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Shelef L, Itzhaky L, Bechor U, Tatsa-Laur L, Mann JJ. Relationships of DSM-5 PTSD symptom clusters to suicidal ideation and death ideation in outpatient military veterans. Psychiatry Res 2024; 339:115993. [PMID: 38878422 DOI: 10.1016/j.psychres.2024.115993] [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: 01/23/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 08/15/2024]
Abstract
Veterans with PTSD are at higher risk for suicide. This study examined the specific associations of PTSD symptom clusters with suicidal ideation (SI) and death ideation (DI), independently from depressive symptom clusters. Participants included 695 Israeli male outpatient military veterans (M = 25.35 years, SD = 5.65), divided into subsamples of probable PTSD (PTSD Checklist for DSM-5 [PCL-5] ≥ 33) and subthreshold PTSD scores (PCL-5 < 33). Data were extracted from medical chartsand self-report questionnaires. The main analyses included logistic regression to evaluate the associations between SI and DI (Brief Symptom Inventory, items 9 and 39) and PTSD symptom clusters (PCL-5), controlling for depressive symptom clusters (Beck Depression Inventory; cognitive-affective and somatization) in each subsample. The results showed that, for veterans with probable PTSD, the negative alterations in cognition and mood symptom cluster was positively correlated with SI and DI, while avoidance was negatively correlated with SI, independently from depressive symptoms clusters. In those with sub-syndromal PTSD, the re-experiencing cluster was positively correlated with DI, independently from the depressive symptom clusters. These findings highlight the importance of targeting PTSD components, such as negative alterations in cognition and mood symptoms experienced by veterans with PTSD, as part of suicide prevention efforts.
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Affiliation(s)
- Leah Shelef
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel; The School of Social Work, Sapir Academic College, D. N. Hof Ashkelon, 79165, Israel.
| | - Liat Itzhaky
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University/New York State Psychiatric Institute. 1051 Riverside Drive, Suite 2917, Box 42, New York, NY, 10032, United States
| | - Uzi Bechor
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - Lucian Tatsa-Laur
- Department of Health and Well-Being, IDF Medical Corps, Israel Defense Forces, Ramat Gan 5262000, Israel
| | - J John Mann
- Molecular Imaging and Neuropathology Division, Department of Psychiatry, Columbia University/New York State Psychiatric Institute. 1051 Riverside Drive, Suite 2917, Box 42, New York, NY, 10032, United States
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Jiang W, Tian Y, Fan F, Fu F, Wei D, Tang S, Chen J, Li Y, Zhu R, Wang L, Shi Z, Wang D, Zhang XY. Effects of comorbid posttraumatic stress disorder on cognitive dysfunction in Chinese male methamphetamine patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110611. [PMID: 35907518 DOI: 10.1016/j.pnpbp.2022.110611] [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: 05/22/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Cognitive dysfunction and posttraumatic stress disorder (PTSD) are common in methamphetamine patients. However, few studies have investigated the cognitive performance of methamphetamine patients with PTSD. The purpose of this study was to investigate the impact of comorbid PTSD on cognitive function in Chinese male methamphetamine patients. METHODS We analyzed 464 methamphetamine patients and 156 healthy volunteers. The PTSD Screening Scale (PCL-5) was used to assess PTSD and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function. RESULTS Compared with healthy controls, methamphetamine patients had more cognitive dysfunction in immediate memory, visuospatial/constructional, language, attention and delayed memory. Moreover, methamphetamine patients with PTSD had less cognitive dysfunction in immediate memory, attention, and delayed memory than methamphetamine patients without PTSD. Further stepwise regression analysis showed that PTSD alterations in arousal and reactivity cluster were risk predictors for language, and PTSD negative alteration in cognition and mood cluster were risk predictors for delayed memory. CONCLUSIONS Our results indicate that methamphetamine patients without PTSD have poorer cognitive dysfunction than those with PTSD. Some demographic and PTSD symptom clusters are protective or risk factors for cognitive dysfunction in methamphetamine patients.
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Affiliation(s)
- Wei Jiang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhanbiao Shi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
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Ning M, Wen S, Zhou P, Zhang C. Ventral tegmental area dopaminergic action in music therapy for post-traumatic stress disorder: A literature review. Front Psychol 2022; 13:1014202. [PMID: 36300072 PMCID: PMC9589351 DOI: 10.3389/fpsyg.2022.1014202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a debilitating sequela of extraordinary traumatic sufferings that threaten personal health and dramatically attenuate the patient's quality of life. Accumulating lines of evidence suggest that functional disorders in the ventral tegmental area (VTA) dopaminergic system contribute substantially to PTSD symptomatology. Notably, music therapy has been shown to greatly ameliorate PTSD symptoms. In this literature review, we focused on whether music improved PTSD symptoms, based on VTA dopaminergic action, including the effects of music on dopamine (DA)-related gene expression, the promotion of DA release and metabolism, and the activation of VTA functional activities. In addition, the strengths and limitations of the studies concerning the results of music therapy on PTSD are discussed. Collectively, music therapy is an effective approach for PTSD intervention, in which the VTA dopaminergic system may hold an important position.
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Affiliation(s)
- Meng Ning
- School of Music, Huainan Normal University, Huainan, China
| | - Shizhe Wen
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
| | - Peiling Zhou
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
- Peiling Zhou
| | - Changzheng Zhang
- School of Educational Sciences, Lingnan Normal University, Zhanjiang, China
- *Correspondence: Changzheng Zhang
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Schafer KM, Daurio A, French JE, Rogers ML, Meltzer AL, Cougle JR, Joiner TE. The relationship between anger and suicidal ideation: Investigations in two samples. J Clin Psychol 2022; 78:1866-1877. [PMID: 35195280 DOI: 10.1002/jclp.23331] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 01/20/2022] [Accepted: 02/11/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Suicidal ideation (SI) nearly always precedes lethal suicide attempts. Anger may play a role in SI, but this appears to vary by gender and nuances in this relationship are unclear. METHOD We investigated whether levels of (a) anger and (b) SI vary by gender, (c) the cross-sectional relationship between anger and SI, and (d) if gender moderates that relationship in two samples: adults seeking care for excessive anger (Study 1) and undergraduates endorsing previous suicide attempt (Study 2). RESULTS In Study 1, anger was more commonly endorsed in women; however, in Study 2, anger did not vary by gender. In both studies, SI did not vary by gender. Further, in both studies, anger and SI were positively related. The relationship between anger and SI did not vary by gender in either study. CONCLUSIONS The strength of the relationship between anger and SI did not vary by gender.
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Affiliation(s)
| | - Allison Daurio
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Juliana E French
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Megan L Rogers
- Icahn School of Medicine, Mount Sinai Beth Israel, New York City, New York, USA
| | - Andrea L Meltzer
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Jesse R Cougle
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Thomas E Joiner
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
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Ni K, Zhu J, Xu X, Liu Y, Yang S, Huang Y, Xu R, Jiang L, Zhang J, Zhang W, Ma Z. Hippocampal Activated Microglia May Contribute to Blood–Brain Barrier Impairment and Cognitive Dysfunction in Post-Traumatic Stress Disorder-Like Rats. J Mol Neurosci 2022; 72:975-982. [PMID: 35167061 PMCID: PMC8852956 DOI: 10.1007/s12031-022-01981-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/02/2022] [Indexed: 12/20/2022]
Abstract
Post-traumatic stress disorder (PTSD)-associated cognitive dysfunction significantly disturbs patients’ quality of life and will to live. However, its underlying mechanism is as yet unknown. Recent researches indicate that blood–brain barrier (BBB) breakdown is responsible for early cognitive dysfunction. Microglia might participate in remodeling of BBB-associated tight junction and regulating BBB integrity. Nevertheless, it is unclear whether microglia activation and BBB injury involve in PTSD-associated cognitive dysfunction. Hence, we established an animal model of PTSD, single prolonged stress (SPS), and investigated permeability changes in the hippocampus and further explored the effects of microglia on BBB remodeling. The Y maze was used to assess the changes of cognitive function. The sodium fluorescein (NaFlu) assay and western blotting analysis were employed to detect BBB integrity changes. Minocycline was administered to inhibit microglial activation. Immunofluorescence stains were used to assess the activation states in microglia. The results showed that SPS-exposed rats exhibited poorer cognitive performance, higher passage of NaFlu, and lower expression of tight junction proteins (occludin and claudin 5) in the hippocampus on the day after SPS, but no difference on the 7th day. Inhibition of microglial activation by minocycline attenuated poor cognitive performance and BBB impairment including the extravasation of NaFlu and protein levels of the tight junction. Taken together, the present study indicates that BBB impairment may underlie the shared pathological basis of PTSD and cognitive dysfunction. Microglial activation may involve in BBB remodeling at the early stage of SPS.
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Affiliation(s)
- Kun Ni
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Jixiang Zhu
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Xuan Xu
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Yue Liu
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Shuai Yang
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Yulin Huang
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Rui Xu
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Li Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, China
| | - Juan Zhang
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
| | - Wei Zhang
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
| | - Zhengliang Ma
- Department of Anesthesiology, Drum Tower Hospital, Medical School of Nanjing University, 321 Zhongshan Road, Nanjing, 210008, China.
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, 321 Zhongshan Road, Nanjing, 210008, China.
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Rohr JC, Rufino KA, Alfano CA, Patriquin MA. Sleep disturbance in patients in an inpatient hospital mediates relationship between PTSD and suicidal ideation. J Psychiatr Res 2021; 133:174-180. [PMID: 33348251 DOI: 10.1016/j.jpsychires.2020.12.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/12/2020] [Accepted: 12/09/2020] [Indexed: 10/22/2022]
Abstract
A common reason for admission to inpatient psychiatric units is suicidal ideation. Growing evidence of the link between sleep disturbance and suicidal ideation brings an interest in greater clarity of the pathways; this paper focused on post-traumatic stress disorder (PTSD), which carries increased risk for both sleep disturbance and suicidal ideation, as well as sex differences in those pathways. Patients were 2822 inpatients studied at admission to an inpatient psychiatric hospital and mediation analyses were used to examine pathways of interest. There was an indirect effect of PTSD on suicidal ideation through sleep disturbances for the entire sample and for men and women separately. The effect for men was larger than that for women, suggesting a stronger effect for sleep disturbance in the relationship for men. For women only, the direct effect between PTSD and suicidal ideation remained significant after mediation. Sleep disturbance plays an important role in the relationship between PTSD and suicidal ideation. Early identification of sleep disturbance in inpatients and targeted focus of sleep in conjunction with resolving trauma-related symptoms may help reduce suicidal ideation. This may be especially true of men; the indirect effect was smaller for women, suggesting that sleep disturbance should be addressed in conjunction with other PTSD symptoms likely leading to suicidal ideation.
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Affiliation(s)
- Jessica C Rohr
- The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA.
| | - Katrina A Rufino
- The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA; The University of Houston Downtown, 1 Main St., Houston TX 77002, USA
| | - Candice A Alfano
- Sleep and Anxiety Center of Houston, University of Houston, 4505 Cullen Blvd., Houston TX 77204, USA
| | - Michelle A Patriquin
- The Menninger Clinic, 12301 S. Main St., Houston TX 77035, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1977 Butler Blvd., Houston TX 77030, USA; Michaeld E. DeBakey Veterans Affairs Medical Center, 2002 Holcombe Blvd, Houston, TX, 77030, USA
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