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Walsh K, Gilmore AK, Barr SC, Frazier P, Ledray L, Acierno R, Ruggiero KJ, Kilpatrick DG, Resnick HS. The Role of Discrimination Experiences in Postrape Adjustment Among Racial and Ethnic Minority Women. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP17325-NP17343. [PMID: 34229508 DOI: 10.1177/08862605211028006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Although recent studies have linked discrimination frequency among Black and Latinx individuals to PTSD symptom severity, to our knowledge, these associations have yet to be examined among a diverse sample of recent rape survivors. The current secondary analysis of existing data examined the role of discrimination experiences in post-traumatic stress disorder (PTSD) symptoms, depression, and alcohol and drug problems among a racially and ethnically diverse sample of recent rape survivors. Participants were 139 Black (48.2%; n = 67), American Indian (18.7%; n = 26), Hispanic (15.1%; n = 21), and mixed race (17.3%; n = 24) girls and women age 15 or older who presented to the emergency department (ED) for a sexual assault forensic medical exam. They were randomly assigned to one of three intervention conditions, and completed a six-month postrape follow-up, including questions about mental health, substance use problems, and discrimination experiences. Regression analyses revealed that Black women experienced discrimination in significantly more situations and with greater frequency compared to American Indian and Hispanic women. Discrimination frequency was positively associated with PTSD and depression symptoms even after controlling for age, education, race, and intervention condition, but was not associated with alcohol or drug problems. Findings highlight the importance of attending to the heterogeneous experiences of discrimination among racial and ethnic minority women. Future work should adapt evidence-based early interventions to be maximally effective at combating both racial and sexual trauma exposures.
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Affiliation(s)
- Kate Walsh
- University of Wisconsin-Madison, WI, USA
| | | | - Simone C Barr
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | | | - Linda Ledray
- SANE SART Resource Service, Minneapolis, MN, USA
| | - Ron Acierno
- University of Texas Health Science Center, Houston, TX, USA
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Balters S, Li R, Espil FM, Piccirilli A, Liu N, Gundran A, Carrion VG, Weems CF, Cohen JA, Reiss AL. Functional near-infrared spectroscopy brain imaging predicts symptom severity in youth exposed to traumatic stress. J Psychiatr Res 2021; 144:494-502. [PMID: 34768071 DOI: 10.1016/j.jpsychires.2021.10.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/11/2021] [Accepted: 10/18/2021] [Indexed: 10/19/2022]
Abstract
Functional near-infrared spectroscopy (fNIRS) is a non-invasive neuroimaging technique with the potential to enable the assessment of posttraumatic stress disorder (PTSD) brain biomarkers in an affordable and portable manner. Consistent with biological models of PTSD, functional magnetic resonance imaging (fMRI) and fNIRS studies of adults with trauma exposure and PTSD symptoms suggest increased activation in the dorsolateral prefrontal cortex (dlPFC) and ventrolateral PFC (vlPFC) in response to negative emotion stimuli. We tested this theory with fNIRS assessment among youth exposed to traumatic stress and experiencing PTSD symptoms (PTSS). A portable fNIRS system collected hemodynamic responses from (N = 57) youth with PTSS when engaging in a classic emotion expression task that included fearful and neutral faces stimuli. The General Linear Model was applied to identify cortical activations associated with the facial stimuli. Subsequently, a prediction model was established via a Support Vector Regression to determine whether PTSS severity could be predicted based on fNIRS-derived cortical response measures and individual demographic information. Results were consistent with findings from adult fMRI and fNIRS studies of PTSS showing increased activation in the dlPFC and vlPFC in response to negative emotion stimuli. Subsequent prediction analysis revealed ten features (i.e., cortical responses from eight frontocortical fNIRS channels, age and sex) strongly correlated with PTSS severity (r = 0.65, p < .001). Our findings suggest the potential utility of fNIRS as a portable tool for the detection of putative PTSS brain biomarkers.
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Affiliation(s)
- Stephanie Balters
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States.
| | - Rihui Li
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States.
| | - Flint M Espil
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Aaron Piccirilli
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Ning Liu
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Andrew Gundran
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Victor G Carrion
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States
| | - Carl F Weems
- Department of Human Development and Family Studies, Iowa State University, United States
| | - Judith A Cohen
- Allegheny Health Network, Drexel University College of Medicine, United States
| | - Allan L Reiss
- Department of Psychiatry and Behavioral Sciences, Stanford University, United States; Department of Radiology, Stanford University, United States; Department of Pediatrics, Stanford University, United States
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Callaghan W. Sex and gender: More than just demographic variables. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2021. [DOI: 10.3138/jmvfh-2021-0027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
LAY SUMMARY Taking as a starting point that sex and gender are not the same thing, a principal understanding of Gender-Based Analysis Plus (GBA+), this article reviews research published in 2020 on the health and well-being of Veterans and currently serving members of the Canadian Armed Forces. The purpose of this review was to see how sex and gender were referred to in this published literature. The published research tended not to differentiate between sex and gender, often using the two terms as though they referred to the same thing. Possible reasons for why this has happened are explored, as is the importance of treating sex and gender as fundamentally different things.
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Affiliation(s)
- Walter Callaghan
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
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Nicholson AA, Ros T, Densmore M, Frewen PA, Neufeld RWJ, Théberge J, Jetly R, Lanius RA. A randomized, controlled trial of alpha-rhythm EEG neurofeedback in posttraumatic stress disorder: A preliminary investigation showing evidence of decreased PTSD symptoms and restored default mode and salience network connectivity using fMRI. Neuroimage Clin 2020; 28:102490. [PMID: 33395981 PMCID: PMC7708928 DOI: 10.1016/j.nicl.2020.102490] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/20/2020] [Accepted: 10/27/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The default-mode network (DMN) and salience network (SN) have been shown to display altered connectivity in posttraumatic stress disorder (PTSD). Restoring aberrant connectivity within these networks with electroencephalogram neurofeedback (EEG-NFB) has been shown previously to be associated with acute decreases in symptoms. Here, we conducted a double-blind, sham-controlled randomized trial of alpha-rhythm EEG-NFB in participants with PTSD (n = 36) over 20-weeks. Our aim was to provide mechanistic evidence underlying clinical improvements by examining changes in network connectivity via fMRI. METHODS We randomly assigned participants with a primary diagnosis of PTSD to either the experimental group (n = 18) or sham-control group (n = 18). We collected resting-state fMRI scans pre- and post-NFB intervention, for both the experimental and sham-control PTSD groups. We further compared baseline brain connectivity measures pre-NFB to age-matched healthy controls (n = 36). RESULTS With regard to the primary outcome measure of PTSD severity, we found a significant main effect of time in the absence of a group × time interaction. Nevertheless, we found significantly decreased PTSD severity scores in the experimental NFB group only, when comparing post-NFB (dz = 0.71) and 3-month follow-up scores (dz = 0.77) to baseline measures. Interestingly, we found evidence to suggest a shift towards normalization of DMN and SN connectivity post-NFB in the experimental group only. Both decreases in PTSD severity and NFB performance were correlated to DMN and SN connectivity post-NFB in the experimental group. Critically, remission rates of PTSD were significant higher in the experimental group (61.1%) as compared to the sham-control group (33.3%). CONCLUSION The current study shows mechanistic evidence for therapeutic changes in DMN and SN connectivity that are known to be associated with PTSD psychopathology with no patient dropouts. This preliminary investigation merits further research to demonstrate fully the clinical efficacy of EEG-NFB as an adjunctive therapy for PTSD.
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Affiliation(s)
- Andrew A Nicholson
- Department of Cognition, Emotion, and Methods in Psychology, University of Vienna, Austria
| | - Tomas Ros
- Departments of Neuroscience and Psychiatry, University of Geneva, Campus Biotech, Geneva, Switzerland
| | - Maria Densmore
- Departments of Neuroscience, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada
| | - Paul A Frewen
- Departments of Neuroscience, Western University, London, ON, Canada; Departments of Psychology, Western University, London, ON, Canada
| | - Richard W J Neufeld
- Departments of Neuroscience, Western University, London, ON, Canada; Departments of Psychiatry, Western University, London, ON, Canada; Departments of Psychology, Western University, London, ON, Canada
| | - Jean Théberge
- Departments of Psychiatry, Western University, London, ON, Canada; Departments of Psychology, Western University, London, ON, Canada; Departments of Medical Imaging, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada; Department of Diagnostic Imaging, St. Joseph's Healthcare, London, ON, Canada
| | - Rakesh Jetly
- Canadian Forces, Health Services, Ottawa, Ontario, Canada
| | - Ruth A Lanius
- Departments of Neuroscience, Western University, London, ON, Canada; Departments of Psychiatry, Western University, London, ON, Canada; Imaging, Lawson Health Research Institute, London, ON, Canada.
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