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Hien DA, López-Castro T, Fitzpatrick S, Ruglass LM, Fertuck EA, Melara R. A unifying translational framework to advance treatment research for comorbid PTSD and substance use disorders. Neurosci Biobehav Rev 2021; 127:779-794. [PMID: 34062208 DOI: 10.1016/j.neubiorev.2021.05.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 11/20/2022]
Abstract
We provide a unifying translational framework that can be used to synthesize extant lines of human laboratory research in four neurofunctional domains that underlie the co-occurrence of posttraumatic stress and substance use disorders (PTSD+SUD). We draw upon the Alcohol and Addiction Research Domain Criteria (AARDOC) to include executive functioning, negative emotionality, reward, and added social cognition from the National Institute of Mental Health (NIMH) Research Domain Criteria into our framework. We review research findings across each of the four domains, emphasizing human experimental studies in PTSD, SUD, and PTSD+SUD for each domain. We also discuss the implications of research findings for treatment development by considering new ways of conceptualizing risk factors and outcomes at the level of the individual patient, which will enhance treatment matching and advance innovations in intervention.
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Affiliation(s)
- Denise A Hien
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, New Jersey, United States.
| | - Teresa López-Castro
- Psychology Department, The City College of New York, New York, NY, United States
| | | | - Lesia M Ruglass
- Center of Alcohol & Substance Use Studies, Graduate School of Applied and Professional Psychology, Rutgers University-New Brunswick, Piscataway, New Jersey, United States; Psychology Department, The City College of New York, New York, NY, United States
| | - Eric A Fertuck
- Psychology Department, The City College of New York, New York, NY, United States
| | - Robert Melara
- Psychology Department, The City College of New York, New York, NY, United States
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Saraiya TC, Fitzpatrick S, Zumberg-Smith K, López-Castro T, Back SE, Hien DA. Social-Emotional Profiles of PTSD, Complex PTSD, and Borderline Personality Disorder Among Racially and Ethnically Diverse Young Adults: A Latent Class Analysis. J Trauma Stress 2021; 34:56-68. [PMID: 33006199 PMCID: PMC9817088 DOI: 10.1002/jts.22590] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 07/23/2020] [Accepted: 07/30/2020] [Indexed: 01/11/2023]
Abstract
The debate around the construct validity of complex posttraumatic stress disorder (CPTSD) has begun to examine whether CPTSD diverges from posttraumatic stress disorder (PTSD) when it co-occurs with the diagnosis of borderline personality disorder (BPD). The present study (a) examined the construct validity of CPTSD through a latent class analysis of a non-treatment-seeking sample of young trauma-exposed adults and (b) characterized each class in terms of trauma characteristics, social emotions (e.g., shame, guilt, blame), and interpersonal functioning. A total of 23 dichotomized survey items were chosen to represent the symptoms of PTSD, CPTSD, and BPD and administered to 197 trauma-exposed participants. Fit statistics compared models with 2-4 latent classes. The four-class model showed the best fit statistics and clinical interpretability. Classes included a "high PTSD+CPTSD+BPD" class, characterized by high-level endorsement of all symptoms for the three diagnoses; a "moderate PTSD+CPTSD+BPD" class, characterized by endorsement of some symptoms across all three diagnoses; a "PTSD" class, characterized by endorsement of the ICD-11 PTSD criteria; and a "healthy" class, characterized by low symptom endorsement overall. Pairwise comparisons showed individuals in the high PTSD+CPTSD+BPD class to have the highest levels of psychological distress, traumatic event history, adverse childhood experiences, and PTSD symptoms. Shame was the only social emotion to significantly differ between the classes, p = .002, η² = .16. The findings diverge from the literature, indicating an overlap of PTSD, CPTSD, and BPD symptoms in a non-treatment-seeking community sample. Further, shame may be a central emotion that differentiates between presentation severities following trauma exposure.
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Affiliation(s)
- Tanya C. Saraiya
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | | | | | - Teresa López-Castro
- Psychology Department, The City College of New York at the City University of New York, New York, New York, USA
| | - Sudie E. Back
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA,Ralph H. Johnson VA Medical Center, Charleston, South Carolina, USA
| | - Denise A. Hien
- The Center of Alcohol & Substance Use Studies, Rutgers University, New Brunswick, New Jersey, USA
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Sharif L, Marusak HA, Peters C, Elrahal F, Rabinak CA. Trustworthiness and electrocortical processing of emotionally ambiguous faces in student police officers. Psychiatry Res Neuroimaging 2021; 307:111237. [PMID: 33338977 PMCID: PMC7819151 DOI: 10.1016/j.pscychresns.2020.111237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 11/26/2022]
Abstract
Perceptions of emotional facial expressions and trustworthiness of others guides behavior and has considerable implications for individuals who work in fields that require rapid decision making, such as law enforcement. This is particularly complicated for more ambiguous expressions, such as 'neutral' faces. We examined behavioral and electrocortical responses to facial expressions in 22 student police officers (18 males; 23.2 ± 3.63 years). Participants completed an emotional face appraisal task that involved viewing three expressions (fearful, neutral, happy) and were asked to identify the emotion and rate the trustworthiness of each face. The late positive potential (LPP), an event-related potential that tracks emotional intensity and/or salience of a stimulus, was measured during the task. Overall, participants rated neutral faces similarly to fearful faces and responded fastest to these expressions. Neutral faces also elicited a robust late LPP response that did not differ from LPP to fearful or happy faces, and there was substantial individual variation in trustworthiness ratings for neutral faces. Together, 'neutral' facial expressions elicited similar trustworthiness ratings to negatively-valenced stimuli. Brain and behavioral responses to neutral faces also varied across student officers; thus, encounters with ambiguous faces in the field may promote increased perceived threat in some officers, which may have real-world consequences (e.g., decision to shoot, risk of psychopathology).
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Affiliation(s)
- Limi Sharif
- Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States
| | - Hilary A Marusak
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States
| | - Craig Peters
- Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States
| | - Farrah Elrahal
- Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States
| | - Christine A Rabinak
- Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States; Department of Psychiatry & Behavioral Neurosciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States; Merrill Palmer Skillman Institute for Child and Family Development, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States; Department of Pharmaceutical Sciences, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States; Translational Neuroscience Program, Wayne State University, 259 Mack Avenue, Detroit, MI 48201, United States.
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