freementalhealth Journal Browser
pubmed: posttraumatic stress...
NCBI: db=pubmed; Term=posttraumatic stress disorder
?-Adrenergic Receptor Function, Arousal and Sleep: Mechanisms and Therapeutic Implications.
?-Adrenergic Receptor Function, Arousal and Sleep: Mechanisms and Therapeutic Implications.
Pharmacopsychiatry. 2012 Jan 30;
Authors: Broese M, Riemann D, Hein L, Nissen C
Abstract
Noradrenergic (NE) neurotransmission and particularly ?-adrenergic receptor function has been identified as a critical component of the sleep/wake regulation in animals and humans. This work (i) provides an update on the impact of NE neurotransmission on the sleep/wake regulation, (ii) summarizes the effects of ?-receptor agonists and antagonists on arousal and sleep in animals and healthy humans, and (iii) reviews the current body of evidence for the effectiveness and safety of these compounds in the treatment of clinical conditions characterized by alterations of arousal or sleep, including attention deficit and hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), borderline personality disorder and primary sleep disorders. This systematic evaluation of the potential and limitations of the effects of ?-adrenergic compounds might promote novel inroads for the treatment of these highly prevalent clinical conditions.
PMID: 22290201 [PubMed - as supplied by publisher]
Development of posttraumatic stress disorder after mild traumatic brain injury.
Development of posttraumatic stress disorder after mild traumatic brain injury.
Arch Phys Med Rehabil. 2012 Feb;93(2):287-92
Authors: Hoffman JM, Dikmen S, Temkin N, Bell KR
Abstract
UNLABELLED: Hoffman JM, Dikmen S, Temkin N, Bell KR. Development of posttraumatic stress disorder after mild traumatic brain injury.
OBJECTIVE: To examine the incidence of and factors associated with the development of posttraumatic stress disorder (PTSD) 6 months after civilian mild traumatic brain injury (MTBI).
DESIGN: Secondary analysis of a randomized controlled trial of telephone follow-up versus usual care to reduce MTBI symptoms and improve function.
SETTING: In-person and telephone interviews.
PARTICIPANTS: Prospectively studied participants (N=239) with MTBI enrolled in the emergency department.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Secondary analysis with main outcome measure of Posttraumatic Stress Disorder Checklist-Civilian Version.
RESULTS: At 6 months after MTBI, 17% of participants met criteria for diagnosis of PTSD. Logistic regression predicting PTSD from baseline characteristics showed that participants who were Hispanic versus white, non-Hispanic and who, at the time of injury, described themselves as less happy and believed they would be more affected by their injury were significantly more likely to have PTSD.
CONCLUSIONS: Rates of PTSD in civilian MTBI in this study are consistent with prior research. Results suggest that personality characteristics and attribution regarding the injury may impact the development of PTSD. Early interventions addressing risk factors may prevent or reduce the likelihood of developing PTSD.
PMID: 22289239 [PubMed - in process]
Emotional Stress and Heart Rate Variability Measures Associated With Cardiovascular Risk in Relocated Katrina Survivors.
Psychosom Med. 2012 Jan 27;
Authors: Tucker P, Pfefferbaum B, Jeon-Slaughter H, Khan Q, Garton T
Abstract
ObjectiveTo explore the effects of hurricane exposure and forced relocation on the mind and body, we compared psychiatric diagnoses and symptoms with heart rate variability (HRV) for 34 relocated Katrina survivors and 34 demographically matched controls.MethodsAll participants were healthy and free of psychiatric and cardiovascular medications. We measured symptoms of posttraumatic stress disorder (PTSD) (Clinician-Administered PTSD Scale 1) and depression (Beck Depression Inventory), Axis I psychiatric diagnoses (Structured Clinical Interview for DSM-IV), psychosocial disability (Sheehan Disability Scale), and power spectral analysis HRV reactivity to trauma reminders.ResultsKatrina-related PTSD occurred in 38% of survivors and 12% of controls. Survivors reported higher levels of PTSD and depression symptoms, within diagnostic ranges, and greater psychosocial disability than controls. Survivors had higher resting heart rate (80.82 [standard deviation = 13.60] versus 74.85 [10.67], p = .05), lower parasympathetic (high-frequency [HF] normalized unit) baseline HRV activity (40.14 [23.81] versus 50.67 [19.93], p = .04) and less reactivity with trauma cues (-2.63 [20.70] versus -11.96 [15.84], p = .04), and higher baseline sympathovagal activity (low frequency/HF ratio) (2.84 [3.08] versus 1.35 [1.08], p = .04) than controls. Survivors with depression (n = 12) and with depression and PTSD combined (n = 7), but not those with PTSD (n = 13), had flattened parasympathetic responsiveness to trauma cues. HRV indices correlated with depressive (low frequency/HF, p = .01; HF normalized unit, p = .046) but not PTSD symptoms (p values > .05).ConclusionsResults showed this multilayer trauma's impact on emotional health and HRV-based measures of autonomic nervous system dysregulation. Specifically, dysregulation of depressed survivors' HRV in response to trauma reminders supports more autonomic involvement in traumatic loss/depression than in PTSD. Diagnostic criteria for PTSD include physiologic reactivity, and the present findings suggest that, in this setting, altered physiologic reactivity observed when PTSD coexists with depression.
PMID: 22286851 [PubMed - as supplied by publisher]
Dark-Enhanced Startle Responses and Heart Rate Variability in a Traumatized Civilian Sample: Putative Sex-Specific Correlates of Posttraumatic Stress Disorder.
Psychosom Med. 2012 Jan 27;
Authors: Kamkwalala A, Norrholm SD, Poole JM, Brown A, Donley S, Duncan E, Bradley B, Ressler KJ, Jovanovic T
Abstract
ObjectiveTrauma is associated with increased risk for anxiety disorders such as posttraumatic stress disorder (PTSD). To further understand biologic mechanisms of PTSD, we examined the dark-enhanced startle response, a psychophysiological correlate of anxiety, and heart rate variability (HRV) in traumatized individuals with and without PTSD. The associations of these measures with PTSD may be sex-specific because of their associations with the bed nucleus of the stria terminalis, a sexually dimorphic brain structure in the limbic system that is approximately 2.5 times larger in men than in women.MethodsThe study sample (N = 141) was recruited from a highly traumatized civilian population seeking treatment at Grady Memorial Hospital in Atlanta, Georgia. Psychophysiological responses during a dark-enhanced startle paradigm task included startle magnitude, assessed by eyeblink reflex, and measures of high-frequency HRV, during light and dark phases of the startle session.ResultsThe startle magnitude was higher during the dark phase than the light phase (mean ± standard error = 98.61 ± 10.68 versus 73.93 ± 8.21 ?V, p < .001). PTSD was associated with a greater degree of dark-enhanced startle in women (p = .03) but not in men (p = .38, p interaction = .48). Although HRV measures did not differ between phases, high-frequency HRV was greater in men with PTSD compared with men without PTSD (p = .02).ConclusionsThis study demonstrates that the dark-enhanced paradigm provides novel insights into the psychophysiological responses associated with PTSD in traumatized civilian sample. Sex differences in altered parasympathetic and sympathetic function during anxiety regulation tasks may provide further insight into the neurobiological mechanisms of PTSD.
PMID: 22286850 [PubMed - as supplied by publisher]
Trauma, Posttraumatic Stress Disorder, and Biological Processes: Care for Trauma-Exposed Individuals and Communities.
Psychosom Med. 2012 Jan 27;
Authors: Ursano RJ
PMID: 22286849 [PubMed - as supplied by publisher]
Early Trauma and Inflammation: Role of Familial Factors in a Study of Twins.
Early Trauma and Inflammation: Role of Familial Factors in a Study of Twins.
Psychosom Med. 2012 Jan 27;
Authors: Rooks C, Veledar E, Goldberg J, Bremner JD, Vaccarino V
Abstract
ObjectiveAlthough early trauma (trauma in childhood) has been linked to adult inflammation and adult disease of inflammatory origin, it remains unknown whether this relationship is due to long-term consequences of early life stress or other familial factors.MethodsWe examined 482 male middle-aged twins (241 pairs) born between 1946 and 1956 from the Vietnam Era Twin Registry. Childhood traumatic experiences, before the age of 18 years, were measured retrospectively with the Early Trauma Inventory and included physical, sexual, emotional abuse and general trauma. Lifetime major depressive disorder and posttraumatic stress disorder were assessed with the Structured Clinical Interview for DSM-IV. Traditional risk factors for cardiovascular disease were also assessed. Plasma C-reactive protein and interleukin 6 were measured to determine levels of inflammation. Mixed-effects regression models with a random intercept for pair were used to separate between- and within-twin pair effects.ResultsWhen twins were analyzed as individuals, increasing levels of early trauma were positively related to C-reactive protein (p = .03) but not to interleukin 6 (p = .12). When estimating within- and between-pair effects, only the between-pair association of early trauma with the inflammatory markers remained significant.ConclusionsThe link between early trauma and inflammation is largely explained by familial factors shared by the twins because levels of inflammation were highest when both twins were exposed to trauma. Exposure to early trauma may be a marker for an unhealthy familial environment. Clarification of familial factors associated with early stress and adult inflammation will be important to uncover correlates of stress and disease.
PMID: 22286843 [PubMed - as supplied by publisher]
Posttraumatic stress disorder, depression, and perceived needs for psychological care in older persons affected by Hurricane Ike.
J Affect Disord. 2012 Jan 27;
Authors: Pietrzak RH, Southwick SM, Tracy M, Galea S, Norris FH
Abstract
OBJECTIVE: To examine the prevalence and correlates of disaster-related posttraumatic stress disorder (PTSD), depression, and needs for psychological care in older persons affected by Hurricane Ike. METHOD: A total of 193 adults aged 60 or older who resided in the Galveston Bay area were interviewed 2-5months following Hurricane Ike. Pre-, peri-, and post-disaster variables hypothesized to be related to PTSD and depressive symptoms, and perceived needs for psychological care were assessed. RESULTS: Weighted prevalences of past-month Ike-related PTSD and depression were 7.6% and 8.6%, respectively. Risk factors for Ike-related PTSD symptoms were predominantly peri-disaster in nature, with greater hurricane exposure, and peri-event dissociative and autonomic activation symptoms associated positively with these symptoms. Risk factors for depressive symptoms were predominantly pre-disaster in nature, with being married/living with partner associated negatively, and prior disaster exposure and pre-disaster PTSD or depression associated positively with these symptoms. 27.2% of the sample endorsed at least one of the perceived needs for psychological care assessed. A history of PTSD or depression, greater peri-event autonomic activation, and Ike-related PTSD and depressive symptoms were associated with greater need for psychological care. LIMITATIONS: This study is limited by its cross-sectional design and employment of psychiatric screening instruments. CONCLUSIONS: A substantial proportion of older adults may have PTSD and depression, as well as perceived needs for psychological care, after a disaster. Assessment of disaster exposures, and peri-event dissociative and autonomic symptoms may help identify older adults at risk for disaster-related psychopathology. Older adults with a history of PTSD or depression, and greater peri-event autonomic activation and PTSD symptoms may be more likely to have needs for psychological care.
PMID: 22285792 [PubMed - as supplied by publisher]
Posttraumatic stress disorder of red cross nurses in the aftermath of the 2008 wenchuan china earthquake.
Arch Psychiatr Nurs. 2012 Feb;26(1):63-70
Authors: Zhen Y, Huang ZQ, Jin J, Deng XY, Zhang LP, Wang JG
Abstract
This study investigated the symptoms, psychological distress characteristics, and related factors in China Red Cross disaster relief nurses following the 2008 Wenchuan Earthquake in China that began on May 12 and lasted to June 23, 2008. A sample of 210 exposed nurses and a reference group of 236 nonexposed Red Cross nurses were surveyed within 1 year after the catastrophic earthquake. They were given a self-report questionnaire to assess demographics, posttraumatic stress disorder, and depression symptoms. Exposed nurses reported higher psychological distress on all aspects than nonexposed nurses. Scores on the Traumatic Stress Symptom Checklist were predicted by the avoidance of traumatic thoughts during the earthquake, personality traits, prior disaster experience, and preexisting stress, and other background factors were associated with scores on measures of psychological distress in exposed nurses. The conclusion indicated that disaster relief nurses experienced psychological distress and that immediate psychological intervention should be initiated.
PMID: 22284081 [PubMed - in process]
Physical Health Conditions Associated with Posttraumatic Stress Disorder in U.S. Older Adults: Results from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.
J Am Geriatr Soc. 2012 Jan 27;
Authors: Pietrzak RH, Goldstein RB, Southwick SM, Grant BF
Abstract
OBJECTIVES: To present findings on past-year medical conditions associated with lifetime trauma exposure and full and partial posttraumatic stress disorder (PTSD) in a nationally representative sample of U.S. older adults. DESIGN: Face-to-face diagnostic interviews. SETTING: Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. PARTICIPANTS: Nine thousand four hundred sixty-three adults aged 60 and older. MEASUREMENTS: Logistic regression analyses adjusting for sociodemographic characteristics and psychiatric comorbidity were used to evaluate associations between PTSD status and past-year medical disorders; linear regression models evaluated associations with past-month physical functioning. RESULTS: After adjustment for sociodemographic characteristics and comorbid lifetime mood, anxiety, substance use, attention-deficit/hyperactivity, and personality disorders, respondents with lifetime PTSD were more likely than respondents who reported experiencing one or more traumatic life events but who did not meet lifetime criteria for full or partial PTSD (trauma controls) to report being diagnosed with hypertension, angina pectoris, tachycardia, other heart disease, stomach ulcer, gastritis, and arthritis (odds ratios (ORs) = 1.3-1.8) by a healthcare professional; they also scored lower on a measure of physical functioning than controls and respondents with partial PTSD. Respondents with lifetime partial PTSD were more likely than controls to report past-year diagnoses of gastritis (OR = 1.7), angina pectoris (OR = 1.5), and arthritis (OR = 1.4) and reported worse physical functioning. Number of lifetime traumatic event types was associated with most of the medical conditions assessed; adjustment for these events reduced the magnitudes of and rendered nonsignificant most associations between PTSD status and medical conditions. CONCLUSION: Older adults with lifetime PTSD have high rates of several physical health conditions, many of which are chronic disorders of aging, and poorer physical functioning. Older adults with lifetime partial PTSD have higher rates of gastritis, angina pectoris, and arthritis and poorer physical functioning.
PMID: 22283516 [PubMed - as supplied by publisher]
Salem VAMC-U.S. Army Fort Bragg Warrior Transition Clinic Telepsychiatry Collaboration: 12-Month Operation Clinical Perspective.
Telemed J E Health. 2012 Jan 27;
Authors: Detweiler MB, Arif S, Candelario J, Altman J, Murphy PF, Halling MH, Vasudeva S, Detweiler JG
Abstract
Abstract Objective: To describe the clinical experience in the first Veterans Affairs (VA)-U.S. Army Warrior Transition Clinic (WTC) telepsychiatry operation (September 2008-August 2009). Materials: Joint VA and U.S. Army records. Methods: Analysis of intake, follow-up, and last visit records. Results: One hundred twenty active-duty U.S. Army soldiers were seen (394 clinic visits). Ninety-eight soldiers had one or more combat tours, principally in Iraq and Afghanistan. Posttraumatic stress disorder was diagnosed in 50.0% of the cases by the WTC telepsychiatrists. The majority of the soldiers had medical comorbidities, especially chronic pain (75.0%), in addition to mental health problems. Several of the soldiers were recovering from trauma (20.8%) and/or surgery (23.3%), 11.7% exhibited traumatic brain injuries, and 17.5% had headaches. Disrupted relationships (74.2%) were notable for non-family members, especially military cohorts such as other persons in the same WTC squad or platoon. Conclusion: The observations in this report come from a cross-section of soldiers who were triaged to meet WTC admission criteria. As this is the prototype VA-U.S. Army telepsychiatry collaboration, there are no comparative data at this time. The nature of the medical and psychiatric problems treated in the military WTC represents an index of the more severe combat trauma treated on military bases from ongoing combat operations and may predict future VA-U.S. Army collaborative telepsychiatry clinic experiences.
PMID: 22283361 [PubMed - as supplied by publisher]
Post-traumatic stress disorder and birthweight: methodological challenges.
Post-traumatic stress disorder and birthweight: methodological challenges.
BJOG. 2012 Jan;119(1):110; author reply 111
Authors: Reed RV
PMID: 22168606 [PubMed - indexed for MEDLINE]
Post-traumatic stress disorder in children after the tsunami disaster in Thailand: a 5-year follow-up.
J Med Assoc Thai. 2011 Aug;94 Suppl 3:S138-44
Authors: Piyasil V, Ketumarn P, Prubrukarn R, Ularntinon S, Sitdhiraksa N, Pithayaratsathien N, Pariwatcharakul P, Lerthattasilp T, Chinajitphant N, Liamwanich K, Wadchareeudomkarn N, Sookatup J, Wanlieng T, Yongpitayapong C, Paveenchana P, Tasri L, Chaiyakun P, Sanguanpanich N
Abstract
BACKGROUND: Children may suffer from post-traumatic stress disorder after disaster. There was a severe tsunami following an undersea earthquake off the Sumatra coast of Indonesia. There were 20,000 children in 6 southwestern provinces of Thailand who were possibly affected.
OBJECTIVE: To study the prevalence of post-traumatic stress disorder (PTSD) in Thai students in the area affected by the December 26th, 2004 tsunami disaster, Thailand.
MATERIAL AND METHOD: One thousand six hundred and fifteen surviving students from two schools in Takua Pa district located in Phang-nga Province, Thailand participated in this longitudinal study. Screening was done by using Pediatric Symptom Checklists part II (PSC-II), Childhood Depressive Intervention (CDI) and the Revised Child Impact of Events Scales (CRIES 8). PTSD was diagnosed by child and adolescent psychiatrists by using criteria of DSM-IV. The intervention included psychological first aid, psycho-education, cognitive-behavioral therapy, medication in severe cases, group support for students, parents and teachers which was done, beginning at 10 days after the tsunami disaster. Data were analyzed by using SPSS version 12.0.
RESULTS: The prevalence rates of PTSD in the students facing the tsunami disaster in the study group were 573, 46.1, 31.6, 7.6, 4.5, 3.9 and 2.7% at 6 weeks, 6 months, 1 year, 2 years, 3 years, 4 years and 5 years after the disaster, respectively. Female to male ratio was 1.7: 1. The peak age was 9-10 years old. The top five on the list of symptoms in PTSD were distress with cue, intrusive thought, functioning impairment, startled response, terrified and hyper vigilance. Seven cases (3.1%) were diagnosed partial PTSD, still exhibited a wide range of PTSD symptoms but did not fulfill the DSM-IV diagnostic criteria. The top five on the list of symptoms in partial PTSD were avoiding thought/feelings, terrified, avoiding place/activities, distress with cue and startled response.
CONCLUSION: The prevalence of PTSD among tsunami victims was 57.3% at 6 weeks after the disaster. It declined sharply at 2 years after the event. Despite receiving financial, rehabilitation and mental health support, 2.7% of the victims continued to suffer from PTSD 5 years after the disaster.
PMID: 22043767 [PubMed - indexed for MEDLINE]
Physical symptoms 14 months after a natural disaster in individuals with or without injury are associated with different types of exposure.
J Psychosom Res. 2011 Sep;71(3):180-7
Authors: Keskinen-Rosenqvist R, Michélsen H, Schulman A, Wahlström L
Abstract
OBJECTIVE: To investigate whether different types of exposure to the 2004 tsunami were associated with physical symptoms 14 months after the disaster and to study correlations between survivors' physical and psychological symptoms.
METHODS: Using a cross-sectional design, 1505 survivors from the 2004 Indian Ocean Tsunami, tourists from Stockholm, who had been present in the disaster areas, responded to a postal questionnaire. Eight groups based on type of exposure were created. Physical symptoms occurring on a daily or weekly basis over the past year were investigated in four indices: musculoskeletal, cardiorespiratory, neurological, and gastrointestinal. Mental health symptoms (General Health Questionnaire-12) and posttraumatic stress symptoms (Impact of Event Scale-Revised) were also investigated. Multiple logistic regression analyses were conducted with controls for background variables and exposure, with physical symptoms as outcome variables. The association between physical and psychological symptoms was studied with the Spearman Rank Order Correlation.
RESULTS: Different types of exposure during the disaster were associated with physical symptoms 14 months later for survivors both with and without severe physical injury. The single exposure of life threat, also in combination with other exposures, was associated with a higher risk for reporting of physical symptoms. Physical symptoms showed modest yet significant correlation with psychological symptoms.
CONCLUSION: It is important to pay attention to both physical and psychological symptoms among disaster survivors whether they have been injured or not. A relatively simple questionnaire about physical symptoms may be a good complement to the scales used to assess psychological problems after disaster.
PMID: 21843754 [PubMed - indexed for MEDLINE]
Posttraumatic stress symptoms following pregnancy complicated by hyperemesis gravidarum.
Posttraumatic stress symptoms following pregnancy complicated by hyperemesis gravidarum.
J Matern Fetal Neonatal Med. 2011 Nov;24(11):1307-11
Authors: Christodoulou-Smith J, Gold JI, Romero R, Goodwin TM, Macgibbon KW, Mullin PM, Fejzo MS
Abstract
OBJECTIVE: Hyperemesis gravidarum (HG) can be accompanied by severe physical and emotional distress. Most studies have focused on the physical and psychological stress associated with this condition during the affected pregnancy. This study explores posttraumatic stress symptoms (PTSS) and negative life outcomes following HG pregnancies.
METHODS: A total of 610 women (HG = 377 and control = 233) were recruited and completed an online survey. ?-square analyses were used to compare the HG and control groups on various life outcome variables.
RESULTS: Eighteen percent of women with HG reported full criteria PTSS (n = 68). Negative life outcomes regarding financial and marital status, career, as well as psychological and physical well-being differed significantly for the HG groups compared to the control group (0.001 < p < 0.05).
CONCLUSIONS: PTSS is common following HG pregnancies and is associated with negative life outcomes including inability to breastfeed, marital problems, financial problems, and inability of self care.
PMID: 21635201 [PubMed - indexed for MEDLINE]
