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1
Stojakovic, Milan. "Forensic psychiatric expertise: Posttraumatic stress disorder." Srpski arhiv za celokupno lekarstvo 139, suppl. 1 (2011): 46–51. http://dx.doi.org/10.2298/sarh11s1046s.
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Introduction. This article presents our experiences in the field of forensic post-traumatic stress disorder (PTSD). Objective. The study examined parameters of 30 patients with PTSD who were the subject of forensic expertise (PTSDF) and in 30 patients with PTSD who were not (PTSDN). Methods. Clinical research and the battery of tests (Impact of Event Scale - IES, Mississippi Scale, and list of symptoms of PCL-M) covered a total of 60 male subjects with a verified diagnosis of PTSD. The study involved socio-demographic variables, catastrophic experience, enduring personality change after catastrophic experience (EPCACE), comorbidity disorders and non-material damage. Results. In terms of respondents? average age, years of education, marital status, time of military engagement, there were no statistically significant differences between PTSDF and PTSDN groups. In terms of EPCACE statistically significant differences were found in both PTSDF and PTSDN groups. Among PTSDF respondents (N=30) EPCACE was verified in 83.33% (N=25), and among PTSDN in 23.33% (N=7) (p<0.05). In terms of comorbidity disorders and the parameter of non-material damage no statistically significant differences were found either in PTSDF or PTSDN group. Conclusion. In terms of EPCACE there were statistically significant differences both in PTSDF and PTSDN group. Forensic and psychiatric meaning of PTSD encompasses a number of complex elements on which forensic expert opinion depends, while the existence of PTSD diagnosis itself does not affect creation of opinions. The study should serve to identify methodological and conceptual problems in the field of forensic aspects of PTSD.
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Segman, Ronnen H., and Arieh Y. Shalev. "Genetics of Posttraumatic Stress Disorder." CNS Spectrums 8, no. 9 (September 2003): 693–98. http://dx.doi.org/10.1017/s1092852900008889.
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ABSTRACTPosttraumatic stress disorder (PTSD) is a prevalent anxiety disorder marked by behavioral, physiologic, and hormonal alterations. PTSD is disabling and commonly follows a chronic course. The etiology of PTSD is unknown, although exposure to a traumatic event constitutes a necessary, but not sufficient, factor. A twin study of Vietnam veterans has shown significant genetic contribution to PTSD. The fact that PTSD's underlying genotypic vulnerability is only expressed following trauma exposure limits the usefulness of family-based linkage approaches. In contrast to the other major psychiatric disorders, large studies for the search of underlying genes have not been described in PTSD to date. Complementary approaches for locating involved genes include association-based studies employing case-control or parental genotypes for transmission dysequilibrium analysis and quantitative trait loci studies in animal models. Identification of susceptibility genes will increase our understanding of traumatic stress disorders and help to elucidate their molecular basis. The current review provides an up-to-date outline of progress in the field of PTSD.
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Spoont, Michele. "Posttraumatic Stress Disorder (PTSD)." JAMA 314, no. 5 (August 4, 2015): 532. http://dx.doi.org/10.1001/jama.2015.8109.
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Ličanin, Ifeta, and Amira Redžić. "Posttraumatic stress disorder (ptsd) and co-morbidity." Bosnian Journal of Basic Medical Sciences 2, no. 1-2 (February 20, 2002): 57–61. http://dx.doi.org/10.17305/bjbms.2002.3583.
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Posttraumatic Stress Disorder (PTSD) very often occurs accompanied with other psychiatric disorders such as: Alcohol and Drug abuse, Personality Disorder, General Anxiety Disorder, Obsessive Compulsive Disorder, Schizophrenia etc. Sometimes it might be a problem for clinicians to differ PTSD symptoms from symptoms of coexisting psychic disorders. The aim of this study was to present the most common PTSD coexisting psycho-disorders. This research was conducted during the period from April 1998 to October 1999. Participants were divided in two groups each containing 30 examinees. The first group consisted of 30 participants with symptoms of PTSD only while the second group included participants who suffered from both PTSD and other psychic disorders (co-morbidity). Both groups were quite similar regarding participants gender and age. The scientific tools used in the research were: Standard Psychiatric Interview, Harvard Trauma Questionnaire (HTQ), Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, and Drug and Alcohol Abuse Checklist. Our research results are indicating that PTSDsymptoms are most common in middle-aged persons, regardless of their gender and age. We have found following coexisting psychic disorders: personality disorder 46.6% (from which 13.3% is permanent personality disorder after the traumatic experience); depression 29.9% (depression without psychotic symptoms 23.3% and depression with coexisting psychotic symptoms 6.6%); drug abuse 13.3; alcohol abuse 6.7% and dissociative (conversion) disorder 3.3%. The results of our work are suggesting that co-morbid psychic symptoms have significant regressive influence on PTSD course and prognosis.
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Lindley, Steven E., Eve Carlson, and Javaid Sheikh. "Psychotic Symptoms in Posttraumatic Stress Disorder." CNS Spectrums 5, no. 9 (September 2000): 52–57. http://dx.doi.org/10.1017/s1092852900021659.
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AbstractRecent data suggest that the presence of psychotic symptoms in patients suffering from posttraumatic stress disorder (PTSD) may represent an underrecognized and unique subtype of PTSD. Among combat veterans with PTSD, 30% to 40% report auditory or visual hallucinations and/or delusions. The presence of psychotic symptoms in PTSD is associated with a more severe level of psychopathology, similar to that of chronic schizophrenia. In this review, the differential diagnosis of psychotic symptoms in PTSD is discussed, including possible comorbid schizophrenia, psychotic depression, substance-induced psychosis, and personality disorder. A recent biologic study supporting the existence of a unique subtype of PTSD with psychotic features is also addressed, as are the similarities between PTSD with psychotic features and psychotic depression disorder. Finally, data on the treatment implications of psychotic symptoms in PTSD are presented. The intriguing recent findings on psychotic symptoms in PTSD need further investigation in noncombat-related PTSD populations before findings can be generalized to all individuals with PTSD.
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Petrova, N. N., B. G. Butoma, and M. V. Dorofeikova. "Potential Biomarkers of Posttraumatic Stress Disorder." Psikhiatriya 19, no. 3 (October 14, 2021): 90–99. http://dx.doi.org/10.30629/2618-6667-2021-19-3-90-99.
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Background: although the search for biomarkers of mental disorders that is aimed at improving diagnosis, individualizing therapy based on knowledge of pathophysiological processes and preventing the development of mental illness is actively underway for endogenous mental disorders, the study of biological markers in non-endogenous mental disorders and posttraumatic stress disorder (PTSD) in particular has received much less attention. Aim: to analyze current state of research dedicated to genetic and biochemical biomarkers that can be used to identify high risk groups and clarify the diagnosis of PTSD. Material and method: keywords “biomarkers”, “post-traumatic stress disorder”, “pathogenesis” have been used to fi nd in PubMed articles published in 2010–2020. Conclusion: research methods for elucidating the mechanisms of PTSD are actively developing, however, the identifi cation of specifi c biomarkers (biochemical, molecular, genetic, epigenetic, neuroimaging, psychophysiological) is a complicated task. This complexity is associated with numerous pathogenic mechanisms of PTSD and frequent comorbidity with mental disorders (depression, anxiety) and somatic diseases, as well as lack of specifi city of detected biomarkers.
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Petrova, N. N., B. G. Butoma, and M. V. Dorofeikova. "Potential Biomarkers of Posttraumatic Stress Disorder." Psikhiatriya 19, no. 3 (October 14, 2021): 90–99. http://dx.doi.org/10.30629/2618-6667-2021-19-3-90-99.
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Background: although the search for biomarkers of mental disorders that is aimed at improving diagnosis, individualizing therapy based on knowledge of pathophysiological processes and preventing the development of mental illness is actively underway for endogenous mental disorders, the study of biological markers in non-endogenous mental disorders and posttraumatic stress disorder (PTSD) in particular has received much less attention. Aim: to analyze current state of research dedicated to genetic and biochemical biomarkers that can be used to identify high risk groups and clarify the diagnosis of PTSD. Material and method: keywords “biomarkers”, “post-traumatic stress disorder”, “pathogenesis” have been used to fi nd in PubMed articles published in 2010–2020. Conclusion: research methods for elucidating the mechanisms of PTSD are actively developing, however, the identifi cation of specifi c biomarkers (biochemical, molecular, genetic, epigenetic, neuroimaging, psychophysiological) is a complicated task. This complexity is associated with numerous pathogenic mechanisms of PTSD and frequent comorbidity with mental disorders (depression, anxiety) and somatic diseases, as well as lack of specifi city of detected biomarkers.
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Malek-Ahmadi, Parviz. "Gabapentin and Posttraumatic Stress Disorder." Annals of Pharmacotherapy 37, no. 5 (May 2003): 664–66. http://dx.doi.org/10.1345/aph.1c082.
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OBJECTIVE: To report the effects of gabapentin in a patient with concurrent depression and posttraumatic stress disorder (PTSD) and review the use of antiepileptic drugs (AEDs) in PTSD. CASE SUMMARY: A 37-year-old Latin American woman was being treated for major depression and PTSD. While the depressive symptoms were in remission, she reported a significant reduction in the frequency of her flashbacks after gabapentin was added to venlafaxine. She did not receive any type of psychotherapy. The flashbacks recurred after she discontinued gabapentin. DISCUSSION: While the improvement reported by the patient may have been related to a placebo effect or spontaneous recovery, treatment with gabapentin may have played a role in alleviating the flashbacks. Other published reports suggest that AEDs have a beneficial effect on some PTSD symptoms. CONCLUSIONS: AEDs may be of some therapeutic value in patients with PTSD. Future controlled studies are warranted to investigate the effectiveness of these agents.
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Carlier, Ingrid V. E., and Berthold P. R. Gersons. "Partial Posttraumatic Stress Disorder (PTSD)." Journal of Nervous and Mental Disease 183, no. 2 (February 1995): 107–8. http://dx.doi.org/10.1097/00005053-199502000-00008.
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Sattar, S. Pirzada, Bernadette Ucci, Kathleen Grant, Subhash C. Bhatia, and Frederick Petty. "Quetiapine Therapy for Posttraumatic Stress Disorder." Annals of Pharmacotherapy 36, no. 12 (December 2002): 1875–78. http://dx.doi.org/10.1345/aph.1c040.
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OBJECTIVE: To report a case of improvement in posttraumatic stress disorder (PTSD) after adjunctive therapy with quetiapine. CASE SUMMARY: A 49-year-old white man witnessed a traumatic event and experienced severe PTSD. He was started on paroxetine, with increases in dosage and no significant improvement. Quetiapine was added to his regimen, with increased doses resulting in improvement of PTSD symptoms, both clinically and as measured on the Hamilton-D rating scale for depression and the clinician-administered PTSD screen. DISCUSSION: This is the first case published in the English language literature describing improvement in PTSD symptoms after treatment with quetiapine. There are several treatment options for PTSD, but some severe cases may require treatment with antipsychotic medications. Because of the lower risks of serious adverse effects, the newer atypical antipsychotics are much safer than the older antipsychotics. Although use of risperidone and olanzapine in the successful treatment of PTSD has been reported in the literature, there are no reports of quetiapine use in this clinical condition. CONCLUSIONS: Quetiapine appeared to improve clinical signs and symptoms of PTSD in this patient. It may be a treatment option in other severe cases of PTSD.
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Precin, Pat. "Pretraumatic stress prevention (PTSP) versus posttraumatic stress disorder (PTSD)." Work 38, no. 1 (2011): 89–90. http://dx.doi.org/10.3233/wor-2011-1108.
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Aukst-Margetić, B., G. Toić, Z. Furjan, A. Boban, and B. Margetić. "Stigma and Posttraumatic Stress Disorder." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)70751-5.
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Goal:To assess perception of stigma in patients suffering from combat-related posttraumatic stress disorder.Methods:Sixty one veterans from 1991-1995 war in Croatia (mean age 43,8 years SD 6,3) with diagnosis of PTSD according to the 10th revision of the International Classification of Diseases hospitalized consecutively on acute psychiatric department during 6 months were assessed. Stigma was measured with Internalized Stigma Mental Illness inventory that has five subscales: Alienation; Stereotype Endorsement; Perceived Discrimination; Social Withdrawal and Stigma Resistance, and with Devaluation-Discrimination Scale both rated on four possibilities Likert scale: (1-strongly disagree to 4-strongly agree). Mississippi Scale for Combat-related PTSD was used to determine the severity of PTSD symptoms. It consists of 35 statements that are rated on a 5-point Likert scale (1 - “absolutely incorrect” to 5 - “absolutely correct”). A 100mm long visual analogue scales anchored with “not at all” and “very strongly” were used for assessing religiosity, social support and family problems caused with patient's illness.Results:Discrimination-devaluation scale was correlated with social support (r=0,373 p=0,003) indicating less discrimination with higher social support and with intensity of PTSD (r=-0,320 p=0,017). ISMI was correlated with intensity of family problems (r=0,299; p=0,019) and M-PTSD (r=0,588; p=0,001). Regression analyses indicated social support as significant predictor of less discrimination (R=0,570; p=0,021), and intensity of symptoms as predictor of high perceived stigma (R=0,653;p=0,001). Unsolved veteran invalidity status was associated with higher number of hospitalizations (t=2,097; df=59; p=0,042).Conclusion:Stigma perception in PTSD depends on social support and intensity of the symptoms.
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Scott, J. Cobb, Steven Paul Woods, Kristen M. Wrocklage, Brian C. Schweinsburg, Steven M. Southwick, and John H. Krystal. "Prospective Memory in Posttraumatic Stress Disorder." Journal of the International Neuropsychological Society 22, no. 7 (June 29, 2016): 724–34. http://dx.doi.org/10.1017/s1355617716000564.
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AbstractObjectives: Neuropsychological studies of posttraumatic stress disorder (PTSD) have revealed deficits in attention/working memory, processing speed, executive functioning, and retrospective memory. However, little is known about prospective memory (PM) in PTSD, a clinically relevant aspect of episodic memory that supports the encoding and retrieval of intentions for future actions. Methods: Here we examined PM performance in 40 veterans with PTSD compared to 38 trauma comparison (TC) veterans who were exposed to combat but did not develop PTSD. All participants were administered the Memory for Intentions Test (MIST; Raskin, Buckheit, & Sherrod, 2010), a standardized and validated measure of PM, alongside a comprehensive neurocognitive battery, structured diagnostic interviews for psychiatric conditions, and behavioral questionnaires. Results: Veterans with PTSD performed moderately lower than TC on time-based PM, with errors primarily characterized as PM failure errors (i.e., omissions). However, groups did not differ in event-based PM, ongoing task performance, or post-test recognition of PM intentions for each trial. Lower time-based PM performance was specifically related to hyperarousal symptoms of PTSD. Time-based-performance was also associated with neuropsychological measures of retrospective memory and executive functions in the PTSD group. Nevertheless, PTSD was significantly associated with poorer PM above and beyond age and performance in retrospective memory and executive functions. Discussion: Results provide initial evidence of PM dysfunction in PTSD, especially in strategic monitoring during time-based PM tasks. Findings have potential implications for everyday functioning and health behaviors in persons with PTSD, and deserve replication and future study. (JINS, 2016, 22, 724–734)
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Cyr, Monica, and Merry Kathleen Farrar. "Treatment for Posttraumatic Stress Disorder." Annals of Pharmacotherapy 34, no. 3 (March 2000): 366–76. http://dx.doi.org/10.1345/aph.19120.
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OBJECTIVE: To thoroughly and critically review the pharmacologic treatment of posttraumatic stress disorder (PTSD) and to review the symptomatology, diagnosis, epidemiology, pathophysiology, and assessment of PTSD. DATA SOURCES: A MEDLINE search (1966–October 1999) in the English language specifying PTSD drug treatment as the search term was used to identify articles. STUDY SELECTION AND DATA EXTRACTION: All articles identified were reviewed; emphasis was given to randomized, double-blind, placebo-controlled studies. DATA SYNTHESIS: It appears that a five-week medication trial is necessary to assess clinical effects on PTSD symptoms. The monoamine oxidase inhibitors appear to be superior to the tricyclic antidepressants in improving reexperiencing and avoidance symptoms. Most studies used assessment tools that neglected hyperarousal symptoms; therefore, no conclusions regarding this symptom cluster can be drawn. Other pharmacotherapeutic interventions reported in open-label trials have yielded varying success. CONCLUSIONS: The current literature does not bear a sufficient number of double-blind, placebo-controlled studies using assessment tools that evaluate the three symptom clusters of PTSD to allow for a definite treatment modality to be formulated. Nonetheless, a treatment hierarchy appears to be in order based on the greatest number of double-blind, placebo-controlled studies evaluating antidepressants. Alternate modalities such as mood stabilizers, antipsychotics, anxiolytics, and adrenergic blockers should not be considered the mainstays of therapy.
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Vermetten, E. "Pain processing in posttraumatic stress disorder." European Psychiatry 26, S2 (March 2011): 2132. http://dx.doi.org/10.1016/s0924-9338(11)73835-4.
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Although posttraumatic stress disorder (PTSD) is associated with chronic pain, preliminary evidence suggests reduced experimental pain sensitivity in this disorder. The questions addressed in the present study were whether pain perception would also be reduced in PTSD patients who are not suffering from chronic pain symptoms, and whether a reduction in pain sensitivity would also be present in combat veterans who did not develop PTSD. For this, we determined thermal detection and pain thresholds in 10 male combat-related PTSD patients, 10 combat control subjects (no PTSD) and 10 healthy controls without combat experience. All subjects were pain free. First, we measured thermal sensory thresholds with ramped heat and cold stimuli using the method of limits. Ramped thermal sensory stimulation revealed no deficits for the detection of (non-noxious) f2.1thermal stimuli between groups. In contrast, heat and cold pain thresholds in both combat groups (PTSD and combat controls) were significantly increased compared to healthy controls. However, these stimuli could not distinguish between the two groups due to ceiling effects. When using longer-lasting heat stimulation at different temperatures (30 s duration; method of fixed stimuli), we found significantly lower frequency of pain reports in PTSD patients compared with both combat and healthy controls, as well as significantly lower pain ratings. Our results suggest an association of PTSD with reduced pain sensitivity, which could be related to PTSD-related (neuro-)psychological alterations or to a pre-existing risk factor for the disorder.
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Azka Rusyda, Humaira, Anjely Doni Lasmi, Salwa Khairunnisa, and Visakha Vidyadevi Wiguna. "Posttraumatic Stress Disorder pada Anak." Jurnal Syntax Fusion 1, no. 10 (October 25, 2021): 578–87. http://dx.doi.org/10.54543/fusion.v1i10.83.
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Gangguan kecemasan yang mungkin terjadi setelah mengalami atau menyaksikan peristiwa traumatis disebut gangguan stres pascatrauma (PTSD). Peristiwa traumatis termasuk pelecehan atau pelecehan fisik atau seksual, cedera, kekerasan, kecelakaan di jalan, trauma perang, luka bakar parah dan bencana. Hingga 18 judul topik, pencarian kata kunci dan sumber dari Google Scholar dan National Center for Biotechnology Information/NCBI dilakukan di portal online publikasi jurnal, dengan kata kunci PTSD. PTSD didefinisikan sebagai "peristiwa traumatis yang dialami atau disaksikan secara langsung oleh seseorang berupa kematian atau ancaman kematian, cedera serius, atau ancaman terhadap integritas fisik seseorang. Menurut data dari National Center for Post-Traumatic Stress Disorder, setiap 100 orang Sekitar 7 atau 8 orang akan mengalami gangguan stres pasca-trauma pada tahap tertentu dalam hidup mereka Intervensi dan pengobatan dini dapat meminimalkan dampak sosial dan emosional dari paparan anak-anak terhadap peristiwa traumatis. PTSD umumnya dapat disembuhkan jika dapat segera dideteksi dan diobati dengan benar. Jika tidak terdeteksi dan diobati tepat waktu, dapat menyebabkan komplikasi medis dan psikologis yang serius dan permanen, yang pada akhirnya akan mengganggu kehidupan sosial anak di masa depan
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Solomon, Zahava, and Avi Bleich. "Comorbidity of Posttraumatic Stress Disorder and Depression in Israeli Veterans." CNS Spectrums 3, S2 (August 1998): 15–21. http://dx.doi.org/10.1017/s1092852900007288.
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AbstractThis article reviews a series of studies conducted on Israeli war veterans that assessed the interrelationship of posttraumatic stress disorder (PTSD) and comorbid disorder, focusing on five issues in particular: (1) the frequency of comorbidity among veterans diagnosed with PTSD; (2) how this comorbidity can be accounted for; (3) whether PTSDs with and without comorbidity are different; (4) the validity of PTSD as a distinct diagnosis; and (5) the clinical implications of comorbidity of PTSD.
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VASTERLING, JENNIFER J., LISA M. DUKE, HOLLY TOMLIN, NATASHA LOWERY, and EDITH KAPLAN. "Global–local visual processing in posttraumatic stress disorder." Journal of the International Neuropsychological Society 10, no. 5 (September 2004): 709–18. http://dx.doi.org/10.1017/s1355617704105031.
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The purpose of this study was to examine a behavioral index of hemispheric asymmetry (i.e., visual hierarchical attention) in posttraumatic stress disorder (PTSD), a disorder characterized by anxiety and other emotional symptoms. A reaction time based, computerized, global–local visual paradigm was administered to 26 PTSD-diagnosed and 22 psychopathology-free right-handed, male Vietnam War zone veterans. Results indicated that PTSD-diagnosed veterans displayed slower reaction times to all targets than the no-mental disorders comparison sample. However, findings also revealed a Group × Target location interaction in which the PTSD group was slower than the no-disorders comparison sample to respond to local, but not global, targets. Moreover, relative global bias was greater among PTSD-diagnosed veterans than their no-diagnosis counterparts. Findings provide partial support for the hypothesis that PTSD may be associated with a functional cerebral asymmetry favoring the right hemisphere. (JINS, 2004,10, 709–718.)
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Havelka Meštrović, Ana, Marina Domijan, Vlatko Mičković, and Zoran Lončar. "Cognitive Functions in Combat Posttraumatic Stress Disorder." Collegium antropologicum 44, no. 4 (2020): 199–207. http://dx.doi.org/10.5671/ca.44.4.2.
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Posttraumatic stress disorder (PTSD) is associated with changes in cognitive functions. The aim of the study was to investigate differences in cognitive abilities between PTSD patients and healthy controls. As PTSD is often accompanied by comorbidity, the PTSD patients with comorbid diagnoses were also included in our study. The study participants included 254 Croatian combat veterans (60 PTSD and 194 PTSD plus comorbidity) and control group of 125 healthy Croatian military and civilian pilots. The diagnosis of PTSD was made by clinical scale for PTSD assessment (CAPS), while cognitive abilities were measured by Wechsler intelligence scale (WAIS-III-R) and Rey test (ROCFT). The study results have confirmed that there is a significant difference in cognitive functions between the PTSD patients and healthy controls regarding age and education. The PTSD patients (PTSD only and PTSD with comorbidity) have shown lower general intellectual abilities, reduced capacity of working, numerical and visual memory, and decreased executive functions when compared to healthy controls. These results are an additional contribution to a better understanding and determination of changes in cognitive functions that occur in combat PTSD as a result of traumatic stress.
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Pratchett, Laura C., and Rachel Yehuda. "Foundations of posttraumatic stress disorder: Does early life trauma lead to adult posttraumatic stress disorder?" Development and Psychopathology 23, no. 2 (April 18, 2011): 477–91. http://dx.doi.org/10.1017/s0954579411000186.
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AbstractThe effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic–pituitary–adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.
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Laukkala, Tanja, Robert Bor, Bruce Budowle, Pooshan Navathe, Antti Sajantila, Markku Sainio, and Alpo Vuorio. "Pilot Posttraumatic Stress Disorder and Fatal Aviation Accidents." Aviation Psychology and Applied Human Factors 8, no. 2 (September 2018): 93–99. http://dx.doi.org/10.1027/2192-0923/a000144.
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Abstract. The National Transportation Safety Board (NTSB) database was searched to identify fatal accidents in aviation related to trauma and stressor-related disorders in the United States and the medical requirements of aviation authorities were assessed. Between 2000 and 2015, eight pilots with a diagnosis of posttraumatic stress disorder (PTSD; of which two were aviation-related PTSDs) died in aviation accidents. These results indicate a minimum frequency of history of diagnosed PTSD in aviation fatalities to be 8 out of 4,862 fatal accidents (0.16%) in the United States. The guidance from aviation regulatory authorities is to medically assess pilots with a prior history of PTSD based on individual functional impairment and treatment response. The assessment of individual impairment would be significantly improved by the systematic data collection following aviation- and work-related traumatic events. It is also important for investigators to recognize the traumatization that occurs in aviation accident and incident investigations.
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McGorry, Patrick D. "The Clinical Boundaries of Posttraumatic Stress Disorder." Australian & New Zealand Journal of Psychiatry 29, no. 3 (September 1995): 385–93. http://dx.doi.org/10.3109/00048679509064945.
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Three sets of clinical boundaries exist for posttraumatic stress disorder (PTSD), as for all concepts of psychiatric disorder. The first involves the border with normal psychology in general, and with the normal psychology of stress response in particular. This boundary can be surveyed from a number of vantage points and the maps which result will not necessarily correspond. The second boundary issue involves internal boundaries between psychiatric disorders, specifically between PTSD and other concepts of disorder. The high level of comorbidity documented in PTSD has ensured that this aspect of boundary setting is particularly contentious. The third set of boundaries is concerned with subtyping within the global construct of PTSD. The validity and extent of subtyping would be based on the degree to which phenomenological differences exist in relation to PTSD syndromes occurring in the wake of certain types of traumatic events. Such clinical subtyping might however need to be buttressed by external validity indicators such as differential treatment responses or outcome. A final boundary issue of major significance to therapists involves the need to place oneself unambiguously on the side of the trauma survivor in the struggle to resolve the traumatic experiences. The pivotal position of PTSD in the psychopathological arena is discussed.
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Walsh, Kate, David DiLillo, Alicia Klanecky, and Dennis McChargue. "Posttraumatic Stress Disorder Symptoms." Journal of Interpersonal Violence 28, no. 3 (August 27, 2012): 558–76. http://dx.doi.org/10.1177/0886260512455511.
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Sexual assault occurring when the victim is unable to consent or resist due to the use or administration of alcohol or drugs (i.e., incapacitated/drug-or-alcohol facilitated rape; IR/DAFR) is a particularly prevalent form of victimization experienced by college women. By definition, substance use precedes IR/DAFR; however, few studies have examined other potential risk factors for IR/DAFR that may be unique from those associated with forcible rape (FR; i.e., sexual assault occurring due to threats or physical restraint). The present investigation tested a model of risk for IR/DAFR and FR suggesting that child or adolescent sexual abuse (CASA) leads to posttraumatic stress disorder (PTSD) symptoms, which in turn increase the likelihood of IR/DAFR, but not FR. Results revealed full mediation for PTSD hyperarousal symptoms in the pathway between CASA and IR/DAFR, and partial mediation for hyperarousal symptoms in the pathway between CASA and FR. Theoretical and clinical implications are discussed.
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Sabic, D., and A. Sabic. "Embitterment in war veterans with posttraumatic stress disorder (PTSD)." European Psychiatry 41, S1 (April 2017): S359—S360. http://dx.doi.org/10.1016/j.eurpsy.2017.02.354.
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The aim of this study was to analyse frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD) as well as the potential impact of embitterment on the development of chronic PTSD.Patients and methodsIt was analyzed 174 subjects (from Health Center Zivinice/mental health center) through a survey conducted in the period from March 2015 to June 2016, of which 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the post-traumatic embitterment disorder self-rating scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the clinician-administered PTSD scale–V (CAPS), the PTSD checklist (PCL), the combat exposure scale (CES), the Hamilton depression rating scale (HAM-D), the Hamilton anxiety rating scale (HAM-A) and the World health organization quality of life scale (WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52.78 ± 5.99. In the control group, average age was 51.42 ± 5.98. Statistical data were analyzed in SPSS statistical program.ResultsComparing the results, t-tests revealed significant difference between group veterans with PTSD and control group (t = −21,21, P < 0.0001). War veterans group with PTSD (X = 51.41, SD = 8,91), control group (X = 14.39, SD = 13.61).ConclusionEmbitterment is frequent in war veterans with PTSD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pervanidou, Panagiota, Gerasimos Makris, George Chrousos, and Agorastos Agorastos. "Early Life Stress and Pediatric Posttraumatic Stress Disorder." Brain Sciences 10, no. 3 (March 14, 2020): 169. http://dx.doi.org/10.3390/brainsci10030169.
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Traumatic stress exposure during critical periods of development may have essential and long-lasting effects on the physical and mental health of individuals. Two thirds of youth are exposed to potentially traumatic experiences by the age of 17, and approximately 5% of adolescents meet lifetime criteria for posttraumatic stress disorder (PTSD). The role of the stress system is the maintenance of homeostasis in the presence of real/perceived and acute/chronic stressors. Early-life stress (ELS) has an impact on neuronal brain networks involved in stress reactions, and could exert a programming effect on glucocorticoid signaling. Studies on pediatric PTSD reveal diverse neuroendocrine responses to adverse events and related long-term neuroendocrine and epigenetic alterations. Neuroendocrine, neuroimaging, and genetic studies in children with PTSD and ELS experiences are crucial in understanding risk and resilience factors, and also the natural history of PTSD.
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De Jong, J. "Interpersonal Psychotherapy (IPT) for Posttraumatic stress disorder." European Psychiatry 65, S1 (June 2022): S397. http://dx.doi.org/10.1192/j.eurpsy.2022.1004.
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Introduction Therapies focused on exposure like prolonged exposure (PE) or Eye Movement Desensitization and Reprocessing (EMDR) dominate the treatment of posttraumatic stress disorder (PTSD). There are many patients with PTSD who are not fully responding with exposure-therapies. or don’t want exposure therapies at all. Many patients don’t like to be confronted with elements of their traumatic experience. IPT has proven to be highly efficient in e.g. depression and bulimia and is promising as a treatment for PTSD while NOT using exposure. IPT aims to repair the damage trauma does to interpersonal trust and social functioning. Objectives Learn more about IPT. Learn more about the way IPT is used in the treatment for patients with PTSD (adaptations). Methods Literature review focused on IPT for PTSD. Results Among the consequences of PTSD are affective numbing, interpersonal hypervigilance, and social withdrawal (1). Numbness, an avoidance particularly of negative affect, makes it hard to read one’s interpersonal environment. Thus in adapting IPT for PTSD, we devote the early part of treatment to affective reattunement: helping patients to identify their emotions and to recognize them as helpful social signals. Once patients can read their feelings, they can put them to use to handle relationships better, deciding whom they can trust and whom they can’t. IPT for PTSD tends to focus on role transitions, which are usually inherent having been traumatized (2). Conclusions In the past there has been several kinds of research that show that group IPT and individual IPT reduce PTSD and depression in traumatized patients with PTSD. Disclosure No significant relationships.
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Falsetti, Sherry A., Jeannine Monnier, Joanne L. Davis, and Heidi S. Resnick. "Intrusive Thoughts in Posttraumatic Stress Disorder." Journal of Cognitive Psychotherapy 16, no. 2 (June 2002): 127–43. http://dx.doi.org/10.1891/jcop.16.2.127.63993.
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This article reviews the literature on prevalence, associated features, assessment, and treatment of intrusive symptoms associated with posttraumatic stress disorder (PTSD). Research indicates that among trauma survivors, intrusive thoughts and imagery are quite common and distressing. It appears that early intrusions may be predictive of long-term distress and that avoidance and suppression can maintain intrusions. The treatment outcome literature for PTSD indicates that current cognitive behavioral treatments are effective in reducing intrusions. New data from a recent treatment outcome study for PTSD with comorbid panic attacks, using Multiple Channel Exposure Therapy, also suggest that this treatment is effective in significantly reducing intrusions.
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Thomson, Paula, and S. Victoria Jaque. "Posttraumatic Stress Disorder and Psychopathology in Dancers." Medical Problems of Performing Artists 30, no. 3 (September 1, 2015): 157–62. http://dx.doi.org/10.21091/mppa.2015.3030.
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This study investigated the prevalence of posttraumatic stress disorder (PTSD) in pre-professional and professional dancers (n=209) who were exposed to traumatic events. Nine self-report instruments assessed (1) adverse childhood experiences, (2) past traumatic events, (3) coping strategies under stressful situations, and (4) fantasy proneness. The psychopathology variables included (5) anxiety, (6) depression, (7) dissociation, (8) shame, and (9) PTSD diagnostic scale. Statistical calculations included descriptive, distributional, and multivariate analysis of covariates (MANCOVA). Results indicate that dancers had a significantly higher distribution of PTSD (20.2%) compared to the normal population (7.8%). They also had a higher frequency of family members with mental illness, an inability to speak about their trauma, and more suicidal thoughts. The PTSD group of dancers had higher levels of psychopathology (anxiety, depression, dissociation, and shame) and they had more childhood adversity and adult trauma. Compared to the no-PTSD group, the PTSD group had higher scores on fantasy proneness and emotion-oriented coping strategies. These coping strategies may increase psychological instability. Addressing early abuse and trauma is recommended. Clinicians may help dancers alter their internal working models that their self is worthless, others are abusive, and the world is threatening and dangerous. By understanding PTSD in dancers, medical and mental health treatment protocols may be established to address the debilitating, and often hidden, symptoms of PTSD.
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Bryant, Richard A., and Allison G. Harvey. "Delayed-Onset Posttraumatic Stress Disorder: A Prospective Evaluation." Australian & New Zealand Journal of Psychiatry 36, no. 2 (April 2002): 205–9. http://dx.doi.org/10.1046/j.1440-1614.2002.01009.x.
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Objective: Delayed onset posttraumatic stress disorder (PTSD) refers to PTSD that develops at least 6 months after the traumatic event. This study aimed to index the features of patients who develop delayed-onset PTSD. Method: This study investigated delayed onset PTSD by prospectively assessing 103 motor vehicle accident survivors within 1 month of the motor vehicle accident for acute stress disorder, and subsequently assessing them for PTSD 6 months post-accident, and 2 years post-accident. Patients were initially assessed for symptoms of traumatic stress, anxiety, depression, and resting heart rate. Results: Five patients displayed PTSD 2 years post-trauma without meeting PTSD criteria 6 months posttrauma. Delayed onset cases were characterized by elevated psychopathology scores and resting heart rate levels within the initial month and elevated psychopathology 6 months posttrauma. Conclusions: These findings suggest that cases of delayed onset PTSD suffer subsyndromal levels of posttraumatic stress prior to the diagnosis of PTSD. These findings challenge the notion of PTSD developing after a period without symptoms.
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Campbell, Rebecca L., and Anne Germain. "Nightmares and Posttraumatic Stress Disorder (PTSD)." Current Sleep Medicine Reports 2, no. 2 (March 22, 2016): 74–80. http://dx.doi.org/10.1007/s40675-016-0037-0.
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Moss, Donald, Fredric Shaffer, and Matthew Watkins. "Posttraumatic Stress Disorder (PTSD): Level 4 – Efficacious." Biofeedback 50, no. 1 (March 1, 2022): 3–19. http://dx.doi.org/10.5298/1081-5937-50.1.02.
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Posttraumatic stress disorder (PTSD) is a psychophysiological disorder characterized by chronic sympathetic nervous system activation, persisting perceptual/sensory vigilance for threats, and recurrent distressing memories of a traumatic event. Persons with PTSD frequently experience intrusive memories, nightmares, and flashbacks lived as if in the present moment. Many also exhibit a persisting negative emotional state, including fear, anger, guilt, and shame (Badour et al., 2017; Moss, 2017). PTSD often produces significant disability, lowered quality of life, and functional impairment (Alonso et al., 2004). The syndrome and symptoms of PTSD have been reported since the early 1800s and described under various diagnostic labels as exhaustion, irritable heart, Da Costa syndrome, and shell shock. Kardiner (1941) described the condition as a physioneurosis, a disorder that is both physiological and psychological. The psychophysiological basis of PTSD calls for psychophysiologically based interventions. Bessel van der Kolk has highlighted the problems in PTSD with affect regulation and called for mind–body interventions such as yoga and neurofeedback (NF) to enhance affective self-regulation (van der Kolk, 2014; van der Kolk et al., 2014, 2016). The purpose of this article is to review the published research on applications of biofeedback (BFB) and NF treatment of PTSD. Much of the research on this topic is still exploratory; several studies were conducted to show the viability of specific protocols. Accordingly, the review will include pilot studies, quasi-experimental studies, and randomized controlled studies. There is an emerging body of research on whether BFB or NF training before combat deployment or before childbirth can prevent the development of PTSD (Hourani et al., 2016; Pyne et al., 2019; Schlesinger et al., 2020). This important research will not be reviewed here.
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Tan, Gabriel, Penelope Wang, and Jay Ginsberg. "Heart Rate Variability and Posttraumatic Stress Disorder." Biofeedback 41, no. 3 (September 1, 2013): 131–35. http://dx.doi.org/10.5298/1081-5937-41.3.05.
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The psychophysiology of posttraumatic stress disorder (PTSD) points towards autonomic dysregulation—specifically, elevated sympathetic response and attenuated parasympathetic response. In view of this, heart rate variability (HRV) biofeedback has been applied and tested as a treatment for PTSD. Review of existing published research suggests that HRV biofeedback seems promising as a treatment for PTSD, both in significantly alleviating the symptoms and in improving cognition for those suffering from PTSD. Drop-out rate is low, and inexpensive and portable HRV biofeedback devices such as the Stress Eraser make it a viable alternative to traditional treatment such as prolonged exposure therapy (PET), cognitive behavior therapy (CBT) and cognitive processing therapy (CPT). More recent research has also shown that combining HRV biofeedback with CBT, PET, and Acceptance and Commitment Therapy (ACT) improved the efficacy of these therapies in treating PTSD. More larger-scale and rigorous controlled trials are needed to confirm these outcomes.
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Mirzamani, Mahmoud, and Derek Bolton. "PTSD Symptoms of Mothers following Occurrence of a Disaster Affecting Their Children." Psychological Reports 90, no. 2 (April 2002): 431–38. http://dx.doi.org/10.2466/pr0.2002.90.2.431.
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This study investigated the PTSD symptoms of 37 mothers whose adolescent children had been directly involved in a disaster, the Jupiter sinking in 1988. This group included mothers whose children were (a) not diagnosed with Posttraumatic Stress Disorder and (b) were diagnosed with Posttraumatic Stress Disorder. The measure used was the Posttraumatic Stress Disorder Symptom Scale. Women whose children were involved in the disaster presented PTSD symptoms. 35% ( n = 13) were diagnosed with PTSD 3 mo. after the disaster, and 8% ( n = 3) of them were diagnosed with PTSD 6 yr. afterward. This effect was greater in the subgroup whose children had developed traumatic stress disorder following the disaster.
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Breslau, Naomi. "Epidemiologic Studies of Trauma, Posttraumatic Stress Disorder, and other Psychiatric Disorders." Canadian Journal of Psychiatry 47, no. 10 (December 2002): 923–29. http://dx.doi.org/10.1177/070674370204701003.
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This paper reviews recent epidemiologic studies of posttraumatic stress disorder (PTSD) in the general population. Estimates of the prevalence of exposure to traumatic events vary with the method used to ascertain trauma exposure and the definition of the stressor criterion. Changes in the DSM-IV definition of “stressor” have increased the number of traumatic events experienced in the community that can be used to diagnose PTSD and thus, the number of PTSD cases. Risk factors for PTSD in adults vary across studies. The 3 factors identified as having relatively uniform effects are 1) preexisting psychiatric disorders, 2) a family history of disorders, and 3) childhood trauma. In civilian populations, women are at a higher risk for PTSD than are men, following exposure to traumatic events. Most community residents have experienced 1 or more PTSD-level traumas in their lifetime, but only a few succumb to PTSD. Trauma victims who do not succumb to PTSD are not at an elevated risk for the subsequent onset of major depression or substance use disorders, compared with unexposed persons.
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Deters, Pamela B., and Lillian M. Range. "Does Writing Reduce Posttraumatic Stress Disorder Symptoms?" Violence and Victims 18, no. 5 (October 2003): 569–80. http://dx.doi.org/10.1891/vivi.2003.18.5.569.
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To see if writing about their trauma lessened PTSD and related symptoms, 57 undergraduates, previously screened for traumatic experiences, wrote for 15 minutes on 4 days across 2 weeks about either their trauma or a trivial topic. They reported PTSD, impact, suicide ideas, dissociation, and depression pre-, post-, and at 6-week follow-up testing. Trauma and trivial writers were not different. Surprisingly, at follow-up everyone reported less severe PTSD symptoms, impact, and dissociation, and fewer health visits, but about the same suicidal ideation and depression. On PTSD symptoms and impact, the pattern of improvement was different: Those writing about trauma got worse at posttesting, but improved to better than their initial state by follow-up. Those writing about a trivial topic got better by posttesting, and held that position at follow-up. In this project, writing seemed to reduce PTSD symptoms regardless of whether it concerned the trauma or what they ate for lunch.
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Khaitovych, M. V., and O. M. Misiura. "EPIDEMIOLOGY, PATHOPHYSIOLOGY AND TREATMENT OF POSTTRAUMATIC STRESS DISORDER. Review." Medical Science of Ukraine (MSU) 18, no. 1 (March 30, 2022): 40–53. http://dx.doi.org/10.32345/2664-4738.1.2022.07.
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Relevance. Posttraumatic stress disorder (PTSD) occurs in people who have suffered a traumatic event (during war, natural disaster, domestic violence, etc.) sometimes even many years after the injury, causing changes in psychological and behavioral levels.
Objective is to consider current data on the prevalence, pathophysiology and therapy of patients with PTSD.
Methods. Analysis of data presented by PubMed by keywords "posttraumatic stress", "prevalence", "pathophysiology", "psychotherapy", "psychopharmacology".
Results. PTSD is observed in 5-10% of the population, twice as often in women than in men, among children PTSD is found in 10%, in girls 4 times more often than in boys. During the war, PTSD is most often associated with stressful events such as bombing, homelessness, sieges, and combat. The highest prevalence of PTSD was among widows and widowers, divorcees, the unemployed and retirees. Hereditary sources of PTSD risk are shown on the basis of general genomic and epigenomic associations, transcriptomic and neuroimaging studies. Changes in the amygdala, islet, hippocampus, anterior cingulate cortex, and prefrontal cortex demonstrate that emotional dysregulation in PTSD occurs due to complications in the large neural network. Methods of non-pharmacological therapy of PTSD are presented and the effectiveness of drugs of different groups (antidepressants; antipsychotics; drugs that affect sympathetic activity, endocannabinoid system, etc.) is described.
Conclusions. Posttraumatic stress disorder is a common disorder that is often undiagnosed, leading to significant psychological and behavioral disorders, increasing the risk of suicide. The review presents modern ideas about its pathophysiology and treatment options.
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Schmidt, Ulrike, Florian Holsboer, and Theo Rein. "Epigenetic Aspects of Posttraumatic Stress Disorder." Disease Markers 30, no. 2-3 (2011): 77–87. http://dx.doi.org/10.1155/2011/343616.
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Development of psychiatric diseases such as posttraumatic stress disorder (PTSD) invokes, as with most complex diseases, both genetic and environmental factors. The era of genome-wide high throughput technologies has sparked the initiation of genotype screenings in large cohorts of diseased and control individuals, but had limited success in identification of disease causing genetic variants. It has become evident that these efforts at the genomic level need to be complemented with endeavours in elucidating the proteome, transcriptome and epigenetic profiles. Epigenetics is attractive in particular because there is accumulating evidence that the lasting impact of adverse life events is reflected in certain covalent modifications of the chromatin.In this review, we outline the characteristics of PTSD as a stress-related disease and survey recent developments revealing epigenetic aspects of stress-related disorders in general. There is also increasing direct evidence for gene programming and epigenetic components in PTSD. Finally, we discuss treatment options in the light of recent discoveries of epigenetic mechanisms of psychotropic drugs.
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Eagle, G. T. "Posttraumatic Stress Disorder (PTSD): The Malleable Diagnosis?" South African Journal of Psychology 32, no. 2 (June 2002): 37–42. http://dx.doi.org/10.1177/008124630203200205.
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The paper seeks to raise questions about the rigour of psychiatric diagnosis with specific reference to the diagnostic category of posttraumatic stress disorder (PTSD). It is argued that because of the inclusion of the stressor criterion (verifiable exposure to an external event) PTSD is very much located in consensual reality. In addition, because of its application to victims in extremity, the diagnosis cannot help but engage with people who are at the receiving end of abuses of power. Such characteristics shape PTSD as a somewhat uniquely socially-located diagnostic category and bring specific challenges to bear in the employment of the diagnosis. Not only is PTSD problematic in its location within a Western, medically-based system of classification, but it has also been drawn upon to serve explicitly political rather than purely clinical agendas. The political role of PTSD has tended to be most evident in the psycho-forensic domain where it has been cited in favour of both complainants and defendants, both perpetrators and victims. Examples of such evidence are discussed with particular emphasis on the role played by PTSD diagnosticians in the South African context. It is argued that the malleability of PTSD offers both problems and opportunities and that ultimately the integrity of the diagnosis may rest on moral as much as clinical principles. In this respect the paper seeks to illustrate that definitions of normality and abnormality in the psychiatric domain remain flawed and open to contestation and abuse. The importance of organizational and collegial support in grappling with these issues is also emphasized.
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Wheler, G. H. Trevor, David Brandon, Aaron Clemons, Crystal Riley, John Kendall, D. Lynn Loriaux, and J. David Kinzie. "Cortisol Production Rate in Posttraumatic Stress Disorder." Journal of Clinical Endocrinology & Metabolism 91, no. 9 (September 1, 2006): 3486–89. http://dx.doi.org/10.1210/jc.2006-0061.
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Abstract Context: Several authors have reported the unsuspected finding of low cortisol levels (urinary, salivary, and serum) in patients with posttraumatic stress disorder (PTSD). Objective: Our objective was to assess concentrations of cortisol and its predominant metabolites, cortisol production rate (CPR), and glucocorticoid receptor (GR) binding characteristics in PTSD compared with normal subjects. Design: Matched PTSD patients and control subjects had CPR determined by a stable isotope dilution technique after infusion of deuterated cortisol. Serum cortisol, urinary cortisol, and its metabolites were measured by gas chromatography/mass spectrometry. GR binding capacity (Ro) and ligand binding affinity (Kd) were measured in mononuclear leukocytes. Setting: All subjects were tested during a 40-h admission in an inpatient clinical research center. Patients and Participants: Ten patients with PTSD were matched by age and gender with 10 controls. Outcome Measures: Statistical comparison was conducted for various measures of cortisol in PTSD patients and normal subjects. Results: No statistical difference was found in mean level or circadian pattern of cortisol secretion using serum or salivary immunoassay detection methods. Although in the normal range, urinary cortisol by immunoassay showed statistically lower values over a 24-h period in PTSD patients compared with controls. This finding was not confirmed by gas chromatography/mass spectrometry determination of cortisol or its metabolites. CPR was not statistically different between these groups. GR also showed no alteration in Ro or Kd between the groups. Conclusion: The data indicate that PTSD in the chronic and unprovoked state is not characterized by an acute biological stress response.
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Bryant, Richard A., and Allison G. Harvey. "Gender Differences in the Relationship Between Acute Stress Disorder and Posttraumatic Stress Disorder Following Motor Vehicle Accidents." Australian & New Zealand Journal of Psychiatry 37, no. 2 (April 2003): 226–29. http://dx.doi.org/10.1046/j.1440-1614.2003.01130.x.
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Objective: Acute stress disorder (ASD) describes initial posttraumatic stress reactions that purportedly predict subsequent posttraumatic stress disorder (PTSD). This study aimed to index the influence of gender on the relationship between ASD and PTSD. Method: Motor vehicle accident survivors were assessed for ASD within 1-month posttrauma (n = 171) and were subsequently assessed for PTSD 6-months later (n = 134). Results: Acute stress disorder was diagnosed in 8% of males and 23% of females, and PTSD was diagnosed in 15% of males and 38% of females. In terms of patients followed up at 6 months, 57% and 92% of males and females, respectively, who met criteria for ASD were diagnosed with PTSD. Females displayed significantly more peritraumatic dissociation than males. Conclusion: Peritraumatic dissociation and ASD is a more accurate predictor of PTSD in females than males. This gender difference may be explained in terms of response bias or biological differences in trauma response between males and females.
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Alderman, Christopher P., Linda C. McCarthy, John T. Condon, Anita C. Marwood, and Judith R. Fuller. "Topiramate in Combat-Related Posttraumatic Stress Disorder." Annals of Pharmacotherapy 43, no. 4 (March 31, 2009): 635–41. http://dx.doi.org/10.1345/aph.1l578.
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Background: Posttraumatic stress disorder (PTSD) is a disabling psychiatric disorder that is common among combat veterans and may lead to very poor sleep and disturbing nightmares. Objective: To examine the safety and effectiveness of topiramate as add-on therapy for the management of combat-related PTSD and to examine the effects of topiramate on sleep and alcohol consumption. Methods: We conducted an 8-week open-label pilot study of topiramate (or male combat veterans (N = 43) with PTSD, with analysis of veterans who completed the protocol. Psychometric, sleep, and alcohol consumption assessments were conducted at baseline and at week 8. Results: Twenty-nine subjects completed the 8-week study. Significant reductions in Clinician Administered PTSD Scale scores were observed at the 8-week endpoint (from 86,3 ± 21.1 to 67.1 ± 25.1; p < 0.01). Decreases were seen in both Stanford Sleepiness Scale scores (from 10.5 ± 0.72 to 9.0 ± 0.58; p = 0.08) and Mississippi PTSD scores (from 120.4 ± 6.5 to 111.5 ± 20.9; p = 0.08), but the extent of the changes did not attain statistical significance for either scale. There was a significant reduction in the proportion of patients with nightmares (from 100% to 62%; p < 0.001) and patients who experienced anxiety that interfered with falling asleep (from 90% to 62%; p < 0.05). The proportion of patients with high-risk drinking patterns also decreased (from 31% to 14%). Two serious adverse events were reported during the study: an increase in tow back pain and an episode of acute confusion. Conclusions: When used in addition to other empiric therapy, topiramate may be effective at reducing general symptoms of combat-related PTSD and reducing high-risk alcohol intake and nightmares. Further randomized controlled trials of topiramate for the treatment of combat-related PTSD are warranted.
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Voicehovskis, Vladimirs, Gunta Ancāne, Jūlija Voicehovska, Grigorijs Orļikovs, Jurijs Karpovs, Igors Ivanovs, Andrejs Šķesters, et al. "Oxidative Stress Parameters in Posttraumatic Stress Disorder Risk Group Patients." Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences 66, no. 6 (December 1, 2012): 242–50. http://dx.doi.org/10.2478/v10046-012-0016-x.
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Increased excitotoxity in response to stressors leads to oxidative stress (OS) due to accumulation of excess reactive oxygen/nitrogen species. Neuronal membrane phospholipids are especially susceptible to oxidative damage, which alters signal transduction mechanisms. The Contingent of International Operations (CIO) has been subjected to various extreme stressors that could cause Posttraumatic Stress Disorder (PTSD). Former studies suggest that heterogeneity due to gender, race, age, nutritional condition and variable deployment factors and stressors produce challenges in studying these processes. The research aim was to assess OS levels in the PTSD risk group in CIO. In a prospective study, 143 participants who were Latvian CIO, regular personnel, males, Europeans, average age of 27.4, with the same tasks during the mission, were examined two months before and immediately after a six-month Peace Support Mission (PSM) in Afghanistan. PCL-M questionnaire, valid Latvian language “Military” version was used for PTSD evaluation. Glutathione peroxidase (GPx), superoxide dismutase (SOD) and lipid peroxidation intensity and malondialdehyde (MDA) as OS indicators in blood were determined. Data were processed using SPSS 20.0. The MDA baseline was 2.5582 μM, which after PSM increased by 24.36% (3.1815 μM). The GPx baseline was 8061.98 U/L, which after PSM decreased by 9.35% (7308.31 U/L). The SOD baseline was 1449.20 U/gHB, which after PSM increased by 2.89% (1491.03 U/gHB). The PTSD symptom severity (total PCL-M score) baseline was 22.90 points, which after PSM increased by 14.45% (26.21 points). The PTSD Prevalence rate (PR) baseline was 0.0357, which after PSM increased by 147.06% (0.0882). We conclude that there is positive correlation between increase of OS, PTSD symptoms severity level, and PTSD PR in a group of patients with risk of PTSD - CIO. PTSD PR depends on MDA intensity and OS severity. OS and increased free radical level beyond excitotoxity, is a possible causal factor for clinical manifestation of PTSD
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Nietlisbach, Gabriela, Andreas Maercker, Wulf Rösler, and Helene Haker. "Are Empathic Abilities Impaired in Posttraumatic Stress Disorder?" Psychological Reports 106, no. 3 (June 2010): 832–44. http://dx.doi.org/10.2466/pr0.106.3.832-844.
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Trauma survivors with PTSD show social interaction and relationship impairments. It is hypothesized that traumatic experiences lead to known PTSD symptoms, empathic ability impairment, and difficulties in sharing affective, emotional, or cognitive states. A PTSD group ( N = 16) and a nontraumatized Control group ( N = 16) were compared on empathic abilities, namely the Empathic Resonance Test, Reading the Mind in the Eyes Test, and Faux Pas Test. The Interpersonal Reactivity Index as a self-report measure of empathy and measures of nonsocial cognitive functions, namely the Verbal Fluency Test, the Five-Point Test, and the Stroop Test, were also administered. The PTSD group showed lower empathic resonance. No clear indications of other impairments in social cognitive functions were found. The PTSD group had significantly higher personal distress. Empathic resonance impairments did not correlate with subjective severity of PTSD symptomatology. This article discusses whether impaired empathic resonance in PTSD trauma survivors is a consequence of trauma itself or a protective coping strategy.
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Liberzon, Israel, and K. Luan Phan. "Brain-Imaging Studies of Posttraumatic Stress Disorder." CNS Spectrums 8, no. 9 (September 2003): 641–50. http://dx.doi.org/10.1017/s109285290000883x.
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ABSTRACTBrain-imaging studies of posttraumatic stress disorder (PTSD) have rapidly increased in recent years. Structural studies have identified potential smaller volumes of the hippocampus of traumatized and/or PTSD subjects. Functional activation studies have implicated hyperactive or altered functioning of brain regions, such as the amygdala and the insula, and a failure to engage emotional regulatory structures, such as the medial prefrontal and anterior cingulate cortex. Recent neurochemical investigations have suggested that neuromodulatory systems (eg, γ-aminobutyric acid, μ-opioid) may underlie these aberrant brain activation patterns. This article reviews the literature on structural, functional, and neurochemical brain-imaging studies of PTSD.
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Kröger, Christoph, and Sören Kliem. "Screening for Posttraumatic Stress Disorder." European Journal of Psychological Assessment 30, no. 2 (January 1, 2014): 93–99. http://dx.doi.org/10.1027/1015-5759/a000174.
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Symptom-based self-rating measures were established to detect individuals with posttraumatic stress disorder (PTSD) after specific traumatic events. The aim of the present study was to compare the diagnostic efficiency of the German version of the Trauma Screening Questionnaire (TSQ), the Posttraumatic Diagnostic Scale (PDS), and an 8-item subset of the PDS. Receiver-operating-characteristic analyses are determined in a treatment-seeking outpatient sample (N = 208) with mixed trauma type. The areas under the curve (AUC) for all measures were found to be moderate (AUC = 0.77–0.81); hence, measures did not differ in terms of their discriminatory abilities. Using the favored cutoff points, sensitivity (53–81%) and specificity (71–84%) values were at a level that was only moderate. Considering the high economic burden due to PTSD and the moderate specificity values, a two-stage screening approach might result in only moderate cost-efficiency for treatment-seeking outpatients. In addition, our results support the notion that discriminatory abilities and operating characteristics based on samples with a specific trauma type have to be cross-validated.
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Hamner, Mark B., Sophie Robert, and B. Christopher Frueh. "Treatment-Resistant Posttraumatic Stress Disorder: Strategies for Intervention." CNS Spectrums 9, no. 10 (October 2004): 740–52. http://dx.doi.org/10.1017/s1092852900022380.
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AbstractThe mainstay of treatment for chronic posttraumatic stress disorder (PTSD) is a combination of psychotherapy and medication treatments. The first-line medications for PTSD are antidepressants, with two selective serotonin reuptake inhibitors (sertraline and paroxetine) currently Food and Drug Administration-indicated for PTSD. However, many patients do not have an adequate response to antidepressants, therefore, combinations with other antidepressants or with other classes of psychotropic medication are often utilized to enhance the therapeutic response. Other agents that have been used include mood stabilizers, antiadrenergics, anxiolytics, and atypical antipsychotics. The heterogeneity of symptom clusters in PTSD as well as the complex psychiatric comorbidities (eg, with depression or substance abuse) further support the notion that combinations of medications may be needed. To date, there is a paucity of data to support specific strategies for augmenting antidepressants in PTSD. This review will address representative existing studies and discuss several potential pharmacologic strategies for patients suffering from treatment refractory PTSD.
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Moraru, Corneliu A., Elena D. Năfureanu, Adelina Proca, Iuliana Zavadovschi, Mariana Floria, and Dragoș M. Popescu. "Post-traumatic stress disorder and cardiovascular disease." Romanian Journal of Military Medicine 125, no. 1 (February 1, 2022): 97–111. http://dx.doi.org/10.55453/rjmm.2022.125.1.13.
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Posttraumatic stress disorder (PTSD) is a psychological-psychiatric state caused by exposure to stressful, traumatic events that manifests as a vivid reminiscence of them by flashbacks, nightmares, reccurent memories, emotional and physical manifestations. Cardiovascular diseases (CVD) are of interest in patients suffering from PTSD because there is an increasing body of evidence that these pathologies are linked. Hypertension, dyslipidemia, diabetes, and other cardiovascular risk factors are common in patients with PTSD and all of them increase the incidence of coronary syndromes, both chronic and acute. Posttraumatic stress disorder has a major impact on the lifestyle and health of subjects exposed to trauma or stress. Cardiovascular diseases tend to appear sooner in PTSD diagnosed patients due to a variety of reasons: poor habits, low addressability to health care systems, chronic inflammation status, changes at molecular levels, etc. Otherwise, PTSD tends to be induced by CVD, thus inclining the balance towards whis association. According with data published until now, there is a strong pathophysiologic relatonship between PTSD and some CVD; there is also outlining a vice versa relationship, from some CVD to PTSD.
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Koltek, Mark, TCR Wilkes, and Mark Atkinson. "The Prevalence of Posttraumatic Stress Disorder in an Adolescent Inpatient Unit." Canadian Journal of Psychiatry 43, no. 1 (February 1998): 64–68. http://dx.doi.org/10.1177/070674379804300107.
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Objective: To examine the prevalence and comorbidity of posttraumatic stress disorder (PTSD) in an adolescent inpatient population. A 2-year retrospective chart study was conducted. Method: Computer-registered data of discharge records from 1993 and 1994 were recovered. Patients were grouped by diagnosis; frequency and chi-square statistical analyses were performed to ascertain the prevalence and the comorbidity of various diagnoses with PTSD. Results: A total of 187patients, 114 females and 73 males, with a mean age of 15 years were reviewed, and 42% (79) of all patients had a diagnosis of PTSD using DSM-III-R criteria. There were 54 females and 25 males with PTSD; however, gender effect was not clinically significant. Associated comorbidity reaching clinical significance included other anxiety disorders (P = 0.008) and depressive disorders (P = 0.003). Asthma was diagnosed as a significant clinical disorder (P = 0.05) comorbid with PTSD. PTSD diagnoses correlated strongly with a history of abuse (P = 0.0001). Conclusions: PTSD occurs frequently in adolescent inpatients and is commonly comorbid with other diagnostic presentations. These findings may affect the management of PTSD and prognosis for this population.
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Daugirdaitė, Viltė, Olga van den Akker, and Satvinder Purewal. "Posttraumatic Stress and Posttraumatic Stress Disorder after Termination of Pregnancy and Reproductive Loss: A Systematic Review." Journal of Pregnancy 2015 (2015): 1–14. http://dx.doi.org/10.1155/2015/646345.
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Objective. The aims of this systematic review were to integrate the research on posttraumatic stress (PTS) and posttraumatic stress disorder (PTSD) after termination of pregnancy (TOP), miscarriage, perinatal death, stillbirth, neonatal death, and failed in vitro fertilisation (IVF).Methods. Electronic databases (AMED, British Nursing Index, CINAHL, MEDLINE, SPORTDiscus, PsycINFO, PubMEd, ScienceDirect) were searched for articles using PRISMA guidelines.Results. Data from 48 studies were included. Quality of the research was generally good. PTS/PTSD has been investigated in TOP and miscarriage more than perinatal loss, stillbirth, and neonatal death. In all reproductive losses and TOPs, the prevalence of PTS was greater than PTSD, both decreased over time, and longer gestational age is associated with higher levels of PTS/PTSD. Women have generally reported more PTS or PTSD than men. Sociodemographic characteristics (e.g., younger age, lower education, and history of previous traumas or mental health problems) and psychsocial factors influence PTS and PTSD after TOP and reproductive loss.Conclusions. This systematic review is the first to investigate PTS/PTSD after reproductive loss. Patients with advanced pregnancies, a history of previous traumas, mental health problems, and adverse psychosocial profiles should be considered as high risk for developing PTS or PTSD following reproductive loss.
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Malgaroli, Matteo, and Katharina Schultebraucks. "Artificial Intelligence and Posttraumatic Stress Disorder (PTSD)." European Psychologist 25, no. 4 (October 2020): 272–82. http://dx.doi.org/10.1027/1016-9040/a000423.
Full textAbstract:
Abstract. Posttraumatic stress disorder (PTSD) is a debilitating disease that can occur after experiencing a traumatic event. Despite recent progress in computational research, it has not yet been possible to identify precise and reliable risk factors that enable predictive models of individual risk for posttraumatic stress after trauma. In this overview, we discuss recent advances in the use of Machine Learning (ML) and Artificial Intelligence (AI) for risk stratification and targeted treatment allocation in the context of stress pathologies and we critically review the benefits and challenges of emerging approaches. The vast heterogeneity in the manifestation and the etiology of PTSD is discussed as one major reason for the need to deploy ML-based computational models to better account for individual differences between patients. Striving for personalized medicine is one of the most important goals of current clinical research and is of great potential for the field of posttraumatic stress research. The use of ML is a promising and necessary approach for reaching more personalized treatments and to make further progress in the field of precision psychiatry.