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Yaeger JDW, Krupp KT, Summers TR, Summers CH. Contextual generalization of social stress learning is modulated by orexin receptors in basolateral amygdala. Neuropharmacology 2022; 215:109168. [PMID: 35724928 PMCID: PMC9285878 DOI: 10.1016/j.neuropharm.2022.109168] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 01/22/2023]
Abstract
Fear-associated memories and behavior are often expressed in contexts/environments distinctively different from those in which they are created. This generalization process contributes to psychological disorders, particularly PTSD. Stress-related neurocircuits in the basolateral amygdala (BLA) receive inputs from hypothalamic orexin (Orx) neurons, which mediate neuronal activity by targeting orexin 1 (Orx1R) and orexin 2 (Orx2R) receptors via opposing functions. In BLA, inhibition of Orx1R or activation of Orx2R ameliorate stress responsiveness and behavior. We discovered that most Orx1R+ cells also express CamKIIα, while a majority of Orx2R+ cells are colocalized with GAD67. Further, Orx1R gene Hcrtr1 expression was positively correlated, and Orx2R gene Hcrtr2 expression was negatively correlated, with freezing in a phenotype-dependent fashion (Escape vs Stay) in the Stress Alternatives Model (SAM). The SAM consists of 4-days of social interaction between test mice and novel larger aggressors. Exits positioned at opposite ends of the SAM oval arena provide opportunities to actively avoid aggression. By Day 2, mice commit to behavioral phenotypes: Escape or Stay. Pharmacologically manipulating Orx receptor activity in the BLA, before Day 3 of the SAM, was followed with standard tests of anxiety: Open Field (OF) and Elevated Plus Maze (EPM). In Stay mice, freezing in response to social conflict and locomotion during SAM interaction (not home cage locomotion) were generalized to OF, and blocked by intra-BLA Orx1R antagonism, but not Orx2R antagonism. Moreover, patterns of social avoidance for Escape and Stay mice were recapitulated in OF, with generalization mediated by Orx1R and Orx2R antagonism, plus Orx2R stimulation.
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Affiliation(s)
- Jazmine D W Yaeger
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA; Veterans Affairs Research Service, Sioux Falls VA Health Care System, Sioux Falls, SD, 57105, USA; Pediatrics and Rare Diseases Group, Sanford Research, Sioux Falls, SD, 57104, USA
| | - Kevin T Krupp
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA
| | - Tangi R Summers
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA; Veterans Affairs Research Service, Sioux Falls VA Health Care System, Sioux Falls, SD, 57105, USA
| | - Cliff H Summers
- Department of Biology, University of South Dakota, Vermillion, SD, 57069, USA; Neuroscience Group, Division of Basic Biomedical Sciences, Sanford School of Medicine, University of South Dakota, Vermillion, SD, 57069, USA; Veterans Affairs Research Service, Sioux Falls VA Health Care System, Sioux Falls, SD, 57105, USA.
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Carmi L, Zohar J, Weissman T, Juven-Wetzler A, Bierer L, Yehuda R, Cohen H. Hydrocortisone in the emergency department: a prospective, double-blind, randomized, controlled posttraumatic stress disorder study. Hydrocortisone during golden hours. CNS Spectr 2022; 28:1-7. [PMID: 35678177 DOI: 10.1017/s1092852922000852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES A blunted response of the hypothalamic-pituitary-adrenal axis immediately after exposure to traumatic events has been proposed as a risk factor for posttraumatic stress disorder (PTSD). Accordingly, administration of hydrocortisone in the aftermath of a traumatic event is indicated. This study consisted of a randomized, placebo-controlled, double-blind trial investigating whether a single intravenous dose of hydrocortisone administered within 6 hours after exposure to trauma would reduce the incidence of PTSD at the 13-month follow-up. METHODS A total of 118 consented patients with acute stress symptoms were administered a single intravenous bolus of hydrocortisone/placebo within 6 hours of the traumatic event. Blood samples were taken before hydrocortisone administration. RESULTS At 13 months, the hydrocortisone group did not differ from the placebo group regarding PTSD prevalence or symptom severity. However, a significant interaction between time of the trauma (ie, night, when cortisol's level is low) and treatment was found. Specifically, a lower prevalence of PTSD was found at the 13-month follow-up in the hydrocortisone night group. CONCLUSIONS Administration of hydrocortisone within 6 hours of the traumatic event was not effective in preventing PTSD compared to placebo. However, nocturnal administration (when cortisol levels are low) may suggest a new venue for research.
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Affiliation(s)
- Lior Carmi
- Post Trauma Center, Chaim Sheba Medical Center, Ramat Gan, Israel
- The Data Science Institution, The Inter Disciplinary Center, Herzliya, Israel
| | - Joseph Zohar
- Post Trauma Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Tal Weissman
- Post Trauma Center, Chaim Sheba Medical Center, Ramat Gan, Israel
| | | | - Linda Bierer
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rachel Yehuda
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- PTSD Clinical Research Program & Laboratory of Clinical Neuroendocrinology and Neurochemistry, James J. Peters Veterans Affairs Medical Center, New York, NY, USA
| | - Hagit Cohen
- Anxiety and Stress Research Unit, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Raut SB, Canales JJ, Ravindran M, Eri R, Benedek DM, Ursano RJ, Johnson LR. Effects of propranolol on the modification of trauma memory reconsolidation in PTSD patients: A systematic review and meta-analysis. J Psychiatr Res 2022; 150:246-256. [PMID: 35405409 DOI: 10.1016/j.jpsychires.2022.03.045] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 03/13/2022] [Accepted: 03/24/2022] [Indexed: 10/18/2022]
Abstract
Post-traumatic stress disorder (PTSD) develops after an exposure to a life-threatening event and is characterized by intrusive memories. According to memory reconsolidation theory retrieval of memory under certain conditions leads to its labilization and subsequent re-storage which could be disrupted by drugs. Propranolol has been the most commonly investigated drug for memory reconsolidation therapy in clinical trials. Intervention with propranolol have shown mixed results in PTSD patients with some studies showing improvement in symptoms while other failing to replicate these findings. We conducted a systematic review and meta-analysis to determine the efficacy of trauma memory disruption by propranolol on PTSD symptoms and physiological responses in PTSD patients. 3224 publications were assessed for eligibility. Seven studies on effects of propranolol on PTSD symptoms and 3 studies on effects of propranolol on physiological responses were incorporated in the meta-analyses. Overall, results indicate that propranolol did not show a beneficial effect on PTSD symptoms (standardized mean difference: 1.29; 95% CI = -2.16 - 0.17). Similarly, propranolol did not influence skin conductance (standardized mean difference: 0.77; 95% CI = -1.85 - 0.31) or EMG response (standardized mean difference: 0.16; 95% CI = -0.65 - 0.33). However, propranolol significantly reduced heart rate after trauma memory recall compared to placebo (standardized mean difference: 0.67; 95% CI = -1.27 to -0.07). This study finds a lack of evidence for the efficacy of propranolol on traumatic memory disruption, in PTSD patients, to recommend its routine clinical use. However, a high level of heterogeneity, variation in propranolol dosage and inadequate sample sizes mean that these findings require cautious interpretation.
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Affiliation(s)
- Sanket B Raut
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia
| | - Juan J Canales
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia
| | - Manoj Ravindran
- Department of Psychiatry, North West Private Hospital, Burnie, TAS, Australia
| | - Rajaraman Eri
- Health Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia
| | - David M Benedek
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, 20814, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, 20814, USA
| | - Luke R Johnson
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS, 7250, Australia; Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD, 20814, USA.
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Pupat A, Dewailly A, Guidot F, Duagani Y, Kawesa E, Carriere R, Mbazzi FB. Global initiative for stress and trauma treatment - traumatic stress relief training for allied and para-professionals to treat traumatic stress in underserved populations: A case study. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2022. [DOI: 10.1016/j.ejtd.2021.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Dunsmoor JE, Cisler JM, Fonzo GA, Creech SK, Nemeroff CB. Laboratory models of post-traumatic stress disorder: The elusive bridge to translation. Neuron 2022; 110:1754-1776. [PMID: 35325617 PMCID: PMC9167267 DOI: 10.1016/j.neuron.2022.03.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/18/2022] [Accepted: 02/28/2022] [Indexed: 12/14/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating mental illness composed of a heterogeneous collection of symptom clusters. The unique nature of PTSD as arising from a precipitating traumatic event helps simplify cross-species translational research modeling the neurobehavioral effects of stress and fear. However, the neurobiological progress on these complex neural circuits informed by animal models has yet to produce novel, evidence-based clinical treatment for PTSD. Here, we provide a comprehensive overview of popular laboratory models of PTSD and provide concrete ideas for improving the validity and clinical translational value of basic research efforts in humans. We detail modifications to simplified animal paradigms to account for myriad cognitive factors affected in PTSD, which may contribute to abnormalities in regulating fear. We further describe new avenues for integrating different areas of psychological research underserved by animal models of PTSD. This includes incorporating emerging trends in the cognitive neuroscience of episodic memory, emotion regulation, social-emotional processes, and PTSD subtyping to provide a more comprehensive recapitulation of the human experience to trauma in laboratory research.
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Affiliation(s)
- Joseph E Dunsmoor
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Austin, TX, USA; Center for Psychedelic Research and Therapy, University of Texas at Austin Dell Medical School, Austin, TX, USA.
| | - Josh M Cisler
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Austin, TX, USA; Institute for Early Life Adversity Research, University of Texas at Austin, Austin, TX, USA; Center for Psychedelic Research and Therapy, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Gregory A Fonzo
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Austin, TX, USA; Institute for Early Life Adversity Research, University of Texas at Austin, Austin, TX, USA; Center for Psychedelic Research and Therapy, University of Texas at Austin Dell Medical School, Austin, TX, USA
| | - Suzannah K Creech
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Austin, TX, USA; Institute for Early Life Adversity Research, University of Texas at Austin, Austin, TX, USA
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin Dell Medical School, Austin, TX, USA; Institute for Early Life Adversity Research, University of Texas at Austin, Austin, TX, USA; Center for Psychedelic Research and Therapy, University of Texas at Austin Dell Medical School, Austin, TX, USA.
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Kaplan GB, Lakis GA, Zhoba H. Sleep-Wake and Arousal Dysfunctions in Post-Traumatic Stress Disorder:Role of Orexin Systems. Brain Res Bull 2022; 186:106-122. [PMID: 35618150 DOI: 10.1016/j.brainresbull.2022.05.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/20/2022] [Accepted: 05/10/2022] [Indexed: 12/15/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a trauma-related condition that produces distressing fear memory intrusions, avoidance behaviors, hyperarousal/startle, stress responses and insomnia. This review focuses on the importance of the orexin neural system as a novel mechanism related to the pathophysiology of PTSD. Orexinergic neurons originate in the lateral hypothalamus and project widely to key neurotransmitter system neurons, autonomic neurons, the hypothalamic-pituitaryadrenal (HPA) axis, and fear-related neural circuits. After trauma or stress, the basolateral amygdala (BLA) transmits sensory information to the central nucleus of the amygdala (CeA) and in turn to the hypothalamus and other subcortical and brainstem regions to promote fear and threat. Orexin receptors have a prominent role in this circuit as fear conditioned orexin receptor knockout mice show decreased fear expression while dual orexin receptor antagonists (DORAs) inhibit fear acquisition and expression. Orexin activation of an infralimbic-amygdala circuit impedes fear extinction while DORA treatments enhance it. Increased orexin signaling to the amygdalocortical- hippocampal circuit promotes avoidance behaviors. Orexin has an important role in activating sympathetic nervous system (SNS) activity and the HPA axis stress responses. Blockade of orexin receptors reduces fear-conditioned startle responses. In PTSD models, individuals demonstrate sleep disturbances such as increased sleep latency and more transitions to wakefulness. Increased orexin activity impairs sleep by promoting wakefulness and reducing total sleep time while DORA treatments enhance sleep onset and maintenance. The orexinergic neural system provides important mechanisms for understanding multiple PTSD behaviors and provides new medication targets to treat this often persistent and debilitating illness.
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Affiliation(s)
- Gary B Kaplan
- Mental Health Service, VA Boston Healthcare System, West Roxbury, MA, 02132 USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, 02118 USA; Department of Pharmacology and Experimental Therapeutics, Boston University School of Medicine, Boston, MA, 02118 USA.
| | - Gabrielle A Lakis
- Research Service, VA Boston Healthcare System, West Roxbury, MA, 02132 USA; Undergraduate Program in Neuroscience, Boston University, Boston, MA, 02215 USA
| | - Hryhoriy Zhoba
- Research Service, VA Boston Healthcare System, West Roxbury, MA, 02132 USA
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Ressler KJ, Berretta S, Bolshakov VY, Rosso IM, Meloni EG, Rauch SL, Carlezon WA. Post-traumatic stress disorder: clinical and translational neuroscience from cells to circuits. Nat Rev Neurol 2022; 18:273-288. [PMID: 35352034 PMCID: PMC9682920 DOI: 10.1038/s41582-022-00635-8] [Citation(s) in RCA: 116] [Impact Index Per Article: 58.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/18/2022] [Indexed: 01/16/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a maladaptive and debilitating psychiatric disorder, characterized by re-experiencing, avoidance, negative emotions and thoughts, and hyperarousal in the months and years following exposure to severe trauma. PTSD has a prevalence of approximately 6-8% in the general population, although this can increase to 25% among groups who have experienced severe psychological trauma, such as combat veterans, refugees and victims of assault. The risk of developing PTSD in the aftermath of severe trauma is determined by multiple factors, including genetics - at least 30-40% of the risk of PTSD is heritable - and past history, for example, prior adult and childhood trauma. Many of the primary symptoms of PTSD, including hyperarousal and sleep dysregulation, are increasingly understood through translational neuroscience. In addition, a large amount of evidence suggests that PTSD can be viewed, at least in part, as a disorder that involves dysregulation of normal fear processes. The neural circuitry underlying fear and threat-related behaviour and learning in mammals, including the amygdala-hippocampus-medial prefrontal cortex circuit, is among the most well-understood in behavioural neuroscience. Furthermore, the study of threat-responding and its underlying circuitry has led to rapid progress in understanding learning and memory processes. By combining molecular-genetic approaches with a translational, mechanistic knowledge of fear circuitry, transformational advances in the conceptual framework, diagnosis and treatment of PTSD are possible. In this Review, we describe the clinical features and current treatments for PTSD, examine the neurobiology of symptom domains, highlight genomic advances and discuss translational approaches to understanding mechanisms and identifying new treatments and interventions for this devastating syndrome.
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Affiliation(s)
- Kerry J Ressler
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA.
| | - Sabina Berretta
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Vadim Y Bolshakov
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Isabelle M Rosso
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Edward G Meloni
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Scott L Rauch
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - William A Carlezon
- SPARED Center, Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, MA, USA
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Raut SB, Marathe PA, van Eijk L, Eri R, Ravindran M, Benedek DM, Ursano RJ, Canales JJ, Johnson LR. Diverse therapeutic developments for post-traumatic stress disorder (PTSD) indicate common mechanisms of memory modulation. Pharmacol Ther 2022; 239:108195. [PMID: 35489438 DOI: 10.1016/j.pharmthera.2022.108195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/20/2022]
Abstract
Post-traumatic stress disorder (PTSD), characterized by abnormally persistent and distressing memories, is a chronic debilitating condition in need of new treatment options. Current treatment guidelines recommend psychotherapy as first line management with only two drugs, sertraline and paroxetine, approved by U.S. Food and Drug Administration (FDA) for treatment of PTSD. These drugs have limited efficacy as they only reduce symptoms related to depression and anxiety without producing permanent remission. PTSD remains a significant public health problem with high morbidity and mortality requiring major advances in therapeutics. Early evidence has emerged for the beneficial effects of psychedelics particularly in combination with psychotherapy for management of PTSD, including psilocybin, MDMA, LSD, cannabinoids, ayahuasca and ketamine. MDMA and psilocybin reduce barrier to therapy by increasing trust between therapist and patient, thus allowing for modification of trauma related memories. Furthermore, research into the memory reconsolidation mechanisms has allowed for identification of various pharmacological targets to disrupt abnormally persistent memories. A number of pre-clinical and clinical studies have investigated novel and re-purposed pharmacological agents to disrupt fear memory in PTSD. Novel therapeutic approaches like neuropeptide Y, oxytocin, cannabinoids and neuroactive steroids have also shown potential for PTSD treatment. Here, we focus on the role of fear memory in the pathophysiology of PTSD and propose that many of these new therapeutic strategies produce benefits through the effect on fear memory. Evaluation of recent research findings suggests that while a number of drugs have shown promising results in preclinical studies and pilot clinical trials, the evidence from large scale clinical trials would be needed for these drugs to be incorporated in clinical practice.
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Affiliation(s)
- Sanket B Raut
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia
| | - Padmaja A Marathe
- Department of Pharmacology and Therapeutics, Seth GS Medical College & KEM Hospital, Parel, Mumbai 400 012, India
| | - Liza van Eijk
- Department of Psychology, College of Healthcare Sciences, James Cook University, QLD 4811, Australia
| | - Rajaraman Eri
- Health Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia
| | - Manoj Ravindran
- Medicine, College of Health and Medicine, University of Tasmania, TAS 7250, Australia; Department of Psychiatry, North-West Private Hospital, Burnie TAS 7320, Australia
| | - David M Benedek
- Centre for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD 20814, USA
| | - Robert J Ursano
- Centre for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD 20814, USA
| | - Juan J Canales
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia
| | - Luke R Johnson
- Schools of Psychological Sciences, College of Health and Medicine, University of Tasmania, TAS 7250, Australia; Centre for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University School of Medicine, Bethesda, MD 20814, USA.
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Traniello IM, Hamilton AR, Gernat T, Cash-Ahmed AC, Harwood GP, Ray AM, Glavin A, Torres J, Goldenfeld N, Robinson GE. Context-dependent influence of threat on honey bee social network dynamics and brain gene expression. J Exp Biol 2022; 225:jeb243738. [PMID: 35202460 PMCID: PMC9001921 DOI: 10.1242/jeb.243738] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 02/17/2022] [Indexed: 11/20/2022]
Abstract
Adverse social experience affects social structure by modifying the behavior of individuals, but the relationship between an individual's behavioral state and its response to adversity is poorly understood. We leveraged naturally occurring division of labor in honey bees and studied the biological embedding of environmental threat using laboratory assays and automated behavioral tracking of whole colonies. Guard bees showed low intrinsic levels of sociability compared with foragers and nurse bees, but large increases in sociability following exposure to a threat. Threat experience also modified the expression of caregiving-related genes in a brain region called the mushroom bodies. These results demonstrate that the biological embedding of environmental experience depends on an individual's societal role and, in turn, affects its future sociability.
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Affiliation(s)
- Ian M. Traniello
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Adam R. Hamilton
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Tim Gernat
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Swarm Intelligence and Complex Systems Group, Department of Computer Science, Leipzig University, Liepzig D-04109, Germany
| | - Amy C. Cash-Ahmed
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Gyan P. Harwood
- Department of Entomology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Allyson M. Ray
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Abigail Glavin
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Jacob Torres
- Department of Entomology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Nigel Goldenfeld
- Department of Physics, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| | - Gene E. Robinson
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
- Department of Entomology, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
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Clephane K, Sartin-Tarm A, Lorenz TK. Four Additional Questions for the Preparation Hypothesis. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:737-742. [PMID: 32681459 DOI: 10.1007/s10508-020-01798-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 06/11/2023]
Affiliation(s)
- Kirstin Clephane
- Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Stadium East C66, Lincoln, NE, 68588-0156, USA
| | - Anneliis Sartin-Tarm
- Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Stadium East C66, Lincoln, NE, 68588-0156, USA
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Tierney K Lorenz
- Center for Brain, Biology and Behavior, University of Nebraska-Lincoln, Stadium East C66, Lincoln, NE, 68588-0156, USA.
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA.
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Gran-Ruaz SM, Taylor RJ, Jacob G, Williams MT. Lifetime Trauma Exposure and Posttraumatic Stress Disorder Among African Americans and Black Caribbeans by Sex and Ethnicity. Front Psychiatry 2022; 13:889060. [PMID: 35800025 PMCID: PMC9253828 DOI: 10.3389/fpsyt.2022.889060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is a debilitating disorder requiring timely diagnosis and treatment, with special attention needed for Black populations in the U.S. Yet, stakeholders often fail to recognize Black communities' heterogeneous ethnic composition, thus not allowing diverse sociocultural realities to inform PTSD interventions. This study aims to characterize sex and ethnic differences in lifetime trauma exposure, lifetime PTSD diagnosis and symptoms, and help-seeking among the African Americans and Black Caribbeans in the U.S. METHOD This study relied on data from the National Survey of American Life 2001-2003 (NSAL) to investigate the lifetime exposure to traumatic events and prevalence of a clinical PTSD diagnosis based on the DSM-IV among African American (n = 3,570) and Black Caribbean (n = 1,623) adults. 44.5% of respondents were men and 55.5% were women. Logistic regression was utilized to investigate the impact of traumatic events on PTSD. RESULTS Several ethnic and sex differences in exposure to potentially traumatic events were identified. African American respondents were more likely to experience spousal abuse and toxin exposure than their Black Caribbean counterparts. Black Caribbeans reported higher lifetime exposure to muggings, natural disasters, harsh parental discipline, being a civilian living in terror and/or being a refugee than African American respondents. Specific to sex, Black men reported more events of combat, a peacekeeper/relief worker, being mugged, toxin exposure, seeing atrocities, and/or injuring someone. Black women were more likely to have been rape/sexual assault and/or intimate partner violence victims. The assaultive violence trauma type was most predictive of lifetime PTSD diagnosis among Black Americans. African American women were more likely to report PTSD symptoms than men, with almost no significant differences in Black Caribbean men and women. Approximately half of Black Americans sought help for their worst traumatic event, commonly engaging family/friends, psychiatrists, and mental health professionals. Further, there were almost no ethnic and sex differences related to professional and non-professional help sought. CONCLUSION Future PTSD-related research should aim to characterize the heterogenous experiences of potentially traumatic events within different Black communities. Clinicians working with Black clients should strive to understand the limitations within their tools/interventions in meeting the needs of diverse groups.
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Affiliation(s)
| | | | - Grace Jacob
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Monnica T Williams
- School of Psychology, University of Ottawa, Ottawa, ON, Canada.,School of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
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Alexandra Kredlow M, Fenster RJ, Laurent ES, Ressler KJ, Phelps EA. Prefrontal cortex, amygdala, and threat processing: implications for PTSD. Neuropsychopharmacology 2022; 47:247-259. [PMID: 34545196 PMCID: PMC8617299 DOI: 10.1038/s41386-021-01155-7] [Citation(s) in RCA: 89] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 02/08/2023]
Abstract
Posttraumatic stress disorder can be viewed as a disorder of fear dysregulation. An abundance of research suggests that the prefrontal cortex is central to fear processing-that is, how fears are acquired and strategies to regulate or diminish fear responses. The current review covers foundational research on threat or fear acquisition and extinction in nonhuman animals, healthy humans, and patients with posttraumatic stress disorder, through the lens of the involvement of the prefrontal cortex in these processes. Research harnessing advances in technology to further probe the role of the prefrontal cortex in these processes, such as the use of optogenetics in rodents and brain stimulation in humans, will be highlighted, as well other fear regulation approaches that are relevant to the treatment of posttraumatic stress disorder and involve the prefrontal cortex, namely cognitive regulation and avoidance/active coping. Despite the large body of translational research, many questions remain unanswered and posttraumatic stress disorder remains difficult to treat. We conclude by outlining future research directions related to the role of the prefrontal cortex in fear processing and implications for the treatment of posttraumatic stress disorder.
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Affiliation(s)
- M. Alexandra Kredlow
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
| | - Robert J. Fenster
- grid.38142.3c000000041936754XDivision of Depression and Anxiety, McLean Hospital; Department of Psychiatry, Harvard Medical School, Cambridge, MA USA
| | - Emma S. Laurent
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
| | - Kerry J. Ressler
- grid.38142.3c000000041936754XDivision of Depression and Anxiety, McLean Hospital; Department of Psychiatry, Harvard Medical School, Cambridge, MA USA
| | - Elizabeth A. Phelps
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, MA USA
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63
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Wang J, Zhao H, Girgenti MJ. Posttraumatic Stress Disorder Brain Transcriptomics: Convergent Genomic Signatures Across Biological Sex. Biol Psychiatry 2022; 91:6-13. [PMID: 33840456 DOI: 10.1016/j.biopsych.2021.02.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/29/2022]
Abstract
While a definitive understanding of the molecular pathology of posttraumatic stress disorder (PTSD) is far from a current reality, it has become increasingly clear that many of the molecular effects of PTSD are sex specific. Women are twice as likely as men to develop PTSD after a traumatic event, and neurobiological evidence suggests that there are structural differences between the brains of males versus females with PTSD. Recent advances in genomic technologies have begun to shed light on the sex-specific molecular determinants of PTSD, which seem to be governed predominantly by dysfunction of GABAergic (gamma-aminobutyric acidergic) signaling and immune function. We review the current state of the field of PTSD genomics focusing on the effect of sex. We provide an overview of difference in heritability of PTSD based on sex, how difference in gene regulation based on sex impacts the PTSD brain, and what is known about genomic regulation that is dysregulated in specific cell types in PTSD.
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Affiliation(s)
- Jiawei Wang
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut; Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Hongyu Zhao
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, Connecticut; Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut
| | - Matthew J Girgenti
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut; Psychiatry Service, Veterans Administration Connecticut Healthcare System, West Haven, Connecticut; Veterans Administration National Center for PTSD, West Haven, Connecticut.
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64
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Rakesh G, Clausen AN, Buckley MN, Clarke-Rubright E, Fairbank JA, Wagner HR, Morey RA. The role of trauma, social support, and demography on veteran resilience. Eur J Psychotraumatol 2022; 13:2058267. [PMID: 35599980 PMCID: PMC9116243 DOI: 10.1080/20008198.2022.2058267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Historically, resilience has often been conceptualized as the sustained lack of symptoms following trauma exposure. In line with a novel conceptualization of resilience as being dynamic over lifespan, determined by interacting biological and environmental factors, we examined the VA Mid-Atlantic Post Deployment Mental Health Repository (PDMH) comprised of 3876 US Military Veterans with and without PTSD diagnoses. METHODS We performed regression modelling to study the relationship between resilience (measured with Connor Davidson Resilience Scale; CD-RISC), posttraumatic stress disorder (PTSD) severity (Davidson Trauma Scale; DTS), social support (Medical Outcome Study Social Support Survey; MOSSS), combat exposure (Combat Exposure Scale; CES), childhood trauma (Trauma Life Events Questionnaire; TLEQ), and demographic factors. CD-RISC was positively correlated with years of education and negatively correlated with DTS, CES and TLEQ scores. RESULTS We found an interaction between CD-RISC and CES in predicting PTSD severity (Davidson Trauma Scale). Specifically, high resilience predicted lower PTSD symptom severity than low resilience, this relationship was amplified with increasing levels of combat exposure. Structural equation modelling (SEM) identified an optimal latent variable that represents resilience and relationships between latent variables for resilience, trauma, and illness. We derived a resilience latent variable composed of age, education level, MOSSS and race. CONCLUSIONS Our results support a conceptualization of resilience as a multifactorial determinant that coexists with PTSD, a state rather than trait variable, and can be quantified by biological and behavioural metrics. HIGHLIGHTS • Historically, resilience has often been conceptualized as the sustained lack of symptoms following trauma exposure.• We examined the VA Mid-Atlantic Post Deployment Mental Health Repository (PDMH) comprised of 3876 US Military Veterans.• We found an interaction effect between CD-RISC and CES in predicting PTSD severity (Davidson Trauma Scale).
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Affiliation(s)
- Gopalkumar Rakesh
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - Ashley N Clausen
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - Mary Nicole Buckley
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - Emily Clarke-Rubright
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA
| | - John A Fairbank
- Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Henry Ryan Wagner
- Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | | | - Rajendra A Morey
- Duke-UNC Brain Imaging and Analysis Center (BIAC), Durham, NC, USA.,Durham VA Health Care System, VISN 6 VA Mid-Atlantic Mental Illness Research Education and Clinical Center (MIRECC), Durham, NC, USA.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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65
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Cerda-De la O B, Cerda-Molina AL, Mayagoitia-Novales L, de la Cruz-López M, Biagini-Alarcón M, Hernández-Zúñiga EL, Borráz-León JI, Whaley-Sánchez JA. Increased Cortisol Response and Low Quality of Life in Women Exposed to Intimate Partner Violence With Severe Anxiety and Depression. Front Psychiatry 2022; 13:898017. [PMID: 35832594 PMCID: PMC9271849 DOI: 10.3389/fpsyt.2022.898017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/06/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) is one of the most prevalent forms of violence against women globally and it is considered a public health problem. Because the experience of IPV is stressful and traumatic for victims, they are at high risk of developing alteration of the Hypothalamus-Pituitary-Adrenal (HPA) axis functioning as well as anxiety and depression symptoms. The aim of this study was to compare the quality of life and changes in cortisol response to an acute stressor between women exposed to IPV and non-exposed women. Differences according to symptoms of anxiety and depression including the risk of suicide thoughts, were also analyzed. METHOD Our sample size consisted of 130 women (ages 18-68) grouped as follows: 71 women experiencing IPV and 59 women without history of IPV as control group. All participants completed a battery of questionnaires including IPV exposure, anxiety, and depression symptoms (Beck Inventories), as well as quality of life (WHOQOL-BREF). Salivary cortisol levels in response to a cognitive test with verbal, mathematical, and abstract reasoning were measured at four time points. RESULTS Women exposed to IPV, with severe anxiety and depression symptoms as well as suicide thoughts, exhibited heightened cortisol response after the cognitive test and reported lower quality of life compared to (i) women experiencing IPV with moderate symptoms of anxiety and depression, who showed a blunted response, and (ii) women without history of IPV with minimal to moderate symptoms, who showed a decreased cortisol profile. Social relationships dimension was in particular the most affected aspect of quality of life. CONCLUSIONS Our findings highlight the role of cortisol responses as a complementary biological marker to be associated with severe psychiatric disturbances in women exposed to IPV.
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Affiliation(s)
- Beatriz Cerda-De la O
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Ana Lilia Cerda-Molina
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Lilian Mayagoitia-Novales
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Margarita de la Cruz-López
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Marcela Biagini-Alarcón
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Erika Lucia Hernández-Zúñiga
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Javier I Borráz-León
- Departamento de Etología, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
| | - Jesús Alfredo Whaley-Sánchez
- Clínica de Género y Sexualidad, Dirección de Servicios Clínicos, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, México
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66
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Rutherford LG, Milton AL. Deconstructing and reconstructing behaviour relevant to mental health disorders: The benefits of a psychological approach, with a focus on addiction. Neurosci Biobehav Rev 2021; 133:104514. [PMID: 34958822 DOI: 10.1016/j.neubiorev.2021.104514] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 09/30/2021] [Accepted: 11/16/2021] [Indexed: 12/14/2022]
Abstract
RUTHERFORD, L.G. and Milton, A.L. Deconstructing and reconstructing behaviour relevant to mental health disorders: what can psychology offer? NEUROSCI BIOBEHAV REV XX(X)XXX-XXX, 2021. - Current treatments for mental health disorders are successful only for some patients, and there is an unmet clinical need for new treatment development. One challenge for treatment development has been how best to model complex human conditions in animals, where mechanism can be more readily studied with a range of neuroscientific techniques. We suggest that an approach to modelling based on associative animal learning theory provides a good framework for deconstructing complex mental health disorders such that they can be studied in animals. These individual simple models can subsequently be used in combination to 'reconstruct' a more complex model of the mental health disorder of interest. Using examples primarily from the field of drug addiction, we explore the 'psychological approach' and suggest that in addition to facilitating translation and backtranslation of tasks between animal models and patients, it is also highly concordant with the concept of triangulation.
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Affiliation(s)
| | - Amy L Milton
- Department of Psychology, University of Cambridge, United Kingdom.
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67
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Long KLP, Chao LL, Kazama Y, An A, Hu KY, Peretz L, Muller DCY, Roan VD, Misra R, Toth CE, Breton JM, Casazza W, Mostafavi S, Huber BR, Woodward SH, Neylan TC, Kaufer D. Regional gray matter oligodendrocyte- and myelin-related measures are associated with differential susceptibility to stress-induced behavior in rats and humans. Transl Psychiatry 2021; 11:631. [PMID: 34903726 PMCID: PMC8668977 DOI: 10.1038/s41398-021-01745-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/30/2021] [Accepted: 11/23/2021] [Indexed: 12/23/2022] Open
Abstract
Individual reactions to traumatic stress vary dramatically, yet the biological basis of this variation remains poorly understood. Recent studies demonstrate the surprising plasticity of oligodendrocytes and myelin with stress and experience, providing a potential mechanism by which trauma induces aberrant structural and functional changes in the adult brain. In this study, we utilized a translational approach to test the hypothesis that gray matter oligodendrocytes contribute to traumatic-stress-induced behavioral variation in both rats and humans. We exposed adult, male rats to a single, severe stressor and used a multimodal approach to characterize avoidance, startle, and fear-learning behavior, as well as oligodendrocyte and myelin basic protein (MBP) content in multiple brain areas. We found that oligodendrocyte cell density and MBP were correlated with behavioral outcomes in a region-specific manner. Specifically, stress-induced avoidance positively correlated with hippocampal dentate gyrus oligodendrocytes and MBP. Viral overexpression of the oligodendrogenic factor Olig1 in the dentate gyrus was sufficient to induce an anxiety-like behavioral phenotype. In contrast, contextual fear learning positively correlated with MBP in the amygdala and spatial-processing regions of the hippocampus. In a group of trauma-exposed US veterans, T1-/T2-weighted magnetic resonance imaging estimates of hippocampal and amygdala myelin associated with symptom profiles in a region-specific manner that mirrored the findings in rats. These results demonstrate a species-independent relationship between region-specific, gray matter oligodendrocytes and differential behavioral phenotypes following traumatic stress exposure. This study suggests a novel mechanism for brain plasticity that underlies individual variance in sensitivity to traumatic stress.
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Affiliation(s)
- Kimberly L P Long
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
- Department of Psychiatry and Behavioral Sciences, University of California, SanFrancisco, San Francisco, CA, 94143, USA
| | - Linda L Chao
- Department of Radiology & Biomedical Imaging, University of California, San Francisco, San Francisco, CA, 94143, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, 94143, USA
| | - Yurika Kazama
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Anjile An
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
- Division of Biostatistics, Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, 10065, USA
| | - Kelsey Y Hu
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Lior Peretz
- Department of Molecular, Cellular, and Developmental Biology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Dyana C Y Muller
- Department of Computer Science, University of Arizona, Tucson, AZ, 85721, USA
| | - Vivian D Roan
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Rhea Misra
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Claire E Toth
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
| | - Jocelyn M Breton
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA
- Department of Psychiatry, Columbia University, New York, NY, 10027, USA
| | - William Casazza
- Department of Statistics and Department of Medical Genetics, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Sara Mostafavi
- Department of Statistics and Department of Medical Genetics, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
- Canadian Institute for Advanced Research, Toronto, ON, M5G 1M1, Canada
| | - Bertrand R Huber
- Department of Neurology, Boston University, Boston, MA, 02215, USA
- National Center for PTSD, VA New England Health Care System, Boston, MA, 02130, USA
| | - Steven H Woodward
- National Center for PTSD, VA Palo Alto Health Care System, Palo Alto, CA, 94304, USA
| | - Thomas C Neylan
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, 94143, USA
- San Francisco VA Health Care System, San Francisco, CA, 94121, USA
| | - Daniela Kaufer
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, CA, 94720, USA.
- Canadian Institute for Advanced Research, Toronto, ON, M5G 1M1, Canada.
- Department of Integrative Biology, University of California, Berkeley, Berkeley, CA, 94720, USA.
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68
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Watanabe N, Takeda M. Neurophysiological dynamics for psychological resilience: A view from the temporal axis. Neurosci Res 2021; 175:53-61. [PMID: 34801599 DOI: 10.1016/j.neures.2021.11.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 10/19/2022]
Abstract
When an individual is faced with adversity, the brain and body work cooperatively to adapt to it. This adaptive process is termed psychological resilience, and recent studies have identified several neurophysiological factors ("neurophysiological resilience"), such as monoamines, oscillatory brain activity, hemodynamics, autonomic activity, stress hormones, and immune systems. Each factor is activated in an interactive manner during specific time windows after exposure to stress. Thus, the differences in psychological resilience levels among individuals can be characterized by differences in the temporal dynamics of neurophysiological resilience. In this review, after briefly introducing the frequently used approaches in this research field and the well-known factors of neurophysiological resilience, we summarize the temporal dynamics of neurophysiological resilience. This viewpoint clarifies an important time window, the more-than-one-hour scale, but the neurophysiological dynamics during this window remain elusive. To address this issue, we propose exploring brain-wide oscillatory activities using concurrent functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG) techniques.
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Affiliation(s)
- Noriya Watanabe
- Research Center for Brain Communication, Research Institute, Kochi University of Technology, Kochi, Japan; Center for Information and Neural Networks, National Institute of Information and Communications Technology, Osaka, Japan.
| | - Masaki Takeda
- Research Center for Brain Communication, Research Institute, Kochi University of Technology, Kochi, Japan
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69
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Ferber SG, Braun K, Weller A. The roots of paternal depression: Experienced and nonexperienced trauma or Folie a Deux? Dev Psychobiol 2021; 63:e22197. [PMID: 34674247 DOI: 10.1002/dev.22197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 08/19/2021] [Accepted: 08/30/2021] [Indexed: 12/14/2022]
Abstract
The transition to fatherhood may be challenged with anxiety and trepidation. A high prevalence has been found for paternal depression and it is reactive to maternal depression. This review aims to address potential sources of paternal depression, which may have adverse consequences on child development. We describe through three hypotheses how fathers may be at risk of depression during the transition to fatherhood: (1) psychological (interacting with ecological systems); (2) brain functional∖structural changes; and (3) (epi)genomic. We propose that paternal stressful experiences during the transition to fatherhood may be the source for paternal depression through direct stressful paternal experiences or via (potential, currently debated) nonexperienced (by the father) epigenomic transgenerational transmission. On the other hand, we suggest that resilient fathers may undergo a transient dysphoric period affected by identifying with the newborn's vulnerability as well as with the mother's postpartum vulnerability resulting in "paternity blues." In accordance with recent views on paternal "heightened sensitivity" toward the infant, we propose that the identification of both parents with the vulnerability of the newborn creates a sensitive period of Folie a Deux (shared madness) which may be a healthy transient, albeit a quasi-pathological period, recruited by the orienting response of the newborn for survival.
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Affiliation(s)
- Sari Goldstein Ferber
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
| | - Katharina Braun
- Department of Zoology and Developmental Neurobiology, Otto von Guericke University Magdeburg, Magdeburg, Germany.,Center for Behavioral and Brain Science, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Aron Weller
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Ramat Gan, Israel
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70
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Stein MB, Jain S, Simon NM, West JC, Marvar PJ, Bui E, He F, Benedek DM, Cassano P, Griffith JL, Howlett J, Malgaroli M, Melaragno A, Seligowski AV, Shu IW, Song S, Szuhany K, Taylor CT, Ressler KJ. Randomized, Placebo-Controlled Trial of the Angiotensin Receptor Antagonist Losartan for Posttraumatic Stress Disorder. Biol Psychiatry 2021; 90:473-481. [PMID: 34275593 DOI: 10.1016/j.biopsych.2021.05.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/20/2021] [Accepted: 05/03/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Evidence-based pharmacological treatments for posttraumatic stress disorder (PTSD) are few and of limited efficacy. Previous work suggests that angiotensin type 1 receptor inhibition facilitates fear inhibition and extinction, important for recovery from PTSD. This study tests the efficacy of the angiotensin type 1 receptor antagonist losartan, an antihypertensive drug, repurposed for the treatment of PTSD. METHODS A randomized controlled trial was conducted for 10 weeks in 149 men and women meeting DSM-5 PTSD criteria. Losartan (vs. placebo) was flexibly titrated from 25 to 100 mg/day by week 6 and held at highest tolerated dose until week 10. Primary outcome was the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) change score at 10 weeks from baseline. A key secondary outcome was change in CAPS-5 associated with a single nucleotide polymorphism of the ACE gene. Additional secondary outcomes included changes in the PTSD Checklist for DSM-5 and the Patient Health Questionnaire-9, and proportion of responders with a Clinical Global Impressions-Improvement scale of "much improved" or "very much improved." RESULTS Both groups had robust improvement in PTSD symptoms, but there was no significant difference on the primary end point, CAPS-5 measured as week 10 change from baseline, between losartan and placebo (mean change difference, 0.9, 95% confidence interval, -3.2 to 5.0). There was no significant difference in the proportion of Clinical Global Impressions-Improvement scale responders for losartan (58.6%) versus placebo (57.9%), no significant differences in changes in PTSD Checklist for DSM-5 or Patient Health Questionnaire-9, and no association between ACE genotype and CAPS-5 improvement on losartan. CONCLUSIONS At these doses and durations, there was no significant benefit of losartan compared with placebo for the treatment of PTSD. We discuss implications for failure to determine the benefit of a repurposed drug with strong a priori expectations of success based on preclinical and epidemiological data.
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Affiliation(s)
- Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, California; Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California; VA San Diego Healthcare System, San Diego, California.
| | - Sonia Jain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
| | - Naomi M Simon
- NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - James C West
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | | | - Eric Bui
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Feng He
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
| | - David M Benedek
- Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Paolo Cassano
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Jonathan Howlett
- Department of Psychiatry, University of California San Diego, La Jolla, California; VA San Diego Healthcare System, San Diego, California
| | - Matteo Malgaroli
- NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Andrew Melaragno
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Antonia V Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Belmont, Massachusetts
| | - I-Wei Shu
- Department of Psychiatry, University of California San Diego, La Jolla, California; VA San Diego Healthcare System, San Diego, California
| | - Suzan Song
- George Washington University, Washington, DC
| | - Kristin Szuhany
- NYU Grossman School of Medicine and NYU Langone Health, New York, New York
| | - Charles T Taylor
- Department of Psychiatry, University of California San Diego, La Jolla, California
| | - Kerry J Ressler
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; McLean Hospital, Belmont, Massachusetts.
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71
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Pajser A, Foster C, Gaeddert B, Pickens CL. Extended operant training increases infralimbic and prelimbic cortex Fos regardless of fear conditioning experience. Behav Brain Res 2021; 414:113476. [PMID: 34302878 PMCID: PMC8428778 DOI: 10.1016/j.bbr.2021.113476] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 07/11/2021] [Accepted: 07/16/2021] [Indexed: 12/28/2022]
Abstract
Extended fear training can lead to initially low fear expression that grows over time, termed fear incubation. Conversely, a single fear conditioning session typically results in high fear initially that is sustained over time. Fear expression decreases across extended training, suggesting that a fear extinction-like process might be responsible for low fear observed soon after training. Because of the prominent role medial prefrontal cortex (mPFC) plays in fear conditioning and extinction, we decided to examine Fos expression resulting from a cued fear retrieval test to gain insight into possible mechanisms involved in extended training fear incubation. Male Long-Evans rats received 1 or 10 days of tone-shock pairings or tone-only exposure (while lever-pressing for food). Two days after the end of fear training, rats received a cued fear test, with perfusions timed to visualize Fos expression during test. As expected, the limited fear conditioning group exhibited higher fear in the test than any of the other groups (as measured with conditioned suppression of lever-pressing). Interestingly, we found that extended training animals (whether they received tone-shock pairings or tone-only exposure) expressed higher levels of Fos in both prelimbic and infralimbic cortices than limited training animals. There was no association between fear expression and mPFC Fos expression. These results suggest we may have visualized Fos expression related to operant overtraining rather than conditioned fear related processes. Further research is needed to determine the neurobiological basis of extended training fear incubation and to determine processes represented by the pattern of Fos expression we observed.
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Affiliation(s)
- Alisa Pajser
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA
| | - Christian Foster
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA
| | - Brooke Gaeddert
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA
| | - Charles L Pickens
- Department of Psychological Sciences, Kansas State University, Manhattan, KS, 66506, USA.
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72
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Rajaraman A, Austin JL, Gover HC, Cammilleri AP, Donnelly DR, Hanley GP. Toward trauma-informed applications of behavior analysis. J Appl Behav Anal 2021; 55:40-61. [PMID: 34525220 DOI: 10.1002/jaba.881] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 12/29/2022]
Abstract
Despite a growing acknowledgement of the importance of understanding the impacts of trauma on therapeutic approaches across human service disciplines, discussions of trauma have been relatively infrequent in the behavior analytic literature. In this paper, we delineate some of the barriers to discussing and investigating trauma in applied behavior analysis (ABA) and describe how the core commitments of trauma-informed care could be applied to behavior analysis. We then provide some examples of how trauma-informed care might be incorporated into ABA practice. We conclude by suggesting opportunities to approach trauma as a viable avenue for behavior analytic research and argue that omitting trauma-informed care from ABA could be detrimental not only to the public perception of ABA, but to the effectiveness of our assessment and treatment procedures.
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73
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Reis R, Ortega F. Neuroscientific perspectives for a theory of trauma: a critical review of integrative models of biology and culture. CAD SAUDE PUBLICA 2021; 37:e00352820. [PMID: 34495102 DOI: 10.1590/0102-311x00352820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
In the last 25 years of the 20th century, psychopathology coded a diverse range of social phenomena under the heading of trauma, featuring the study of psychological trauma as an autonomous area progressively informed by cultural and neurobiological research. In this scenario, we witnessed the emergence of the biocultural paradigm, an epistemological perspective that seeks to elucidate the interactive trajectories by which culture and biology consolidate each other´s effects. This article will address the intersections between the field of psychological trauma and neurosciences, based on the analytical dimensions of expansion of the category of posttraumatic stress disorder (PTSD), the epistemological premises of neurobehavioral studies of stress and fear, and the limitations of the bidirectionality hypothesis advanced by contemporary cultural neurosciences. The elaboration of definitively integrative approaches can assist the development of comprehensive models capable of conceiving knowledges and practices at the level of human experience, avoiding reductionist interpretations that submit complex cultural and subjective experiences alternatingly to the imperatives of the brain and to semiologic codes of pathogenic reasoning.
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Affiliation(s)
- Ramon Reis
- Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brasil.,Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Francisco Ortega
- Institució Catalana de Recerca i Estudis Avançats, Barcelona, Espanya.,Centre de Recerca en Antropologia Mèdica, Universitat Rovira i Virgili, Tarragona, Espanya
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74
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Serum cortisol as a predictor for posttraumatic stress disorder symptoms in post-myocardial infarction patients. J Affect Disord 2021; 292:687-694. [PMID: 34157664 DOI: 10.1016/j.jad.2021.05.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 04/03/2021] [Accepted: 05/30/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND After an acute myocardial infarction (MI2), patients may develop posttraumatic stress disorder (PTSD3). There is evidence for alterations in the hypothalamic-pituitary-adrenal axis in PTSD. An association between patients` cortisol level after experiencing an MI and subsequent PTSD symptoms has not been investigated yet. Therefore, the aim of this study was to examine whether serum cortisol measured in patients admitted to hospital for acute coronary care after MI is predictive of PTSD symptoms at three and 12 months post-MI, respectively. METHODS Patients (N=106) with a verified MI and high risk for the development of MI-induced PTSD symptoms were included in the study within 48 hours of hospital admission for acute coronary intervention. Serum cortisol was measured from fasting venous blood samples the next morning. Hierarchical regression analysis was used to test for an independent contribution of cortisol levels from admission to the Clinician-Administered PTSD Scale sum score three and 12 months after discharge from the coronary care unit. RESULTS Hierarchical regression analysis showed that lower serum cortisol levels were significantly associated with more severe PTSD symptoms three months (B=-0.002, p=0.042) and 12 months (B=-0.002, p=0.043) post-MI. LIMITATIONS The generalizability of the findings is limited to patients with high acute peri-traumatic distress and without an acute severe depressive episode. The study does not provide any information about the diurnal cortisol pattern. CONCLUSION Lower serum cortisol measured during MI hospitalization may predict more severe MI-induced PTSD symptoms three and 12 months after hospital discharge.
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75
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Feng P, Chen Z, Becker B, Liu X, Zhou F, He Q, Qiu J, Lei X, Chen H, Feng T. Predisposing Variations in Fear-Related Brain Networks Prospectively Predict Fearful Feelings during the 2019 Coronavirus (COVID-19) Pandemic. Cereb Cortex 2021; 32:540-553. [PMID: 34297795 DOI: 10.1093/cercor/bhab232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/20/2021] [Accepted: 06/21/2021] [Indexed: 01/21/2023] Open
Abstract
The novel coronavirus (COVID-19) pandemic has led to a surge in mental distress and fear-related disorders, including posttraumatic stress disorder (PTSD). Fear-related disorders are characterized by dysregulations in fear and the associated neural pathways. In the present study, we examined whether individual variations in the fear neural connectome can predict fear-related symptoms during the COVID-19 pandemic. Using machine learning algorithms and back-propagation artificial neural network (BP-ANN) deep learning algorithms, we demonstrated that the intrinsic neural connectome before the COVID-19 pandemic could predict who would develop high fear-related symptoms at the peak of the COVID-19 pandemic in China (Accuracy rate = 75.00%, Sensitivity rate = 65.83%, Specificity rate = 84.17%). More importantly, prediction models could accurately predict the level of fear-related symptoms during the COVID-19 pandemic by using the prepandemic connectome state, in which the functional connectivity of lvmPFC (left ventromedial prefrontal cortex)-rdlPFC (right dorsolateral), rdACC (right dorsal anterior cingulate cortex)-left insula, lAMY (left amygdala)-lHip (left hippocampus) and lAMY-lsgACC (left subgenual cingulate cortex) was contributed to the robust prediction. The current study capitalized on prepandemic data of the neural connectome of fear to predict participants who would develop high fear-related symptoms in COVID-19 pandemic, suggesting that individual variations in the intrinsic organization of the fear circuits represent a neurofunctional marker that renders subjects vulnerable to experience high levels of fear during the COVID-19 pandemic.
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Affiliation(s)
- Pan Feng
- Faculty of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
| | - Zhiyi Chen
- Faculty of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
| | - Benjamin Becker
- Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Chengdu 611731, China
| | - Xiqin Liu
- Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Chengdu 611731, China
| | - Feng Zhou
- Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 611731, China.,The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, Chengdu 611731, China
| | - Qinghua He
- Faculty of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
| | - Jiang Qiu
- Faculty of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
| | - Xu Lei
- Faculty of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
| | - Hong Chen
- Faculty of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
| | - Tingyong Feng
- Faculty of Psychology, Southwest University, Chongqing 400715, China.,Key Laboratory of Cognition and Personality, Ministry of Education, Chongqing 400715, China
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76
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Sullivan GM, Gendreau RM, Gendreau J, Peters P, Peters A, Engels J, Daugherty BL, Vaughn B, Weathers FW, Lederman S. Randomized clinical trial of bedtime sublingual cyclobenzaprine (TNX-102 SL) in military-related PTSD and the role of sleep quality in treatment response. Psychiatry Res 2021; 301:113974. [PMID: 33979763 DOI: 10.1016/j.psychres.2021.113974] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/24/2021] [Indexed: 01/10/2023]
Abstract
Effective posttraumatic stress disorder (PTSD) pharmacotherapy is needed. This 12-week randomized multicenter trial evaluated efficacy and safety of TNX-102 SL, a bedtime sublingual formulation of cyclobenzaprine, in patients with military-related PTSD randomized to TNX-102 SL 2.8 mg or 5.6 mg, or placebo. Primary analysis comparing change from baseline in Clinician-Administered PTSD Scale-5 score between 2.8 mg (n=90) and placebo (n=92) was not significant. Secondary analysis of 5.6 mg (n=49) vs placebo demonstrated a mean difference of -4.5 units, p=.05, or, accounting for missing data by multiple imputation, -5.0 units, p=.03. Clinician Global Impression - Improvement responder rate was greater in 5.6 mg than placebo (p=0.04), as was mean functional improvement in Sheehan Disability Scale social domain (p=.03) and trended in work domain (p=.05). Post-hoc analyses showed early sleep improvement predicted improvement in PTSD after 12 weeks for TNX-102 SL (p<.01), not for placebo. Most common administration site reaction in TNX-102 SL groups was oral hypoaesthesia (5.6 mg, 36%; 2.8 mg, 39%; placebo, 2%), while most common systemic adverse event was somnolence (5.6 mg, 16%; 2.8 mg, 12%; placebo, 6%). This provides preliminary evidence that TNX-102 SL 5.6 mg reduces PTSD symptoms, improves sleep and psychosocial function, and is well tolerated. Clinicaltrials.gov Identifier: NCT02277704.
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Affiliation(s)
| | | | | | | | | | - Jean Engels
- Engels Statistical Consulting, LLC, Minneapolis, MN
| | | | | | - Frank W Weathers
- National Center for PTSD, and Department of Psychology, Auburn University, Auburn, AL
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77
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Cooper MA, Clinard CT, Dulka BN, Grizzell JA, Loewen AL, Campbell AV, Adler SG. Gonadal steroid hormone receptors in the medial amygdala contribute to experience-dependent changes in stress vulnerability. Psychoneuroendocrinology 2021; 129:105249. [PMID: 33971475 PMCID: PMC8217359 DOI: 10.1016/j.psyneuen.2021.105249] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/21/2021] [Accepted: 04/25/2021] [Indexed: 02/06/2023]
Abstract
Social experience can generate neural plasticity that changes how individuals respond to stress. Winning aggressive encounters alters how animals respond to future challenges and leads to increased plasma testosterone concentrations and androgen receptor (AR) expression in the social behavior neural network. In this project, our aim was to identify neuroendocrine mechanisms that account for changes in stress-related behavior following the establishment of dominance relationships over a two-week period. We used a Syrian hamster model in which acute social defeat stress increases anxiety-like responses in a conditioned defeat test in males and in a social avoidance test in females. First, we administered flutamide, an AR antagonist, via intraperitoneal injections daily during the establishment of dominance relationships in male hamsters. We found that pharmacological blockade of AR prevented a reduction in conditioned defeat in dominant males and blocked an upregulation of AR in the posterior dorsal medial amygdala (MePD) and posterior ventral medial amygdala (MePV), but not in the ventral lateral septum. Next, we administered flutamide into the posterior aspects of the medial amygdala (MeP) prior to acute social defeat stress or prior to conditioned defeat testing in males. We found that pharmacological blockade of AR in the MeP prior to social defeat, but not prior to testing, increased the conditioned defeat response in dominant males and did not alter behavior in subordinates. Finally, we developed a procedure to establish dominance relationships in female hamsters and investigated status-dependent changes in plasma steroid hormone concentrations, estrogen receptor alpha (ERα) immunoreactivity, and defeat-induced social avoidance. We found that dominant female hamsters showed reduced social avoidance regardless of social defeat exposure as well as increased ERα expression in the MePD, but no status-dependent changes in the concentration of plasma steroid hormones. Overall, these findings suggest that achieving and maintaining stable social dominance leads to sex-specific neural plasticity in the MeP that underlies status-dependent changes in stress vulnerability.
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Affiliation(s)
- Matthew A Cooper
- Department of Psychology, University of Tennessee, Knoxville, TN 37996, United States.
| | - Catherine T Clinard
- Department of Social Sciences, Dalton State College, Dalton, GA, United States
| | - Brooke N Dulka
- Department of Psychology, University of Wisconsin, Milwaukee, WI, United States
| | - J Alex Grizzell
- Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, United States
| | - Annie L Loewen
- Department of Psychology, University of Tennessee, Knoxville, TN 37996, United States
| | - Ashley V Campbell
- Department of Psychology, University of Tennessee, Knoxville, TN 37996, United States
| | - Samuel G Adler
- Department of Psychology, University of Tennessee, Knoxville, TN 37996, United States
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78
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Bainomugisa CK, Sutherland HG, Parker R, Mcrae AF, Haupt LM, Griffiths LR, Heath A, Nelson EC, Wright MJ, Hickie IB, Martin NG, Nyholt DR, Mehta D. Using Monozygotic Twins to Dissect Common Genes in Posttraumatic Stress Disorder and Migraine. Front Neurosci 2021; 15:678350. [PMID: 34239411 PMCID: PMC8258453 DOI: 10.3389/fnins.2021.678350] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/31/2021] [Indexed: 01/03/2023] Open
Abstract
Epigenetic mechanisms have been associated with genes involved in Posttraumatic stress disorder (PTSD). PTSD often co-occurs with other health conditions such as depression, cardiovascular disorder and respiratory illnesses. PTSD and migraine have previously been reported to be symptomatically positively correlated with each other, but little is known about the genes involved. The aim of this study was to understand the comorbidity between PTSD and migraine using a monozygotic twin disease discordant study design in six pairs of monozygotic twins discordant for PTSD and 15 pairs of monozygotic twins discordant for migraine. DNA from peripheral blood was run on Illumina EPIC arrays and analyzed. Multiple testing correction was performed using the Bonferroni method and 10% false discovery rate (FDR). We validated 11 candidate genes previously associated with PTSD including DOCK2, DICER1, and ADCYAP1. In the epigenome-wide scan, seven novel CpGs were significantly associated with PTSD within/near IL37, WNT3, ADNP2, HTT, SLFN11, and NQO2, with all CpGs except the IL37 CpG hypermethylated in PTSD. These results were significantly enriched for genes whose DNA methylation was previously associated with migraine (p-value = 0.036). At 10% FDR, 132 CpGs in 99 genes associated with PTSD were also associated with migraine in the migraine twin samples. Genes associated with PTSD were overrepresented in vascular smooth muscle, axon guidance and oxytocin signaling pathways, while genes associated with both PTSD and migraine were enriched for AMPK signaling and longevity regulating pathways. In conclusion, these results suggest that common genes and pathways are likely involved in PTSD and migraine, explaining at least in part the co-morbidity between the two disorders.
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Affiliation(s)
- Charlotte K Bainomugisa
- Centre for Genomics and Personalised Health, School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Heidi G Sutherland
- Centre for Genomics and Personalised Health, School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, Australia
| | - Richard Parker
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, QLD, Australia
| | - Allan F Mcrae
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - Larisa M Haupt
- Centre for Genomics and Personalised Health, School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, Australia
| | - Lyn R Griffiths
- Centre for Genomics and Personalised Health, School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia.,Centre for Genomics and Personalised Health, Genomics Research Centre, School of Biomedical Sciences, Institute of Health and Biomedical Innovation, Kelvin Grove, QLD, Australia
| | - Andrew Heath
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Elliot C Nelson
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - Margaret J Wright
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia.,Centre for Advanced Imaging, The University of Queensland, Brisbane, QLD, Australia
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Nicholas G Martin
- QIMR Berghofer Medical Research Institute, Royal Brisbane Hospital, Herston, QLD, Australia
| | - Dale R Nyholt
- Centre for Genomics and Personalised Health, School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Divya Mehta
- Centre for Genomics and Personalised Health, School of Biomedical Science, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
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79
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Russo AS, Parsons RG. Behavioral Expression of Contextual Fear in Male and Female Rats. Front Behav Neurosci 2021; 15:671017. [PMID: 34220462 PMCID: PMC8249797 DOI: 10.3389/fnbeh.2021.671017] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 04/16/2021] [Indexed: 01/07/2023] Open
Abstract
The study of fear conditioning has led to a better understanding of fear and anxiety-based disorders such as post-traumatic stress disorder (PTSD). Despite the fact many of these disorders are more common in women than in men, the vast majority of work investigating fear conditioning in rodents has been conducted in males. The goal of the work presented here was to better understand how biological sex affects contextual fear conditioning and expression. To this end, rats of both sexes were trained to fear a specific context and fear responses were measured upon re-exposure to the conditioning context. In the first experiment, male and female rats were given context fear conditioning and tested the next day during which freezing behavior was measured. In the second experiment, rats were trained and tested in a similar fashion while fear-potentiated startle and defecation were measured. We found that males showed more freezing behavior than females during a fear expression test. The expression of fear-potentiated startle did not differ between sexes, while males exhibited more defecation during a test in a novel context. These data suggest that the expression of defensive behavior differs between sexes and highlight the importance of using multiple measures of fear when comparing between sexes.
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Affiliation(s)
- Amanda S Russo
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Ryan G Parsons
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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80
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The advent of fear conditioning as an animal model of post-traumatic stress disorder: Learning from the past to shape the future of PTSD research. Neuron 2021; 109:2380-2397. [PMID: 34146470 DOI: 10.1016/j.neuron.2021.05.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 03/23/2021] [Accepted: 05/11/2021] [Indexed: 01/06/2023]
Abstract
Translational research on post-traumatic stress disorder (PTSD) has produced limited improvements in clinical practice. Fear conditioning (FC) is one of the dominant animal models of PTSD. In fact, FC is used in many different ways to model PTSD. The variety of FC-based models is ill defined, creating confusion and conceptual vagueness, which in turn impedes translation into the clinic. This article takes a historical and conceptual approach to provide a comprehensive picture of current research and help reorient the research focus. This work historically reviews the variety of models that have emerged from the initial association of PTSD with FC, highlighting conceptual pitfalls that have limited the translation of animal research into clinical advances. We then provide some guidance on how future translational research could benefit from conceptual and technological improvements to translate basic findings in patients. This objective will require transdisciplinary approaches and should involve physicians, engineers, philosophers, and neuroscientists.
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81
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Okonogi T, Sasaki T. Theta-Range Oscillations in Stress-Induced Mental Disorders as an Oscillotherapeutic Target. Front Behav Neurosci 2021; 15:698753. [PMID: 34177486 PMCID: PMC8219864 DOI: 10.3389/fnbeh.2021.698753] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/14/2021] [Indexed: 12/13/2022] Open
Abstract
Emotional behavior and psychological disorders are expressed through coordinated interactions across multiple brain regions. Brain electrophysiological signals are composed of diverse neuronal oscillations, representing cell-level to region-level neuronal activity patterns, and serve as a biomarker of mental disorders. Here, we review recent observations from rodents demonstrating how neuronal oscillations in the hippocampus, amygdala, and prefrontal cortex are engaged in emotional behavior and altered by psychiatric changes such as anxiety and depression. In particular, we focus mainly on theta-range (4–12 Hz) oscillations, including several distinct oscillations in this frequency range. We then discuss therapeutic possibilities related to controlling such mental disease-related neuronal oscillations to ameliorate psychiatric symptoms and disorders in rodents and humans.
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Affiliation(s)
- Toya Okonogi
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
| | - Takuya Sasaki
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, Japan
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82
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De Brier N, Borra V, Dockx K, Scheers H, Stroobants S, De Buck E, Lauwers K, Vandekerckhove P. Best Available Evidence on Communicative First Aid Interventions by Laypeople for Preventing and Relieving Posttraumatic Stress Disorder-Related Symptomatology Following Traumatic Events. J Trauma Stress 2021; 34:538-550. [PMID: 33217083 DOI: 10.1002/jts.22625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/07/2020] [Accepted: 10/17/2020] [Indexed: 11/09/2022]
Abstract
Trauma-exposed individuals are at risk of developing mental health problems, including posttraumatic stress disorder (PTSD). As an exposed individual's friend or family member may be the first person to provide posttrauma relief, informing and training laypeople in psychosocial first aid may benefit mental health outcomes of trauma-exposed individuals. We aimed to (a) collect the best available evidence on communication as a first aid intervention in assisting individuals following traumatic events and (b) formulate practical recommendations. Systematic literature searches were conducted in three databases (March 2019). Following study selection, the extracted data were tabulated and synthesized narratively. The evidence was appraised according to the GRADE methodology and evaluated by a multidisciplinary expert panel to formulate recommendations for practice. Out of 1,724 articles, no experimental studies were identified, showing a complete lack of high-quality controlled studies on the efficacy of communicative practices. However, when lower-quality study designs were included, nine cross-sectional studies constituted the best available evidence. The studies suggested that positive communication by family members, r = -.38, aOR = 0.26, β = -.22, p < .001-p < .05, and expressive coping by the victim, β = -.62, p < .001, were associated with PTSD diagnosis and/or symptom severity; however, the evidence was of very low certainty. The expert panel took the methodological limitations into account when formulating weak practical recommendations. Cross-sectional studies currently provide the best possible evidence for developing guidelines on psychosocial first aid. High-quality controlled studies are needed to establish casual associations and identify the most effective interventions.
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Affiliation(s)
- Niels De Brier
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Vere Borra
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Cochrane First Aid, Mechelen, Belgium
| | - Kim Dockx
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | - Hans Scheers
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium
| | | | - Emmy De Buck
- Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium.,Cochrane First Aid, Mechelen, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Karen Lauwers
- Humanitarian Services, Belgian Red Cross, Mechelen, Belgium
| | - Philippe Vandekerckhove
- Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Belgian Red Cross, Mechelen, Belgium
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83
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Postel C, Mary A, Dayan J, Fraisse F, Vallée T, Guillery-Girard B, Viader F, Sayette VDL, Peschanski D, Eustache F, Gagnepain P. Variations in response to trauma and hippocampal subfield changes. Neurobiol Stress 2021; 15:100346. [PMID: 34113695 PMCID: PMC8170416 DOI: 10.1016/j.ynstr.2021.100346] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 01/01/2023] Open
Abstract
Models of posttraumatic stress disorder (PTSD) suggest that the hippocampus is key to the persistence of traumatic memory. Yet very little is known about the precise changes that take place in this structure, nor their relation with PTSD symptoms. Previous studies have mostly used magnetic resonance imaging (MRI) at low resolutions, making it impossible to identify sensitive anatomical landmarks, or compared groups often unequally matched in terms of traumatic exposure. The present cross-sectional study included 92 individuals who had all been exposed to the terrorist attacks in Paris on November 13, 2015 (53 of whom subsequently developed PTSD) and 56 individuals who had not been exposed. Hippocampal subfield volumes were estimated using cross-validated automatic segmentation of high-resolution MRI images. Results revealed changes in CA1 and CA2-3/dentate gyrus (DG) volumes in individuals with PTSD, but not in resilient (i.e., exposed but without PTSD) individuals, after controlling for potential nuisance variables such as previous traumatic exposure and substance abuse. In line with current models of hippocampal subfield functions, CA1 changes were linked to the uncontrollable re-experiencing of intrusive memories, while CA2-3/DG changes, potentially exacerbated by comorbid depression, fostered the overgeneralization of fear linked to avoidance and hypervigilance behaviors. Additional analyses revealed that CA1 integrity was linked to optimum functioning of the memory control network in resilient individuals. These findings shed new light on potential pathophysiological mechanisms in the hippocampus subtending the development of PTSD and the failure to recover from trauma.
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Affiliation(s)
- Charlotte Postel
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Alison Mary
- Neuropsychology and Functional Neuroimaging Research Unit (UR2NF), Centre for Research in Cognition and Neurosciences (CRCN), UNI-ULB Neuroscience Institute, Université libre de Bruxelles, 1050, Brussels, Belgium
| | - Jacques Dayan
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Florence Fraisse
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Thomas Vallée
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Bérengère Guillery-Girard
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Fausto Viader
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Vincent de la Sayette
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Denis Peschanski
- Université Paris I Panthéon Sorbonne, HESAM Université, EHESS, CNRS, UMR8209, Paris, France
| | - Francis Eustache
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Pierre Gagnepain
- Normandie Univ, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, GIP Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
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Kark SM, Birnie MT, Baram TZ, Yassa MA. Functional Connectivity of the Human Paraventricular Thalamic Nucleus: Insights From High Field Functional MRI. Front Integr Neurosci 2021; 15:662293. [PMID: 33967711 PMCID: PMC8096909 DOI: 10.3389/fnint.2021.662293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/29/2021] [Indexed: 12/30/2022] Open
Abstract
The paraventricular thalamic nucleus (PVT) is a small but highly connected nucleus of the dorsal midline thalamus. The PVT has garnered recent attention as a context-sensitive node within the thalamocortical arousal system that modulates state-dependent motivated behaviors. Once considered related to generalized arousal responses with non-specific impacts on behavior, accumulating evidence bolsters the contemporary view that discrete midline thalamic subnuclei belong to specialized corticolimbic and corticostriatal circuits related to attention, emotions, and cognition. However, the functional connectivity patterns of the human PVT have yet to be mapped. Here, we combined high-quality, high-resolution 7T and 3T resting state MRI data from 121 young adult participants from the Human Connectome Project (HCP) and thalamic subnuclei atlas masks to investigate resting state functional connectivity of the human PVT. The 7T results demonstrated extensive positive functional connectivity with the brainstem, midbrain, ventral and dorsal medial prefrontal cortex (mPFC), anterior and posterior cingulate, ventral striatum, hippocampus, and amygdala. These connections persist upon controlling for functional connectivity of the rest of the thalamus. Whole-brain contrasts provided further evidence that, compared to three nearby midline thalamic subnuclei, functional connectivity of the PVT is strong with the hippocampus, amygdala, ventral and dorsal mPFC, and middle temporal gyrus. These findings suggest that, even during rest, the human PVT is functionally coupled with many regions known to be structurally connected to rodent and non-human primate PVT. Further, cosine similarity analysis results suggested the PVT is integrated into the default mode network (DMN), an intrinsic connectivity network associated with episodic memory and self-referential thought. The current work provides a much-needed foundation for ongoing and future work examining the functional roles of the PVT in humans.
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Affiliation(s)
- Sarah M. Kark
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
| | - Matthew T. Birnie
- Department of Pediatrics, University of California, Irvine, Irvine, CA, United States
| | - Tallie Z. Baram
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
- Department of Pediatrics, University of California, Irvine, Irvine, CA, United States
- Department of Anatomy & Neurobiology, University of California, Irvine, Irvine, CA, United States
| | - Michael A. Yassa
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, United States
- Department of Anatomy & Neurobiology, University of California, Irvine, Irvine, CA, United States
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85
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Kundu S, Ming J, Stevens J. Developing Multimodal Dynamic Functional Connectivity as a Neuroimaging Biomarker. Brain Connect 2021; 11:529-542. [PMID: 33544014 DOI: 10.1089/brain.2020.0900] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Background: In spite of increasing evidence highlighting the role of dynamic functional connectivity (FC) in characterizing mental disorders, there is a lack of (a) reliable statistical methods to compute dynamic connectivity and (b) rigorous dynamic FC-based approaches for predicting mental health outcomes in heterogeneous disorders such as post-traumatic stress disorder (PTSD). Methods: In one of the first such efforts, we develop a reliable and accurate approach for estimating dynamic FC guided by brain structural connectivity (SC) computed using diffusion tensor imaging data and investigate the potential of the proposed multimodal dynamic FC to predict continuous mental health outcomes. We develop concrete measures of temporal network variability that are predictive of PTSD resilience, and identify regions whose temporal connectivity fluctuations are significantly related to resilience. Results: Our results illustrate that the multimodal approach is more sensitive to connectivity change points, it can clearly detect localized brain regions with the dynamic network features such as small-worldedness, clustering coefficients, and efficiency associated with resilience, and that it has superior predictive performance compared with existing static and dynamic network models when modeling PTSD resilience. Discussion: While the majority of resting-state network modeling in psychiatry has focused on static FC, our novel multimodal dynamic network analyses that are sensitive to network fluctuations allowed us to provide a model of neural correlates of resilience with high accuracy compared with existing static connectivity approaches or those that do not use brain SC information, and provided us with an expanded understanding of the neurobiological causes for PTSD. Impact statement The methods developed in this article provide reliable and accurate dynamic functional connectivity (FC) approaches by fusing multimodal imaging data that are highly predictive of continuous clinical phenotypes in heterogeneous mental disorders. Currently, there is very little theoretical work to explain how network dynamics might contribute to individual differences in behavior or psychiatric symptoms. Our analysis conclusively discovers localized brain resting-state networks, regions, and connections where variations in dynamic FC (that is estimated after incorporating brain structural connectivity information) are associated with post-traumatic stress disorder resilience, which could potentially provide valuable tools for the development of neural circuit modeling in psychiatry in the future.
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Affiliation(s)
- Suprateek Kundu
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Jin Ming
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia, USA
| | - Jennifer Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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Bonn-Miller MO, Sisley S, Riggs P, Yazar-Klosinski B, Wang JB, Loflin MJE, Shechet B, Hennigan C, Matthews R, Emerson A, Doblin R. The short-term impact of 3 smoked cannabis preparations versus placebo on PTSD symptoms: A randomized cross-over clinical trial. PLoS One 2021; 16:e0246990. [PMID: 33730032 PMCID: PMC7968689 DOI: 10.1371/journal.pone.0246990] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 01/26/2021] [Indexed: 12/01/2022] Open
Abstract
IMPORTANCE There is a pressing need for development of novel pharmacology for the treatment of Posttraumatic Stress Disorder (PTSD). Given increasing use of medical cannabis among US military veterans to self-treat PTSD, there is strong public interest in whether cannabis may be a safe and effective treatment for PTSD. OBJECTIVE The aim of the present study was to collect preliminary data on the safety and potential efficacy of three active concentrations of smoked cannabis (i.e., High THC = approximately 12% THC and < 0.05% CBD; High CBD = 11% CBD and 0.50% THC; THC+CBD = approximately 7.9% THC and 8.1% CBD, and placebo = < 0.03% THC and < 0.01% CBD) compared to placebo in the treatment of PTSD among military veterans. METHODS The study used a double-blind, cross-over design, where participants were randomly assigned to receive three weeks of either active treatment or placebo in Stage 1 (N = 80), and then were re-randomized after a 2-week washout period to receive one of the other three active treatments in Stage 2 (N = 74). The primary outcome measure was change in PTSD symptom severity from baseline to end of treatment in Stage 1. RESULTS The study did not find a significant difference in change in PTSD symptom severity between the active cannabis concentrations and placebo by the end of Stage 1. All three active concentrations of smoked cannabis were generally well tolerated. CONCLUSIONS AND RELEVANCE The present study is the first randomized placebo-controlled trial of smoked cannabis for PTSD. All treatment groups, including placebo, showed good tolerability and significant improvements in PTSD symptoms during three weeks of treatment, but no active treatment statistically outperformed placebo in this brief, preliminary trial. Additional well-controlled and adequately powered studies with cannabis suitable for FDA drug development are needed to determine whether smoked cannabis improves symptoms of PTSD. TRIAL REGISTRATION Identifier: NCT02759185; ClinicalTrials.gov.
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Affiliation(s)
- Marcel O. Bonn-Miller
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Sue Sisley
- Scottsdale Research Institute, Scottsdale, Arizona, United States of America
| | - Paula Riggs
- School of Medicine, University of Colorado, Aurora, Colorado, United States of America
| | - Berra Yazar-Klosinski
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, California, United States of America
| | - Julie B. Wang
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, California, United States of America
| | - Mallory J. E. Loflin
- Center of Excellence for Stress and Mental Health & National Center for PTSD, VA San Diego Healthcare System, San Diego, California, United States of America
- San Diego School of Medicine, Department of Psychiatry, University of California, San Diego, California, United States of America
| | - Benjamin Shechet
- Scottsdale Research Institute, Scottsdale, Arizona, United States of America
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, California, United States of America
| | - Colin Hennigan
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, California, United States of America
| | - Rebecca Matthews
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, California, United States of America
| | - Amy Emerson
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, California, United States of America
| | - Rick Doblin
- Multidisciplinary Association for Psychedelic Studies, Santa Cruz, California, United States of America
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87
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Maja RA, Kilshaw RE, Garcia-Barrera MA, Karr JE. Current Posttraumatic Stress Symptoms Mediate the Relationship Between Adverse Childhood Experiences and Executive Functions. Psychol Rep 2021; 125:763-786. [PMID: 33573503 DOI: 10.1177/0033294120979690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Adverse childhood experiences (ACEs) and posttraumatic stress disorder (PTSD) are both associated with lower performances on executive function tasks. However, few researchers have evaluated ACEs, posttraumatic stress (PTS) symptoms, and executive function difficulties in conjunction. Using an online micropayment service, the current study assessed whether PTS symptoms mediated the relationship between ACEs and executive functions. In total, 83 participants (54.2% female, age: M = 28.86, SD = 7.71) were administered the ACE questionnaire, PTSD Checklist for DSM-5 (PCL-5), and the Executive Function Index (EFI). A higher number of reported ACEs was related to greater PTS symptom severity (β = .40, p < .001) and worse self-rated executive functions (β = -.32, p = .002). Controlling for the number of reported ACEs, current PTS symptom severity was related to worse executive functions (β = -.45, p < .001). A bootstrapped 95% confidence interval (CI) indicated a significant indirect effect, β = -.18 (95% CI: -.30, -.08), by which current PTS symptoms mediated the relationship between the number of reported ACEs and executive functions. These results suggest that psychological interventions targeting PTS symptoms, in the context of a history of childhood trauma, may concurrently improve executive functions in adult populations.
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Affiliation(s)
- Rachel A Maja
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, BC, Canada
| | - Robyn E Kilshaw
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | | - Justin E Karr
- Department of Psychology, 4530University of Kentucky, Lexington, KY, USA
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88
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Perizzolo Pointet VC, Moser DA, Vital M, Rusconi Serpa S, Todorov A, Schechter DS. Violence Exposure Is Associated With Atypical Appraisal of Threat Among Women: An EEG Study. Front Psychol 2021; 11:576852. [PMID: 33510667 PMCID: PMC7835125 DOI: 10.3389/fpsyg.2020.576852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction The present study investigates the association of lifetime interpersonal violence (IPV) exposure, related posttraumatic stress disorder (IPV-PTSD), and appraisal of the degree of threat posed by facial avatars. Methods We recorded self-rated responses and high-density electroencephalography (HD-EEG) among women, 16 of whom with lifetime IPV-PTSD and 14 with no PTSD, during a face-evaluation task that displayed male face avatars varying in their degree of threat as rated along dimensions of dominance and trustworthiness. Results The study found a significant association between lifetime IPV exposure, under-estimation of dominance, and over-estimation of trustworthiness. Characterization of EEG microstates supported that lifetime IPV-PTSD modulates emotional appraisal, specifically in encoding and decoding processing associated with N170 and LPP evoked potentials. EEG source localization demonstrated an overactivation of the limbic system, in particular the parahippocampal gyrus, in response to non-threatening avatars. Additionally, dysfunctional involvement of attention-related processing anterior prefrontal cortex (aPFC) was found in response to relatively trustworthy avatars in IPV-PTSD individuals compared with non-PTSD controls. Discussion This study showed that IPV exposure and related PTSD modulate individuals' evaluation of facial characteristics suggesting threat. Atypical processing of these avatar characteristics was marked by group differences in brain regions linked to facial processing, emotion regulation, and memory.
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Affiliation(s)
| | - Dominik Andrea Moser
- University Service of Child and Adolescent Psychiatry, Lausanne University Medical Center, Lausanne, Switzerland.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Marylène Vital
- Department of Child and Adolescent Psychiatry, University of Geneva Hospitals, Geneva, Switzerland
| | - Sandra Rusconi Serpa
- Department of Psychology, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Alexander Todorov
- Department of Psychology, Princeton University, Princeton, NJ, United States
| | - Daniel Scott Schechter
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,University Service of Child and Adolescent Psychiatry, Lausanne University Medical Center, Lausanne, Switzerland.,Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine, New York, NY, United States
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Laricchiuta D, Sciamanna G, Gimenez J, Termine A, Fabrizio C, Caioli S, Balsamo F, Panuccio A, De Bardi M, Saba L, Passarello N, Cutuli D, Mattioni A, Zona C, Orlando V, Petrosini L. Optogenetic Stimulation of Prelimbic Pyramidal Neurons Maintains Fear Memories and Modulates Amygdala Pyramidal Neuron Transcriptome. Int J Mol Sci 2021; 22:ijms22020810. [PMID: 33467450 PMCID: PMC7830910 DOI: 10.3390/ijms22020810] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 12/26/2022] Open
Abstract
Fear extinction requires coordinated neural activity within the amygdala and medial prefrontal cortex (mPFC). Any behavior has a transcriptomic signature that is modified by environmental experiences, and specific genes are involved in functional plasticity and synaptic wiring during fear extinction. Here, we investigated the effects of optogenetic manipulations of prelimbic (PrL) pyramidal neurons and amygdala gene expression to analyze the specific transcriptional pathways associated to adaptive and maladaptive fear extinction. To this aim, transgenic mice were (or not) fear-conditioned and during the extinction phase they received optogenetic (or sham) stimulations over photo-activable PrL pyramidal neurons. At the end of behavioral testing, electrophysiological (neural cellular excitability and Excitatory Post-Synaptic Currents) and morphological (spinogenesis) correlates were evaluated in the PrL pyramidal neurons. Furthermore, transcriptomic cell-specific RNA-analyses (differential gene expression profiling and functional enrichment analyses) were performed in amygdala pyramidal neurons. Our results show that the optogenetic activation of PrL pyramidal neurons in fear-conditioned mice induces fear extinction deficits, reflected in an increase of cellular excitability, excitatory neurotransmission, and spinogenesis of PrL pyramidal neurons, and associated to strong modifications of the transcriptome of amygdala pyramidal neurons. Understanding the electrophysiological, morphological, and transcriptomic architecture of fear extinction may facilitate the comprehension of fear-related disorders.
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Affiliation(s)
- Daniela Laricchiuta
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
- Correspondence:
| | - Giuseppe Sciamanna
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
| | - Juliette Gimenez
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
| | - Andrea Termine
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
- Department of Systems Medicine, Tor Vergata University of Rome, 00133 Rome, Italy;
| | - Carlo Fabrizio
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
- Department of Systems Medicine, Tor Vergata University of Rome, 00133 Rome, Italy;
| | - Silvia Caioli
- Unit of Neurology, IRCCS Neuromed, 86077 Pozzilli, Italy;
| | - Francesca Balsamo
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
| | - Anna Panuccio
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
- Department of Psychology, University “Sapienza” of Rome, 00185 Rome, Italy
| | - Marco De Bardi
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
| | - Luana Saba
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
| | - Noemi Passarello
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
| | - Debora Cutuli
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
- Department of Psychology, University “Sapienza” of Rome, 00185 Rome, Italy
| | - Anna Mattioni
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
| | - Cristina Zona
- Department of Systems Medicine, Tor Vergata University of Rome, 00133 Rome, Italy;
| | - Valerio Orlando
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
- Biological Environmental Science and Engineering Division, KAUST Environmental Epigenetics Program, Thuwal 23955-6900, Saudi Arabia
| | - Laura Petrosini
- Department of Experimental Neuroscience, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy; (G.S.); (J.G.); (A.T.); (C.F.); (F.B.); (A.P.); (M.D.B.); (L.S.); (N.P.); (D.C.); (A.M.); (V.O.); (L.P.)
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Girgenti MJ, Wang J, Ji D, Cruz DA, Stein MB, Gelernter J, Young KA, Huber BR, Williamson DE, Friedman MJ, Krystal JH, Zhao H, Duman RS. Transcriptomic organization of the human brain in post-traumatic stress disorder. Nat Neurosci 2021; 24:24-33. [PMID: 33349712 DOI: 10.1038/s41593-020-00748-7] [Citation(s) in RCA: 91] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 10/26/2020] [Indexed: 12/22/2022]
Abstract
Despite extensive study of the neurobiological correlates of post-traumatic stress disorder (PTSD), little is known about its molecular determinants. Here, differential gene expression and network analyses of four prefrontal cortex subregions from postmortem tissue of people with PTSD demonstrate extensive remodeling of the transcriptomic landscape. A highly connected downregulated set of interneuron transcripts is present in the most significant gene network associated with PTSD. Integration of this dataset with genotype data from the largest PTSD genome-wide association study identified the interneuron synaptic gene ELFN1 as conferring significant genetic liability for PTSD. We also identified marked transcriptomic sexual dimorphism that could contribute to higher rates of PTSD in women. Comparison with a matched major depressive disorder cohort revealed significant divergence between the molecular profiles of individuals with PTSD and major depressive disorder despite their high comorbidity. Our analysis provides convergent systems-level evidence of genomic networks within the prefrontal cortex that contribute to the pathophysiology of PTSD in humans.
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Affiliation(s)
- Matthew J Girgenti
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Psychiatry Service, VA Connecticut Health Care System, West Haven, CT, USA.
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, VT, USA.
| | - Jiawei Wang
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - Dingjue Ji
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA
| | - Dianne A Cruz
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Murray B Stein
- VA San Diego Healthcare System, San Diego, CA, USA
- Departments of Psychiatry and of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Psychiatry Service, VA Connecticut Health Care System, West Haven, CT, USA
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, VT, USA
| | - Keith A Young
- Baylor Scott and White Psychiatry, Temple, TX, USA
- Department of Psychiatry, Texas A&M College of Medicine, Bryan, Texas, USA
- Department of Veterans Affairs, VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, Texas, USA
- Central Texas Veterans Health Care System, Temple, TX, USA
| | - Bertrand R Huber
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, VT, USA
- VA Boston Healthcare System, Boston, MA, USA
- Boston University Alzheimer's Disease Center and CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Douglas E Williamson
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
- Durham VA Healthcare System, Durham, NC, USA
| | - Matthew J Friedman
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, VT, USA.
- Department of Psychiatry, Geisel School of Medicine at Dartmouth College, Hanover, NH, USA.
| | - John H Krystal
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
- Psychiatry Service, VA Connecticut Health Care System, West Haven, CT, USA.
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, VT, USA.
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA.
- Program of Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA.
| | - Ronald S Duman
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- National Center for PTSD, US Department of Veterans Affairs, White River Junction, VT, USA
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91
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Lancel M, van Marle HJF, Van Veen MM, van Schagen AM. Disturbed Sleep in PTSD: Thinking Beyond Nightmares. Front Psychiatry 2021; 12:767760. [PMID: 34899428 PMCID: PMC8654347 DOI: 10.3389/fpsyt.2021.767760] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
Sleep disturbances frequently co-occur with posttraumatic stress disorder (PTSD). Insomnia and nightmares are viewed as core symptoms of PTSD. Yet, relations between disturbed sleep and PTSD are far more complex: PTSD is linked to a broad range of sleep disorders and disturbed sleep markedly affects PTSD-outcome. This article provides a concise overview of the literature on prevalent comorbid sleep disorders, their reciprocal relation with PTSD and possible underlying neurophysiological mechanisms. Furthermore, diagnostic procedures, standard interventions-particularly first choice non-pharmacological therapies-and practical problems that often arise in the assessment and treatment of sleep disturbances in PTSD are described. Finally, we will present some perspectives on future multidisciplinary clinical and experimental research to develop new, more effective sleep therapies to improve both sleep and PTSD.
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Affiliation(s)
- Marike Lancel
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe Mental Health Institute, Assen, Netherlands.,Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - Hein J F van Marle
- Department of Psychiatry, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam UMC, Amsterdam, Netherlands.,GGZ InGeest Specialized Mental Health Care, Amsterdam, Netherlands
| | - Maaike M Van Veen
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe Mental Health Institute, Assen, Netherlands
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92
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Abstract
Objectives: Research on dissociative symptomatology in the context of Posttraumatic Stress Disorder (PTSD) has been gaining traction, with dissociation being studied as a set of complex symptoms following trauma exposure and as a specific subtype of PTSD. The aims of this review are to summarize the literature as it stands, examine the efficacy of existing interventions in treating dissociative symptomatology within the context of PTSD, and offer potential suggestions for future research. Methods: A systematic approach was taken to locate empirical studies on PTSD that included dissociation as an outcome in the PubMed, Scopus, and PsycINFO databases. Recent experimental designs with adult subjects (18+ years) in the English language were included, yielding 103 potentially eligible studies. Thirty-three full-text articles were screened with 17 articles meeting criteria for inclusion in the systematic review. Results: Designs, populations, treatments, and inventories were extremely diverse. Most therapies did not target dissociation specifically, although the results of this review suggest that PTSD patients who experience dissociative symptoms could benefit from trauma-focused treatments, which often significantly reduced dissociative and trauma-related symptoms. Conclusion: Future work should consider the evaluation of dissociation as a unique outcome to gain understanding about the nature of traumatic stress and to develop treatment options for its many presentations. The current literature displays limited generalizability to the treatment of individuals with high dissociation, which is a line of inquiry that should be explored. More RCTs are needed.
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Affiliation(s)
- Rachel Atchley
- Department of Precision Medicine, Brigham and Women's Hospital, Harvard Medical School , Boston, MA, USA
| | - Carter Bedford
- Department of Psychology, Florida State University , Tallahassee, FL, USA
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93
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Elman I, Upadhyay J, Lowen S, Karunakaran K, Albanese M, Borsook D. Mechanisms Underlying Unconscious Processing and Their Alterations in Post-traumatic Stress Disorder: Neuroimaging of Zero Monetary Outcomes Contextually Framed as "No Losses" vs. "No Gains". Front Neurosci 2020; 14:604867. [PMID: 33390889 PMCID: PMC7772193 DOI: 10.3389/fnins.2020.604867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022] Open
Abstract
Although unconscious processing is a key element of mental operation, its neural correlates have not been established. Also, clinical observations suggest that unconscious processing may be involved in the pathophysiology of post-traumatic stress disorder (PTSD), but the neurobiological mechanisms underlying such impairments remain unknown. The purpose of the present study was to examine putative mechanisms underlying unconscious processing by healthy participants and to determine whether these mechanisms may be altered in PTSD patients. Twenty patients with PTSD and 27 healthy individuals were administered a validated wheel of fortune-type gambling task during functional magnetic resonance imaging (fMRI). Unconscious processing was elicited using unconscious contextual framing of the zero monetary outcomes as "no loss," "no gain" or as "neutral." Brief passive visual processing of the "no loss" vs. "no gain" contrast by healthy participants yielded bilateral frontal-, temporal- and insular cortices and striatal activations. Between-group comparison revealed smaller activity in the left anterior prefrontal-, left dorsolateral prefrontal-, right temporal- and right insular cortices and in bilateral striatum in PTSD patients with the left dorsolateral prefrontal cortex activity been more pronounced in those with greater PTSD severity. These observations implicate frontal-, temporal-, and insular cortices along with the striatum in the putative mechanisms underlying unconscious processing of the monetary outcomes. Additionally, our results support the hypothesis that PTSD is associated with primary cortical and subcortical alterations involved in the above processes and that these alterations may be related to some aspects of PTSD symptomatology.
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Affiliation(s)
- Igor Elman
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Jaymin Upadhyay
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, United States
| | | | - Keerthana Karunakaran
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Mark Albanese
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, United States
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94
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Ornelas LC, Tyler RE, Irukulapati P, Paladugu S, Besheer J. Increased alcohol self-administration following exposure to the predator odor TMT in active coping female rats. Behav Brain Res 2020; 402:113068. [PMID: 33333108 DOI: 10.1016/j.bbr.2020.113068] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/20/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022]
Abstract
Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are highly comorbid. Additionally, individual differences in response to stress suggest resilient and susceptible populations. The current study exposed male and female Long Evans rats to the synthetically produced predator odor 2,5-dihydro-2,4,5-trimethylthiazoline (TMT) to examine individual differences in stress-reactive behaviors (digging and immobility) and whether these differences were related to subsequent alcohol drinking. Male and female Long Evans rats were trained on operant alcohol self-administration. After 9 sessions, rats underwent exposure to TMT or water (Control) in a distinct context. 6 days after TMT exposure, rats underwent re-exposure to the TMT-paired context (without TMT), and a series of behavioral assessments (acoustic startle, zero maze, light/dark box), after which rats resumed alcohol self-administration. TMT subgroups were created using a ratio of digging to immobility behavior during TMT exposure and rats with a ratio score < 1.0 or> 1.0 were grouped into TMT-1 (low digging/high immobility) or TMT-2 (high digging/low immobility), respectively. All male rats exposed to TMT met criteria for TMT-1, while female rats were divided into the two subgroups. In females, high digging/low immobility behavior during TMT exposure (TMT-2) was related to increased alcohol self-administration, but this was not observed in males or females that engaged in low digging/high immobility (TMT-1). These data show that individual differences in stress-reactivity can lead to lasting behavioral changes which may lead to a better understanding of increases in alcohol drinking following stress in females.
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Affiliation(s)
| | - Ryan E Tyler
- Bowles Center for Alcohol Studies, United States; Neuroscience Curriculum, United States
| | | | | | - Joyce Besheer
- Bowles Center for Alcohol Studies, United States; Neuroscience Curriculum, United States; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, 27599, United States.
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95
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Gurel NZ, Wittbrodt MT, Jung H, Shandhi MMH, Driggers EG, Ladd SL, Huang M, Ko YA, Shallenberger L, Beckwith J, Nye JA, Pearce BD, Vaccarino V, Shah AJ, Inan OT, Bremner JD. Transcutaneous cervical vagal nerve stimulation reduces sympathetic responses to stress in posttraumatic stress disorder: A double-blind, randomized, sham controlled trial. Neurobiol Stress 2020; 13:100264. [PMID: 33344717 PMCID: PMC7739181 DOI: 10.1016/j.ynstr.2020.100264] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/08/2020] [Accepted: 10/15/2020] [Indexed: 02/06/2023] Open
Abstract
Objective Exacerbated autonomic responses to acute stress are prevalent in posttraumatic stress disorder (PTSD). The purpose of this study was to assess the effects of transcutaneous cervical VNS (tcVNS) on autonomic responses to acute stress in patients with PTSD. The authors hypothesized tcVNS would reduce the sympathetic response to stress compared to a sham device. Methods Using a randomized double-blind approach, we studied the effects of tcVNS on physiological responses to stress in patients with PTSD (n = 25) using noninvasive sensing modalities. Participants received either sham (n = 12) or active tcVNS (n = 13) after exposure to acute personalized traumatic script stress and mental stress (public speech, mental arithmetic) over a three-day protocol. Physiological parameters related to sympathetic responses to stress were investigated. Results Relative to sham, tcVNS paired to traumatic script stress decreased sympathetic function as measured by: decreased heart rate (adjusted β = -5.7%; 95% CI: ±3.6%, effect size d = 0.43, p < 0.01), increased photoplethysmogram amplitude (peripheral vasodilation) (30.8%; ±28%, 0.29, p < 0.05), and increased pulse arrival time (vascular function) (6.3%; ±1.9%, 0.57, p < 0.0001). Similar (p < 0.05) autonomic, cardiovascular, and vascular effects were observed when tcVNS was applied after mental stress or without acute stress. Conclusion tcVNS attenuates sympathetic arousal associated with stress related to traumatic memories as well as mental stress in patients with PTSD, with effects persisting throughout multiple traumatic stress and stimulation testing days. These findings show that tcVNS has beneficial effects on the underlying neurophysiology of PTSD. Such autonomic metrics may also be evaluated in daily life settings in tandem with tcVNS therapy to provide closed-loop delivery and measure efficacy.ClinicalTrials.gov Registration # NCT02992899.
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Affiliation(s)
- Nil Z Gurel
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Matthew T Wittbrodt
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Hewon Jung
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Md Mobashir H Shandhi
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Emily G Driggers
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Stacy L Ladd
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.,Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Minxuan Huang
- Department of Epidemiology, Rollins School of Pu;blic Health, Atlanta, GA, USA
| | - Yi-An Ko
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Atlanta, GA, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Pu;blic Health, Atlanta, GA, USA
| | - Joy Beckwith
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jonathon A Nye
- Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Bradley D Pearce
- Department of Epidemiology, Rollins School of Pu;blic Health, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Pu;blic Health, Atlanta, GA, USA.,Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Pu;blic Health, Atlanta, GA, USA.,Department of Internal Medicine, Emory University School of Medicine, Atlanta, GA, USA.,Atlanta VA Medical Center, Decatur, GA, USA
| | - Omer T Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, USA.,Coulter Department of Bioengineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - J Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.,Department of Radiology, Emory University School of Medicine, Atlanta, GA, USA.,Atlanta VA Medical Center, Decatur, GA, USA
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96
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Rodriguez G, Moore SJ, Neff RC, Glass ED, Stevenson TK, Stinnett GS, Seasholtz AF, Murphy GG, Cazares VA. Deficits across multiple behavioral domains align with susceptibility to stress in 129S1/SvImJ mice. Neurobiol Stress 2020; 13:100262. [PMID: 33344715 PMCID: PMC7739066 DOI: 10.1016/j.ynstr.2020.100262] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/07/2020] [Accepted: 10/16/2020] [Indexed: 01/08/2023] Open
Abstract
Acute physical or psychological stress can elicit adaptive behaviors that allow an organism maintain homeostasis. However, intense and/or prolonged stressors often have the opposite effect, resulting in maladaptive behaviors and curbing goal-directed action; in the extreme, this may contribute to the development of psychiatric conditions like generalized anxiety disorder, major depressive disorder, or post-traumatic stress disorder. While treatment of these disorders generally focuses on reducing reactivity to potentially threatening stimuli, there are in fact impairments across multiple domains including valence, arousal, and cognition. Here, we use the genetically stress-susceptible 129S1 mouse strain to explore the effects of stress across multiple domains. We find that 129S1 mice exhibit a potentiated neuroendocrine response across many environments and paradigms, and that this is associated with reduced exploration, neophobia, decreased novelty- and reward-seeking, and spatial learning and memory impairments. Taken together, our results suggest that the 129S1 strain may provide a useful model for elucidating mechanisms underlying myriad aspects of stress-linked psychiatric disorders as well as potential treatments that may ameliorate symptoms.
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Affiliation(s)
- G Rodriguez
- Michigan Neuroscience Institute, USA.,Neuroscience Graduate Program, USA
| | - S J Moore
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA
| | - R C Neff
- Department of Molecular and Integrative Physiology, USA
| | - E D Glass
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA
| | | | | | - A F Seasholtz
- Michigan Neuroscience Institute, USA.,Neuroscience Graduate Program, USA.,Department of Biological Chemistry University of Michigan, Ann Arbor, MI, USA
| | - G G Murphy
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA.,Neuroscience Graduate Program, USA
| | - V A Cazares
- Department of Molecular and Integrative Physiology, USA.,Michigan Neuroscience Institute, USA.,Department of Psychology, Williams College, MA, USA
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97
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Lv Y, Chen P, Shan QH, Qin XY, Qi XH, Zhou JN. Regulation of Cued Fear Expression via Corticotropin-Releasing-Factor Neurons in the Ventral Anteromedial Thalamic Nucleus. Neurosci Bull 2020; 37:217-228. [PMID: 33052547 DOI: 10.1007/s12264-020-00592-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 07/15/2020] [Indexed: 11/26/2022] Open
Abstract
The ventral part of the anteromedial thalamic nucleus (AMv) is in a position to convey information to the cortico-hippocampal-amygdalar circuit involved in the processing of fear memory. Corticotropin-releasing-factor (CRF) neurons are closely associated with the regulation of stress and fear. However, few studies have focused on the role of thalamic CRF neurons in fear memory. In the present study, using a conditioned fear paradigm in CRF transgenic mice, we found that the c-Fos protein in the AMv CRF neurons was significantly increased after cued fear expression. Chemogenetic activation of AMv CRF neurons enhanced cued fear expression, whereas inhibition had the opposite effect on the cued fear response. Moreover, chemogenetic manipulation of AMv CRF neurons did not affect fear acquisition or contextual fear expression. In addition, anterograde tracing of projections revealed that AMv CRF neurons project to wide areas of the cerebral cortex and the limbic system. These results uncover a critical role of AMv CRF neurons in the regulation of conditioned fear memory.
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Affiliation(s)
- Yin Lv
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, Chinese Academy of Sciences Key Laboratory of Brain Function and Diseases, University of Science and Technology of China, Hefei, 230027, China
| | - Peng Chen
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, Chinese Academy of Sciences Key Laboratory of Brain Function and Diseases, University of Science and Technology of China, Hefei, 230027, China.
| | - Qing-Hong Shan
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, Chinese Academy of Sciences Key Laboratory of Brain Function and Diseases, University of Science and Technology of China, Hefei, 230027, China
| | - Xin-Ya Qin
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, Chinese Academy of Sciences Key Laboratory of Brain Function and Diseases, University of Science and Technology of China, Hefei, 230027, China
| | - Xiu-Hong Qi
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, Chinese Academy of Sciences Key Laboratory of Brain Function and Diseases, University of Science and Technology of China, Hefei, 230027, China
| | - Jiang-Ning Zhou
- Hefei National Laboratory for Physical Sciences at the Microscale, School of Life Sciences, Chinese Academy of Sciences Key Laboratory of Brain Function and Diseases, University of Science and Technology of China, Hefei, 230027, China.
- Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China.
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98
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Offensive Behavior, Striatal Glutamate Metabolites, and Limbic-Hypothalamic-Pituitary-Adrenal Responses to Stress in Chronic Anxiety. Int J Mol Sci 2020; 21:ijms21207440. [PMID: 33050201 PMCID: PMC7589759 DOI: 10.3390/ijms21207440] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 10/01/2020] [Accepted: 10/02/2020] [Indexed: 02/07/2023] Open
Abstract
Variations in anxiety-related behavior are associated with individual allostatic set-points in chronically stressed rats. Actively offensive rats with the externalizing indicators of sniffling and climbing the stimulus and material tearing during 10 days of predator scent stress had reduced plasma corticosterone, increased striatal glutamate metabolites, and increased adrenal 11-dehydrocorticosterone content compared to passively defensive rats with the internalizing indicators of freezing and grooming, as well as to controls without any behavioral changes. These findings suggest that rats that display active offensive activity in response to stress develop anxiety associated with decreased allostatic set-points and increased resistance to stress.
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99
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Castro-Vale I, Carvalho D. The Pathways between Cortisol-Related Regulation Genes and PTSD Psychotherapy. Healthcare (Basel) 2020; 8:healthcare8040376. [PMID: 33019527 PMCID: PMC7712185 DOI: 10.3390/healthcare8040376] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/24/2020] [Accepted: 09/24/2020] [Indexed: 01/30/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) only develops after exposure to a traumatic event in some individuals. PTSD can be chronic and debilitating, and is associated with co-morbidities such as depression, substance use, and cardiometabolic disorders. One of the most important pathophysiological mechanisms underlying the development of PTSD and its subsequent maintenance is a dysfunctional hypothalamic-pituitary-adrenal (HPA) axis. The corticotrophin-releasing hormone, cortisol, glucocorticoid receptor (GR), and their respective genes are some of the mediators of PTSD's pathophysiology. Several treatments are available, including medication and psychotherapies, although their success rate is limited. Some pharmacological therapies based on the HPA axis are currently being tested in clinical trials and changes in HPA axis biomarkers have been found to occur in response not only to pharmacological treatments, but also to psychotherapy-including the epigenetic modification of the GR gene. Psychotherapies are considered to be the first line treatments for PTSD in some guidelines, even though they are effective for some, but not for all patients with PTSD. This review aims to address how knowledge of the HPA axis-related genetic makeup can inform and predict the outcomes of psychotherapeutic treatments.
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Affiliation(s)
- Ivone Castro-Vale
- Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
- i3S-Institute for Research and Innovation in Health, University of Porto, Rua Alfredo Allen, 208, 4200-135 Porto, Portugal
- Correspondence:
| | - Davide Carvalho
- Department of Endocrinology, Diabetes and Metabolism, São João Hospital University Centre, Faculty of Medicine, University of Porto, Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal;
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100
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Voith LA, Logan-Greene P, Strodthoff T, Bender AE. A Paradigm Shift in Batterer Intervention Programming: A Need to Address Unresolved Trauma. TRAUMA, VIOLENCE & ABUSE 2020; 21:691-705. [PMID: 30060720 DOI: 10.1177/1524838018791268] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Intimate partner violence (IPV) is a significant public health problem affecting women, men, and children across the United States. Batterer intervention programs (BIPs) serve as the primary intervention for men who use violence, employing three primary modalities: psychoeducation, cognitive-behavioral therapy (CBT), and other forms of group therapy such as alcohol or drug treatment. However, research indicates that program effectiveness of the primary BIP modalities is limited, due, in part, to the theoretical underpinnings guiding intervention such as learned behavior (psychoeducation), patriarchy as the root cause (Duluth model), and "dysfunctional" thinking (CBT). Considering the mental, physical, and economic toll of IPV on families and the limited effectiveness of current intervention approaches, an assessment of the strengths and weaknesses of current modalities and an incorporation of the latest science addressing violence prevention and cessation are paramount. This article draws upon existing theories of trauma and the etiologies of violence perpetration and proposes an alternative model of care for men with IPV histories. Experiences of childhood adversity and trauma have well-established associations with a range of negative sequelae, including neurological, cognitive, behavioral, physical, and emotional outcomes. Childhood trauma is also associated with later violence and IPV perpetration. Thus, incorporating trauma-informed care principles and trauma interventions into programming for IPV perpetrators warrants further investigation. Practice and policy implications of a trauma interventions for men with IPV histories, as well as areas for future research, are discussed.
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Affiliation(s)
- Laura A Voith
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Anna E Bender
- Jack, Joseph, and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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