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Specht L, Freiberg A, Mojahed A, Garthus-Niegel S, Schellong J. Adrenocortical deviations and adverse clinical outcomes in children and adolescents exposed to interparental intimate partner violence: A systematic review. Neurosci Biobehav Rev 2024; 165:105866. [PMID: 39233285 DOI: 10.1016/j.neubiorev.2024.105866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 08/21/2024] [Accepted: 08/25/2024] [Indexed: 09/06/2024]
Abstract
Childhood exposure to interparental intimate partner violence (i-IPV) is a pervasive form of child maltreatment, posing major public health concerns and elevating risks for enduring adverse clinical and developmental consequences. However, assessing the full spectrum of clinical effects is challenging, potentially leading to inconsistent identification of children in need of early intervention. This systematic review aimed to identify hypothalamic-pituitary-adrenocortical axis dysfunction following i-IPV exposure, elucidating the underlying biopsychobehavioural mechanisms and predicting adverse outcomes. We searched Embase, MEDLINE, and PsycINFO for peer-reviewed studies from infancy through adolescence, screened reference lists and conducted forward searches. Analysis of 23 publications (N = 1848) revealed associations between i-IPV and altered adrenocortical function from early childhood, influenced by FKBP5 haplotype, parental caregiving and offspring emotional insecurity. Results showed that the adrenocortical stress response may predict internalising and externalising problems, childhood asthma, impaired executive function and poor academic performance. Nonetheless, inconsistencies in findings between studies suggest methodological heterogeneity and potential bias. Identifying biomarkers such as cortisol can enhance prediction and mechanism-based intervention efforts but long-term studies with a common theoretical and methodological framework are needed for comprehensive understanding. Integrating biological, emotional, and behavioural assessments could potentiate trauma services and research, ultimately improving outcomes for affected children.
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Affiliation(s)
- Lina Specht
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany.
| | - Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Amera Mojahed
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
| | - Susan Garthus-Niegel
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany; Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany; Institute for Systems Medicine (ISM) and Faculty of Medicine, Medical School Hamburg, Am Kaiserkai 1, Hamburg 20457, Germany; Department of Childhood and Families, Norwegian Institute of Public Health, Postboks 222 Skøyen, Oslo 0213, Norway
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstraße 74, Dresden 01307, Germany
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Shin Y, Nam JK, Park M, Lee A, Kim Y. Latent transition analysis on post-traumatic stress and post-traumatic growth among firefighters. Eur J Psychotraumatol 2024; 15:2387477. [PMID: 39140605 PMCID: PMC11328797 DOI: 10.1080/20008066.2024.2387477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 07/12/2024] [Accepted: 07/21/2024] [Indexed: 08/15/2024] Open
Abstract
Background: Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.Objective: This study investigated the longitudinal impact of trauma incidents during duty on firefighters using latent transition analysis.Method: Data from 346 firefighters in South Korea who had experienced trauma events while on duty were utilized. Initially, latent groups were identified based on the relationship between post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). Groups were labelled based on the analysis of differences in PTSD, mental health, and growth-related factors among classified groups. Subsequently, transition probabilities and patterns from Time 1 to Time 2 were examined, followed by an investigation into variances based on demographic factors (gender, age) and occupational factors (work experience, shift pattern) using variance analysis and multinomial logistic regression analysis.Results: First, at Time 2, a five-group model was classified into 'Growth,' 'Resilience or Numbness,' 'Struggle,' 'Partial Struggle,' and 'PTSD' groups. Second, upon examining the transition patterns between latent groups, four patterns emerged: 'continued distress,' 'growth,' 'adaptation,' and 'escalated distress.' Third, the 'Struggle' group showed a 0% probability of transitioning to the 'Growth' group, whereas it displayed the highest probability among the groups transitioning to the 'PTSD' group. Fourth, latent transition analysis results showed a strong tendency for the 'Growth' group and 'Resilience or Numbness' group to remain in the same category. Fifth, age was found to be a significant factor affecting the transition of latent groups.Conclusion: This research represents the inaugural attempt to longitudinally investigate the interplay between PTSD and PTG among firefighters.
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Affiliation(s)
- Yongchan Shin
- Counseling & Welfare Center for Youth, Dangjin City Youth Foundation, Dangjin-si, South Korea
| | - JeeEun Karin Nam
- Graduate School of Education, Kyung Hee University, Seoul, South Korea
| | - Minho Park
- Korea Institute for Curriculum and Evaluation, Jincheon-gun, South Korea
| | - Aeyoung Lee
- Department of Counseling and Psychotherapy, Inje University, Gimhae-si, South Korea
| | - Youngkeun Kim
- Department of Counseling and Psychotherapy, Inje University, Gimhae-si, South Korea
- Department of Psychology, University of Windsor, Windsor, Canada
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Schwabe L. Memory Under Stress: From Adaptation to Disorder. Biol Psychiatry 2024:S0006-3223(24)01385-4. [PMID: 38880463 DOI: 10.1016/j.biopsych.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/02/2024] [Accepted: 06/10/2024] [Indexed: 06/18/2024]
Abstract
Stressful events are ubiquitous in everyday life. Exposure to these stressors initiates the temporally orchestrated release of a multitude of hormones, peptides, and neurotransmitters that target brain areas that have been critically implicated in learning and memory. This review summarizes recent insights on the profound impact of stress on 4 fundamental processes of memory: memory formation, memory contextualization, memory retrieval, and memory flexibility. Stress mediators instigate dynamic alterations in these processes, thereby facilitating efficient responding under stress and the creation of a decontextualized memory representation that can effectively aid coping with novel future threats. While they are generally adaptive, the same stress-related changes may contribute to the rigid behaviors, uncontrollable intrusions, and generalized fear responding seen in anxiety disorders and posttraumatic stress disorder. Drawing on recent discoveries in cognitive neuroscience and psychiatry, this review discusses how stress-induced alterations in memory processes can simultaneously foster adaptation to stressors and fuel psychopathology. The transition from adaptive to maladaptive changes in the impact of stress on memory hinges on the nuanced interplay of stressor characteristics and individual predispositions. Thus, taking individual differences in the cognitive response to stressors into account is essential for any successful treatment of stress-related mental disorders.
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Affiliation(s)
- Lars Schwabe
- Department of Cognitive Psychology, Institute of Psychology, Universität Hamburg, Hamburg, Germany.
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Samir H, Swelum AA, Farag A, El-Sherbiny HR. Emotional temperaments in advanced pregnant goats and its relationship with the feto-maternal blood flow and placentome echotexture. Vet Res Commun 2024; 48:1545-1561. [PMID: 38379058 PMCID: PMC11147941 DOI: 10.1007/s11259-024-10330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024]
Abstract
The current study aimed to investigate the effect of xylazine sedation (non-sedated versus sedated conditions) and animal temperament on the fetal and maternal hemodynamics during the late stage of gestation in goats. In addition, it aimed to study the concentrations of cortisol and the echotexture of the placentome. Fourteen goats were assigned into two equal groups (n = 7, each) based on the animal's emotional temperament (calm versus nervous groups). All goats were examined for assessment of the blood flow within the fetal aorta (FA), umbilical artery (UMA), and middle uterine artery (MUA) using color-pulsed Doppler ultrasonography. Goats were exposed to light sedation using the recommended dose of xylazine (0.05 mg/Kg Bw) intramuscularly. Goats in each group were reassessed for the studied parameters after sedation. Blood samples were drawn to determine the concentrations of cortisol. Placentome echotexture pixel intensity (PXI) was evaluated using computer image analysis software. Results revealed the significant impact of the xylazine sedation on the Doppler indices of the blood flow within the measured arteries (FA, UMA, and MUA), the PXI of placentome echotexture, and cortisol concentrations. The emotional temperament of goats had significant effects on the blood flow parameters of the MUA and UMA, concentrations of cortisol, and the PXI of the placentome. The interaction effect (sedation x temperament) was noticed in the measured parameters of the UMA blood flow, fetal heart rate, and cortisol concentrations. In conclusion, xylazine sedation and emotional temperaments induced alterations in the echotexture of the placentomes as well as the hemodynamic parameters of late-stage pregnant goats without affecting the pregnancy outcomes.
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Affiliation(s)
- Haney Samir
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt.
| | - Ayman A Swelum
- Department of Theriogenology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed Farag
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt
| | - Hossam R El-Sherbiny
- Department of Theriogenology, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt
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Lukas E, Veeneman RR, Smit DJA, Vermeulen JM, Pathak GA, Polimanti R, Verweij KJH, Treur JL. A genetic exploration of the relationship between Posttraumatic Stress Disorder and cardiovascular diseases. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.20.24304533. [PMID: 38562880 PMCID: PMC10984043 DOI: 10.1101/2024.03.20.24304533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background and Aims Experiencing a traumatic event may lead to Posttraumatic Stress Disorder (PTSD), including symptoms such as flashbacks and hyperarousal. Individuals suffering from PTSD are at increased risk of cardiovascular disease (CVD), but it is unclear why. This study assesses shared genetic liability and potential causal pathways between PTSD and CVD. Methods We leveraged summary-level data of genome-wide association studies (PTSD: N= 1,222,882; atrial fibrillation (AF): N=482,409; coronary artery disease (CAD): N=1,165,690; hypertension: N=458,554; heart failure (HF): N=977,323). First, we estimated genetic correlations and utilized genomic structural equation modeling to identify a common genetic factor for PTSD and CVD. Next, we assessed biological, behavioural, and psychosocial factors as potential mediators. Finally, we employed multivariable Mendelian randomization to examine causal pathways between PTSD and CVD, incorporating the same potential mediators. Results Significant genetic correlations were found between PTSD and CAD, HT, and HF (rg =0.21-0.32, p≤ 3.08 · 10-16), but not between PTSD and AF. Insomnia, smoking, alcohol dependence, waist-to-hip ratio, and inflammation (IL6, C-reactive protein) partly mediated these associations. Mendelian randomization indicated that PTSD causally increases CAD (IVW OR=1.53, 95% CIs=1.19-1.96, p=0.001), HF (OR=1.44, CIs=1.08-1.92, p=0.012), and to a lesser degree hypertension (OR=1.25, CIs=1.05-1.49, p=0.012). While insomnia, smoking, alcohol, and inflammation were important mediators, independent causal effects also remained. Conclusions In addition to shared genetic liability between PTSD and CVD, we present strong evidence for causal effects of PTSD on CVD. Crucially, we implicate specific lifestyle and biological mediators (insomnia, substance use, inflammation) which has important implications for interventions to prevent CVD in PTSD patients.
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Affiliation(s)
- Eva Lukas
- Genetic Epidemiology Group, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Rada R Veeneman
- Genetic Epidemiology Group, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Dirk JA Smit
- Genetic Epidemiology Group, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | | | - Jentien M Vermeulen
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Gita A Pathak
- Department of Psychiatry, Yale University School of Medicine, 60 Temple, Suite 7A, New Haven, CT, USA
- Veteran Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale University School of Medicine, 60 Temple, Suite 7A, New Haven, CT, USA
- Veteran Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Karin JH Verweij
- Genetic Epidemiology Group, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jorien L Treur
- Genetic Epidemiology Group, Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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Sep MSC, Sarabdjitsingh RA, Geuze E, Joels M. Pre-trauma memory contextualization as predictor for PTSD-like behavior in male rats. J Psychiatr Res 2024; 171:84-94. [PMID: 38262164 DOI: 10.1016/j.jpsychires.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024]
Abstract
While many people experience potentially threatening events during their life, only a minority develops posttraumatic stress disorder (PTSD). The identification of individuals at risk among those exposed to trauma is crucial for PTSD prevention in the future. Since re-experiencing trauma elements outside of the original trauma-context is a core feature of PTSD, we investigate if the ability to bind memories to their original encoding context (i.e. memory contextualization) predicts PTSD vulnerability. We hypothesize that pre-trauma neutral memory contextualization (under stress) negatively relates to PTSD-like behavior, in a prospective design using the cut-off behavioral criteria rat model for PTSD. 72 male Sprague Dawley rats were divided in two experimental groups to assess the predictive value of 1) memory contextualization without acute stress (NS-group) and 2) memory contextualization during the recovery phase of the acute stress-response (S-group) for susceptibility to PTSD-like behavior. A powerful extension to regression analysis -path analysis-was used to test this specific hypothesis, together with secondary research questions. Following traumatic predator scent stress, 19.4% of the rats displayed PTSD-like behavior. Results showed a negative relation between pre-trauma memory contextualization and PTSD-like behavior, but only in the NS-group. Pre-trauma memory contextualization was positively related to fear association in the trauma environment, again only in the NS group. If the predictive value of pre-trauma contextualization of neutral information under non-stressful conditions for PTSD susceptibility is replicated in prospective studies in humans, this factor would supplement already known vulnerability factors for PTSD and improve the identification of individuals at risk among the trauma exposed, especially those at high trauma risk such as soldiers deployed on a mission.
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Affiliation(s)
- Milou S C Sep
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands; Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, the Netherlands; Department of Psychiatry, Amsterdam University Medical Center location Vrije Universiteit, Amsterdam, the Netherlands; GGZ inGeest Mental Health Care, Amsterdam, the Netherlands; Amsterdam Neuroscience, Mood Anxiety, Psychosis, Sleep & Stress Program, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health Program, Amsterdam, the Netherlands.
| | - R Angela Sarabdjitsingh
- Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, the Netherlands
| | - Elbert Geuze
- Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands; Department of Psychiatry, UMC Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - Marian Joels
- Department of Translational Neuroscience, UMC Utrecht Brain Center, Utrecht University, the Netherlands; University of Groningen, University Medical Center Groningen, the Netherlands
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Payne YA, Sadeh N, Hitchens BK, Bounoua N. Elevations in Blood Pressure Associated with Exposure to Violence are Mitigated by Pro-gun-Carrying Attitudes among Street-Identified Black Males and Females. J Urban Health 2024; 101:11-22. [PMID: 37833516 PMCID: PMC10897111 DOI: 10.1007/s11524-023-00787-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/28/2023] [Indexed: 10/15/2023]
Abstract
Living in neighborhoods with elevated rates of violent crime, such as in many poor Black American communities, is a risk factor for a range of physical and mental health challenges. However, the individual different factors that influence health outcomes in these stressful environments remain poorly understood. This study examined relations between exposure to violence, gun-carrying attitudes, and blood pressure in a community sample of street-identified Black American boys/men and girls/women. Survey data and blood pressure were collected from 329 participants (ages 16-54; 57.1% male) recruited from two small urban neighborhoods with high rates of violence using street participatory action research methodology. Results revealed that systolic blood pressure was elevated in the sample as was exposure to severe forms of direct and vicarious violence (e.g., shootings, assault). Attitudes about carrying guns moderated associations between the degree of violence exposure endorsed by participants and both systolic and diastolic blood pressure. Specifically, the positive association between exposure to violence and both systolic and diastolic blood pressure at low levels of pro-gun-carrying attitudes was no longer apparent at high levels of pro-gun attitudes. Furthermore, pro-gun attitudes appeared to moderate the association between exposure to violence and systolic pressure for older participants but not younger participants. Results suggest that positive attitudes about carrying guns (presumably indicative of pro-gun-carrying behavior) weakened the link between violence exposure and blood pressure. These novel findings suggest that carrying a gun may protect against the harmful effects of chronic stress from violence exposure on physical health outcomes (i.e., hypertension) among street-identified Black Americans.
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Affiliation(s)
- Yasser Arafat Payne
- Department of Sociology and Criminal Justice, University of Delaware, 337 Smith Hall, Newark, DE, 19716, USA.
| | - Naomi Sadeh
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
| | - Brooklynn K Hitchens
- Department of Criminology and Criminal Justice, University of Maryland, College Park, MD, USA
| | - Nadia Bounoua
- Department of Psychological and Brain Sciences, University of Delaware, Newark, DE, USA
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Latent profile analysis of post-traumatic stress and post-traumatic growth among firefighters. Eur J Psychotraumatol 2023; 14:2159048. [PMID: 37052101 PMCID: PMC9848271 DOI: 10.1080/20008066.2022.2159048] [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] [Indexed: 01/12/2023] Open
Abstract
Background: Due to the job characteristics, firefighters are repeatedly exposed to trauma incidents. However, not all firefighters exhibit the same level of post-traumatic stress disorder (PTSD) or post-traumatic growth (PTG). Despite this, few studies have looked into firefighters' PTSD and PTG.Objective: This study identified subgroups of firefighters based on their PTSD and PTG levels, and investigated the influence of demographic factors and PTSD/PTG-related factors on latent class classification.Method: Latent profile analysis was used to examine the patterns of PTSD and PTG among 483 firefighters in South Korea. Using a cross-sectional design, demographic factors and job factors were examined as group covariates through a three-step approach. PTSD-related factors such as depression and suicide ideation, as well as PTG-related factors such as emotion-based response were analysed as differentiating factors.Results: Four classes were identified and named 'Low PTSD-low PTG (65.2%),' 'Mid PTSD-mid PTG (15.5%),' 'Low PTSD-high PTG (15.3%),' and 'High PTSD-mid PTG (3.9%).' The likelihood of belonging to the group with high trauma-related risks increased with more rotating shift work and years of service. The differentiating factors revealed differences based on the levels of PTSD and PTG in each group.Conclusions: 34.8% of firefighters experienced changes due to traumatic events while on the job, and some required serious attention. Modifiable job characteristics, such as the shift pattern, indirectly affected PTSD and PTG levels. Individual and job factors should be considered together when developing trauma interventions for firefighters.
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Yu Y, Wu K, Yang X, Long J, Chang C. Terahertz Photons Improve Cognitive Functions in Posttraumatic Stress Disorder. RESEARCH (WASHINGTON, D.C.) 2023; 6:0278. [PMID: 38111677 PMCID: PMC10726292 DOI: 10.34133/research.0278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/12/2023] [Indexed: 12/20/2023]
Abstract
Posttraumatic stress disorder (PTSD) is a serious psychosis leading to cognitive impairment. To restore cognitive functions for patients, the main treatments are based on medication or rehabilitation training but with limited effectiveness and strong side effects. Here, we demonstrate a new treatment approach for PTSD by using terahertz (THz) photons stimulating the hippocampal CA3 subregion. We verified that this method can nonthermally restore cognitive function in PTSD rats in vivo. After THz photon irradiation, the PTSD rats' recognitive index improved by about 10% in a novel object recognition test, the PTSD rats' accuracy improved by about 100% in a shuttler box test, the PTSD rats' numbers to identify target box was about 5 times lower in a Barnes maze test, and the rate of staying in new arm increased by approximately 40% in a Y-maze test. Further experimental studies found that THz photon (34.5 THz) irradiation could improve the expression of NR2B (increased by nearly 40%) and phosphorylated NR2B (increased by about 50%). In addition, molecular dynamics simulations showed that THz photons at a frequency of 34.5 THz are mainly absorbed by the pocket of glutamate receptors rather than by glutamate molecules. Moreover, the binding between glutamate receptors and glutamate molecules was increased by THz photons. This study offers a nondrug, nonthermal approach to regulate the binding between the excitatory neurotransmitter (glutamate) and NR2B. By increasing synaptic plasticity, it effectively improves the cognitive function of animals with PTSD, providing a promising treatment strategy for NR2B-related cognitive disorders.
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Affiliation(s)
- Yun Yu
- School of Life Science and Technology,
Xi’an Jiaotong University, Xi’an 710049, China
- Innovation Laboratory of Terahertz Biophysics,
National Innovation Institute of Defense Technology, Beijing 100071, China
| | - Kaijie Wu
- Innovation Laboratory of Terahertz Biophysics,
National Innovation Institute of Defense Technology, Beijing 100071, China
| | - Xiao Yang
- Innovation Laboratory of Terahertz Biophysics,
National Innovation Institute of Defense Technology, Beijing 100071, China
| | - Jiangang Long
- School of Life Science and Technology,
Xi’an Jiaotong University, Xi’an 710049, China
| | - Chao Chang
- Innovation Laboratory of Terahertz Biophysics,
National Innovation Institute of Defense Technology, Beijing 100071, China
- School of Physics,
Peking University, Beijing 100871, China
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Beutler S, Croy I. Psychophysiological reactions during the trauma-film paradigm and their predictive value for intrusions. Eur J Psychotraumatol 2023; 14:2281753. [PMID: 38059504 PMCID: PMC10990446 DOI: 10.1080/20008066.2023.2281753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/12/2023] [Indexed: 12/08/2023] Open
Abstract
Background: Adequate adaptation of the autonomic nervous system (ANS) is crucial in potentially life-threatening situations. The defence cascade provides a descriptive model of progressing dominant physiological reactions in such situations, including cardiovascular parameters and body mobility. The empirical evidence for this model is scarce, and the influence of physiological reactions in this model for predicting trauma-induced intrusions is unresolved.Objectives: Using a trauma-film paradigm, we aimed to test physiological reactions to a highly stressful film as an analogue to a traumatic event along the defence cascade model. We also aimed to examine the predictive power of physiological activity for subsequent intrusive symptoms.Method: Forty-seven healthy female participants watched a stressful and a neutral film in randomized order. Heart rate (HR), heart rate variability (HRV), and body sway were measured. Participants tracked frequency, distress, and quality of subsequent intrusions in a diary for 7 consecutive days.Results: For the stressful film, we observed an initial decrease in HR, followed by an increase, before the HR stabilized at a high level, which was not found during the neutral film. No differences in HRV were observed between the two films. Body sway and trembling frequency were heightened during the stressful film. Neither HR nor HRV predicted subsequent intrusions, whereas perceived distress during the stressful film did.Conclusions: Our results suggest that the physiological trauma-analogue response is characterized by an orientation response and subsequent hyperarousal, reaching a high physiological plateau. In contrast to the assumptions of the defence cascade model, the hyperarousal was not followed by downregulation. Potential explanations are discussed. For trauma-associated intrusions in the subsequent week, psychological distress during the film seems to be more important than physiological distress. Understanding the interaction between physiological and psychological responses during threat informs the study of ANS imbalances in mental disorders such as post-traumatic stress disorder.
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Affiliation(s)
- Sarah Beutler
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, Friedrich Schiller University of Jena, Jena, Germany
| | - Ilona Croy
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, Friedrich Schiller University of Jena, Jena, Germany
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Lodh S, Das PK, Mukherjee J, Naskar S, Banerjee D, Ghosh PR, Munsi S, Patra AK. Effect of dietary oregano essential oil and milk replacer on physiological status and immunological responses of pre- and post-weaned Ghoongroo piglets. Anim Biotechnol 2023; 34:2793-2804. [PMID: 36062916 DOI: 10.1080/10495398.2022.2118131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Ghoongroo pigs have good adaptability in a low input production system with high prolificacy. The present study was conducted on pre-and post-weaned Ghoongroo piglets from 2-3 days to 12 weeks of age to evaluate the effect of a milk replacer and oregano essential oil (EO) on growth, physiological and immunological responses. Thirty six piglets were randomly divided into three groups. The control group (n = 12) was allowed to suck mother's milk. Second group piglets were provided milk replacer (MR) and piglets of the third group were provided milk replacer along with oregano EO at 500 mg/kg diet. After weaning, piglets were provided standard concentrate diets. The results showed that the body weight in MR and MR + EO groups were significantly higher compared with the control. The MR + EO group had better intestinal microbiota, greater nonspecific innate immunity with the phagocytosis efficacy of neutrophils, lower cortisol concentration and more stable thyroid hormones than the other groups. The better haematological status supported the rapid organ development and improved intestinal health status in both the experimental groups. In conclusion, milk replacer, especially with the inclusion of oregano EO, can lower weaning stress, enhance nonspecific immunity and improve growth and health status of piglets.
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Affiliation(s)
- Sweta Lodh
- Department of Veterinary Physiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Pradip Kumar Das
- Department of Veterinary Physiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Joydip Mukherjee
- Department of Veterinary Physiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Shyamal Naskar
- Indian Council of Agricultural Research - Indian Veterinary Research Institute, Eastern Regional Station, Kolkata, India
| | - Dipak Banerjee
- Department of Veterinary Physiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Prabal Ranjan Ghosh
- Department of Veterinary Physiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Suparna Munsi
- Department of Veterinary Microbiology, West Bengal University of Animal and Fishery Sciences, Kolkata, India
| | - Amlan Kumar Patra
- Department of Animal Nutrition, West Bengal University of Animal and Fishery Sciences, Kolkata, India
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Dmytriv TR, Tsiumpala SA, Semchyshyn HM, Storey KB, Lushchak VI. Mitochondrial dysfunction as a possible trigger of neuroinflammation at post-traumatic stress disorder (PTSD). Front Physiol 2023; 14:1222826. [PMID: 37942228 PMCID: PMC10628526 DOI: 10.3389/fphys.2023.1222826] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a neuropsychiatric disorder that occurs in approximately 15% of people as a result of some traumatic events. The main symptoms are re-experiencing and avoidance of everything related to this event and hyperarousal. The main component of the pathophysiology of PTSD is an imbalance in the functioning of the hypothalamic-pituitary-adrenal axis (HPA) and development of neuroinflammation. In parallel with this, mitochondrial dysfunction is observed, as in many other diseases. In this review, we focus on the question how mitochondria may be involved in the development of neuroinflammation and its maintaining at PTSD. First, we describe the differences in the operation of the neuro-endocrine system during stress versus PTSD. We then show changes in the activity/expression of mitochondrial proteins in PTSD and how they can affect the levels of hormones involved in PTSD development, as well as how mitochondrial damage/pathogen-associated molecule patterns (DAMPs/PAMPs) trigger development of inflammation. In addition, we examine the possibility of treating PTSD-related inflammation using mitochondria as a target.
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Affiliation(s)
- Tetiana R. Dmytriv
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Sviatoslav A. Tsiumpala
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Halyna M. Semchyshyn
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
| | - Kenneth B. Storey
- Department of Biology, Institute of Biochemistry, Carleton University, Ottawa, ON, Canada
| | - Volodymyr I. Lushchak
- Department of Biochemistry and Biotechnology, Vasyl Stefanyk Precarpathian National University, Ivano-Frankivsk, Ukraine
- Research and Development University, Ivano-Frankivsk, Ukraine
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13
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Gillam W, Godbole N, Sangam S, DeTommaso A, Foreman M, Lucke-Wold B. Neurologic Injury-Related Predisposing Factors of Post-Traumatic Stress Disorder: A Critical Examination. Biomedicines 2023; 11:2732. [PMID: 37893106 PMCID: PMC10604790 DOI: 10.3390/biomedicines11102732] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 09/30/2023] [Accepted: 10/04/2023] [Indexed: 10/29/2023] Open
Abstract
The present review aimed to identify the means through which neurologic injury can predispose individuals to Post-Traumatic Stress Disorder (PTSD). In recent years, comprehensive studies have helped to clarify which structures in the central nervous system can lead to distinct PTSD symptoms-namely, dissociative reactions or flashbacks-when damaged. Our review narrowed its focus to three common neurologic injuries, traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), and stroke. We found that in each of the three cases, individuals may be at an increased risk of developing PTSD symptoms. Beyond discussing the potential mechanisms by which neurotrauma may lead to PTSD, we summarized our current understanding of the pathophysiology of the disorder and discussed predicted associations between the limbic system and PTSD. In particular, the effect of noradrenergic neuromodulatory signaling on the hypothalamic pituitary adrenal (HPA) axis as it pertains to fear memory recall needs to be further explored to better understand its effects on limbic structures in PTSD patients. At present, altered limbic activity can be found in both neurotrauma and PTSD patients, suggesting a potential causative link. Particularly, changes in the function of the limbic system may be associated with characteristic symptoms of PTSD such as intrusive memories and acute psychological distress. Despite evidence demonstrating the correlation between neurotrauma and PTSD, a lack of PTSD prognosis exists in TBI, SAH, and stroke patients who could benefit from early treatment. It should be noted that PTSD symptoms often compound with pre-existing issues, further deteriorating health outcomes for these patients. It is ultimately our goal to clarify the relationship between neurotrauma and PTSD so that earlier diagnoses and appropriate treatment are observed in clinic.
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Affiliation(s)
- Wiley Gillam
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (W.G.)
| | - Nikhil Godbole
- School of Medicine, Tulane University, New Orleans, LA 70112, USA;
| | - Shourya Sangam
- College of Liberal Arts and Sciences, University of Florida, Gainesville, FL 32603, USA
| | - Alyssa DeTommaso
- College of Health Professions and Sciences, University of Central Florida, Orlando, FL 32827, USA
| | - Marco Foreman
- College of Medicine, University of Florida, Gainesville, FL 32610, USA; (W.G.)
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, FL 32610, USA
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14
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Lewis MW, Webb CA, Kuhn M, Akman E, Jobson SA, Rosso IM. Predicting Fear Extinction in Posttraumatic Stress Disorder. Brain Sci 2023; 13:1131. [PMID: 37626488 PMCID: PMC10452660 DOI: 10.3390/brainsci13081131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Fear extinction is the basis of exposure therapies for posttraumatic stress disorder (PTSD), but half of patients do not improve. Predicting fear extinction in individuals with PTSD may inform personalized exposure therapy development. The participants were 125 trauma-exposed adults (96 female) with a range of PTSD symptoms. Electromyography, electrocardiogram, and skin conductance were recorded at baseline, during dark-enhanced startle, and during fear conditioning and extinction. Using a cross-validated, hold-out sample prediction approach, three penalized regressions and conventional ordinary least squares were trained to predict fear-potentiated startle during extinction using 50 predictor variables (5 clinical, 24 self-reported, and 21 physiological). The predictors, selected by penalized regression algorithms, were included in multivariable regression analyses, while univariate regressions assessed individual predictors. All the penalized regressions outperformed OLS in prediction accuracy and generalizability, as indexed by the lower mean squared error in the training and holdout subsamples. During early extinction, the consistent predictors across all the modeling approaches included dark-enhanced startle, the depersonalization and derealization subscale of the dissociative experiences scale, and the PTSD hyperarousal symptom score. These findings offer novel insights into the modeling approaches and patient characteristics that may reliably predict fear extinction in PTSD. Penalized regression shows promise for identifying symptom-related variables to enhance the predictive modeling accuracy in clinical research.
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Affiliation(s)
- Michael W. Lewis
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Christian A. Webb
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Manuel Kuhn
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Eylül Akman
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Sydney A. Jobson
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
| | - Isabelle M. Rosso
- Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, MA 02478, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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15
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Watkins LL, LoSavio ST, Calhoun P, Resick PA, Sherwood A, Coffman CJ, Kirby AC, Beaver TA, Dennis MF, Beckham JC. Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial. J Psychosom Res 2023; 170:111351. [PMID: 37178469 PMCID: PMC10283083 DOI: 10.1016/j.jpsychores.2023.111351] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/27/2023] [Accepted: 04/30/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is associated with elevated risk of coronary heart disease (CHD); however, the effects of PTSD treatment on CHD biomarkers is unknown. This study examined whether cognitive processing therapy (CPT) improves 24-hourheart rate variability (HRV), a predictor of CHD mortality. METHODS Individuals between the ages of 40 and 65 years with PTSD (n = 112) were randomized to receive 12 sessions of CPT or a Waiting List (WL) intervention comprised of 6 weekly telephone checks of emotional status. The primary outcome variable was 24-hour HRV estimated from the standard deviation of all normal R-R intervals (SDNN); secondary outcomes were the root mean square of successive differences between heart beats (RMSSD), low-frequency HRV (LF-HRV) and high-frequency HRV (HF-HRV). Secondary outcomes also included 24-hour urinary catecholamine excretion, plasma C-reactive protein (CRP), and flow-mediated dilation (FMD) of the brachial artery. For outcomes, linear mixed longitudinal models were used to estimate mean differences (Mdiff). RESULTS Participants randomized to the CPT group did not show improved SDNN (Mdiff = 9.8; 95%CI, -2.7 to 22.3; p = 0.12), the primary outcome variable, but showed improved RMSSD (Mdiff = 3.8; 95% CI, 0.5 to 7.1; p = 0.02), LF- HRV (Mdiff =0.3; 95% CI, 0.1 to 0.5; p = 0.01), and HF-HRV (Mdiff = 0.3; 95% CI, 0.0 to 0.6; p = 0.03) compared to WL. There were no differences between groups in catecholamine excretion, FMD, or inflammatory markers. CONCLUSION Treating PTSD may not only improve quality of life but may also help ameliorate heightened CHD risk characteristics of PTSD.
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Affiliation(s)
- Lana L Watkins
- Duke University Medical Center, Durham, NC, United States of America.
| | | | - Patrick Calhoun
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
| | - Patricia A Resick
- Duke University Medical Center, Durham, NC, United States of America
| | - Andrew Sherwood
- Duke University Medical Center, Durham, NC, United States of America
| | - Cynthia J Coffman
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Healthcare System, United States of America
| | - Angela C Kirby
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
| | - Tiffany A Beaver
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America
| | - Michelle F Dennis
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America
| | - Jean C Beckham
- Duke University Medical Center, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America; VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, United States of America
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16
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Abi-Dargham A, Moeller SJ, Ali F, DeLorenzo C, Domschke K, Horga G, Jutla A, Kotov R, Paulus MP, Rubio JM, Sanacora G, Veenstra-VanderWeele J, Krystal JH. Candidate biomarkers in psychiatric disorders: state of the field. World Psychiatry 2023; 22:236-262. [PMID: 37159365 PMCID: PMC10168176 DOI: 10.1002/wps.21078] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 05/11/2023] Open
Abstract
The field of psychiatry is hampered by a lack of robust, reliable and valid biomarkers that can aid in objectively diagnosing patients and providing individualized treatment recommendations. Here we review and critically evaluate the evidence for the most promising biomarkers in the psychiatric neuroscience literature for autism spectrum disorder, schizophrenia, anxiety disorders and post-traumatic stress disorder, major depression and bipolar disorder, and substance use disorders. Candidate biomarkers reviewed include various neuroimaging, genetic, molecular and peripheral assays, for the purposes of determining susceptibility or presence of illness, and predicting treatment response or safety. This review highlights a critical gap in the biomarker validation process. An enormous societal investment over the past 50 years has identified numerous candidate biomarkers. However, to date, the overwhelming majority of these measures have not been proven sufficiently reliable, valid and useful to be adopted clinically. It is time to consider whether strategic investments might break this impasse, focusing on a limited number of promising candidates to advance through a process of definitive testing for a specific indication. Some promising candidates for definitive testing include the N170 signal, an event-related brain potential measured using electroencephalography, for subgroup identification within autism spectrum disorder; striatal resting-state functional magnetic resonance imaging (fMRI) measures, such as the striatal connectivity index (SCI) and the functional striatal abnormalities (FSA) index, for prediction of treatment response in schizophrenia; error-related negativity (ERN), an electrophysiological index, for prediction of first onset of generalized anxiety disorder, and resting-state and structural brain connectomic measures for prediction of treatment response in social anxiety disorder. Alternate forms of classification may be useful for conceptualizing and testing potential biomarkers. Collaborative efforts allowing the inclusion of biosystems beyond genetics and neuroimaging are needed, and online remote acquisition of selected measures in a naturalistic setting using mobile health tools may significantly advance the field. Setting specific benchmarks for well-defined target application, along with development of appropriate funding and partnership mechanisms, would also be crucial. Finally, it should never be forgotten that, for a biomarker to be actionable, it will need to be clinically predictive at the individual level and viable in clinical settings.
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Affiliation(s)
- Anissa Abi-Dargham
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Scott J Moeller
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Farzana Ali
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Centre for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Guillermo Horga
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Amandeep Jutla
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Roman Kotov
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | | | - Jose M Rubio
- Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY, USA
- Feinstein Institute for Medical Research - Northwell, Manhasset, NY, USA
- Zucker Hillside Hospital - Northwell Health, Glen Oaks, NY, USA
| | - Gerard Sanacora
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy Veenstra-VanderWeele
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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17
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On making (and turning adaptive to) maladaptive aversive memories in laboratory rodents. Neurosci Biobehav Rev 2023; 147:105101. [PMID: 36804263 DOI: 10.1016/j.neubiorev.2023.105101] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/03/2023] [Accepted: 02/14/2023] [Indexed: 02/18/2023]
Abstract
Fear conditioning and avoidance tasks usually elicit adaptive aversive memories. Traumatic memories are more intense, generalized, inflexible, and resistant to attenuation via extinction- and reconsolidation-based strategies. Inducing and assessing these dysfunctional, maladaptive features in the laboratory are crucial to interrogating posttraumatic stress disorder's neurobiology and exploring innovative treatments. Here we analyze over 350 studies addressing this question in adult rats and mice. There is a growing interest in modeling several qualitative and quantitative memory changes by exposing already stressed animals to freezing- and avoidance-related tests or using a relatively high aversive training magnitude. Other options combine aversive/fearful tasks with post-acquisition or post-retrieval administration of one or more drugs provoking neurochemical or epigenetic alterations reported in the trauma aftermath. It is potentially instructive to integrate these procedures and incorporate the measurement of autonomic and endocrine parameters. Factors to consider when defining the organismic and procedural variables, partially neglected aspects (sex-dependent differences and recent vs. remote data comparison) and suggestions for future research (identifying reliable individual risk and treatment-response predictors) are discussed.
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18
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Moore SM, Welsh MC, Peterson E. Childhood maltreatment predicts physical health in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:942-951. [PMID: 34152945 DOI: 10.1080/07448481.2021.1909047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: Childhood maltreatment (CM) is associated with physical health problems throughout the lifespan, yet more research is needed regarding the trajectory of health problems (e.g., onset of health risk indicators) in young adults. The current study examined whether college students self-reporting higher levels of CM exhibited poorer physical health outcomes. Method: Young adults in college (N = 100) completed a physical health assessment (heart rate, body mass index (BMI), blood pressure, blood sugar, waist circumference), self-reported measures of health (symptoms of illness), and CM during spring semester 2018. Results: CM scores predicted higher heart rate and increased symptoms of illness. Females with maltreatment history presented higher levels of obesity and more metabolic syndrome conditions than their peers. Conclusions: Findings support the importance of examining the trajectory of CM to chronic disease, as health risk indicators are present in young adults.
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Affiliation(s)
- Susannah M Moore
- School of Psychological Sciences, University of Northern Colorado, Greeley, Colorado, USA
| | - Marilyn C Welsh
- School of Psychological Sciences, University of Northern Colorado, Greeley, Colorado, USA
| | - Eric Peterson
- School of Psychological Sciences, University of Northern Colorado, Greeley, Colorado, USA
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19
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Kinney KL, Rao U, Bailey B, Hellman N, Kelly C, McAfee NW, Morris MC. Dynamics of diurnal cortisol and alpha-amylase secretion and their associations with PTSD onset in recent interpersonal trauma survivors. Psychol Med 2023; 53:2263-2273. [PMID: 37310311 PMCID: PMC10264829 DOI: 10.1017/s0033291721004050] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Dysfunction in major stress response systems during the acute aftermath of trauma may contribute to risk for developing posttraumatic stress disorder (PTSD). The current study investigated how PTSD diagnosis and symptom severity, depressive symptoms, and childhood trauma uniquely relate to diurnal neuroendocrine secretion (cortisol and alpha-amylase rhythms) in women who recently experienced interpersonal trauma compared to non-traumatized controls (NTCs). METHOD Using a longitudinal design, we examined diurnal cortisol and alpha-amylase rhythms in 98 young women (n = 57 exposed to recent interpersonal trauma, n = 41 NTCs). Participants provided saliva samples and completed symptom measures at baseline and 1-, 3-, and 6-month follow-up. RESULTS Multilevel models (MLMs) revealed lower waking cortisol predicted the development of PTSD in trauma survivors and distinguished at-risk women from NTCs. Women with greater childhood trauma exposure exhibited flatter diurnal cortisol slopes. Among trauma-exposed individuals, lower waking cortisol levels were associated with higher concurrent PTSD symptom severity. Regarding alpha-amylase, MLMs revealed women with greater childhood trauma exposure exhibited higher waking alpha-amylase and slower diurnal alpha-amylase increase. CONCLUSIONS Results suggest lower waking cortisol in the acute aftermath of trauma may be implicated in PTSD onset and maintenance. Findings also suggest childhood trauma may predict a different pattern of dysfunction in stress response systems following subsequent trauma exposure than the stress system dynamics associated with PTSD risk; childhood trauma appears to be associated with flattened diurnal cortisol and alpha-amylase slopes, as well as higher waking alpha-amylase.
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Affiliation(s)
- Kerry L. Kinney
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Uma Rao
- Departments of Psychiatry & Human Behavior, Pediatrics and Psychological Science, and Center for the Neurobiology of Learning and Memory, University of California – Irvine, California, USA
- Children’s Hospital of Orange County, Orange, CA, USA
| | - Brooklynn Bailey
- Department of Psychology, the Ohio State University, Columbus, Ohio, USA
| | - Natalie Hellman
- Department of Psychology, University of Tulsa, Tulsa, Oklahoma, USA
| | - Chris Kelly
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Nicholas W. McAfee
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Matthew C. Morris
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
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20
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Bailey M, Meiser‐Stedman R, Hiller R, Haag K, Lobo S, Halligan SL. Child posttraumatic stress symptoms in an acute injury sample: Patterns of associations among child report, parent report, and child heart rate parameters. J Trauma Stress 2023; 36:333-345. [PMID: 36787341 PMCID: PMC10946953 DOI: 10.1002/jts.22913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 02/15/2023]
Abstract
Parent-child agreement on measures of child posttraumatic stress disorder (PTSD) is moderate at best, and understanding of this discrepancy is limited. To address this, we conducted an item-level investigation of parent-child symptom agreement to examine the potential influence of parental posttraumatic stress symptoms (PTSS) on parents' reports of their child's PTSS. We also examined heart rate (HR) indices as possible independent indicators of child PTSD, examining patterns of association with parent versus child report. Parent-child dyads (N = 132, child age: 6-13 years, 91.7% White) were recruited after the child's hospital admission following an acute, single-incident traumatic event. At 1-month posttrauma, questionnaires assessing children's PTSS (self- and parental reports) and parental PTSS were administered. For a subset of participants (n = 70), children's HR recordings were obtained during a trauma narrative task and analyzed. Parent and child reports of child PTSS were weakly positively correlated, r = .25. Parental PTSS were found to be stronger positive predictors of parental reports of child PTSS than the children's own symptom reports, β = 0.60 vs. β = 0.14, and were associated with higher parent-reported child PTSS relative to child reports. Finally, children's self-reported PTSS were associated with HR indices, whereas parent reports were not, βs = -.33-.30 vs. βs = -.15-.01. Taken together, children's self-reported PTSS could be a more accurate reflection of their posttrauma physiological distress than parent reports. The potential influence of parental PTSS on their perceptions of their child's symptoms warrants further consideration.
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Affiliation(s)
- Megan Bailey
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Richard Meiser‐Stedman
- Department of Clinical Psychology and Psychological TherapiesNorwich Medical SchoolUniversity of East AngliaUnited Kingdom
| | - Rachel Hiller
- Division of Psychology & Language SciencesUniversity College LondonLondonUnited Kingdom
- Anna Freud National Centre for Children & FamiliesLondonUnited Kingdom
| | - Katharina Haag
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Sarah Lobo
- Department of PsychologyUniversity of BathBathUnited Kingdom
| | - Sarah L. Halligan
- Department of PsychologyUniversity of BathBathUnited Kingdom
- Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
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21
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Al Jowf GI, Ahmed ZT, Reijnders RA, de Nijs L, Eijssen LMT. To Predict, Prevent, and Manage Post-Traumatic Stress Disorder (PTSD): A Review of Pathophysiology, Treatment, and Biomarkers. Int J Mol Sci 2023; 24:ijms24065238. [PMID: 36982313 PMCID: PMC10049301 DOI: 10.3390/ijms24065238] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) can become a chronic and severely disabling condition resulting in a reduced quality of life and increased economic burden. The disorder is directly related to exposure to a traumatic event, e.g., a real or threatened injury, death, or sexual assault. Extensive research has been done on the neurobiological alterations underlying the disorder and its related phenotypes, revealing brain circuit disruption, neurotransmitter dysregulation, and hypothalamic–pituitary–adrenal (HPA) axis dysfunction. Psychotherapy remains the first-line treatment option for PTSD given its good efficacy, although pharmacotherapy can also be used as a stand-alone or in combination with psychotherapy. In order to reduce the prevalence and burden of the disorder, multilevel models of prevention have been developed to detect the disorder as early as possible and to reduce morbidity in those with established diseases. Despite the clinical grounds of diagnosis, attention is increasing to the discovery of reliable biomarkers that can predict susceptibility, aid diagnosis, or monitor treatment. Several potential biomarkers have been linked with pathophysiological changes related to PTSD, encouraging further research to identify actionable targets. This review highlights the current literature regarding the pathophysiology, disease development models, treatment modalities, and preventive models from a public health perspective, and discusses the current state of biomarker research.
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Affiliation(s)
- Ghazi I. Al Jowf
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
- Correspondence: (G.I.A.J.); (L.M.T.E.)
| | - Ziyad T. Ahmed
- College of Medicine, Sulaiman Al Rajhi University, Al-Bukairyah 52726, Saudi Arabia
| | - Rick A. Reijnders
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Laurence de Nijs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Lars M. T. Eijssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Bioinformatics—BiGCaT, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
- Correspondence: (G.I.A.J.); (L.M.T.E.)
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22
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Rountree-Harrison D, Berkovsky S, Kangas M. Heart and brain traumatic stress biomarker analysis with and without machine learning: A scoping review. Int J Psychophysiol 2023; 185:27-49. [PMID: 36720392 DOI: 10.1016/j.ijpsycho.2023.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
The enigma of post-traumatic stress disorder (PTSD) is embedded in a complex array of physiological responses to stressful situations that result in disruptions in arousal and cognitions that characterise the psychological disorder. Deciphering these physiological patterns is complex, which has seen the use of machine learning (ML) grow in popularity. However, it is unclear to what extent ML has been used with physiological data, specifically, the electroencephalogram (EEG) and electrocardiogram (ECG) to further understand the physiological responses associated with PTSD. To better understand the use of EEG and ECG biomarkers, with and without ML, a scoping review was undertaken. A total of 124 papers based on adult samples were identified comprising 19 ML studies involving EEG and ECG. A further 21 studies using EEG data, and 84 studies employing ECG meeting all other criteria but not employing ML were included for comparison. Identified studies indicate classical ML methodologies currently dominate EEG and ECG biomarkers research, with derived biomarkers holding clinically relevant diagnostic implications for PTSD. Discussion of the emerging trends, algorithms used and their success is provided, along with areas for future research.
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Affiliation(s)
- Darius Rountree-Harrison
- Macquarie University, Balaclava Road, Macquarie Park, New South Wales 2109, Australia; New South Wales Service for the Rehabilitation and Treatment of Torture and Trauma Survivors (STARTTS), 152-168 The Horsley Drive Carramar, New South Wales 2163, Australia.
| | - Shlomo Berkovsky
- Macquarie University, Balaclava Road, Macquarie Park, New South Wales 2109, Australia
| | - Maria Kangas
- Macquarie University, Balaclava Road, Macquarie Park, New South Wales 2109, Australia
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Klinger-König J, Hannemann A, Friedrich N, Nauck M, Völzke H, Grabe HJ. Association between childhood maltreatment and adult cortisol concentrations mediated through subjective health complaints. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1098822. [PMID: 38455886 PMCID: PMC10911021 DOI: 10.3389/fepid.2023.1098822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 03/09/2024]
Abstract
Background Lower cortisol concentrations in adulthood were repeatedly associated with more severe childhood maltreatment. Additionally, childhood maltreatment was reported to promote health risk behavior, such as smoking or alcohol consumption, and to increase the risk of mental and somatic diseases during adulthood, such as major depressive disorders or obesity. The present study investigated if health risk behavior and disease symptoms in adults mediate the associations between past childhood maltreatment and present basal serum cortisol concentrations. Methods Data from two independent adult cohorts of the general population-based Study of Health in Pomerania (SHIP-TREND-0: N = 3,517; SHIP-START-2: N = 1,640) was used. Childhood maltreatment was assessed via the Childhood Trauma Questionnaire (CTQ). Cortisol concentrations were measured in single-point serum samples. Health risk behavior and mental and physical symptoms were used as mediators. Mediation analyses were calculated separately for both cohorts; results were integrated via meta-analyses. Results In mediator-separated analyses, associations between childhood maltreatment and basal serum cortisol concentrations were partly mediated by depressive symptoms (BDI-II: βindirect effect = -.011, pFDR = .017, 21.0% mediated) and subjective somatic health complaints (somatic complaints: βindirect effect = -.010, pFDR = .005, 19.4% mediated). In the second step, both mediators were simultaneously integrated into one mediation model. The model replicated the mediation effects of the subjective somatic health complaints (whole model: βindirect effect = -.014, p = .001, 27.6% mediated; BDI-II: βindirect effect = -.006, p = .163, 11.4% mediated, somatic complaints: βindirect effect = -.020, p = .020, 15.5% mediated). Conclusion The results support the hypothesis that the long-lasting effects of childhood maltreatment on the stress response system are partly mediated through self-perceived disease symptoms. However, no mediation was found for health risk behavior or physically measured mediators. Mediation models with multiple simultaneous mediators pointed to a relevant overlap between the potential mediators. This overlap should be focused on in future studies.
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Affiliation(s)
- Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, University Medicine Greifswald, Greifswald, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Site Rostock/Greifswald, Greifswald, Germany
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Hair glucocorticoids during pregnancy in the context of trauma exposure and their predictive value for the development of childbirth-related posttraumatic stress disorder symptoms. Psychoneuroendocrinology 2023; 148:105973. [PMID: 36481577 DOI: 10.1016/j.psyneuen.2022.105973] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 10/07/2022] [Accepted: 11/09/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Childbirth-related posttraumatic stress disorder (CB-PTSD) is gaining attention as a mental disorder with negative sequela for mothers and their offspring. Maternal trauma history is a well-known vulnerability factor for CB-PTSD symptoms (CB-PTSS). Furthermore, alterations of the hypothalamus-pituitary-adrenal axis have been linked to both trauma exposure and PTSD development. Hence, we investigated whether trauma history was associated with long-term glucocorticoid (GC) levels during pregnancy and their predictive role for CB-PTSS. Further, we examined whether GCs act as a mediator in the relationship between trauma history and CB-PTSS and whether this was moderated by the subjective birth experience. METHODS 212 women participating in the prospective cohort study DREAMHAIR provided hair samples for quantification of long-term integrated cortisol and cortisone levels prior to their anticipated birth date accompanied by measures of trauma history. CB-PTSS and subjective birth experience were assessed two months postpartum. FINDINGS Trauma history predicted elevated hair cortisol and hair cortisone during the third trimester of pregnancy, however associations did not remain significant when Bonferroni correction due to multiple testing was applied. Trauma history also predicted higher CB-PTSS. Hair GC levels during pregnancy neither predicted CB-PTSS two months after birth nor mediated the relationship between trauma history and CB-PTSS. The subjective birth experience moderated the relationship of hair cortisol and cortisone with CB-PTSS. CONCLUSION Our data suggest that a history of trauma contributes to a higher risk to develop CB-PTSS and elevated long-term GC levels during the third pregnancy trimester. Further, the predictive role of hair cortisol and cortisone levels for CB-PTSS may depend on subjective birth experience. This highlights the need to consider the latter in future investigations when examining the role of stress-related biomarkers in more severely affected samples.
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Sbisa AM, Madden K, Toben C, McFarlane AC, Dell L, Lawrence-Wood E. Potential peripheral biomarkers associated with the emergence and presence of posttraumatic stress disorder symptomatology: A systematic review. Psychoneuroendocrinology 2023; 147:105954. [PMID: 36308820 DOI: 10.1016/j.psyneuen.2022.105954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/16/2022] [Accepted: 10/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Evidence suggests posttraumatic stress disorder (PTSD) involves an interplay between psychological manifestations and biological systems. Biological markers of PTSD could assist in identifying individuals with underlying dysregulation and increased risk; however, accurate and reliable biomarkers are yet to be identified. METHODS A systematic review following the PRISMA guidelines was conducted. Databases included EMBASE, MEDLINE, and Cochrane Central. Studies from a comprehensive 2015 review (Schmidt et al., 2015) and English language papers published subsequently (between 2014 and May 2022) were included. Forty-eight studies were eligible. RESULTS Alterations in neuroendocrine and immune markers were most commonly associated with PTSD symptoms. Evidence indicates PTSD symptoms are associated with hypothalamic-pituitary-adrenal axis dysfunction as represented by low basal cortisol, a dysregulated immune system, characterized by an elevated pro-inflammatory state, and metabolic dysfunction. However, a considerable number of studies neglected to measure sex or prior trauma, which have the potential to affect the biological outcomes of posttraumatic stress symptoms. Mixed findings are indicative of the complexity and heterogeneity of PTSD and suggest the relationship between allostatic load, biological markers, and PTSD remain largely undefined. CONCLUSIONS In addition to prospective research design and long-term follow up, it is imperative future research includes covariates sex, prior trauma, and adverse childhood experiences. Future research should include exploration of biological correlates specific to PTSD symptom domains to determine whether underlying processes differ with symptom expression, in addition to subclinical presentation of posttraumatic stress symptoms, which would allow for greater understanding of biomarkers associated with disorder risk and assist in untangling directionality.
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Affiliation(s)
- Alyssa M Sbisa
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Kelsey Madden
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Catherine Toben
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | | | - Lisa Dell
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Ellie Lawrence-Wood
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
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Ogłodek EA. Changes in the Serum Concentration Levels of Serotonin, Tryptophan and Cortisol among Stress-Resilient and Stress-Susceptible Individuals after Experiencing Traumatic Stress. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16517. [PMID: 36554398 PMCID: PMC9779530 DOI: 10.3390/ijerph192416517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Stress is a common response to many environmental adversities. However, once dysregulated, this reaction can lead to psychiatric illnesses, such as post-traumatic stress disorder (PTSD). Individuals can develop PTSD after exposure to traumatic events, severely affecting their quality of life. Nevertheless, not all individuals exposed to stress will develop psychiatric disorders, provided they show enhanced stress-resilience mechanisms that enable them to successfully adapt to stressful situations and thus avoid developing a persistent psychopathology. METHODS The study involved 93 participants. Of them, 62 comprised a study group and 31 comprised a control group. The aim of the study was to assess serotonin, cortisol and tryptophan concentration levels in subjects with PTSD (stress-susceptible; PTSD-SS) and in healthy individuals (stress-resilient; PTSD-SR), who had experienced a traumatic event but fully recovered after the trauma. The subjects were between 18 and 50 years of age (mean 35.56 ± 8.26 years). The serum concentration levels of serotonin, cortisol and tryptophan were measured with an ELISA kit. RESULTS It was found that the serotonin, tryptophan and cortisol concentration levels were consistent with the features of both PTSD-SR and PTSD-SS patients. It was reported that the mean cortisol concentration levels increased more significantly in the PTSD-SS group than in the PTSD-SR group, versus those in the control group. Similarly, the PTSD-SS group was found to show a larger decrease in the mean serotonin concentration levels than the PTSD-SR group, versus those in the control group. No significant changes were found in the tryptophan concentration levels between the study groups, versus those in the control group. CONCLUSIONS These findings can be useful when attempting to improve resilience in individuals using neuropharmacological methods. However, it is necessary to conduct more cross-sectional studies that would address different types of negative stress to find out whether they share common pathways.
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Affiliation(s)
- Ewa Alicja Ogłodek
- Department of Health Sciences, Jan Dlugosz University, 42-200 Częstochowa, Poland
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27
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Samir H, Mandour AS, Radwan F, Swelum AA, Nagaoka K, Sasaki K, Watanabe G. Effect of xylazine sedation on testicular blood flow, testicular echotexture, and circulating hormones in Shiba goats. Vet Res Commun 2022; 47:849-859. [DOI: 10.1007/s11259-022-10046-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/23/2022] [Indexed: 12/02/2022]
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Calhoun CD, Stone KJ, Cobb AR, Patterson MW, Danielson CK, Bendezú JJ. The Role of Social Support in Coping with Psychological Trauma: An Integrated Biopsychosocial Model for Posttraumatic Stress Recovery. Psychiatr Q 2022; 93:949-970. [PMID: 36199000 PMCID: PMC9534006 DOI: 10.1007/s11126-022-10003-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/29/2022]
Abstract
This theoretical review proposes an integrated biopsychosocial model for stress recovery, highlighting the interconnectedness of intra- and interpersonal coping processes. The proposed model is conceptually derived from prior research examining interpersonal dynamics in the context of stressor-related disorders, and it highlights interconnections between relational partner dynamics, perceived self-efficacy, self-discovery, and biological stress responsivity during posttraumatic recovery. Intra- and interpersonal processes are discussed in the context of pre-, peri-, and post-trauma stress vulnerability as ongoing transactions occurring within the individual and between the individual and their environment. The importance of adopting an integrated model for future traumatic stress research is discussed. Potential applications of the model to behavioral interventions are also reviewed, noting the need for more detailed assessments of relational dynamics and therapeutic change mechanisms to determine how relational partners can most effectively contribute to stress recovery.
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Affiliation(s)
- Casey D Calhoun
- Department of Psychology and Neuroscience, University of North Carolina, 235 E. Cameron Avenue, CB 3270, Chapel Hill, NC, 27599, USA.
| | - Katie J Stone
- Division of Clinical Behavioral Neuroscience, University of Minnesota, Masonic Institute for the Developing Brain, Minneapolis, MN, USA
| | - Adam R Cobb
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Megan W Patterson
- Anschutz Medical Campus, Department of Psychiatry, University of Colorado, Aurora, CO, USA
| | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Jason José Bendezú
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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29
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Simpson TL, Kaysen DL, Fleming CB, Rhew IC, Jaffe AE, Desai S, Hien DA, Berliner L, Donovan D, Resick PA. Cognitive Processing Therapy or Relapse Prevention for comorbid Posttraumatic Stress Disorder and Alcohol Use Disorder: A randomized clinical trial. PLoS One 2022; 17:e0276111. [PMID: 36445895 PMCID: PMC9707793 DOI: 10.1371/journal.pone.0276111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 08/12/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To compare a Posttraumatic Stress Disorder (PTSD) treatment (Cognitive Processing Therapy; CPT), an Alcohol Use Disorder (AUD) treatment (Relapse Prevention; RP), and assessment-only (AO) for those meeting diagnostic criteria for both PTSD and AUD. METHOD Participants with current PTSD/AUD (N = 101; mean age = 42.10; 56% female) were initially randomized to CPT, RP, or AO and assessed post-treatment or 6-weeks post-randomization (AO). AO participants were then re-randomized to CPT or RP. Follow-ups were at immediate post-treatment, 3-, and 12-months. Mixed effects intent-to-treat models compared conditions on changes in PTSD symptom severity, drinking days, and heavy drinking days. RESULTS At post-treatment, participants assigned to CPT showed significantly greater improvement than those in AO on PTSD symptom severity (b = -9.72, 95% CI [-16.20, -3.23], d = 1.22); the RP and AO groups did not differ significantly on PTSD. Both active treatment conditions significantly decreased heavy drinking days relative to AO (CPT vs. AO: Count Ratio [CR] = 0.51, 95% CI [0.30, 0.88]; RP vs. AO: CR = 0.34, 95% CI [0.19, 0.59]). After re-randomization both treatment conditions showed substantial improvements in PTSD symptoms and drinking between pre-treatment and post-treatment over the 12-month follow-up period, with RP showing an advantage on heavy drinking days. CONCLUSION Treatments targeting one or the other aspects of the PTSD/AUD comorbidity may have salutary effects on both PTSD and drinking outcomes. These preliminary results suggest that people with this comorbidity may have viable treatment options whether they present for mental health or addiction care. TRIAL REGISTRATION The trial is registered at clinicaltrials.gov (NCT01663337).
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Affiliation(s)
- Tracy L. Simpson
- Center of Excellence in Substance Addiction Treatment and Education, VA Puget Sound Health Care, Seattle, WA, United States of America
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States of America
- * E-mail:
| | - Debra L. Kaysen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States of America
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Charles B. Fleming
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States of America
| | - Isaac C. Rhew
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States of America
| | - Anna E. Jaffe
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, United States of America
| | - Sruti Desai
- Center for the Study of Health and Risk Behaviors, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States of America
| | - Denise A. Hien
- Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, Center of Alcohol & Substance Use Studies, Piscataway, NJ, United States of America
| | - Lucy Berliner
- Harborview Center for Sexual Assault and Traumatic Stress, University of Washington, Seattle, WA, United States of America
| | - Dennis Donovan
- Alcohol and Drug Abuse Institute, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, United States of America
| | - Patricia A. Resick
- Department of Psychiatry and Behavioral Sciences, Duke Health, Durham, NC, United States of America
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Shapira I, Richman J, Pace TWW, Lim KO, Polusny MA, Hamner MB, Bremner JD, Mumba MN, Jacobs ML, Pilkinton P, Davis LL. Biomarker Response to Mindfulness Intervention in Veterans Diagnosed with Post-traumatic Stress Disorder. Mindfulness (N Y) 2022; 13:2448-2460. [PMID: 36938380 PMCID: PMC10022677 DOI: 10.1007/s12671-022-01969-6] [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] [Accepted: 08/18/2022] [Indexed: 10/14/2022]
Abstract
Objectives This study evaluates the effects of treatment with mindfulness-based stress reduction (MBSR) compared to the active control, present-centered group therapy (PCGT), on morning plasma cortisol, interleukin-6 (IL-6), and C-reactive protein (CRP) in veterans diagnosed with post-traumatic stress disorder (PTSD). Methods In a post hoc exploratory analysis, we pooled biomarkers and clinical outcomes of mindfulness, PTSD, and depression from two randomized controlled trials comparing MBSR (n = 104) to PCGT (n = 106) in U.S. military veterans diagnosed with PTSD. Linear mixed-effects modeling was used to evaluate associations between changes in biomarkers and clinical outcomes from baseline to 9-week primary endpoint and 16-week follow-up endpoint. Results Cortisol levels were inversely related to self-reported PTSD symptoms at baseline (p = 0.02). Cortisol increased from baseline to 9-week endpoint for both groups, but significantly less so in the MBSR group compared to PCGT group (mean difference 1.69 ± 0.8 SE; p = 0.035). Changes in IL-6 and CRP did not differ between groups at either baseline or week 9. From baseline to week 9, increased mindfulness was significantly associated with increased cortisol (p = 0.02) and decreased PTSD and depression severity (p < 0.01). Increased IL-6 and CRP were significantly associated with decreased PTSD severity (p < 0.05), but not depression. Pooled analysis corroborated earlier findings that MBSR is significantly better than PCGT in improving clinical outcomes. Increased mindfulness was strongly associated with improved symptoms. Conclusions Increased mindfulness is associated with a recalibration of cortisol levels which may be indicative of therapeutic response, especially in patients with lower baseline cortisol. Furthermore, mindfulness-based practices improve symptoms of PTSD and depression in a significant correlation with self-reported levels of mindfulness. Clinical Trial Registration clinicaltrialsgov NCT01532999 and NCT01548742.
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Affiliation(s)
- Itamar Shapira
- School of Medicine, UAB Heersink School of Medicine, 1670 University Blvd, Birmingham, AL 35233, USA
| | - Joshua Richman
- Department of Surgery, UAB Heersink School of Medicine, Birmingham, AL, USA
- Birmingham VA Health Care System, Research Service, Birmingham, AL, USA
| | | | - Kelvin O. Lim
- Department of Psychiatry and Behavioral Science, University of Minnesota, Minneapolis, MN, USA
- Geriatric Research, Education, and Clinical Centers, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Melissa A. Polusny
- Department of Psychiatry and Behavioral Science, University of Minnesota, Minneapolis, MN, USA
- Center for Care Delivery Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA
| | - Mark B. Hamner
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - J. Douglas Bremner
- Departments of Psychiatry and Radiology, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Medical Center, Mental Health Service, Decatur, GA, USA
| | - Mercy N. Mumba
- Research Service, Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
- University of Alabama, Capstone College of Nursing, Tuscaloosa, AL, USA
| | - M. Lindsey Jacobs
- Research Service, Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Patricia Pilkinton
- Research Service, Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
- Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa, AL, USA
| | - Lori L. Davis
- Research Service, Tuscaloosa VA Medical Center, Tuscaloosa, AL, USA
- Department of Psychiatry and Behavioral Neurobiology, UAB Heersink School of Medicine, Birmingham, AL, USA
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Seligowski AV, Webber TK, Marvar PJ, Ressler KJ, Philip NS. Involvement of the brain-heart axis in the link between PTSD and cardiovascular disease. Depress Anxiety 2022; 39:663-674. [PMID: 35708302 PMCID: PMC9588548 DOI: 10.1002/da.23271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/22/2022] [Accepted: 05/13/2022] [Indexed: 01/27/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) has long been associated with a heightened risk of cardiovascular disease (CVD). A number of mechanisms have been implicated to underlie this brain-heart axis relationship, such as altered functioning of the autonomic nervous system and increased systemic inflammation. While neural alterations have repeatedly been observed in PTSD, they are rarely considered in the PTSD-CVD link. The brain-heart axis is a pathway connecting frontal and limbic brain regions to the brainstem and periphery via the autonomic nervous system and it may be a promising model for understanding CVD risk in PTSD given its overlap with PTSD neural deficits. We first provide a summary of the primary mechanisms implicated in the association between PTSD and CVD. We then review the brain-heart axis and its relevance to PTSD, as well as findings from PTSD trials demonstrating that a number of PTSD treatments have effects on areas of the brain-heart axis. Finally, we discuss sex considerations in the PTSD-CVD link. A critical next step in this study is to determine if PTSD treatments that affect the brain-heart axis (e.g., brain stimulation that improves autonomic function) also reduce the risk of CVD.
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Affiliation(s)
- Antonia V. Seligowski
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | | | | | - Kerry J. Ressler
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- McLean Hospital, Belmont, MA, USA
| | - Noah S. Philip
- VA RR&D Center for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, RI, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School, of Brown University, Providence, RI, USA
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Morris MC, Sanchez-Sáez F, Bailey B, Hellman N, Williams A, Schumacher JA, Rao U. Predicting Posttraumatic Stress Disorder Among Survivors of Recent Interpersonal Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP11460-NP11489. [PMID: 33256508 PMCID: PMC8164639 DOI: 10.1177/0886260520978195] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
A substantial minority of women who experience interpersonal violence will develop posttraumatic stress disorder (PTSD). One critical challenge for preventing PTSD is predicting whose acute posttraumatic stress symptoms will worsen to a clinically significant degree. This 6-month longitudinal study adopted multilevel modeling and exploratory machine learning (ML) methods to predict PTSD onset in 58 young women, ages 18 to 30, who experienced an incident of physical and/or sexual assault in the three months prior to baseline assessment. Women completed baseline assessments of theory-driven cognitive and neurobiological predictors and interview-based measures of PTSD diagnostic status and symptom severity at 1-, 3-, and 6-month follow-ups. Higher levels of self-blame, generalized anxiety disorder severity, childhood trauma exposure, and impairment across multiple domains were associated with a pattern of high and stable posttraumatic stress symptom severity over time. Predictive performance for PTSD onset was similarly strong for a gradient boosting machine learning model including all predictors and a logistic regression model including only baseline posttraumatic stress symptom severity. The present findings provide directions for future work on PTSD prediction among interpersonal violence survivors that could enhance early risk detection and potentially inform targeted prevention programs.
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Affiliation(s)
- Matthew C. Morris
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Brooklynn Bailey
- Department of Psychology, the Ohio State University, Columbus, Ohio, USA
| | - Natalie Hellman
- Department of Psychology, University of Tulsa, Tulsa, Oklahoma, USA
| | - Amber Williams
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Julie A. Schumacher
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Uma Rao
- Departments of Psychiatry & Human Behavior and Pediatrics, and Center for the Neurobiology of Learning and Memory, University of California – Irvine, California, USA
- Children’s Hospital of Orange County, Orange, CA, USA
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Kondashevskaya MV, Artem’yeva KA, Aleksankina VV, Areshidze DA, Kozlova MA, Makartseva LA. Phenotypically Determined Liver Dysfunction in a Wistar Rat Model of Post-Traumatic Stress Disorder. J EVOL BIOCHEM PHYS+ 2022; 58:1015-1024. [PMID: 36061071 PMCID: PMC9420240 DOI: 10.1134/s002209302204007x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/19/2022] [Accepted: 05/24/2022] [Indexed: 11/23/2022]
Abstract
The extraordinary situation of the 2019–2022 pandemic caused
a dramatic jump in the incidence of post-traumatic stress disorder
(PTSD). PTSD is currently regarded not only as a neuropsychiatric
disorder, but also as a comorbidity accompanied by cardiovascular
diseases, circulatory disorders, liver dysfunction, etc. The relationship
between behavioral disorders and the degree of morphofunctional
changes in the liver remains obscure. In this study, PTSD was modeled in
sexually mature male Wistar rats using predatory stress induced
by a prey’s fear for a predator. Testing in an elevated plus maze
allowed the rat population to be divided into animals with low-anxiety
(LAP) and high-anxiety (HAP) phenotypes. It was found that morphofunctional
analysis of the liver, in contrast to its biochemical profiling,
provides a clearer evidence that predatory stress induces liver
dysfunction in rats of both phenotypes. This may indicate a decrease
in the range of compensatory adaptive reactions in stressed animals.
However, in HAP rats, the level of morphofunctional abnormalities
in the mechanisms responsible for carbohydrate-fat, water-electrolyte
and protein metabolism in the liver testified the prenosological
state of the organ, while further functional loading and resulting
tension of the regulatory systems could lead to homeostatic downregulation.
Meanwhile, the liver of LAP animals was only characterized by insignificant diffuse
changes. Thus, we demonstrate here a link between behavioral changes
and the degree of morphofunctional transformation of the liver.
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Affiliation(s)
- M. V. Kondashevskaya
- A.P. Avtsyn Research Institute of Human Morphology, Petrovsky National Research Center of Surgery, Moscow, Russia
| | - K. A. Artem’yeva
- A.P. Avtsyn Research Institute of Human Morphology, Petrovsky National Research Center of Surgery, Moscow, Russia
| | - V. V. Aleksankina
- A.P. Avtsyn Research Institute of Human Morphology, Petrovsky National Research Center of Surgery, Moscow, Russia
| | - D. A. Areshidze
- A.P. Avtsyn Research Institute of Human Morphology, Petrovsky National Research Center of Surgery, Moscow, Russia
| | - M. A. Kozlova
- A.P. Avtsyn Research Institute of Human Morphology, Petrovsky National Research Center of Surgery, Moscow, Russia
| | - L. A. Makartseva
- A.P. Avtsyn Research Institute of Human Morphology, Petrovsky National Research Center of Surgery, Moscow, Russia
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Bourgeon-Ghittori I, Couette M, Marini S, Ouedraogo R, Alves A, Razazi K, Carras D, Pallud AC, Kentish-Barnes N, Mekontso Dessap A. Corporeal rehabilitation to manage acute stress in critically ill patients. Ann Intensive Care 2022; 12:49. [PMID: 35689146 PMCID: PMC9187824 DOI: 10.1186/s13613-022-01019-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background Intensive care unit (ICU) patients often endure discomfort and distress brought about by their medical environment and the subjective experience of their stay. Distress, pain, and loss of control are important predictors of future neuropsychiatric disorders. Depression, anxiety, and post-traumatic stress are common after discharge. We aimed at mitigating acute stress and discomfort via a novel intervention based on body image rehabilitation and rehabilitation of senses performed following a holistic approach guided by positive communication (corporeal rehabilitation care, CRC). Results We conducted a prospective observational study on 297 consecutively enrolled patients participating in at least one CRC session. Benefits of CRC were assessed on both subjective analogical scales of stress, pain, and well-being criteria, and objective clinical measures of dyspnea, respiratory rate, and systolic arterial pressure, just after CRC and long after (a median of 72 min later) to estimate its remote effect. Results showed that CRC had a positive effect on all overt measures of distress (acute stress, pain, discomfort) just after CRC and remotely. This beneficial effect was also observed on dyspnea and respiratory rate. Results also showed that best CRC responders had higher baseline values of stress and heart rate and lower baseline values of well-being score, indicating that the care targeted the population most at risk of developing psychological sequelae. Interestingly, a positive CRC response was associated with a better survival even after adjustment for physiologic severity, indicating a potential to identify patients prompt to better respond to other therapeutics and/or rehabilitation. Conclusion This study demonstrated the feasibility of an innovative holistic patient-centered care approach and its short-term positive effects on critical parameters that are considered risk factors for post-intensive care syndrome. Further studies are warranted to study long-term benefits for patients, and overall benefits for relatives as well as ICU staff.
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Affiliation(s)
- Irma Bourgeon-Ghittori
- Groupe de recherche CARMAS, Univ Paris Est Créteil, 94010, Créteil, France.,INSERM, IMRB, Univ Paris Est Créteil, 94010, Créteil, France.,DMU SAPHIRE, AP-HP, Hôpitaux Universitaires Henri-Mondor, 94010, Créteil, France
| | - Maryline Couette
- Groupe de recherche CARMAS, Univ Paris Est Créteil, 94010, Créteil, France.,Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France
| | - Sylvie Marini
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France
| | - Rachida Ouedraogo
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France
| | - Aline Alves
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France
| | - Keyvan Razazi
- Groupe de recherche CARMAS, Univ Paris Est Créteil, 94010, Créteil, France.,INSERM, IMRB, Univ Paris Est Créteil, 94010, Créteil, France.,Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France
| | - Damien Carras
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France
| | - Ann-Cecile Pallud
- Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France
| | - Nancy Kentish-Barnes
- Groupe de Recherche Famiréa, Service de Médecine Intensive Réanimation, CHU Saint-Louis, AP-HP, 94010, Paris, France
| | - Armand Mekontso Dessap
- Groupe de recherche CARMAS, Univ Paris Est Créteil, 94010, Créteil, France. .,INSERM, IMRB, Univ Paris Est Créteil, 94010, Créteil, France. .,Service de Médecine Intensive Réanimation, Hôpitaux Universitaires Henri-Mondor, AP-HP, 1 Rue Gustavec Eiffel, 94010, Créteil, France.
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Hilberdink CE, de Rooij SR, Olff M, Bosch JA, van Zuiden M. Acute stress reactivity and intrusive memory development: a randomized trial using an adjusted trauma film paradigm. Psychoneuroendocrinology 2022; 139:105686. [PMID: 35193044 DOI: 10.1016/j.psyneuen.2022.105686] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 12/14/2022]
Abstract
Understanding the neurobiological and cognitive processes underlying the development of posttraumatic stress disorder (PTSD) and its specific symptoms may facilitate preventive intervention development. Severe traumatic stress and resulting biological stress system activations can alter contextual memory processes. This may provide a neurobiological explanation for the occurrence of intrusive memories following trauma. Investigating the associations between temporal aspects and individual variation in peri- and post-traumatic hypothalamic pituitary adrenal (HPA) axis and sympathetic nervous system (SNS) stress reactivity and memory processing may increase our understanding of intrusive symptom development. The experimental trauma film paradigm is commonly used for this purpose but lacks robust SNS and HPA axis activation. Here, we performed an RCT to investigate the effect of an adjusted trauma film paradigm containing an added brief psychosocial stressor on HPA and SNS stress reactivity throughout the experiment and intrusive memory frequency in the following week in healthy males (N = 63, mean age = 22.3). Secondary, we investigated effects on film-related declarative memory accuracy and intrusion-related characteristics, and associations between acute HPA and SNS stress reactivity, film-related memory, glucocorticoid receptor functioning and intrusion frequency and characteristics. Participants were randomized to the socially-evaluated cold pressor test (seCPT n = 29) or control condition (warm water n = 34) immediately prior to a trauma film. Linear Mixed Models revealed increased acute SNS and cortisol reactivity, lower recognition memory accuracy and more intrusions that were more vivid and distressing during the following week in the seCPT compared to control condition. Linear regression models revealed initial associations between cortisol and alpha amylase reactivity during the experimental assessment and subsequent intrusions, but these effects did not survive multiple comparison corrections. Thus, with this adjustment, we increased the translational value of the trauma film paradigm as it appears to elicit a stronger stress response that is likely more comparable to real-life trauma. The adapted paradigm may be useful to investigate individual variation in biological and cognitive processes underlying early post-trauma PTSD symptoms and could advance potential preventive interventions.
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Affiliation(s)
- C E Hilberdink
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - S R de Rooij
- Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - M Olff
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; ARQ, National Psychotrauma Centre, Diemen, The Netherlands.
| | - J A Bosch
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - M van Zuiden
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Xu S, Lin Y, Lin L, Peng Y, Chen L. Predictive Value of Increased Perioperative Heart Rate for All-Cause Mortality After Cardiac Surgery: A Systematic Review and Meta-Analysis. Biol Res Nurs 2022; 24:379-387. [PMID: 35437047 DOI: 10.1177/10998004221085986] [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: 11/17/2022]
Abstract
Background: Accumulated studies have revealed that heart rates are associated with all-cause mortality in cardiac surgery patients, but the results remain controversial. This meta-analysis aimed to evaluate the predictive value of increased perioperative heart rate for all-cause mortality after cardiac surgery. Methods: We searched PubMed, Embase, Web of Science, and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases for studies from inception to October 11, 2021. Two researchers independently screened the studies. Titles, authors, publication years, and hazard ratios were extracted. We used a random-effects model to combine the HRs and 95% confidence intervals. Several subgroup analyses were conducted. Statistical significance was set at p < .05. Results: Eleven studies were included in the meta-analysis of 33,849 patients and 3166 (9.4%) deaths. The HR of higher perioperative heart rates was 2.09 (95% CI 1.53-2.86, p < .001, I2 = 81%). The HR with a 10-bpm increase in preoperative heart rate was 1.19 (95% CI 1.11-1.26, p < .001, I2 = 51%). Subgroup analysis showed patients with higher preoperative heart rates had an HR of 1.88 (95% CI 1.51-2.34, p < .001, I2 = 0%), and patients with a higher postoperative heart rate had an HR of 2.29 (95% CI 1.28- 4.09, p < .0001, I2 = 91%) compared to patients with lower postoperative heart rates. Conclusion: Increased perioperative heart rate is associated with all-cause mortality in patients undergoing cardiac surgery.
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Affiliation(s)
- Shurong Xu
- School of Nursing, 74551Fujian Medical University, Fuzhou, China
| | - Yanjuan Lin
- Department of Nursing, Union Hospital, 117890Fujian Medical University, Fuzhou, China
| | - Lingyu Lin
- School of Nursing, 74551Fujian Medical University, Fuzhou, China
| | - Yanchun Peng
- Department of Cardiac Surgery, Union Hospital, 117890Fujian Medical University, Fuzhou, China
| | - Liangwan Chen
- Department of Cardiac Surgery, Union Hospital, 117890Fujian Medical University, Fuzhou, China
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37
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Intranasal oxytocin administration impacts the acquisition and consolidation of trauma-associated memories: a double-blind randomized placebo-controlled experimental study in healthy women. Neuropsychopharmacology 2022; 47:1046-1054. [PMID: 34887528 PMCID: PMC8938422 DOI: 10.1038/s41386-021-01247-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/06/2021] [Accepted: 11/19/2021] [Indexed: 11/08/2022]
Abstract
Intrusive memories are a hallmark symptom of post-traumatic stress disorder (PTSD) and oxytocin has been implicated in the formation of intrusive memories. This study investigates how oxytocin influences the acquisition and consolidation of trauma-associated memories and whether these effects are influenced by individual neurobiological and genetic differences. In this randomized, double-blind, placebo-controlled study, 220 healthy women received either a single dose of intranasal 24IU oxytocin or a placebo before exposure to a trauma film paradigm that solicits intrusive memories. We used a "general random forest" machine learning approach to examine whether differences in the noradrenergic and hypothalamic-pituitary-adrenal axis activity, polygenic risk for psychiatric disorders, and genetic polymorphism of the oxytocin receptor influence the effect of oxytocin on the acquisition and consolidation of intrusive memories. Oxytocin induced significantly more intrusive memories than placebo did (t(188.33) = 2.12, p = 0.035, Cohen's d = 0.30, 95% CI 0.16-0.44). As hypothesized, we found that the effect of oxytocin on intrusive memories was influenced by biological covariates, such as salivary cortisol, heart rate variability, and PTSD polygenic risk scores. The five factors that were most relevant to the oxytocin effect on intrusive memories were included in a Poisson regression, which showed that, besides oxytocin administration, higher polygenic loadings for PTSD and major depressive disorder were directly associated with a higher number of reported intrusions after exposure to the trauma film stressor. These results suggest that intranasal oxytocin amplifies the acquisition and consolidation of intrusive memories and that this effect is modulated by neurobiological and genetic factors. Trial registration: NCT03031405.
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38
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Yang J, Kershaw KN. Feasibility of using ecological momentary assessment and continuous heart rate monitoring to measure stress reactivity in natural settings. PLoS One 2022; 17:e0264200. [PMID: 35263368 PMCID: PMC8906632 DOI: 10.1371/journal.pone.0264200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/06/2022] [Indexed: 01/28/2023] Open
Abstract
The way people respond to stressful situations (i.e., stress reactivity) varies widely. Researchers typically measure stress reactivity in controlled studies, but this is limited because laboratory stressors cannot capture the variety, severity, or duration of stressors that individuals face in their daily lives. The present study examined the feasibility of using ecological momentary assessment (EMA) and a wireless electrocardiography (ECG) patch to develop an understanding of stress reactivity in natural settings. Thirty-five adult women completed EMA surveys about stressors they were exposed to while wearing a wireless ECG monitor for 7 consecutive days. Daily stressors were measured using seven questions adapted from the Daily Inventory of Stressful Events and a stressor interval was defined as the presence of at least one stressor during the EMA survey prompt. Participants wore the Cardea SOLO wireless ECG monitor (Cardiac Insight Inc., Bellevue, WA) to continuously track their heart rate. Participant-specific differences in 5-minute heart rate variability (HRV) between intervals when participants did and did not report stressors were calculated and displayed in a heat map. Survey response rate was satisfactory (72.0%, n = 588) and nearly all participants (33 out of 35) reported both stressor and non-stressor intervals. Each participant reported at least one stressor on approximately 35% of completed surveys while wearing the ECG patch. Mean wear time (6.6 days) and the duration of analyzable data with an ECG monitor were close to the 7-day study period. While many participants had lower HRV during stressor versus non-stressor intervals, the magnitude and direction of these differences varied widely. In summary, we found that a 7-day sampling scheme combining ecological momentary assessment (EMA) with HRV measured using continuous ECG monitoring was feasible and effective in capturing a variety of daily stressors and measuring autonomic stress reactivity.
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Affiliation(s)
- Jessica Yang
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
| | - Kiarri N. Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States of America
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39
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Siciliano RE, Anderson AS, Compas BE. Autonomic nervous system correlates of posttraumatic stress symptoms in youth: Meta-analysis and qualitative review. Clin Psychol Rev 2022; 92:102125. [PMID: 35078039 PMCID: PMC8858870 DOI: 10.1016/j.cpr.2022.102125] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 11/25/2021] [Accepted: 01/09/2022] [Indexed: 11/17/2022]
Abstract
Physiological dysregulation is a key diagnostic criterion for posttraumatic stress disorder (PTSD). While PTSD is defined by trauma exposure, symptom presentations are varied. Similarly, findings of autonomic nervous system (ANS), including parasympathetic (PNS) and sympathetic nervous system (SNS), function in youth exposed to trauma are mixed (e.g., hyporeactivity and hyperreactivity). The present meta-analysis quantitatively assesses the relation between ANS measures broadly, and PNS- and SNS-specific measures, and posttraumatic stress symptoms (PTSS) in youth (ages 4.98 to 19.55 years) across 38 cross-sectional and longitudinal studies (N = 3488). Findings demonstrate that heightened ANS activity is related to increased PTSS during stress tasks (r = 0.07), while decreased SNS activity at rest corresponded to increased PTSS (r = -0.09). The correlation between PNS measures and PTSS was non-significant. The moderation effect of age on the relation between PNS activity measured during stress tasks and PTSS approached significance, such that younger children showed a stronger negative relation between symptoms and PNS activity compared to older youth. Qualitative review of included studies revealed significant variability across sample and stressor characteristics and study methodology. Findings indicate the importance of autonomic dysregulation in youth with PTSS. Additional considerations for future research are discussed.
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Affiliation(s)
- Rachel E. Siciliano
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Allegra S. Anderson
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
| | - Bruce E. Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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40
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Schumacher S, Engel S, Niemeyer H, Küster A, Burchert S, Skoluda N, Rau H, Nater UM, Willmund GD, Knaevelsrud C. Salivary Cortisol and Alpha-Amylase in Posttraumatic Stress Disorder and Their Potential Role in the Evaluation of Cognitive Behavioral Treatment Outcomes. J Trauma Stress 2022; 35:78-89. [PMID: 34022094 DOI: 10.1002/jts.22683] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 11/08/2022]
Abstract
Alterations in HPA-axis and autonomic nervous system activity have been associated with posttraumatic stress disorder (PTSD) development and maintenance and are potentially associated with trauma-focused cognitive behavioral therapy (TF-CBT) outcomes. We examined the role of salivary cortisol (sCort) and alpha-amylase (sAA) in PTSD and TF-CBT outcomes in German Armed Forces service members (N = 100). Participants categorized as PTSD patients (n = 39), previously deployed healthy controls (n = 33), and nondeployed healthy controls (n = 28) provided diurnal profiles of sCort and sAA; PTSD patients provided samples before, immediately after, and 3 months after an internet-based TF-CBT intervention. No group differences emerged regarding total daily sCort and sAA output or daily slopes, ps = .224-.897, fs = 0.05-0.24. Participants with PTSD demonstrated a significantly attenuated sCort awakening response compared to deployed, p = .021, d = 0.59, but not nondeployed controls, p = .918, d = 0.08. Moreover, a significantly steeper sAA awakening response emerged in PTSD patients, p = .034, d = 0.67, and deployed controls, p = .014, d = 0.80, compared to nondeployed controls. From pretreatment to posttreatment (n = 21) and posttreatment to follow-up (n = 14), stable sCort, ps = .282-.628, fs = 0.34-0.49, and sAA concentrations, ps = .068-.758, fs = 0.24-1.13 paralleled a nonsignificant treatment effect. Both PTSD and trauma exposure were associated with alterations in awakening responses, but further investigation is needed to determine whether the observed correspondence remains when PTSD symptoms significantly decline.
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Affiliation(s)
- Sarah Schumacher
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany.,Clinical Psychology and Psychotherapy, Faculty of Health, HMU Health and Medical University Potsdam, Potsdam, Germany
| | - Sinha Engel
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Helen Niemeyer
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Annika Küster
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Sebastian Burchert
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Nadine Skoluda
- Department of Clinical Psychology of Adulthood, University of Vienna, Vienna, Austria
| | - Heinrich Rau
- Psychotrauma Centre, German Armed Forces Hospital Berlin, Berlin, Germany
| | - Urs M Nater
- Department of Clinical Psychology of Adulthood, University of Vienna, Vienna, Austria
| | | | - Christine Knaevelsrud
- Division of Clinical Psychological Intervention, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
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41
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Sadeghi M, Sasangohar F, McDonald AD, Hegde S. Understanding Heart Rate Reactions to Post-Traumatic Stress Disorder (PTSD) Among Veterans: A Naturalistic Study. HUMAN FACTORS 2022; 64:173-187. [PMID: 34292055 DOI: 10.1177/00187208211034024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE We collected naturalistic heart rate data from veterans diagnosed with post-traumatic stress disorder (PTSD) to investigate the effects of various factors on heart rate. BACKGROUND PTSD is prevalent among combat veterans in the United States. While a positive correlation between PTSD and heart rate has been documented, specific heart rate profiles during the onset of PTSD symptoms remain unknown. METHOD Veterans were recruited during five cycling events in 2017 and 2018 to record resting and activity-related heart rate data using a wrist-worn device. The device also logged self-reported PTSD hyperarousal events. Regression analyses were performed on demographic and behavioral covariates including gender, exercise, antidepressants, smoking habits, sleep habits, average heart rate during reported hyperarousal events, age, glucocorticoids consumption, and alcohol consumption. Heart rate patterns during self-reported PTSD hyperarousal events were analyzed using Auto Regressive Integrated Moving Average (ARIMA). Heart rate data were also compared to an open-access non-PTSD representative case. RESULTS Of 99 veterans with PTSD, 91 participants reported at least one hyperarousal event, with a total of 1023 events; demographic information was complete for 38 participants who formed the subset for regression analyses. The results show that factors including smoking, sleeping, gender, and medication significantly affect resting heart rate. Moreover, unique heart rate patterns associated with PTSD symptoms in terms of stationarity, autocorrelation, and fluctuation characteristics were identified. CONCLUSION Our findings show distinguishable heart rate patterns and characteristics during PTSD hyperarousal events. APPLICATION These findings show promise for future work to detect the onset of PTSD symptoms.
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Affiliation(s)
| | | | | | - Sudeep Hegde
- 265514736 Texas A&M University, College Station, USA
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42
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Yrondi A, Colineaux H, Claudet I, Sales de Gauzy J, Huo S, Taib S, Bui E, Birmes P. Prevalence and prediction of PTSD and depression in mothers of children surviving a motor vehicle crash. Eur J Psychotraumatol 2022; 13:2121014. [PMID: 36212115 PMCID: PMC9543172 DOI: 10.1080/20008066.2022.2121014] [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] [Indexed: 11/09/2022] Open
Abstract
Introduction: Few studies have examined the psychopathological consequences for parents of children who were survivors of a motor vehicle crash (MVC). This study assessed the impact of dissociation and peritraumatic distress on the severity of PTSD and post-traumatic major depressive episode (MDE) symptoms in mothers during the first years after the MVC and the role that cortisol response might play in this association. Methods: 125 mothers were included. Peritraumatic distress and dissociation were assessed. Morning salivary cortisol was tested at the baseline. Participants were assessed for a probable diagnosis of PTSD and MDE at 5 weeks, 6 months and 12 months. Results: At 5 weeks, 12 (13.6%) mothers exhibited probable PTSD. During the first year, the PCL score was higher when the (i) Peritraumatic Distress Inventory (PDI) score increased and (ii) the Peritraumatic Dissociation Experience Questionnaire (PDEQ) score increased. Cortisol levels were lower when the PDI score increased. Conclusion: This is the first study to assess the mothers of MVC survivors for one year following the trauma. We confirm that peritraumatic responses are useful for predicting the severity of PTSD symptoms. These results could encourage the implementation of follow-up programmes not only for survivors but also for their mothers. HIGHLIGHTS Mothers of children involved in motor vehicle accident are at risk for developing PTSD.Peritraumatic responses (distress and dissociation) are associated to the severity of PTSD symptoms.Low salivary cortisol levels were associated with high peritraumatic distress.
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Affiliation(s)
- Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante FondaMental, CHU Toulouse, Hopital Purpan, ToNIC, Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - Hélène Colineaux
- UMR1027, Université Toulouse III, Inserm, Toulouse, France.,Département d'Epidemiologie, CHU Toulouse, Toulouse, France
| | - Isabelle Claudet
- Département des Urgences Pédiatriques, CHU Toulouse, Toulouse, France
| | - Jérome Sales de Gauzy
- Département de chirurgie orthopédique, Hopital des enfants, CHU Toulouse, Toulouse, France
| | - Samantha Huo
- Département d'Epidemiologie, CHU Toulouse, Toulouse, France
| | - Simon Taib
- Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France
| | - Eric Bui
- Université de Caen Normandie et CHU Caen, Caen, France.,Massachusetts General Hospital, Boston
| | - Philippe Birmes
- Toulouse NeuroImaging Centre, University of Toulouse, Inserm, UPS, Toulouse, France
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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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Kong LN, Shen YL, Chen YL, Chen X, Su GM, Wang JH, Xiao GB, Guo QW, Zhang JC, Fang DZ, Lin J. Insertion/deletion polymorphism at angiotensin-converting enzyme gene in PTSD individuals and their reciprocal effects on blood pressure. Clin Exp Hypertens 2021; 44:208-214. [PMID: 34935564 DOI: 10.1080/10641963.2021.2018598] [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: 10/19/2022]
Abstract
OBJECTIVES The aim of the present study was to investigate relationships between insertion/deletion (I/D) polymorphism at angiotensin-converting enzyme gene (ACE) and post-traumatic stress disorder (PTSD), as well as their interactions on blood pressure. METHODS Variants of ACE I/D were identified by polymerase chain reaction method and verified by DNA sequencing. PTSD symptoms were assessed by the PTSD Checklist-Civilian Version (PCL-C) based on DSM-IV-TR criteria among high school students at 6 months after the 2008 Wenchuan earthquake. RESULTS Female subjects were found to have higher prevalence of PTSD and PCL-C scores than male counterparts in the II homozygotes (p = .038 for PTSD and p = .003 for PCL-C scores) and the ID heterozygotes (p = .000 for PTSD and p = .000 for PCL-C scores), but not in the DD homozygotes. Male subjects with the ID (p = .046) or the DD genotype (p = .039) had lower pulse pressure (PP) than the male II homozygotes, while the female II homozygotes had lower diastolic blood pressure (DBP) than the female DD homozygotes (p = .036). ACE I/D, PTSD, or PCL-C scores, as well as gender and BMI, were found to be the predictors of PP. CONCLUSIONS These results indicate that there are interactions of ACE I/D and PTSD, together with gender and BMI, on PP. This finding may be the additional explanation for the heterogeneous relationships between PTSD and blood pressure, and suggest psychiatry care and different medication strategies for patients with comorbidities of PTSD and hypertension and with different genotypes of ACE I/D.
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Affiliation(s)
- Ling Nan Kong
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Yi Lin Shen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Yong Li Chen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Xu Chen
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Guo Ming Su
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Jin Hua Wang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Gui Bang Xiao
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Qi Wei Guo
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Ji Cheng Zhang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Ding Zhi Fang
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
| | - Jia Lin
- Department of Biochemistry and Molecular Biology, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, China
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Simpson TL, Goldberg SB, Louden DKN, Blakey SM, Hawn SE, Lott A, Browne KC, Lehavot K, Kaysen D. Efficacy and acceptability of interventions for co-occurring PTSD and SUD: A meta-analysis. J Anxiety Disord 2021; 84:102490. [PMID: 34763220 PMCID: PMC8819868 DOI: 10.1016/j.janxdis.2021.102490] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/17/2022]
Abstract
Over the past 20 years, numerous treatments addressing comorbid Posttraumatic Stress Disorder (PTSD) and Substance Use Disorder (SUD) have been developed and tested. The current meta-analysis examined the efficacy and acceptability of the two central treatment types- trauma-focused and non-trauma-focused - compared with all comparators and with cognitive-behavioral manualized SUD treatments immediately post-treatment and at longest follow-up. Twenty-eight randomized clinical trials (N = 3247) were included. There were small to large within-group effects for all forms of active treatment (gs = 0.30-1.11). Trauma-focused but not non-trauma-focused treatments outperformed all comparators on PTSD outcomes at post-treatment. Neither trauma-focused nor non-trauma-focused treatment outperformed all comparators on SUD outcomes at post-treatment. Neither trauma- nor non-trauma-focused treatment outperformed manualized SUD treatments on PTSD outcomes at either time point. Manualized SUD treatments outperformed trauma-focused treatments on SUD outcomes at post-treatment and non-trauma-focused treatments on PTSD outcomes at follow-up. Regarding treatment retention, neither trauma-focused nor non-trauma-focused treatments significantly differed from all comparators or from manualized SUD treatments. Between-group results were largely unchanged in trim-and-fill analyses, but were not robust to fail-safe N. Few moderators were detected. Taken together, results suggest that trauma-focused, non-trauma-focused, and manualized SUD interventions are sound options for individuals with comorbid PTSD/SUD.
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Affiliation(s)
- Tracy L Simpson
- VA Puget Sound Center of Excellence in Substance Addiction Treatment and Education, 1660 South Columbian Way, Seattle, WA 98108, USA; University of Washington, Department of Psychiatry, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin - Madison, 1000 Bascom Mall, Madison, WI 53706, USA.
| | - Diana K N Louden
- University of Washington, Health Sciences Libraries, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Shannon M Blakey
- Durham VA Medical Center, 508 Fulton St, Durham, NC 27705, USA; VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, 3022 Croasdaile Dr, Durham, NC 27705, USA.
| | - Sage E Hawn
- Boston VA Medical Center, 150S Huntington Ave, Boston, MA 02130, USA.
| | - Aline Lott
- VA Puget Sound Center of Excellence in Substance Addiction Treatment and Education, 1660 South Columbian Way, Seattle, WA 98108, USA.
| | - Kendall C Browne
- VA Puget Sound Center of Excellence in Substance Addiction Treatment and Education, 1660 South Columbian Way, Seattle, WA 98108, USA; University of Washington, Department of Psychiatry, 1959 NE Pacific St, Seattle, WA 98195, USA.
| | - Keren Lehavot
- University of Washington, Department of Psychiatry, 1959 NE Pacific St, Seattle, WA 98195, USA; VA Puget Sound Seattle/Denver HSR&D COIN, 1660 South Columbian Way, Seattle, WA 98108, USA.
| | - Debra Kaysen
- Stanford University, Department of Psychiatry, 401 Quarry Road, Stanford, CA 94305, USA.
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46
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Gordon I, Horesh D, Milstein N, Tomashin A, Mayo O, Korisky A. Pre-pandemic autonomic nervous system activity predicts mood regulation expectancies during COVID-19 in Israel. Psychophysiology 2021; 58:e13910. [PMID: 34329495 PMCID: PMC8420474 DOI: 10.1111/psyp.13910] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 12/11/2022]
Abstract
Despite the unfolding impact of the COVID‐19 pandemic on psychological well‐being, there is a lack of prospective studies that target physiological markers of distress. There is a need to examine physiological predictors from the pre‐pandemic period to identify and treat individuals at‐risk. In this study, our aim was to use pre‐pandemic markers of autonomic nervous system (ANS) parasympathetic and sympathetic regulation to predict individuals' psychological well‐being during the crisis. We also assessed the role of mood regulation expectancies as a mediator of the association between pre‐pandemic physiological measures and COVID‐related well‐being. In May to June 2020, 185 Israeli adults completed online questionnaires assessing their mood regulation expectancies since COVID‐19 began, and their current well‐being. These individuals had participated in lab studies 1.5–3 years prior to this assessment, where their physiological measures were taken, including respiratory sinus arrhythmia (RSA) and skin conductance level (SCL). RSA was positively related to mood regulation expectancies during COVID‐19 (b = 3.46, 95% CI [0.84, 6.05]). Mood regulation expectancies, in turn, positively predicted well‐being during the crisis (b = 0.021, 95% CI [0.016, 0.027]). The mediation was significant and moderated by SCL (index = −0.09, 95% CI [−0.02, −0.0001]), such that it was strongest for individuals with low SCL. We point to pre‐pandemic physiological mechanisms underlying individuals' mental well‐being during the COVID‐19 pandemic. These findings have theoretical, diagnostic, and clinical implications that may refine our understanding of the physiological basis of resilience to the COVID‐19 pandemic and thus may be implemented to identify and assist individuals in these times. Our study offers a unique psychophysiological approach to predicting mood regulation and mental well‐being during COVID‐19 from pre‐pandemic resting physiological activity. We show that pre‐pandemic markers of the autonomic nervous system, which were collected during routine 2–3 years prior to the pandemic, allow us to prospectively understand emotion regulation and well‐being during COVID‐19.
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Affiliation(s)
- Ilanit Gordon
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.,The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat-Gan, Israel
| | - Danny Horesh
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.,Department of Psychiatry, Grossman School of Medicine, New York University, New York, NY, USA
| | - Nir Milstein
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Alon Tomashin
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel.,The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat-Gan, Israel
| | - Oded Mayo
- Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
| | - Adi Korisky
- The Gonda Multidisciplinary Brain Research Center, Bar Ilan University, Ramat-Gan, Israel
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47
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Malikowska-Racia N, Salat K, Gdula-Argasinska J, Popik P. Sex, Pramipexole and Tiagabine Affect Behavioral and Hormonal Response to Traumatic Stress in a Mouse Model of PTSD. Front Pharmacol 2021; 12:691598. [PMID: 34276379 PMCID: PMC8277945 DOI: 10.3389/fphar.2021.691598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 05/19/2021] [Indexed: 11/13/2022] Open
Abstract
Posttraumatic stress disorder (PTSD) has been associated with abnormal regulation of the hypothalamic-pituitary-adrenal gland axis (HPA). Women demonstrate a more robust HPA response and are twice as likely to develop PTSD than men. The role of sex hormones in PTSD remains unclear. We investigated whether post-trauma chronic treatment with the GABA-ergic agent tiagabine and dopamine-mimetic pramipexole affected the behavioral outcome and plasma levels of corticosterone, testosterone, or 17β-estradiol in female and male mice. These medications were investigated due to their potential capacity to restore GABA-ergic and dopaminergic deficits in PTSD. Animals were exposed to a single prolonged stress procedure (mSPS). Following 13 days treatment with tiagabine (10 mg/kg) or pramipexole (1 mg/kg) once daily, the PTSD-like phenotype was examined in the fear conditioning paradigm. Plasma hormones were measured almost immediately following the conditioned fear assessment. We report that the exposure to mSPS equally enhanced conditioned fear in both sexes. However, while males demonstrated decreased plasma corticosterone, its increase was observed in females. Trauma elevated plasma testosterone in both sexes, but it had no significant effects on 17β-estradiol. Behavioral manifestation of trauma was reduced by pramipexole in both sexes and by tiagabine in females only. While neither compound affected corticosterone in stressed animals, testosterone levels were further enhanced by tiagabine in females. This study shows sex-dependent efficacy of tiagabine but not pramipexole in a mouse model of PTSD-like symptoms and a failure of steroid hormones’ levels to predict PTSD treatment efficacy.
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Affiliation(s)
- Natalia Malikowska-Racia
- Department of Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland.,Department of Pharmacodynamics, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Kinga Salat
- Department of Pharmacodynamics, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Joanna Gdula-Argasinska
- Department of Radioligands, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Piotr Popik
- Department of Behavioral Neuroscience and Drug Development, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland.,Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
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Saputra F, Lai YH, Fernandez RAT, Macabeo APG, Lai HT, Huang JC, Hsiao CD. Acute and Sub-Chronic Exposure to Artificial Sweeteners at the Highest Environmentally Relevant Concentration Induce Less Cardiovascular Physiology Alterations in Zebrafish Larvae. BIOLOGY 2021; 10:548. [PMID: 34207293 PMCID: PMC8233861 DOI: 10.3390/biology10060548] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022]
Abstract
Artificial sweeteners are widely used food ingredients in beverages and drinks to lower calorie intake which in turn helps prevent lifestyle diseases such as obesity. However, as their popularity has increased, the release of artificial sweetener to the aquatic environment has also increased at a tremendous rate. Thus, our study aims to systematically explore the potential cardiovascular physiology alterations caused by eight commercial artificial sweeteners, including acesulfame-K, alitame, aspartame, sodium cyclamate, dulcin, neotame, saccharine and sucralose, at the highest environmentally relevant concentration on cardiovascular performance using zebrafish (Danio rerio) as a model system. Embryonic zebrafish were exposed to the eight artificial sweeteners at 100 ppb and their cardiovascular performance (heart rate, ejection fraction, fractional shortening, stroke volume, cardiac output, heartbeat variability, and blood flow velocity) was measured and compared. Overall, our finding supports the safety of artificial sweetener exposure. However, several finding like a significant increase in the heart rate and heart rate variability after incubation in several artificial sweeteners are noteworthy. Biomarker testing also revealed that saccharine significantly increase the dopamine level in zebrafish larvae, which is might be the reason for the cardiac physiology changes observed after saccharine exposure.
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Affiliation(s)
- Ferry Saputra
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan 320314, Taiwan;
| | - Yu-Heng Lai
- Department of Chemistry, Chinese Culture University, Taipei 11114, Taiwan;
| | - Rey Arturo T. Fernandez
- Laboratory for Organic Reactivity, Discovery and Synthesis (LORDS), Research Center for the Natural and Applied Sciences, University of Santo Tomas, Espana St., Manila 1015, Philippines; (R.A.T.F.); (A.P.G.M.)
| | - Allan Patrick G. Macabeo
- Laboratory for Organic Reactivity, Discovery and Synthesis (LORDS), Research Center for the Natural and Applied Sciences, University of Santo Tomas, Espana St., Manila 1015, Philippines; (R.A.T.F.); (A.P.G.M.)
| | - Hong-Thih Lai
- Department of Aquatic Biosciences, National Chiayi University, Chiayi 600355, Taiwan
| | - Jong-Chin Huang
- Department of Applied Chemistry, National Pingtung University, Pingtung 90003, Taiwan
| | - Chung-Der Hsiao
- Department of Bioscience Technology, Chung Yuan Christian University, Taoyuan 320314, Taiwan;
- Center for Nanotechnology, Chung Yuan Christian University, Taoyuan 320314, Taiwan
- Research Center for Aquatic Toxicology and Pharmacology, Chung Yuan Christian University, Taoyuan 320314, Taiwan
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49
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Ajdacic-Gross V, Ajdacic L, Xu Y, Müller M, Rodgers S, Wyss C, Olbrich S, Buadze A, Seifritz E, Wagner EYN, Radovanovic D, von Wyl V, Steinemann N, Landolt MA, Castelao E, Strippoli MPF, Gholamrezaee MM, Glaus J, Vandeleur C, Preisig M, von Känel R. Backtracing persistent biomarker shifts to the age of onset: A novel procedure applied to men’s and women’s white blood cell counts in post-traumatic stress disorder. Biomark Neuropsychiatry 2021. [DOI: 10.1016/j.bionps.2021.100030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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50
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Post-traumatic stress disorder and its association with stroke and stroke risk factors: A literature review. Neurobiol Stress 2021; 14:100332. [PMID: 34026954 PMCID: PMC8122169 DOI: 10.1016/j.ynstr.2021.100332] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 03/27/2021] [Accepted: 04/20/2021] [Indexed: 12/19/2022] Open
Abstract
Stroke is a major cause of mortality and disability globally that has multiple risk factors. A risk factor that has recently gained more attention is post-traumatic stress disorder (PTSD). Literature searches were carried out for updated PTSD information and for the relationship between PTSD and stroke. The review was divided into two sections, one exploring PTSD as an independent risk factor for stroke, with a second concentrating on PTSD's influence on stroke risk factors. The study presents accumulating evidence that shows traumatic stress predicts stroke and is also linked to many major stroke risk factors. The review contributes knowledge to stroke aetiology and acts as a reference for understanding the relationship between PTSD and stroke. The information presented indicates that screening and identification of traumatic experience would be beneficial for directing stroke patients to appropriate psychological and lifestyle interventions. In doing so, the burden of stroke may be reduced worldwide.
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