62.2%) were female, and the mean (SD) age was 35.8 (13.0) years. Eight wrist-wearable device biomarkers for symptoms of adverse posttraumatic neuropsychiatric sequelae exceeded significance thresholds in the derivation cohort. One of these, reduced 24-hour activity variance, was associated with greater pain severity (r = -0.14; 95% CI, -0.20 to -0.07). Changes in 6 rest-activity measures were associated with changes in pain over time, and changes in the number of transitions between sleep and wake over time were associated with changes in pain, sleep, and anxiety. Simple cutoffs for these biomarkers identified individuals with good recovery for pain (positive predictive value [PPV], 0.85; 95% CI, 0.82-0.88), sleep (PPV, 0.63; 95% CI, 0.59-0.67, and anxiety (PPV, 0.76; 95% CI, 0.72-0.80) with high predictive value. Conclusions and Relevance These findings suggest that wrist-wearable device biomarkers may have utility as screening tools for pain, sleep, and anxiety symptom outcomes after trauma exposure in high-risk populations.
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Affiliation(s)
- Laura D. Straus
- San Francisco VA Medical Center, San Francisco, California
- Department of Psychiatry, University of California, San Francisco
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill
| | - Yinyao Ji
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill
| | - Samuel A. McLean
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill
- Department of Emergency Medicine, University of North Carolina at Chapel Hill
| | - Thomas C. Neylan
- Department of Psychiatry, University of California, San Francisco
- Department of Neurology, University of California, San Francisco
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24
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Beaudoin FL, An X, Basu A, Ji Y, Liu M, Kessler RC, Doughtery RF, Zeng D, Bollen KA, House SL, Stevens JS, Neylan TC, Clifford GD, Jovanovic T, Linnstaedt SD, Germine LT, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Swor RA, Murty VP, McGrath ME, Hudak LA, Pascual JL, Datner EM, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, Neil BJO, Sergot P, Sanchez LD, Bruce SE, Baker JT, Joormann J, Miller MW, Pietrzak RH, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Harte SE, Elliott JM, Koenen KC, Ressler KJ, McLean SA. Use of serial smartphone-based assessments to characterize diverse neuropsychiatric symptom trajectories in a large trauma survivor cohort. Transl Psychiatry 2023; 13:4. [PMID: 36609484 PMCID: PMC9823011 DOI: 10.1038/s41398-022-02289-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/25/2022] [Accepted: 12/14/2022] [Indexed: 01/09/2023] Open
Abstract
The authors sought to characterize adverse posttraumatic neuropsychiatric sequelae (APNS) symptom trajectories across ten symptom domains (pain, depression, sleep, nightmares, avoidance, re-experiencing, anxiety, hyperarousal, somatic, and mental/fatigue symptoms) in a large, diverse, understudied sample of motor vehicle collision (MVC) survivors. More than two thousand MVC survivors were enrolled in the emergency department (ED) and completed a rotating battery of brief smartphone-based surveys over a 2-month period. Measurement models developed from survey item responses were used in latent growth curve/mixture modeling to characterize homogeneous symptom trajectories. Associations between individual trajectories and pre-trauma and peritraumatic characteristics and traditional outcomes were compared, along with associations within and between trajectories. APNS across all ten symptom domains were common in the first two months after trauma. Many risk factors and associations with high symptom burden trajectories were shared across domains. Both across and within traditional diagnostic boundaries, APNS trajectory intercepts, and slopes were substantially correlated. Across all domains, symptom severity in the immediate aftermath of trauma (trajectory intercepts) had the greatest influence on the outcome. An interactive data visualization tool was developed to allow readers to explore relationships of interest between individual characteristics, symptom trajectories, and traditional outcomes ( http://itr.med.unc.edu/aurora/parcoord/ ). Individuals presenting to the ED after MVC commonly experience a broad constellation of adverse posttraumatic symptoms. Many risk factors for diverse APNS are shared. Individuals diagnosed with a single traditional outcome should be screened for others. The utility of multidimensional categorizations that characterize individuals across traditional diagnostic domains should be explored.
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Affiliation(s)
- Francesca L Beaudoin
- Department of Epidemiology, Brown University, Providence, RI, USA
- Department of Emergency Medicine, Brown University, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Archana Basu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Yinyao Ji
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mochuan Liu
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | | | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- The Many Brains Project, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Scott L Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, USA
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, USA
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Vishnu P Murty
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, PA, USA
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Brian J O' Neil
- Department of Emergency Medicine, Wayne State University, Detroit, MI, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School, University of Texas Health, Houston, TX, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | | | - Jutta Joormann
- Department of Psychology, Yale University, West Haven, CT, USA
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - John F Sheridan
- Department of Biosciences, OSU Wexner Medical Center, Columbus, OH, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, USA
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local, Health District, NSW, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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25
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Yan R, Guo SJ, An X, Jiang LJ, Liu TY, Xue T, Ma HL, Yao K, Shi YX, Han H. [Efficacy and safety of neoadjuvant toripalimab combined with nimotuzumab and chemotherapy in patients with unresectable stage Ⅳ squamous cell carcinoma of penis]. Zhonghua Wai Ke Za Zhi 2022; 60:1093-1099. [PMID: 36480877 DOI: 10.3760/cma.j.cn112139-20220509-00209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective: To compare the efficacy and safety of neoadjuvant chemotherapy alone or combined with toripalimab and nimotuzumab in patients with unresectable locally advanced or metastatic squamous cell carcinoma of penis. Methods: A total of 33 patients with unresectable squamous cell carcinoma of penis undergoing neoadjuvant chemotherapy alone or combined with toripalimab and nimotuzumab at Sun Yat-sen University Cancer Center from May 2015 to June 2021 were enrolled retrospectively. All the patients were male, with a median age (M(IQR))of 49.0 (13.5) years (range: 30 to 70 years). According to the therapy protocols, patients were divided into the chemotherapy group (16 cases) and the triple combination group (17 cases). Log-rank test was used to compare the progression-free survival and overall survival. χ2 test or Fisher exact method was used to compare the objective response rate, pathological down-stage rate and adverse events between these two groups. Results: The follow-up time was 28.1(19.2) months (range: 1.5 to 33.4 months). Patients of triple combination group were observed significantly longer progression-free survival (30.0 months vs. 8.2 months, χ²=3.998, P=0.046) than those of chemotherapy group. The median overall survival of the triple combination group and chemotherapy group were not reached and 15.2 months (χ²=3.298, P=0.069), respectively. Although there was no significant difference in the subsequent surgical resection rate between these two groups (12/17 vs.11/16, P=1), the objective response rate and the pathological complete response rate in triple combination group were significantly higher than in chemotherapy group (13/17 vs. 6/16, χ²=5.125, P=0.024; 6/7 vs. 0, P=0.001). The main common grade 1 to 2 adverse events in the triple combination group were alopecia (16 cases), anemia (15 cases), and nausea (14 cases). The main common grade 1 to 2 adverse events in the chemotherapy group were anemia (14 cases), alopecia (12 cases), decreased appetite (12 cases), and nausea (11 cases). The incidence of adverse events ≥grade 3 was similar in the triple combination group and chemotherapy group (8/17 vs. 6/16, χ²=0.308, P=0.579). There was no grade 3 adverse event in both groups. Conclusion: Compared with traditional chemotherapy alone, chemotherapy combined with toripalimab and nimotuzumab provides longer progression-free survival and similar toxicity for unresectable stage Ⅳ squamous cell carcinoma of penis.
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Affiliation(s)
- R Yan
- Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - S J Guo
- Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - X An
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - L J Jiang
- Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - T Y Liu
- Department of Experimental Research, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - T Xue
- Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - H L Ma
- Department of Radiology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - K Yao
- Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Y X Shi
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - H Han
- Department of Urology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
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Short NA, van Rooij SJH, Murty VP, Stevens JS, An X, Ji Y, McLean SA, House SL, Beaudoin FL, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Bruce SE, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Harte SE, Elliott JM, Kessler RC, Koenen KC, Jovanovic T. Anxiety sensitivity as a transdiagnostic risk factor for trajectories of adverse posttraumatic neuropsychiatric sequelae in the AURORA study. J Psychiatr Res 2022; 156:45-54. [PMID: 36242943 PMCID: PMC10960961 DOI: 10.1016/j.jpsychires.2022.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/16/2022] [Accepted: 09/16/2022] [Indexed: 01/20/2023]
Abstract
Anxiety sensitivity, or fear of anxious arousal, is cross-sectionally associated with a wide array of adverse posttraumatic neuropsychiatric sequelae, including symptoms of posttraumatic stress disorder, depression, anxiety, sleep disturbance, pain, and somatization. The current study utilizes a large-scale, multi-site, prospective study of trauma survivors presenting to emergency departments. Hypotheses tested whether elevated anxiety sensitivity in the immediate posttrauma period is associated with more severe and persistent trajectories of common adverse posttraumatic neuropsychiatric sequelae in the eight weeks posttrauma. Participants from the AURORA study (n = 2,269 recruited from 23 emergency departments) completed self-report assessments over eight weeks posttrauma. Associations between heightened anxiety sensitivity and more severe and/or persistent trajectories of trauma-related symptoms identified by growth mixture modeling were analyzed. Anxiety sensitivity assessed two weeks posttrauma was associated with severe and/or persistent posttraumatic stress, depression, anxiety, sleep disturbance, pain, and somatic symptoms in the eight weeks posttrauma. Effect sizes were in the small to medium range in multivariate models accounting for various demographic, trauma-related, pre-trauma mental health-related, and personality-related factors. Anxiety sensitivity may be a useful transdiagnostic risk factor in the immediate posttraumatic period identifying individuals at risk for the development of adverse posttraumatic neuropsychiatric sequelae. Further, considering anxiety sensitivity is malleable via brief intervention, it could be a useful secondary prevention target. Future research should continue to evaluate associations between anxiety sensitivity and trauma-related pathology.
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Affiliation(s)
- Nicole A Short
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA; Department of Psychology, University of Nevada, Las Vegas, NV, 89154, USA.
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Vishnu P Murty
- Department of Psychology, Temple University, Philadelphia, PA, 19121, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Yinyao Ji
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Francesca L Beaudoin
- Department of Epidemiology, The Brown University School of Public Health, Providence, RI, 02930, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27559, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA; Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA; The Many Brains Project, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Scott L Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA; Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, 01655, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, 43210, USA; Ohio State University College of Nursing, Columbus, OH, 43210, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, 48309, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, 19104, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, PA, 19141, USA; Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, 48202, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, 48202, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School at UTHealth, Houston, TX, 77030, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, 06510, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - John F Sheridan
- Division of Biosciences, Ohio State University College of Dentistry, Columbus, OH, 43210, USA; Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, 02114, USA; Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, 02142, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - James M Elliott
- Kolling Institute, University of Sydney, St Leonards, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, 2006, Australia; Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, 48202, USA
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An X, Zang M, Xiong L, Ke H, Tao Y, Chen C, Li H. HX301, a potent CSF1R inhibitor, suppresses tumor associated M2 macrophage (TAM), enhancing tumor immunity and causing transit tumor inhibition in syngeneic EMT-6 tumors. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01126-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Levy M, Ferraro G, Planoutene M, Li L, Han Y, Varicchio L, Fournier S, An X, Morris S, Koehler M, Hoffman R, Fretland A, Roulston A, Ginzburg Y. ATR inhibitor camonsertib (RP-3500) suppresses early-stage erythroblasts by mediating ferroptosis. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01064-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Punches BE, Stolz U, Freiermuth CE, Ancona RM, McLean SA, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Clifford GD, Jovanovic T, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Kurz MC, Gentile NT, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Harris E, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O’Neil BJ, Sanchez LD, Bruce SE, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Smoller JW, Luna B, Harte SE, Elliott JM, Kessler RC, Ressler KJ, Koenen KC, Lyons MS. Predicting at-risk opioid use three months after ed visit for trauma: Results from the AURORA study. PLoS One 2022; 17:e0273378. [PMID: 36149896 PMCID: PMC9506640 DOI: 10.1371/journal.pone.0273378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/07/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Whether short-term, low-potency opioid prescriptions for acute pain lead to future at-risk opioid use remains controversial and inadequately characterized. Our objective was to measure the association between emergency department (ED) opioid analgesic exposure after a physical, trauma-related event and subsequent opioid use. We hypothesized ED opioid analgesic exposure is associated with subsequent at-risk opioid use. Methods Participants were enrolled in AURORA, a prospective cohort study of adult patients in 29 U.S., urban EDs receiving care for a traumatic event. Exclusion criteria were hospital admission, persons reporting any non-medical opioid use (e.g., opioids without prescription or taking more than prescribed for euphoria) in the 30 days before enrollment, and missing or incomplete data regarding opioid exposure or pain. We used multivariable logistic regression to assess the relationship between ED opioid exposure and at-risk opioid use, defined as any self-reported non-medical opioid use after initial ED encounter or prescription opioid use at 3-months. Results Of 1441 subjects completing 3-month follow-up, 872 participants were included for analysis. At-risk opioid use occurred within 3 months in 33/620 (5.3%, CI: 3.7,7.4) participants without ED opioid analgesic exposure; 4/16 (25.0%, CI: 8.3, 52.6) with ED opioid prescription only; 17/146 (11.6%, CI: 7.1, 18.3) with ED opioid administration only; 12/90 (13.3%, CI: 7.4, 22.5) with both. Controlling for clinical factors, adjusted odds ratios (aORs) for at-risk opioid use after ED opioid exposure were: ED prescription only: 4.9 (95% CI 1.4, 17.4); ED administration for analgesia only: 2.0 (CI 1.0, 3.8); both: 2.8 (CI 1.2, 6.5). Conclusions ED opioids were associated with subsequent at-risk opioid use within three months in a geographically diverse cohort of adult trauma patients. This supports need for prospective studies focused on the long-term consequences of ED opioid analgesic exposure to estimate individual risk and guide therapeutic decision-making.
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Affiliation(s)
- Brittany E. Punches
- College of Nursing, The Ohio State University, Columbus, OH, United States of America
- Department of Emergency Medicine College of Medicine, The Ohio State University, Columbus, OH, United States of America
- * E-mail:
| | - Uwe Stolz
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, United States of America
| | - Caroline E. Freiermuth
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, United States of America
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
| | - Rachel M. Ancona
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Samuel A. McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Francesca L. Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, United States of America
| | - Xinming An
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Thomas C. Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, United States of America
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, United States of America
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States of America
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, United States of America
| | - Sarah D. Linnstaedt
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Laura T. Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, United States of America
- The Many Brains Project, Belmont, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Kenneth A. Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Scott L. Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, United States of America
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
- Department of Psychiatry, McLean Hospital, Belmont, MA, United States of America
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, United States of America
| | - Alan B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Christopher Lewandowski
- Department of Emergency Medicine, Henry Ford Health System, Detroit, MI, United States of America
| | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, United States of America
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, United States of America
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, United States of America
| | - Michael C. Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, United States of America
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, United States of America
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Nina T. Gentile
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, United States of America
| | - Meghan E. McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, United States of America
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Jose L. Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, United States of America
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, United States of America
| | - Mark J. Seamon
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, United States of America
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, United States of America
| | - Erica Harris
- Department of Emergency Medicine, Einstein Healthcare Network, Pennsylvania, PA, United States of America
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA, United States of America
| | - Anna M. Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, United States of America
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MA, United States of America
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, United States of America
| | - Roland C. Merchant
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United States of America
| | - Robert M. Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, United States of America
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, United States of America
| | - Brian J. O’Neil
- Department of Emergency Medicine, Wayne State University, Detroit, MA, United States of America
| | - Leon D. Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, United States of America
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, United States of America
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri—St. Louis, St. Louis, MO, United States of America
| | - Robert H. Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, United States of America
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States of America
| | - Jutta Joormann
- Department of Psychology, Yale School of Medicine, New Haven, CT, United States of America
| | - Deanna M. Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, MO, United States of America
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, United States of America
| | - Jordan W. Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, United States of America
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, United States of America
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, United States of America
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, United States of America
| | - James M. Elliott
- Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States of America
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, United States of America
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Michael S. Lyons
- Department of Emergency Medicine, University of Cincinnati, Cincinnati, OH, United States of America
- Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
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Lebois LAM, Harnett NG, van Rooij SJH, Ely TD, Jovanovic T, Bruce SE, House SL, Ravichandran C, Dumornay NM, Finegold KE, Hill SB, Merker JB, Phillips KA, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Swor RA, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Chang AM, Pearson C, Domeier RM, Rathlev NK, O’Neil BJ, Sergot P, Sanchez LD, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Luna B, Harte SE, Elliott JM, Kessler RC, Koenen KC, McLean SA, Stevens JS, Ressler KJ. Persistent Dissociation and Its Neural Correlates in Predicting Outcomes After Trauma Exposure. Am J Psychiatry 2022; 179:661-672. [PMID: 35730162 PMCID: PMC9444876 DOI: 10.1176/appi.ajp.21090911] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Dissociation, a disruption or discontinuity in psychological functioning, is often linked with worse psychiatric symptoms; however, the prognostic value of dissociation after trauma is inconsistent. Determining whether trauma-related dissociation is uniquely predictive of later outcomes would enable early identification of at-risk trauma populations. The authors conducted the largest prospective longitudinal biomarker study of persistent dissociation to date to determine its predictive capacity for adverse psychiatric outcomes following acute trauma. METHODS All data were part of the Freeze 2 data release from the Advancing Understanding of Recovery After Trauma (AURORA) study. Study participants provided self-report data about persistent derealization (N=1,464), a severe type of dissociation, and completed a functional MRI emotion reactivity task and resting-state scan 2 weeks posttrauma (N=145). Three-month follow-up reports were collected of posttraumatic stress, depression, pain, anxiety symptoms, and functional impairment. RESULTS Derealization was associated with increased ventromedial prefrontal cortex (vmPFC) activation in the emotion reactivity task and decreased resting-state vmPFC connectivity with the cerebellum and orbitofrontal cortex. In separate analyses, brain-based and self-report measures of persistent derealization at 2 weeks predicted worse 3-month posttraumatic stress symptoms, distinct from the effects of childhood maltreatment history and current posttraumatic stress symptoms. CONCLUSIONS The findings suggest that persistent derealization is both an early psychological and biological marker of worse later psychiatric outcomes. The neural correlates of trauma-related dissociation may serve as potential targets for treatment engagement to prevent posttraumatic stress disorder. These results underscore dissociation assessment as crucial following trauma exposure to identify at-risk individuals, and they highlight an unmet clinical need for tailored early interventions.
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Affiliation(s)
- Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Caitlin Ravichandran
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Lurie Center for Autism, 1 Maguire Road, Lexington, MA, 02421, USA
| | - Nathalie M Dumornay
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | | | - Sarah B Hill
- Department of Psychology, Northern Illinois University, DeKalb, IL, 60115, USA
| | - Julia B Merker
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - Karlye A Phillips
- McLean Hospital, Belmont, MA, 02478, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Francesca L Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, 02930, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- The Many Brains Project, Belmont, MA, 02478, USA
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
- College of Nursing, University of Cincinnati, Cincinnati, OH, 45221, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, 48309, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Pennsylvania, PA, 19141, USA
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA, 19107, USA
| | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, 19107, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA
| | - Brian J O’Neil
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School, University of Texas Health, Houston, TX, 77030, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jutta Joormann
- Department of Psychology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
| | - John F Sheridan
- Department of Biosciences, OSU Wexner Medical Center, Columbus, OH, 43210, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, 02114, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, 02142, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - James M Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, 2006, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
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Li H, Chen M, Xue C, Li L, Hu A, Yang W, Zheng Z, Ni M, Zhang L, Zeng Y, Peng J, Yao K, Zhou F, Liu Z, An X, Shi Y. 1744P Camrelizumab plus nab-paclitaxel in platinum-resistant patients with unresectable locally advanced or metastatic urothelial carcinoma: A multicentre, single-arm, phase II study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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32
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Tanriverdi B, Gregory DF, Olino TM, Ely TD, Harnett NG, van Rooij SJH, Lebois LAM, Seligowski AV, Jovanovic T, Ressler KJ, House SL, Beaudoin FL, An X, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Pearson C, Domeier RM, Rathlev NK, O'Neil BJ, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Harte SE, Elliott JM, McLean SA, Kessler RC, Koenen KC, Stevens JS, Murty VP. Hippocampal Threat Reactivity Interacts with Physiological Arousal to Predict PTSD Symptoms. J Neurosci 2022; 42:6593-6604. [PMID: 35879096 PMCID: PMC9410748 DOI: 10.1523/jneurosci.0911-21.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/21/2022] Open
Abstract
Hippo campal impairments are reliably associated with post-traumatic stress disorder (PTSD); however, little research has characterized how increased threat sensitivity may interact with arousal responses to alter hippocampal reactivity, and further how these interactions relate to the sequelae of trauma-related symptoms. In a sample of individuals recently exposed to trauma (N = 116, 76 female), we found that PTSD symptoms at 2 weeks were associated with decreased hippocampal responses to threat as assessed with fMRI. Further, the relationship between hippocampal threat sensitivity and PTSD symptomology only emerged in individuals who showed transient, high threat-related arousal, as assayed by an independently collected measure of fear potentiated startle. Collectively, our finding suggests that development of PTSD is associated with threat-related decreases in hippocampal function because of increases in fear-potentiated arousal.SIGNIFICANCE STATEMENT Alterations in hippocampal function linked to threat-related arousal are reliably associated with post-traumatic stress disorder (PTSD); however, how these alterations relate to the sequelae of trauma-related symptoms is unknown. Prior models based on nontrauma samples suggest that arousal may impact hippocampal neurophysiology leading to maladaptive behavior. Here we show that decreased hippocampal threat sensitivity interacts with fear-potentiated startle to predict PTSD symptoms. Specifically, individuals with high fear-potentiated startle and low, transient hippocampal threat sensitivity showed the greatest PTSD symptomology. These findings bridge literatures of threat-related arousal and hippocampal function to better understand PTSD risk.
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Affiliation(s)
- Büşra Tanriverdi
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
| | - David F Gregory
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
| | - Thomas M Olino
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Antonia V Seligowski
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan 48202
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Francesca L Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and Miriam Hospital, Providence, Rhode Island 02930
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, California 94143
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia 30332
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, Georgia 30332
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts 02478
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
- Institute for Technology in Psychiatry/Department of Psychiatry, McLean Hospital, Belmont, Massachusetts 02478
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, Massachusetts 01655
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee 37232
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, Indiana 46202
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida 32209
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, Florida 32209
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey 08103
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267
- College of Nursing, University of Cincinnati, Cincinnati, Ohio 45221
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama 35294
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, Alabama 35294
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, Alabama 35294
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts 02118
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, Pennsylvania 19104
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, Pennsylvania 19141
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania 19107
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan 48202
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, Michigan 48197
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts 01107
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan 48202
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215
- Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts 02115
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, Missouri 63121
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, Massachusetts 02130
- Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, Connecticut 06516
- Department of Psychiatry, Yale School of Medicine, West Haven, Connecticut 06510
| | - Jutta Joormann
- Department of Psychology, Yale University, West Haven, Connecticut 06520
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, Missouri 63130
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts 02478
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts 02115
| | - John F Sheridan
- Department of Biosciences, Ohio State University Wexner Medical Center, Columbus, Ohio 43210
- Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus, Ohio 43211
| | - Jordan W Smoller
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts 02114
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, Massachusetts 02142
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan 48109
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, Michigan 48109
| | - James M Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales 2006, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60208
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27559
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts 02115
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts 02115
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia 30329
| | - Vishnu P Murty
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania 19121
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33
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Harnett NG, Finegold KE, Lebois LAM, van Rooij SJH, Ely TD, Murty VP, Jovanovic T, Bruce SE, House SL, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Swor RA, Hudak LA, Pascual JL, Seamon MJ, Harris E, Chang AM, Pearson C, Peak DA, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Harte SE, Elliott JM, Kessler RC, Koenen KC, McLean SA, Nickerson LD, Ressler KJ, Stevens JS. Structural covariance of the ventral visual stream predicts posttraumatic intrusion and nightmare symptoms: a multivariate data fusion analysis. Transl Psychiatry 2022; 12:321. [PMID: 35941117 PMCID: PMC9360028 DOI: 10.1038/s41398-022-02085-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 07/14/2022] [Accepted: 07/20/2022] [Indexed: 01/16/2023] Open
Abstract
Visual components of trauma memories are often vividly re-experienced by survivors with deleterious consequences for normal function. Neuroimaging research on trauma has primarily focused on threat-processing circuitry as core to trauma-related dysfunction. Conversely, limited attention has been given to visual circuitry which may be particularly relevant to posttraumatic stress disorder (PTSD). Prior work suggests that the ventral visual stream is directly related to the cognitive and affective disturbances observed in PTSD and may be predictive of later symptom expression. The present study used multimodal magnetic resonance imaging data (n = 278) collected two weeks after trauma exposure from the AURORA study, a longitudinal, multisite investigation of adverse posttraumatic neuropsychiatric sequelae. Indices of gray and white matter were combined using data fusion to identify a structural covariance network (SCN) of the ventral visual stream 2 weeks after trauma. Participant's loadings on the SCN were positively associated with both intrusion symptoms and intensity of nightmares. Further, SCN loadings moderated connectivity between a previously observed amygdala-hippocampal functional covariance network and the inferior temporal gyrus. Follow-up MRI data at 6 months showed an inverse relationship between SCN loadings and negative alterations in cognition in mood. Further, individuals who showed decreased strength of the SCN between 2 weeks and 6 months had generally higher PTSD symptom severity over time. The present findings highlight a role for structural integrity of the ventral visual stream in the development of PTSD. The ventral visual stream may be particularly important for the consolidation or retrieval of trauma memories and may contribute to efficient reactivation of visual components of the trauma memory, thereby exacerbating PTSD symptoms. Potentially chronic engagement of the network may lead to reduced structural integrity which becomes a risk factor for lasting PTSD symptoms.
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Affiliation(s)
- Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | | | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Vishnu P Murty
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- The Many Brains Project, Belmont, MA, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine-Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, Ohio State University College of Medicine, Columbus, OH, USA
- Ohio State University College of Nursing, Columbus, OH, USA
| | - Michael C Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, USA
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, USA
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J Seamon
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School, University of Texas Health, Houston, TX, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Mark W Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - John F Sheridan
- Division of Biosciences, Ohio State University College of Dentistry, Columbus, OH, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M Elliott
- Kolling Institute, University of Sydney, St Leonards, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Samuel A McLean
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Institute for Trauma Recovery, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa D Nickerson
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Imaging Center, McLean Hospital, Belmont, MA, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Joormann J, McLean SA, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Clifford G, Linnstaedt SD, Germine LT, Rauch S, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Fermann G, Hudak LA, Mohiuddin K, Murty V, McGrath ME, Haran JP, Pascual J, Seamon M, Peak DA, Pearson C, Domeier RM, Sergot P, Merchant R, Sanchez LD, Rathlev NK, Peacock WF, Bruce SE, Barch D, Pizzagalli DA, Luna B, Harte SE, Hwang I, Lee S, Sampson N, Koenen KC, Ressler K, Kessler RC. Socio-demographic and trauma-related predictors of depression within eight weeks of motor vehicle collision in the AURORA study. Psychol Med 2022; 52:1934-1947. [PMID: 33118917 PMCID: PMC9341273 DOI: 10.1017/s0033291720003773] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND This is the first report on the association between trauma exposure and depression from the Advancing Understanding of RecOvery afteR traumA(AURORA) multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience. METHODS We focus on participants presenting at EDs after a motor vehicle collision (MVC), which characterizes most AURORA participants, and examine associations of participant socio-demographics and MVC characteristics with 8-week depression as mediated through peritraumatic symptoms and 2-week depression. RESULTS Eight-week depression prevalence was relatively high (27.8%) and associated with several MVC characteristics (being passenger v. driver; injuries to other people). Peritraumatic distress was associated with 2-week but not 8-week depression. Most of these associations held when controlling for peritraumatic symptoms and, to a lesser degree, depressive symptoms at 2-weeks post-trauma. CONCLUSIONS These observations, coupled with substantial variation in the relative strength of the mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated in more in-depth analyses of the rich and evolving AURORA database to find new targets for intervention and new tools for risk-based stratification following trauma exposure.
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Affiliation(s)
- Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Samuel A. McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Francesca L. Beaudoin
- Department of Emergency Medicine, The Alpert Medical School of Brown University, Providence, RI, USA
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C. Neylan
- San Francisco VA Healthcare System, San Francisco, CA, USA
- Departments of Psychiatry and Neurology, University of California, San Francisco, CA, USA
| | - Gari Clifford
- Department of Biomedical Informatics, Emory University School of Medicine and Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Sarah D. Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T. Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- The Many Brains Project, Acton, MA, USA
| | - Scott Rauch
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine - Jacksonville, Jacksonville, FL, USA
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E. Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Gregory Fermann
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University, Grady Memorial Hospital, Atlanta, GA, USA
| | - Kamran Mohiuddin
- Department of Emergency Medicine/Internal Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Vishnu Murty
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Meghan E. McGrath
- Departmentof Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jose Pascual
- Department of Surgery and Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Mark Seamon
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Claire Pearson
- Wayne State University Department of Emergency Medicine, Ascension St. John Hospital, Detroit, MI, USA
| | - Robert M. Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Paulina Sergot
- Department of Emergency Medicine, University of Texas Health Science Center, Houston, TX, USA
| | - Roland Merchant
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Leon D. Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - William F. Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Deanna Barch
- Departments of Psychological & Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | | | - Beatriz Luna
- Laboratory of Neurocognitive Development, Western Psychiatric Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Steven E. Harte
- Chronic Pain and Fatigue Research Center, Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Nancy Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Kerry Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Arendt V, Mabud T, Cohn D, Jeon G, An X, Fu J, Kuo W, Hofmann L. Abstract No. 152 Outcomes following IVC stent placement across the renal veins. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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36
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Tang BD, Zhang JY, Ma HX, Wang N, An X, Li GM, Zhou Z. SYNTHESIS, CRYSTAL STRUCTURE, AND DFT STUDY OF 1-(PYRROLIDIN-1- YL-METHYL)-4-(THIOPHEN-2-YL-METHYL)- [1,2,4]TRIAZOLO[4,3-a]QUINAZOLIN-5(4H)-ONE. J STRUCT CHEM+ 2022. [DOI: 10.1134/s0022476622010036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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37
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Germine LT, Joormann J, Passell E, Rutter LA, Scheuer L, Martini P, Hwang I, Lee S, Sampson N, Barch DM, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Linnstaedt SD, Jovanovic T, Clifford GD, Neylan TC, Rauch SL, Lewandowski C, Hendry PL, Sheikh S, Storrow AB, Musey PI, Jones CW, Punches BE, McGrath ME, Pascual JL, Mohiuddin K, Pearson C, Peak DA, Domeier RM, Bruce SE, Rathlev NK, Sanchez LD, Pietrzak RH, Pizzagalli DA, Harte SE, Elliott JM, Koenen KC, Ressler KJ, McLean SA, Kessler RC. Neurocognition after motor vehicle collision and adverse post-traumatic neuropsychiatric sequelae within 8 weeks: Initial findings from the AURORA study. J Affect Disord 2022; 298:57-67. [PMID: 34800569 PMCID: PMC10878171 DOI: 10.1016/j.jad.2021.10.104] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 09/14/2021] [Accepted: 10/23/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous work has indicated that differences in neurocognitive functioning may predict the development of adverse post-traumatic neuropsychiatric sequelae (APNS). Such differences may be vulnerability factors or simply correlates of APNS-related symptoms. Longitudinal studies that measure neurocognitive functioning at the time of trauma are needed to determine whether such differences precede the development of APNS. METHODS Here, we present findings from a subsample of 666 ambulatory patients from the AURORA (Advancing Understanding of RecOvery afteR trumA) study. All patients presented to EDs after a motor vehicle collision (MVC). We examined associations of neurocognitive test performance shortly after MVC with peritraumatic symptoms in the ED and APNS (depression, post-traumatic stress, post-concussive symptoms, and pain) 2 weeks and 8 weeks later. Neurocognitive tests assessed processing speed, attention, verbal reasoning, memory, and social perception. RESULTS Distress in the ED was associated with poorer processing speed and short-term memory. Poorer short-term memory was also associated with depression at 2 weeks post-MVC, even after controlling for peritraumatic distress. Finally, higher vocabulary scores were associated with pain 2 weeks post-MVC. LIMITATIONS Self-selection biases among those who present to the ED and enroll in the study limit generalizability. Also, it is not clear whether observed neurocognitive differences predate MVC exposure or arise in the immediate aftermath of MVC exposure. CONCLUSIONS Our results suggest that processing speed and short-term memory may be useful predictors of trauma-related characteristics and the development of some APNS, making such measures clinically-relevant for identifying at-risk individuals.
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Affiliation(s)
- Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, 1010 Pleasant Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; The Many Brains Project, Belmont, MA, USA.
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Eliza Passell
- Institute for Technology in Psychiatry, McLean Hospital, 1010 Pleasant Street, Belmont, MA 02478, USA
| | - Lauren A Rutter
- Institute for Technology in Psychiatry, McLean Hospital, 1010 Pleasant Street, Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Luke Scheuer
- Institute for Technology in Psychiatry, McLean Hospital, 1010 Pleasant Street, Belmont, MA 02478, USA
| | | | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Nancy Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Deanna M Barch
- Department of Psychological and Brain Sciences, College of Arts and Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Emergency Medicine and Health Services, Policy, and Practice, The Alpert Medical School of Brown University, USA; Department of Emergency Medicine, Rhode Island Hospital, Providence, RI, USA; Department of Emergency Medicine, The Miriam Hospital, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, School of Medicine, Emory University, USA; Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Thomas C Neylan
- San Francisco VA Healthcare System, San Francisco, CA, USA; Departments of Psychiatry, University of California, San Francisco, CA, USA; Departments of Neurology, University of California, San Francisco, CA, USA
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | | | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittney E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - Jose L Pascual
- Department of Surgery and Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Kamran Mohiuddin
- Dept. of Emergency Medicine/Internal Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; McLean Hospital, Belmont, MA, USA
| | - Steven E Harte
- Chronic Pain and Fatigue Research Center, Departments of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA; Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M Elliott
- The Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia; Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Karesten C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety Disorders, McLean hospital, Belmont, MA, USA
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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An X, Xiao L, Yang X, Tang X, Lai F, Liang XH. Economic burden of public health care and hospitalisation associated with COVID-19 in China. Public Health 2022; 203:65-74. [PMID: 35032917 PMCID: PMC8754688 DOI: 10.1016/j.puhe.2021.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/10/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to evaluate the socio-economic burden imposed on the Chinese healthcare system during the coronavirus disease 2019 (COVID-19) pandemic. STUDY DESIGN A cross-sectional study was used to investigate how COVID-19 impacted health and medical costs in China. Data were derived from a subdivision of the Centers for Disease control and Prevention of China. METHODS We prospectively collected information from the Centers for Disease Control and Prevention and the designated hospitals to determine the cost of public health care and hospitalisation due to COVID-19. We estimated the resource use and direct medical costs associated with public health. RESULTS The average costs, per case, for specimen collection and nucleic acid testing (NAT [specifically, polymerase chain reaction {PCR}]) in low-risk populations were $29.49 and $53.44, respectively; however, the average cost of NAT in high-risk populations was $297.94 per capita. The average costs per 1000 population for epidemiological surveys, disinfectant, health education and centralised isolation were $49.54, $247.01, $90.22 and $543.72, respectively. A single hospitalisation for COVID-19 in China cost a median of $2158.06 ($1961.13-$2325.65) in direct medical costs incurred only during hospitalisation, whereas the total costs associated with hospitalisation of patients with COVID-19 were estimated to have reached nearly $373.20 million in China as of 20, May, 2020. The cost of public health care associated with COVID-19 as of 20, May, 2020 ($6.83 billion) was 18.31 times that of hospitalisation. CONCLUSIONS This study highlights the magnitude of resources needed to treat patients with COVID-19 and control the COVID-19 pandemic. Public health measures implemented by the Chinese government have been valuable in reducing the infection rate and may be cost-effective ways to control emerging infectious diseases.
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Affiliation(s)
- X An
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - L Xiao
- Disease Control and Prevention Center of Jiulongpo District, Chongqing, China
| | - X Yang
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - X Tang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China
| | - F Lai
- Department of Pediatrics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiao-Hua Liang
- Department of Clinical Epidemiology and Biostatistics, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
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Joormann J, Ziobrowski HN, King A, Gildea SM, Lee S, Sampson NA, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Chang AM, Pearson C, Peak DA, Domeier RM, Rathlev NK, O’Neil BJ, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Barch DM, Pizzagalli DA, Harte SE, Elliott JM, Koenen KC, McLean SA, Kessler RC. Prior histories of posttraumatic stress disorder and major depression and their onset and course in the three months after a motor vehicle collision in the AURORA study. Depress Anxiety 2022; 39:56-70. [PMID: 34783142 PMCID: PMC8732322 DOI: 10.1002/da.23223] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/17/2021] [Accepted: 10/26/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND A better understanding of the extent to which prior occurrences of posttraumatic stress disorder (PTSD) and major depressive episode (MDE) predict psychopathological reactions to subsequent traumas might be useful in targeting posttraumatic preventive interventions. METHODS Data come from 1306 patients presenting to 29 U.S. emergency departments (EDs) after a motor vehicle collision (MVC) in the advancing understanding of recovery after trauma study. Patients completed self-reports in the ED and 2-weeks, 8-weeks, and 3-months post-MVC. Associations of pre-MVC probable PTSD and probable MDE histories with subsequent 3-months post-MVC probable PTSD and probable MDE were examined along with mediation through intervening peritraumatic, 2-, and 8-week disorders. RESULTS 27.6% of patients had 3-month post-MVC probable PTSD and/or MDE. Pre-MVC lifetime histories of these disorders were not only significant (relative risk = 2.6-7.4) but were dominant (63.1% population attributable risk proportion [PARP]) predictors of this 3-month outcome, with 46.6% prevalence of the outcome among patients with pre-MVC disorder histories versus 9.9% among those without such histories. The associations of pre-MVC lifetime disorders with the 3-month outcome were mediated largely by 2- and 8-week probable PTSD and MDE (PARP decreasing to 22.8% with controls for these intervening disorders). Decomposition showed that pre-MVC lifetime histories predicted both onset and persistence of these intervening disorders as well as the higher conditional prevalence of the 3-month outcome in the presence of these intervening disorders. CONCLUSIONS Assessments of pre-MVC PTSD and MDE histories and follow-ups at 2 and 8 weeks could help target early interventions for psychopathological reactions to MVCs.
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Affiliation(s)
- Jutta Joormann
- Department of Psychology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Hannah N. Ziobrowski
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Andrew King
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Sarah M. Gildea
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Francesca L. Beaudoin
- Department of Emergency Medicine, The Alpert Medical School of Brown University, Providence, RI, 02930, USA
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Providence, RI, 02930, USA
- Rhode Island Hospital, Providence, RI, 02930, USA
- The Miriam Hospital, Providence, RI, 02930, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27559, USA
| | - Thomas C. Neylan
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94143, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA
- Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Sarah D. Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Laura T. Germine
- Department of Biomedical Engineering, Emory University, Atlanta, GA, 30332, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- The Many Brains Project, Belmont, MA, 02478, USA
| | - Kenneth A. Bollen
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
- Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Scott L. Rauch
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Alan B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
| | - Brittany E. Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
- College of Nursing, University of Cincinnati, Cincinnati, OH, 45221, USA
| | - Meghan E. McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Jose L. Pascual
- Department of Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Mark J. Seamon
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Anna M. Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, 19107, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Robert M. Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA
| | - Brian J. O’Neil
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - Leon D. Sanchez
- Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA
| | - Mark W. Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Robert H. Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Deanna M. Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - James M. Elliott
- Kolling Institute of Medical Research, University of Sydney, St. Leonards, New South Wales, 2065, Australia
- Faculty of Medicine and Health, University of Sydney, New South Wales, 2006, Australia
- Northern Sydney Local Health District, New South Wales, 2006, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Samuel A. McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
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40
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Ziobrowski HN, Kennedy CJ, Ustun B, House SL, Beaudoin FL, An X, Zeng D, Bollen KA, Petukhova M, Sampson NA, Puac-Polanco V, Lee S, Koenen KC, Ressler KJ, McLean SA, Kessler RC, Stevens JS, Neylan TC, Clifford GD, Jovanovic T, Linnstaedt SD, Germine LT, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Lyons MS, Murty VP, McGrath ME, Pascual JL, Seamon MJ, Datner EM, Chang AM, Pearson C, Peak DA, Jambaulikar G, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Bruce SE, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Harte SE, Elliott JM, van Rooij SJH. Development and Validation of a Model to Predict Posttraumatic Stress Disorder and Major Depression After a Motor Vehicle Collision. JAMA Psychiatry 2021; 78:1228-1237. [PMID: 34468741 PMCID: PMC8411364 DOI: 10.1001/jamapsychiatry.2021.2427] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE A substantial proportion of the 40 million people in the US who present to emergency departments (EDs) each year after traumatic events develop posttraumatic stress disorder (PTSD) or major depressive episode (MDE). Accurately identifying patients at high risk in the ED would facilitate the targeting of preventive interventions. OBJECTIVES To develop and validate a prediction tool based on ED reports after a motor vehicle collision to predict PTSD or MDE 3 months later. DESIGN, SETTING, AND PARTICIPANTS The Advancing Understanding of Recovery After Trauma (AURORA) study is a longitudinal study that examined adverse posttraumatic neuropsychiatric sequalae among patients who presented to 28 US urban EDs in the immediate aftermath of a traumatic experience. Enrollment began on September 25, 2017. The 1003 patients considered in this diagnostic/prognostic report completed 3-month assessments by January 31, 2020. Each patient received a baseline ED assessment along with follow-up self-report surveys 2 weeks, 8 weeks, and 3 months later. An ensemble machine learning method was used to predict 3-month PTSD or MDE from baseline information. Data analysis was performed from November 1, 2020, to May 31, 2021. MAIN OUTCOMES AND MEASURES The PTSD Checklist for DSM-5 was used to assess PTSD and the Patient Reported Outcomes Measurement Information System Depression Short-Form 8b to assess MDE. RESULTS A total of 1003 patients (median [interquartile range] age, 34.5 [24-43] years; 715 [weighted 67.9%] female; 100 [weighted 10.7%] Hispanic, 537 [weighted 52.7%] non-Hispanic Black, 324 [weighted 32.2%] non-Hispanic White, and 42 [weighted 4.4%] of non-Hispanic other race or ethnicity were included in this study. A total of 274 patients (weighted 26.6%) met criteria for 3-month PTSD or MDE. An ensemble machine learning model restricted to 30 predictors estimated in a training sample (patients from the Northeast or Midwest) had good prediction accuracy (mean [SE] area under the curve [AUC], 0.815 [0.031]) and calibration (mean [SE] integrated calibration index, 0.040 [0.002]; mean [SE] expected calibration error, 0.039 [0.002]) in an independent test sample (patients from the South). Patients in the top 30% of predicted risk accounted for 65% of all 3-month PTSD or MDE, with a mean (SE) positive predictive value of 58.2% (6.4%) among these patients at high risk. The model had good consistency across regions of the country in terms of both AUC (mean [SE], 0.789 [0.025] using the Northeast as the test sample and 0.809 [0.023] using the Midwest as the test sample) and calibration (mean [SE] integrated calibration index, 0.048 [0.003] using the Northeast as the test sample and 0.024 [0.001] using the Midwest as the test sample; mean [SE] expected calibration error, 0.034 [0.003] using the Northeast as the test sample and 0.025 [0.001] using the Midwest as the test sample). The most important predictors in terms of Shapley Additive Explanations values were symptoms of anxiety sensitivity and depressive disposition, psychological distress in the 30 days before motor vehicle collision, and peritraumatic psychosomatic symptoms. CONCLUSIONS AND RELEVANCE The results of this study suggest that a short set of questions feasible to administer in an ED can predict 3-month PTSD or MDE with good AUC, calibration, and geographic consistency. Patients at high risk can be identified in the ED for targeting if cost-effective preventive interventions are developed.
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Affiliation(s)
| | - Chris J. Kennedy
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts
| | - Berk Ustun
- Halıcıoğlu Data Science Institute, University of California, San Diego
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St Louis, Missouri
| | - Francesca L. Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, Rhode Island
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill
| | - Kenneth A. Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill
| | - Maria Petukhova
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Victor Puac-Polanco
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Sue Lee
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Harvard University, Boston, Massachusetts
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts
| | - Samuel A. McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill,Department of Emergency Medicine, University of North Carolina at Chapel Hill
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | | | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California, San Francisco
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, Georgia.,Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts.,The Many Brains Project, Belmont, Massachusetts
| | - Scott L Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Institute for Technology in Psychiatry, McLean Hospital, Belmont, Massachusetts.,Department of Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, New Jersey
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.,College of Nursing, University of Cincinnati, Cincinnati, Ohio.,Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Michael S Lyons
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Vishnu P Murty
- Department of Psychology, Temple University, Philadelphia, Pennsylvania
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, Massachusetts
| | - Jose L Pascual
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia.,Department of Neurosurgery, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Mark J Seamon
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, Pennsylvania.,Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, Pennsylvania
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston
| | | | - Roland C Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, Michigan
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit, Michigan
| | - Paulina Sergot
- McGovern Medical School, University of Texas Health Science Center, Houston
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.,Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri, St Louis
| | - Robert H Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, Veterans Affairs Connecticut Healthcare System, West Haven.,Department of Psychiatry, Yale School of Medicine, West Haven, Connecticut
| | - Jutta Joormann
- Department of Psychology, Yale University, West Haven, Connecticut
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University, St Louis, Missouri
| | - Diego A Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.,Division of Depression and Anxiety, McLean Hospital, Belmont, Massachusetts.,Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - John F Sheridan
- Department of Biosciences and Neuroscience, Wexner Medical Center, The Ohio State University, Columbus.,Institute for Behavioral Medicine Research, Wexner Medical Center, The Ohio State University, Columbus
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor.,Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor
| | - James M Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, Australia.,Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, Australia.,Department of Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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41
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Seligowski AV, Steuber ER, Hinrichs R, Reda MH, Wiltshire CN, Wanna CP, Winters SJ, Phillips KA, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Guffanti G, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Murty VP, McGrath ME, Hudak LA, Pascual JL, Seamon MJ, Datner EM, Chang AM, Pearson C, Peak DA, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Luna B, Harte SE, Elliott JM, Koenen KC, Kessler RC, McLean SA, Ressler KJ, Jovanovic T. A prospective examination of sex differences in posttraumatic autonomic functioning. Neurobiol Stress 2021; 15:100384. [PMID: 34485632 PMCID: PMC8397921 DOI: 10.1016/j.ynstr.2021.100384] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Cross-sectional studies have found that individuals with posttraumatic stress disorder (PTSD) exhibit deficits in autonomic functioning. While PTSD rates are twice as high in women compared to men, sex differences in autonomic functioning are relatively unknown among trauma-exposed populations. The current study used a prospective design to examine sex differences in posttraumatic autonomic functioning. METHODS 192 participants were recruited from emergency departments following trauma exposure (Mean age = 35.88, 68.2% female). Skin conductance was measured in the emergency department; fear conditioning was completed two weeks later and included measures of blood pressure (BP), heart rate (HR), and high frequency heart rate variability (HF-HRV). PTSD symptoms were assessed 8 weeks after trauma. RESULTS 2-week systolic BP was significantly higher in men, while 2-week HR was significantly higher in women, and a sex by PTSD interaction suggested that women who developed PTSD demonstrated the highest HR levels. Two-week HF-HRV was significantly lower in women, and a sex by PTSD interaction suggested that women with PTSD demonstrated the lowest HF-HRV levels. Skin conductance response in the emergency department was associated with 2-week HR and HF-HRV only among women who developed PTSD. CONCLUSIONS Our results indicate that there are notable sex differences in autonomic functioning among trauma-exposed individuals. Differences in sympathetic biomarkers (BP and HR) may have implications for cardiovascular disease risk given that sympathetic arousal is a mechanism implicated in this risk among PTSD populations. Future research examining differential pathways between PTSD and cardiovascular risk among men versus women is warranted.
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Affiliation(s)
- Antonia V. Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | | | - Rebecca Hinrichs
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Mariam H. Reda
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | | | - Cassandra P. Wanna
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | - Sterling J. Winters
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
| | - Karlye A. Phillips
- McLean Hospital, Belmont, MA, 02478, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Stacey L. House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, 63110, USA
| | - Francesca L. Beaudoin
- Department of Emergency Medicine & Department of Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and the Miriam Hospital, Providence, RI, 02930, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27559, USA
| | - Thomas C. Neylan
- Departments of Psychiatry and Neurology, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Gari D. Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, 30332, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, 30332, USA
| | - Sarah D. Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Laura T. Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- The Many Brains Project, Belmont, MA, 02478, USA
| | - Kenneth A. Bollen
- Department of Psychology and Neuroscience & Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Guia Guffanti
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - Scott L. Rauch
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
- Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA
| | - John P. Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, 01655, USA
| | - Alan B. Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | | | - Paul I. Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Phyllis L. Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, 32209, USA
| | - Christopher W. Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, 08103, USA
| | - Brittany E. Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, 45267, USA
- College of Nursing, University of Cincinnati, Cincinnati, OH, 45221, USA
| | - Michael C. Kurz
- Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, AL, 35294, USA
- Department of Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham, AL, 35294, USA
- Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Vishnu P. Murty
- Department of Psychology, Temple University, Philadelphia, PA, 19121, USA
| | - Meghan E. McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, 02118, USA
| | - Lauren A. Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30329, USA
| | - Jose L. Pascual
- Department of Surgery, Department of Neurosurgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Mark J. Seamon
- Perelman School of Medicine, University of Pennsylvania, Pennsylvania, PA, 19104, USA
- Department of Surgery, Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Pennsylvania, PA, 19104, USA
| | - Elizabeth M. Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Pennsylvania, PA, 19141, USA
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Pennsylvania, PA, 19107, USA
| | - Anna M. Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Pennsylvania, PA, 19107, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - David A. Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Roland C. Merchant
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Robert M. Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ypsilanti, MI, 48197, USA
| | - Niels K. Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, 01107, USA
| | - Brian J. O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit, MA, 48202, USA
| | - Leon D. Sanchez
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, 02115, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, 02115, USA
| | - Steven E. Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, 63121, USA
| | - Mark W. Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, 02130, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Robert H. Pietrzak
- National Center for PTSD, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, 06516, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Jutta Joormann
- Department of Psychology, Yale School of Medicine, New Haven, CT, 06510, USA
| | - Deanna M. Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, 63130, USA
| | - Diego A. Pizzagalli
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - John F. Sheridan
- Department of Biosciences, OSU Wexner Medical Center, Columbus, OH, 43210, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, 43211, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Steven E. Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - James M. Elliott
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, 2065, Australia
- Faculty of Medicine and Health, University of Sydney, Northern Sydney Local Health District, New South Wales, 2006, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60208, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, 02115, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, 02115, USA
| | - Samuel A. McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27559, USA
| | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, 02115, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, 02478, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MA, 48202, USA
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Stevens JS, Harnett NG, Lebois LAM, van Rooij SJH, Ely TD, Roeckner A, Vincent N, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Rauch SL, Lewandowski C, Storrow AB, Hendry PL, Sheikh S, Musey PI, Haran JP, Jones CW, Punches BE, Lyons MS, Kurz MC, McGrath ME, Pascual JL, Datner EM, Chang AM, Pearson C, Peak DA, Domeier RM, O'Neil BJ, Rathlev NK, Sanchez LD, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Luna B, Harte SE, Elliott JM, Murty VP, Jovanovic T, Bruce SE, House SL, Kessler RC, Koenen KC, McLean SA, Ressler KJ. Brain-Based Biotypes of Psychiatric Vulnerability in the Acute Aftermath of Trauma. Am J Psychiatry 2021; 178:1037-1049. [PMID: 34645277 PMCID: PMC9069566 DOI: 10.1176/appi.ajp.2021.20101526] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Major negative life events, such as trauma exposure, can play a key role in igniting or exacerbating psychopathology. However, few disorders are diagnosed with respect to precipitating events, and the role of these events in the unfolding of new psychopathology is not well understood. The authors conducted a multisite transdiagnostic longitudinal study of trauma exposure and related mental health outcomes to identify neurobiological predictors of risk, resilience, and different symptom presentations. METHODS A total of 146 participants (discovery cohort: N=69; internal replication cohort: N=77) were recruited from emergency departments within 72 hours of a trauma and followed for the next 6 months with a survey, MRI, and physiological assessments. RESULTS Task-based functional MRI 2 weeks after a motor vehicle collision identified four clusters of individuals based on profiles of neural activity reflecting threat reactivity, reward reactivity, and inhibitory engagement. Three clusters were replicated in an independent sample with a variety of trauma types. The clusters showed different longitudinal patterns of posttrauma symptoms. CONCLUSIONS These findings provide a novel characterization of heterogeneous stress responses shortly after trauma exposure, identifying potential neuroimaging-based biotypes of trauma resilience and psychopathology.
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Affiliation(s)
- Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Nathaniel G Harnett
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Lauren A M Lebois
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Alyssa Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Nico Vincent
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Francesca L Beaudoin
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Xinming An
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Donglin Zeng
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Thomas C Neylan
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Gari D Clifford
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Sarah D Linnstaedt
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Laura T Germine
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Scott L Rauch
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Christopher Lewandowski
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Alan B Storrow
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Phyllis L Hendry
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Sophia Sheikh
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Paul I Musey
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - John P Haran
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Christopher W Jones
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Brittany E Punches
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Michael S Lyons
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Michael C Kurz
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Meghan E McGrath
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Jose L Pascual
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Elizabeth M Datner
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Anna M Chang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Claire Pearson
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - David A Peak
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Robert M Domeier
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Brian J O'Neil
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Niels K Rathlev
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Leon D Sanchez
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Robert H Pietrzak
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Jutta Joormann
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Deanna M Barch
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Diego A Pizzagalli
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - John F Sheridan
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Beatriz Luna
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Steven E Harte
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - James M Elliott
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Vishnu P Murty
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Steven E Bruce
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Stacey L House
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Ronald C Kessler
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Karestan C Koenen
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Samuel A McLean
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (Stevens, van Rooij, Ely, Roeckner, Vincent); Division of Depression and Anxiety, McLean Hospital, Belmont, Mass. (Harnett, Lebois, Ressler); Department of Psychiatry, Harvard Medical School, Boston (Harnett, Lebois, Pizzagalli, Ressler); Departments of Emergency Medicine and Health Services, Policy, and Practice, Alpert Medical School of Brown University, Rhode Island Hospital, and the Miriam Hospital, Providence, R.I. (Beaudoin); Department of Anesthesiology, Institute of Trauma Recovery, University of North Carolina, Chapel Hill (An, Linnstaedt, McLean); Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (Zeng); Departments of Psychiatry and Neurology, University of California, San Francisco (Neylan); Department of Biomedical Informatics, Emory University School of Medicine, Atlanta (Clifford); Institute for Technology in Psychiatry (Germine) and Department of Psychiatry (Rauch), McLean Hospital, Belmont, Mass.; Department of Emergency Medicine, Henry Ford Health System, Detroit (Lewandowski); Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tenn. (Storrow); Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville (Hendry, Sheikh); Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis (Musey); Department of Emergency Medicine, University of Massachusetts Medical School, Worcester (Haran); Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, N.J. (Jones); Department of Emergency Medicine, College of Medicine and College of Nursing, University of Cincinnati, Cincinnati (Punches); Department of Emergency Medicine and Center for Addiction Research, University of Cincinnati College of Medicine, Cincinnati (Lyons); Departments of Emergency Medicine and Surgery, Division of Acute Care Surgery, University of Alabama School of Medicine, Birmingham (Kurz); Center for Injury Science, University of Alabama, Birmingham (Kurz); Department of Emergency Medicine, Boston Medical Center, Boston (McGrath); Departments of Surgery (Pascual) and Neurosurgery (Pascual), Perelman School of Medicine, University of Pennsylvania, Philadelphia; Department of Emergency Medicine, Einstein Health Care Network, Philadelphia (Datner); Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia (Chang); Department of Emergency Medicine, Wayne State University, Detroit (Pearson); Department of Emergency Medicine, Massachusetts General Hospital, Boston (Peak); Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, Mich. (Domeier); Department of Emergency Medicine, Wayne State University School of Medicine, Detroit (O'Neil); Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield (Rathley); Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston (Sanchez); Department of Emergency Medicine, Harvard Medical School, Boston (Sanchez); Department of Psychiatry, Yale School of Medicine, and U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, Veterans Affairs Connecticut Healthcare System, New Haven, Conn. (Pietrzak); Department of Psychology, Yale University, New Haven, Conn. (Joorman); Department of Psychological and Brain Sciences, Washington University, St. Louis (Barch); Department of Biosciences and Neuroscience and Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus (Sheridan); Department of Psychiatry, University of Pittsburgh, Pittsburgh (Luna); Departments of Anesthesiology and Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor (Harte); the Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, and Faculty of Medicine and Health, University of Sydney, Sydney, Australia (Elliott); Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago (Elliott); Department of Psychology, Temple University, Philadelphia (Murty); Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit (Jovanovich); Department of Psychological Sciences, University of Missouri, St. Louis (Bruce); Department of Emergency Medicine, Washington University School of Medicine, St. Louis (House); Department of Health Care Policy, Harvard Medical School, Boston (Kessler); Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston (Koenen); Department of Emergency Medicine, University of North Carolina, Chapel Hill (McLean)
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AURORA Study Group, Beaudoin F, An X, Li Q, House S, Musey P, Hendry P, Jones C, Lewandowski C, Storrow A, McLean S. 207 Associations Between Alcohol Use and Adverse Posttraumatic Neuropsychiatric Sequelae in the Early Aftermath of Trauma. Ann Emerg Med 2021. [DOI: 10.1016/j.annemergmed.2021.09.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Steuber ER, Seligowski AV, Roeckner AR, Reda M, Lebois LAM, van Rooij SJH, Murty VP, Ely TD, Bruce SE, House SL, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Rauch SL, Lewandowski C, Sheikh S, Jones CW, Punches BE, Swor RA, McGrath ME, Hudak LA, Pascual JL, Chang AM, Pearson C, Peak DA, Domeier RM, O'Neil BJ, Rathlev NK, Sanchez LD, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Elliott JM, Kessler RC, Koenen KC, McLean SA, Ressler KJ, Jovanovic T, Harnett NG, Stevens JS. Thalamic volume and fear extinction interact to predict acute posttraumatic stress severity. J Psychiatr Res 2021; 141:325-332. [PMID: 34304036 PMCID: PMC8513112 DOI: 10.1016/j.jpsychires.2021.07.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/04/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Abstract
Posttraumatic stress disorder (PTSD) is associated with lower gray matter volume (GMV) in brain regions critical for extinction of learned threat. However, relationships among volume, extinction learning, and PTSD symptom development remain unclear. We investigated subcortical brain volumes in regions supporting extinction learning and fear-potentiated startle (FPS) to understand brain-behavior interactions that may impact PTSD symptom development in recently traumatized individuals. Participants (N = 99) completed magnetic resonance imaging and threat conditioning two weeks following trauma exposure as part of a multisite observational study to understand the neuropsychiatric effects of trauma (AURORA Study). Participants completed self-assessments of PTSD (PTSD Checklist for DSM-5; PCL-5), dissociation, and depression symptoms two- and eight-weeks post-trauma. We completed multiple regressions to investigate relationships between FPS during late extinction, GMV, and PTSD symptom development. The interaction between thalamic GMV and FPS during late extinction at two weeks post-trauma predicted PCL-5 scores eight weeks (t (75) = 2.49, β = 0.28, p = 0.015) post-trauma. Higher FPS predicted higher PCL-5 scores in the setting of increased thalamic GMV. Meanwhile, lower FPS also predicted higher PCL-5 scores in the setting of decreased thalamic GMV. Thalamic GMV and FPS interactions also predicted posttraumatic dissociative and depressive symptoms. Amygdala and hippocampus GMV by FPS interactions were not associated with posttraumatic symptom development. Taken together, thalamic GMV and FPS during late extinction interact to contribute to adverse posttraumatic neuropsychiatric outcomes. Multimodal assessments soon after trauma have the potential to distinguish key phenotypes vulnerable to posttraumatic neuropsychiatric outcomes.
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Affiliation(s)
| | - Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Alyssa R Roeckner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Mariam Reda
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Vishnu P Murty
- Department of Psychology, College of Liberal Arts, Temple University, Philadelphia, PA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Emergency Medicine & Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA
| | - Xinming An
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Neylan
- San Francisco VA Healthcare System and Departments of Psychiatry and Neurology, University of California, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine and Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA; The Many Brains Project, Acton, MA, USA
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | | | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine & University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jose L Pascual
- Department of Surgery and Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Ascension St. John Hospital, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Brian J O'Neil
- Department of Emergency Medicine, Wayne State University, Detroit Receiving Hospital, Detroit, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA & Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, College of Arts & Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | | | - James M Elliott
- The Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia; Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia; Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samuel A McLean
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nathaniel G Harnett
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.
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Cakmak AS, Alday EAP, Da Poian G, Rad AB, Metzler TJ, Neylan TC, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Linnstaedt SD, Jovanovic T, Germine LT, Bollen KA, Rauch SL, Lewandowski CA, Hendry PL, Sheikh S, Storrow AB, Musey PI, Haran JP, Jones CW, Punches BE, Swor RA, Gentile NT, McGrath ME, Seamon MJ, Mohiuddin K, Chang AM, Pearson C, Domeier RM, Bruce SE, O'Neil BJ, Rathlev NK, Sanchez LD, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Harte SE, Elliott JM, Kessler RC, Koenen KC, Ressler KJ, Mclean SA, Li Q, Clifford GD. Classification and Prediction of Post-Trauma Outcomes Related to PTSD Using Circadian Rhythm Changes Measured via Wrist-Worn Research Watch in a Large Longitudinal Cohort. IEEE J Biomed Health Inform 2021; 25:2866-2876. [PMID: 33481725 PMCID: PMC8395207 DOI: 10.1109/jbhi.2021.3053909] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Post-Traumatic Stress Disorder (PTSD) is a psychiatric condition resulting from threatening or horrifying events. We hypothesized that circadian rhythm changes, measured by a wrist-worn research watch are predictive of post-trauma outcomes. APPROACH 1618 post-trauma patients were enrolled after admission to emergency departments (ED). Three standardized questionnaires were administered at week eight to measure post-trauma outcomes related to PTSD, sleep disturbance, and pain interference with daily life. Pulse activity and movement data were captured from a research watch for eight weeks. Standard and novel movement and cardiovascular metrics that reflect circadian rhythms were derived using this data. These features were used to train different classifiers to predict the three outcomes derived from week-eight surveys. Clinical surveys administered at ED were also used as features in the baseline models. RESULTS The highest cross-validated performance of research watch-based features was achieved for classifying participants with pain interference by a logistic regression model, with an area under the receiver operating characteristic curve (AUC) of 0.70. The ED survey-based model achieved an AUC of 0.77, and the fusion of research watch and ED survey metrics improved the AUC to 0.79. SIGNIFICANCE This work represents the first attempt to predict and classify post-trauma symptoms from passive wearable data using machine learning approaches that leverage the circadian desynchrony in a potential PTSD population.
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Kessler RC, Ressler KJ, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Linnstaedt SD, Germine LT, Musey PI, Hendry PL, Sheikh S, Storrow AB, Jones CW, Punches BE, Datner EM, Mohiuddin K, Gentile NT, McGrath ME, van Rooij SJ, Hudak LA, Haran JP, Peak DA, Domeier RM, Pearson C, Sanchez LD, Rathlev NK, Peacock WF, Bruce SE, Miller MW, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Smoller JW, Pace TWW, Harte SE, Elliott JM, Harnett NG, Lebois LAM, Hwang I, Sampson NA, Koenen KC, McLean SA. Socio-demographic and trauma-related predictors of PTSD within 8 weeks of a motor vehicle collision in the AURORA study. Mol Psychiatry 2021; 26:3108-3121. [PMID: 33077855 PMCID: PMC8053721 DOI: 10.1038/s41380-020-00911-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 09/18/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023]
Abstract
This is the initial report of results from the AURORA multisite longitudinal study of adverse post-traumatic neuropsychiatric sequelae (APNS) among participants seeking emergency department (ED) treatment in the aftermath of a traumatic life experience. We focus on n = 666 participants presenting to EDs following a motor vehicle collision (MVC) and examine associations of participant socio-demographic and participant-reported MVC characteristics with 8-week posttraumatic stress disorder (PTSD) adjusting for pre-MVC PTSD and mediated by peritraumatic symptoms and 2-week acute stress disorder (ASD). Peritraumatic Symptoms, ASD, and PTSD were assessed with self-report scales. Eight-week PTSD prevalence was relatively high (42.0%) and positively associated with participant sex (female), low socioeconomic status (education and income), and several self-report indicators of MVC severity. Most of these associations were entirely mediated by peritraumatic symptoms and, to a lesser degree, ASD, suggesting that the first 2 weeks after trauma may be a uniquely important time period for intervening to prevent and reduce risk of PTSD. This observation, coupled with substantial variation in the relative strength of mediating pathways across predictors, raises the possibility of diverse and potentially complex underlying biological and psychological processes that remain to be elucidated with more in-depth analyses of the rich and evolving AURORA data.
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Affiliation(s)
- Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA.
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Emergency Medicine, The Alpert Medical School of Brown University, Providence, RI, USA
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
- Rhode Island Hospital, Providence, RI, USA
- The Miriam Hospital, Providence, RI, USA
| | - Xinming An
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Thomas C Neylan
- San Francisco VA Healthcare System, San Francisco, CA, USA
- Departments of Psychiatry and Neurology, University of California, San Francisco, CA, USA
| | - Sarah D Linnstaedt
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
- The Many Brains Project, Acton, MA, USA
| | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine -Jacksonville, Jacksonville, FL, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
- University of Cincinnati College of Nursing, Cincinnati, OH, USA
| | - Elizabeth M Datner
- Department of Emergency Medicine, Einstein Healthcare Network, Philadelphia, PA, USA
- Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Kamran Mohiuddin
- Department of Internal Medicine, Einstein Medical Center, Philadelphia, PA, USA
- Department of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Nina T Gentile
- Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - Sanne J van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Emergency Medicine, Grady Memorial Hospital, Atlanta, GA, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Claire Pearson
- Wayne State University Department of Emergency Medicine, Ascension St. John Hospital, Detroit, MI, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MA, USA
| | - William F Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, St. Louis, MO, USA
| | - Mark W Miller
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Deanna M Barch
- Departments of Psychological & Brain Sciences, Psychiatry, and Radiology, Washington University in St. Louis, St. Louis, MO, USA
| | | | - John F Sheridan
- Department of Neuroscience, Ohio State University Wexner Medical Center, Columbus, OH, USA
- College of Dentistry Division of Bioscience, Ohio State University, Columbus, OH, USA
- Institute for Behavioral Medicine Research, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Boston, MA, USA
| | - Thaddeus W W Pace
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Steven E Harte
- Chronic Pain and Fatigue Research Center, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M Elliott
- The Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
- Faculty of Health Sciences, University of Sydney, St Leonards, NSW, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Nathaniel G Harnett
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Lauren A M Lebois
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, MA, USA
| | - Irving Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Nancy A Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samuel A McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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McLean SA, Ressler K, Koenen KC, Neylan T, Germine L, Jovanovic T, Clifford GD, Zeng D, An X, Linnstaedt S, Beaudoin F, House S, Bollen KA, Musey P, Hendry P, Jones CW, Lewandowski C, Swor R, Datner E, Mohiuddin K, Stevens JS, Storrow A, Kurz MC, McGrath ME, Fermann GJ, Hudak LA, Gentile N, Chang AM, Peak DA, Pascual JL, Seamon MJ, Sergot P, Peacock WF, Diercks D, Sanchez LD, Rathlev N, Domeier R, Haran JP, Pearson C, Murty VP, Insel TR, Dagum P, Onnela JP, Bruce SE, Gaynes BN, Joormann J, Miller MW, Pietrzak RH, Buysse DJ, Pizzagalli DA, Rauch SL, Harte SE, Young LJ, Barch DM, Lebois LAM, van Rooij SJH, Luna B, Smoller JW, Dougherty RF, Pace TWW, Binder E, Sheridan JF, Elliott JM, Basu A, Fromer M, Parlikar T, Zaslavsky AM, Kessler R. Correction: The AURORA Study: a longitudinal, multimodal library of brain biology and function after traumatic stress exposure. Mol Psychiatry 2021; 26:3658. [PMID: 32989243 PMCID: PMC10853881 DOI: 10.1038/s41380-020-00897-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Samuel A McLean
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA.
| | - Kerry Ressler
- Department of Psychiatry, McLean Hospital, Boston, MA, USA
| | | | - Thomas Neylan
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Laura Germine
- Department of Psychiatry, McLean Hospital, Boston, MA, USA
| | - Tanja Jovanovic
- Department of Psychiatry & Behavioral Neuroscience, Wayne State University School of Medicine, Detroit, MI, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
| | - Donglin Zeng
- Department of Biostatistics, UNC Gillings School of Public Health, Chapel Hill, NC, USA
| | - Xinming An
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Sarah Linnstaedt
- Department of Anesthesiology, Institute of Trauma Recovery, UNC School of Medicine, Chapel Hill, NC, USA
| | - Francesca Beaudoin
- Department of Emergency Medicine, Alpert Medical School of Brown University, Providence, RI, USA
| | - Stacey House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Kenneth A Bollen
- Department of Statistics and Operational Research, University of North Carolina, Chapel Hill, NC, USA
| | - Paul Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Phyllis Hendry
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper University Health Care, Camden, NJ, USA
| | | | - Robert Swor
- Department of Emergency Medicine, William Beaumont School of Medicine, Royal Oak, MI, USA
| | - Elizabeth Datner
- Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Kamran Mohiuddin
- Department of Emergency Medicine, Einstein Health Medical Center, Philadelphia, PA, USA
| | - Jennifer S Stevens
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Alan Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Michael Christopher Kurz
- Department of Emergency Medicine, School of Medicine, University of Alabama, Birmingham, AL, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston University Medical Center, Boston, MA, USA
| | - Gregory J Fermann
- Department of Emergency Medicine, University of Cincinnati Medical Center, Cincinnati, OH, USA
| | - Lauren A Hudak
- Department of Emergency Medicine, Emory University Hospital, Atlanta, GA, USA
| | - Nina Gentile
- Department of Emergency Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA
| | - Anna Marie Chang
- Department of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Jose L Pascual
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J Seamon
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Paulina Sergot
- Department of Emergency Medicine, McGovern Medical School, University of Texas, Houston, TX, USA
| | - W Frank Peacock
- Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Deborah Diercks
- Department of Emergency Medicine, UT Southwestern Medical Center, Dallas, TX, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Niels Rathlev
- Department of Emergency Medicine, Baystate Medical Center, Springfield, MA, USA
| | - Robert Domeier
- Department of Emergency Medicine, St. Joseph Mercy Ann Arbor Hospital, Ypsilanti, MI, USA
| | - John Patrick Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, MI, USA
| | - Vishnu P Murty
- Department of Psychology, College of Liberal Arts, Temple University, Philadelphia, PA, USA
| | | | - Paul Dagum
- Mindstrong Health, Mountain View, CA, USA
| | - Jukka-Pekka Onnela
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Steven E Bruce
- Department of Psychological Sciences, University of Missouri, St. Louis, MO, USA
| | - Bradley N Gaynes
- Department of Psychiatry, UNC School of Medicine, Chapel Hill, NC, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Mark W Miller
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, West Haven, CT, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Boston, MA, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Larry J Young
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Sanne J H van Rooij
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Beatriz Luna
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jordan W Smoller
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | - Thaddeus W W Pace
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Elisabeth Binder
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - John F Sheridan
- College of Dentistry, Ohio State University School of Medicine, Columbus, OH, USA
| | - James M Elliott
- Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Archana Basu
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | | | | | - Alan M Zaslavsky
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Ronald Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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Shi Y, An X, Yan R, Yao K, Xue C, Guo S, Liu T, Li J, Ma H, Tian L, Zhou F, Shi Y, Han H. A phase II study to evaluate safety and efficacy of PD-1 blockade plus anti-EGFR target therapy plus chemotherapy in patients with advanced penile squamous cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01057-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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49
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Harnett NG, van Rooij SJH, Ely TD, Lebois LAM, Murty VP, Jovanovic T, Hill SB, Dumornay NM, Merker JB, Bruce SE, House SL, Beaudoin FL, An X, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Lewandowski C, Hendry PL, Sheikh S, Storrow AB, Musey PI, Haran JP, Jones CW, Punches BE, Swor RA, McGrath ME, Pascual JL, Seamon MJ, Mohiuddin K, Chang AM, Pearson C, Peak DA, Domeier RM, Rathlev NK, Sanchez LD, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Sheridan JF, Harte SE, Elliott JM, Kessler RC, Koenen KC, Mclean S, Ressler KJ, Stevens JS. Prognostic neuroimaging biomarkers of trauma-related psychopathology: resting-state fMRI shortly after trauma predicts future PTSD and depression symptoms in the AURORA study. Neuropsychopharmacology 2021; 46:1263-1271. [PMID: 33479509 PMCID: PMC8134491 DOI: 10.1038/s41386-020-00946-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 01/30/2023]
Abstract
Neurobiological markers of future susceptibility to posttraumatic stress disorder (PTSD) may facilitate identification of vulnerable individuals in the early aftermath of trauma. Variability in resting-state networks (RSNs), patterns of intrinsic functional connectivity across the brain, has previously been linked to PTSD, and may thus be informative of PTSD susceptibility. The present data are part of an initial analysis from the AURORA study, a longitudinal, multisite study of adverse neuropsychiatric sequalae. Magnetic resonance imaging (MRI) data from 109 recently (i.e., ~2 weeks) traumatized individuals were collected and PTSD and depression symptoms were assessed at 3 months post trauma. We assessed commonly reported RSNs including the default mode network (DMN), central executive network (CEN), and salience network (SN). We also identified a proposed arousal network (AN) composed of a priori brain regions important for PTSD: the amygdala, hippocampus, mamillary bodies, midbrain, and pons. Primary analyses assessed whether variability in functional connectivity at the 2-week imaging timepoint predicted 3-month PTSD symptom severity. Left dorsolateral prefrontal cortex (DLPFC) to AN connectivity at 2 weeks post trauma was negatively related to 3-month PTSD symptoms. Further, right inferior temporal gyrus (ITG) to DMN connectivity was positively related to 3-month PTSD symptoms. Both DLPFC-AN and ITG-DMN connectivity also predicted depression symptoms at 3 months. Our results suggest that, following trauma exposure, acutely assessed variability in RSN connectivity was associated with PTSD symptom severity approximately two and a half months later. However, these patterns may reflect general susceptibility to posttraumatic dysfunction as the imaging patterns were not linked to specific disorder symptoms, at least in the subacute/early chronic phase. The present data suggest that assessment of RSNs in the early aftermath of trauma may be informative of susceptibility to posttraumatic dysfunction, with future work needed to understand neural markers of long-term (e.g., 12 months post trauma) dysfunction. Furthermore, these findings are consistent with neural models suggesting that decreased top-down cortico-limbic regulation and increased network-mediated fear generalization may contribute to ongoing dysfunction in the aftermath of trauma.
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Affiliation(s)
- Nathaniel G Harnett
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Timothy D Ely
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Vishnu P Murty
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, USA
| | - Sarah B Hill
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | | | - Julia B Merker
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
| | - Steve E Bruce
- Department of Psychological Sciences, University of Missouri - St. Louis, Springfield, MO, USA
| | - Stacey L House
- Department of Emergency Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Francesca L Beaudoin
- Department of Emergency Medicine & Health Services, Policy, and Practice, Rhode Island Hospital and The Miriam Hospital, The Alpert Medical School of Brown University, Providence, RI, USA
| | - Xinming An
- Institute of Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas C Neylan
- Departments of Psychiatry and Neurology, University of California at San Francisco, San Francisco, CA, USA
| | - Gari D Clifford
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA
| | - Sarah D Linnstaedt
- Institute of Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura T Germine
- Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Kenneth A Bollen
- Department of Psychology and Neuroscience, Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Belmont, MA, USA
| | | | - Phyllis L Hendry
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Sophia Sheikh
- Department of Emergency Medicine, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Alan B Storrow
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Paul I Musey
- Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John P Haran
- Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Christopher W Jones
- Department of Emergency Medicine, Cooper Medical School of Rowan University, Camden, NJ, USA
| | - Brittany E Punches
- Department of Emergency Medicine, College of Medicine & College of Nursing, University of Cincinnati, Cincinnati, OH, USA
| | - Robert A Swor
- Department of Emergency Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Meghan E McGrath
- Department of Emergency Medicine, Boston Medical Center, Boston, MA, USA
| | - Jose L Pascual
- Department of Surgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Mark J Seamon
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Kamran Mohiuddin
- Department of Emergency Medicine, Einstein Medical Center, Philadelphia, PA, USA
| | - Anna M Chang
- Department of Emergency Medicine, Jefferson University Hospitals, Philadelphia, PA, USA
| | - Claire Pearson
- Department of Emergency Medicine, Wayne State University, Detroit, MI, USA
| | - David A Peak
- Department of Emergency Medicine, Massachusetts General Hospital, Massachusetts, MA, USA
| | - Robert M Domeier
- Department of Emergency Medicine, Saint Joseph Mercy Hospital, Ann Arbor, MI, USA
| | - Niels K Rathlev
- Department of Emergency Medicine, University of Massachusetts Medical School-Baystate, Springfield, MO, USA
| | - Leon D Sanchez
- Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Diego A Pizzagalli
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - John F Sheridan
- Department of Biosciences and Neuroscience, OSU Wexner Medical Center, Columbus, OH, USA
- Institute for Behavioral Medicine Research, OSU Wexner Medical Center, Columbus, OH, USA
| | - Steven E Harte
- Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA
- Department of Internal Medicine-Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James M Elliott
- The Kolling Institute of Medical Research, Northern Clinical School, University of Sydney, Camperdown, NSW, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
- Physical Therapy & Human Movement Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Samuel Mclean
- Institute of Trauma Recovery, Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Jennifer S Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA.
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50
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Beaudoin FL, Kessler RC, Hwang I, Lee S, Sampson NA, An X, Ressler KJ, Koenen KC, McLean SA. Pain after a motor vehicle crash: The role of socio-demographics, crash characteristics and peri-traumatic stress symptoms. Eur J Pain 2021; 25:1119-1136. [PMID: 33458880 PMCID: PMC10913946 DOI: 10.1002/ejp.1733] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 01/13/2021] [Indexed: 11/05/2022]
Abstract
BACKGROUND The vast majority of individuals who come to the emergency department (ED) for care after a motor vehicle collision (MVC) are diagnosed with musculoskeletal strain only and are discharged to home. A significant subset of this population will still develop persistent pain and posttraumatic psychological sequelae may play an important role in pain persistence. METHODS We conducted a multisite longitudinal cohort study of adverse post-traumatic neuropsychiatric sequelae among patients seeking ED treatment in the aftermath of a traumatic life experience. We report on a sub-group of patients (n = 666) presenting after an MVC, the most common type of trauma and we examine associations of socio-demographic and MVC characteristics, and persistent pain 8 weeks after MVC. We also examine the degree to which these associations are related to peritraumatic psychological symptoms and 2-week acute stress reactions using an applied approach. RESULTS Eight-week prevalence of persistent moderate or severe pain was high (67.4%) and positively associated with patient sex (female), older age, low socioeconomic status (education and income) and pain severity in the ED. Peritraumatic stress symptoms (distress and dissociation) appear to exert some influence on both acute pain and the transition from acute to persistent pain. DISCUSSION AND CONCLUSIONS The early aftermath of an MVC may be an important time period for intervening to prevent and reduce persistent pain. Substantial variation in mediating pathways across predictors also suggests potential diverse and complex underlying biological and psychological pathogenic processes are at work in the early weeks following trauma. SIGNIFICANCE The first several days after trauma may dictate recovery trajectories. Persistent pain, pain lasting beyond the expected time of recovery, is associated with pain early in the recovery period, but also mediated through other pathways. Future work is needed to understand the complex neurobiological processes in involved in the development of persistent and acute post-traumatic pain.
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Affiliation(s)
- Francesca L. Beaudoin
- Department of Emergency Medicine & Health Services, Policy, and Practice, The Alpert Medical School of Brown University, Providence, RI, USA
- Rhode Island Hospital and The Miriam Hospital, Providence, RI, USA
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - I. Hwang
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - S. Lee
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - X. An
- Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - K. J. Ressler
- Department of Psychiatry, Harvard Medical School and McLean Hospital, Belmont, MA, USA
| | - K. C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S. A. McLean
- Department of Anesthesiology, Institute for Trauma Recovery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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