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Amsalem D, Lopez-Yianilos A, Lowell A, Pickover AM, Arnon S, Zhu X, Suarez-Jimenez B, Ryba M, Bergman M, Such S, Zalman H, Sanchez-Lacay A, Lazarov A, Markowitz JC, Neria Y. Treatment dropout among veterans and their families: Quantitative and qualitative findings. Psychol Trauma 2022; 14:578-586. [PMID: 34582228 PMCID: PMC8924016 DOI: 10.1037/tra0001109] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Psychotherapy noncompletion rates for veterans and their families are high. This study sought to (a) measure noncompletion rates of such patients at a university-based treatment center, (b) compare veteran and family member attrition rates, (c) identify dropout predictors, and (d) explore clinicians' perspectives on treatment noncompletion. METHOD Using quantitative and qualitative approaches, we analyzed demographic and clinical characteristics of 141 patients (90 military veterans; 51 family members) in a university treatment center. We defined dropout as not completing the time-limited therapy contract. Reviewing semistructured interview data assessing clinicians' perspectives on their patients' dropout, three independent raters agreed on key themes, with interrater coefficient kappa range .74 to 1. RESULTS Patient attrition was 24%, not differing significantly between veterans and family members. Diagnosis of major depression (MDD) and exposure-based therapies predicted noncompletion, as did higher baseline Hamilton Depression Rating Scale (HDRS) total scores, severe depression (HDRS > 20), lack of Beck Depression Inventory weekly improvement, and history of military sexual trauma. Clinicians mostly attributed noncompletion to patient difficulties coping with intense emotions, especially in exposure-based therapies. CONCLUSION Noncompletion rate at this study appeared relatively low compared to other veteran-based treatment centers, if still unfortunately substantial. Patients with comorbid MDD/PTSD and exposure-based therapies carried greater noncompletion risk due to the MDD component, and this should be considered in treatment planning. Ongoing discussion of dissatisfaction and patient discontinuation, in the context of a strong therapeutic alliance, might reduce noncompletion in this at-risk population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Doron Amsalem
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
| | | | - Ari Lowell
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Alison M. Pickover
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Shay Arnon
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Xi Zhu
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Benjamin Suarez-Jimenez
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Matt Ryba
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Maja Bergman
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Sara Such
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Hemrie Zalman
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Arturo Sanchez-Lacay
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Amit Lazarov
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
- School of Psychological Sciences, Tel Aviv University
| | - John C. Markowitz
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
| | - Yuval Neria
- New York State Psychiatric Institute
- Department of Psychiatry, Columbia University Irving Medical Center
- Department of Epidemiology, Columbia University Irving Medical Center
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Fisher PW, Lazarov A, Lowell A, Arnon S, Turner JB, Bergman M, Ryba M, Such S, Marohasy C, Zhu X, Suarez-Jimenez B, Markowitz JC, Neria Y. Equine-Assisted Therapy for Posttraumatic Stress Disorder Among Military Veterans: An Open Trial. J Clin Psychiatry 2021; 82. [PMID: 34464523 DOI: 10.4088/jcp.21m14005] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: As veterans have high rates of posttraumatic stress disorder (PTSD) and historically poor treatment outcomes and high attrition, alternative treatments have gained much popularity despite lack of rigorous research. In this study, a recently developed and manualized 8-session group Equine-Assisted Therapy for PTSD (EAT-PTSD) was tested in an open trial to assess its preliminary feasibility, acceptability, and outcomes for military veterans. Methods: The study was conducted from July 2016 to July 2019. Sixty-three treatment-seeking veterans with PTSD enrolled. PTSD diagnosis was ascertained using the Structured Clinical Interview for DSM-5, Research Version (SCID-5-RV) and confirmed using the Clinician-Administered PTSD Scale (CAPS-5). Mean age was 50 years, and 23 patients (37%) were women. Clinician and self-report measures of PTSD and depression were assessed at pretreatment, midtreatment, and posttreatment and at a 3-month follow-up. An intent-to-treat analysis and a secondary analysis of those who completed all 4 clinical assessments were utilized. Results: Only 5 patients (8%) withdrew from treatment, 4 before midtreatment and 1 afterward. Posttreatment assessment revealed marked reductions in both clinician-rated and self-reported PTSD and depression symptoms, which persisted at 3-month follow-up. Specifically, mean (SD) CAPS-5 scores fell from 38.6 (8.1) to 26.9 (12.4) at termination. Thirty-two patients (50.8%) showed clinically significant change (≥ 30% decrease in CAPS-5 score) at posttreatment and 34 (54.0%) at follow-up. Conclusions: Manualized EAT-PTSD shows promise as a potential new intervention for veterans with PTSD. It appears safe, feasible, and clinically viable. These preliminary results encourage examination of EAT-PTSD in larger, randomized controlled trials. Trial Registration: ClinicalTrials.gov identifier: NCT03068325.
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Affiliation(s)
- Prudence W Fisher
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,First authors-equal contribution
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,First authors-equal contribution.,Corresponding author: Amit Lazarov, PhD, Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY, 10032
| | - Ari Lowell
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Shay Arnon
- New York State Psychiatric Institute, New York, New York
| | - J Blake Turner
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Maja Bergman
- New York State Psychiatric Institute, New York, New York
| | - Matthew Ryba
- New York State Psychiatric Institute, New York, New York
| | - Sara Such
- New York State Psychiatric Institute, New York, New York
| | | | - Xi Zhu
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Benjamin Suarez-Jimenez
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - John C Markowitz
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Yuval Neria
- New York State Psychiatric Institute, New York, New York.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York.,Department of Epidemiology, Columbia University Irving Medical Center, New York, New York
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Pickover A, Lowell A, Lazarov A, Lopez-Yianilos A, Sanchez-Lacay A, Ryba M, Such S, Arnon S, Amsalem D, Neria Y, Markowitz JC. Interpersonal Psychotherapy of Posttraumatic Stress Disorder for Veterans and Family Members: An Open Trial. Psychiatr Serv 2021; 72:866-873. [PMID: 33557597 PMCID: PMC8328866 DOI: 10.1176/appi.ps.202000355] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Military service members and veterans have high rates of posttraumatic stress disorder (PTSD), as do military family members. Exposure-based, cognitive-behavioral approaches have received ample research, but other PTSD therapies require further empirical attention. Interpersonal psychotherapy (IPT) targets affective awareness, life circumstances, and social support. IPT has shown efficacy for civilians with PTSD but awaits rigorous testing among military personnel; only two small military pilot studies and two case reports have been published. Military family members have received minimal attention from clinical outcomes research. Addressing these gaps, this open trial examined IPT for PTSD among veterans, service members, and family members, including a patient subset with comorbid PTSD and depression. METHODS Fifty U.S. military service members, veterans, and family members (age ≥18 years) were offered 14 sessions of IPT for PTSD. Individuals with psychosis, bipolar disorder, moderate or severe substance use disorders, or high suicide risk were excluded. PTSD and depressive symptoms were assessed at baseline, midtreatment, posttreatment, and 3-month follow-up. RESULTS Clinician-assessed PTSD (Clinician-Administered PTSD Scale) and depression (Hamilton Depression Rating Scale) symptoms decreased over time in the full sample and the comorbid PTSD/depression subset (p<0.05). Service members, veterans, and family members had similar treatment responses. CONCLUSIONS Patients receiving IPT showed reductions in PTSD and depressive symptoms. These open trial findings provide preliminary support for the utility of IPT in reducing PTSD symptoms among veterans and family members. This largest IPT trial to date for PTSD in military patients also bolsters the literature on treating military family members.
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Affiliation(s)
- Alison Pickover
- New York State Psychiatric Institute, NY
- Department of Psychiatry, Columbia University Irving Medical Center, NY
| | - Ari Lowell
- New York State Psychiatric Institute, NY
- Department of Psychiatry, Columbia University Irving Medical Center, NY
| | - Amit Lazarov
- Department of Psychiatry, Columbia University Irving Medical Center, NY
- School of Psychological Sciences, Tel Aviv University, Israel
| | | | - Arturo Sanchez-Lacay
- New York State Psychiatric Institute, NY
- Department of Psychiatry, Columbia University Irving Medical Center, NY
| | - Matthew Ryba
- New York State Psychiatric Institute, NY
- Department of Psychiatry, Weill-Cornell Medical Center, NY
| | - Sara Such
- New York State Psychiatric Institute, NY
| | - Shay Arnon
- New York State Psychiatric Institute, NY
| | - Doron Amsalem
- New York State Psychiatric Institute, NY
- Department of Psychiatry, Columbia University Irving Medical Center, NY
| | - Yuval Neria
- New York State Psychiatric Institute, NY
- Department of Psychiatry, Columbia University Irving Medical Center, NY
| | - John C. Markowitz
- New York State Psychiatric Institute, NY
- Department of Psychiatry, Columbia University Irving Medical Center, NY
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von Doetinchem P, Perez K, Aramaki T, Baker S, Barwick S, Bird R, Boezio M, Boggs S, Cui M, Datta A, Donato F, Evoli C, Fabris L, Fabbietti L, Ferronato Bueno E, Fornengo N, Fuke H, Gerrity C, Gomez Coral D, Hailey C, Hooper D, Kachelriess M, Korsmeier M, Kozai M, Lea R, Li N, Lowell A, Manghisoni M, Moskalenko I, Munini R, Naskret M, Nelson T, Ng K, Nozzoli F, Oliva A, Ong R, Osteria G, Pierog T, Poulin V, Profumo S, Pöschl T, Quinn S, Re V, Rogers F, Ryan J, Saffold N, Sakai K, Salati P, Schael S, Serksnyte L, Shukla A, Stoessl A, Tjemsland J, Vannuccini E, Vecchi M, Winkler M, Wright D, Xiao M, Xu W, Yoshida T, Zampa G, Zuccon P. Cosmic-ray antinuclei as messengers of new physics: status and outlook for the new decade. J Cosmol Astropart Phys 2020; 2020:035. [PMID: 34712102 PMCID: PMC8549764 DOI: 10.1088/1475-7516/2020/08/035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The precise measurement of cosmic-ray antinuclei serves as an important means for identifying the nature of dark matter and other new astrophysical phenomena, and could be used with other cosmic-ray species to understand cosmic-ray production and propagation in the Galaxy. For instance, low-energy antideuterons would provide a "smoking gun" signature of dark matter annihilation or decay, essentially free of astrophysical background. Studies in recent years have emphasized that models for cosmic-ray antideuterons must be considered together with the abundant cosmic antiprotons and any potential observation of antihelium. Therefore, a second dedicated Antideuteron Workshop was organized at UCLA in March 2019, bringing together a community of theorists and experimentalists to review the status of current observations of cosmic-ray antinuclei, the theoretical work towards understanding these signatures, and the potential of upcoming measurements to illuminate ongoing controversies. This review aims to synthesize this recent work and present implications for the upcoming decade of antinuclei observations and searches. This includes discussion of a possible dark matter signature in the AMS-02 antiproton spectrum, the most recent limits from BESS Polar-II on the cosmic antideuteron flux, and reports of candidate antihelium events by AMS-02; recent collider and cosmic-ray measurements relevant for antinuclei production models; the state of cosmic-ray transport models in light of AMS-02 and Voyager data; and the prospects for upcoming experiments, such as GAPS. This provides a roadmap for progress on cosmic antinuclei signatures of dark matter in the coming years.
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Affiliation(s)
- P. von Doetinchem
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K. Perez
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - T. Aramaki
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - S. Baker
- Imperial College London, London, SW7 2AZ, U.K
| | - S. Barwick
- Department of Physics & Astronomy, University of California at Irvine, 4129 Frederick Reines Hall, Irvine, CA 92697, U.S.A
| | - R. Bird
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - M. Boezio
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - S.E. Boggs
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Cui
- Purple Mountain Observatory, Yuanhua Road, Qixia District, Nanjing 210033, China
| | - A. Datta
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - F. Donato
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - C. Evoli
- Gran Sasso Science Institute, Viale Francesco Crispi 7, 67100 L’Aquila, Italy
- INFN, Laboratori Nazionali del Gran Sasso, Via G. Acitelli, 22, 67100 Assergi, L’Aquila, Italy
| | - L. Fabris
- Isotope and Fuel Cycle and Technology Division, Oak Ridge National Laboratory, PO BOX 2008, Oak Ridge, TN 37831, U.S.A
| | - L. Fabbietti
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - E. Ferronato Bueno
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - N. Fornengo
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - H. Fuke
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - C. Gerrity
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - D. Gomez Coral
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Physics, National Autonomous University of Mexico, Circuito de la investigación científica, C.U. 04510, Ciudad de México, Mexico
| | - C. Hailey
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - D. Hooper
- Theoretical Astrophysics, Fermi National Accelerator Laboratory, Wilson and Kirk Rds, Batavia, IL 60510, U.S.A
- Department of Astronomy and Astrophysics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
| | - M. Kachelriess
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - M. Korsmeier
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
- Institute for Theoretical Particle Physics and Cosmology, RWTH Aachen University, 52056 Aachen, Germany
| | - M. Kozai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - R. Lea
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
- Dipartimento di Fisica dell’Universitá Trieste, Via Valerio 2, 34127 Trieste, Italy
| | - N. Li
- CAS Key Laboratory of Theoretical Physics, Institute of Theoretical Physics, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, No.19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - A. Lowell
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Manghisoni
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - I.V. Moskalenko
- Hansen Experimental Physics Laboratory, Stanford University, 452 Lomita Mall, Stanford, CA 94305, U.S.A
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, CA 94305, U.S.A
| | - R. Munini
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - M. Naskret
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Theoretical Physics, University of Wroclaw, pl. M. Borna 9, 50-204 Wroclaw, Poland
| | - T. Nelson
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K.C.Y. Ng
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - F. Nozzoli
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
| | - A. Oliva
- INFN, Sezione di Bologna, Via Irnerio 46, Bologna 40126, Italy
| | - R.A. Ong
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - G. Osteria
- INFN, Sezione di Napoli, Strada Comunale Cinthia, 80126 Naples, Italy
| | - T. Pierog
- Institute for Nuclear Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - V. Poulin
- Laboratoire Univers & Particules de Montpellier, CNRS, Université de Montpellier, Place Eugène Bataillon, 34095 Montpellier Cedex 05, France
| | - S. Profumo
- Department of Physics and Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, U.S.A
| | - T. Pöschl
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - S. Quinn
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - V. Re
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - F. Rogers
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - J. Ryan
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - N. Saffold
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - K. Sakai
- NASA-Goddard Space Flight Center), 8800 Greenbelt Rd, Greenbelt, MD 20771, U.S.A
- CRESST, University of Maryland, Baltimore County, MD 21250, U.S.A
| | - P. Salati
- Laboratoire d’Annecy-le-Vieux de Physique Théorique, 9 Chemin de Bellevue, 74940 Annecy, France
| | - S. Schael
- I. Physikalisches Institut, RWTH Aachen University, Sommerfeldstr. 14, 52074 Aachen, Germany
| | - L. Serksnyte
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - A. Shukla
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - A. Stoessl
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - J. Tjemsland
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - E. Vannuccini
- INFN, Sezione di Firenze, 50019 Sesto Fiorentino, Florence, Italy
| | - M. Vecchi
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - M.W. Winkler
- The Oskar Klein Centre for Cosmoparticle Physics, Department of Physics, Stockholm University, Alba Nova, 10691 Stockholm, Sweden
| | - D. Wright
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - M. Xiao
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - W. Xu
- Department of Physics, Harvard University, 17 Oxford St, Cambridge, MA, 95129, U.S.A
| | - T. Yoshida
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - G. Zampa
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - P. Zuccon
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
- Department of Physics, University of Trento, Via Sommarive 14, 38123 Povo, Italy
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Arnon S, Fisher PW, Pickover A, Lowell A, Turner JB, Hilburn A, Jacob-McVey J, Malajian BE, Farber DG, Hamilton JF, Hamilton A, Markowitz JC, Neria Y. Equine-Assisted Therapy for Veterans with PTSD: Manual Development and Preliminary Findings. Mil Med 2020; 185:e557-e564. [PMID: 32034416 PMCID: PMC7282489 DOI: 10.1093/milmed/usz444] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Equine-assisted therapy (EAT) for post-traumatic stress disorder (PTSD) has attracted great interest despite lacking empirical support, a manual, and a standardized protocol. Our team of experts in EAT and PTSD developed an eight-session group EAT treatment protocol for PTSD (EAT-PTSD) and administered it to two pilot groups of military veterans to assess initial effects. MATERIALS AND METHODS We describe the development of the treatment manual, which was used with two pilot groups of veterans. Protocol safety, feasibility, and acceptability were assessed by reported adverse events, treatment completion rates, and self-rated patient satisfaction. Preliminary data on PTSD, depressive, and anxiety symptoms and quality of life were collected pretreatment, midpoint, post-treatment, and at 3-month follow up. RESULTS No adverse events were recorded. All patients completed treatment, reporting high satisfaction. Preliminary data showed decreases in clinician-assessed PTSD and depressive symptoms from pre to post-treatment and follow-up (medium to large effect sizes, d = .54-1.8), with similar trends across self-report measures (d = 0.72-1.6). In our pilot sample, treatment response and remission varied; all patients showed some benefit post-treatment, but gains did not persist at follow-up. CONCLUSIONS This article presents the first standardized EAT protocol. Highly preliminary results suggest our new manualized group EAT-PTSD appears safe, well-regarded, and well-attended, yielding short-term benefits in symptomatology and quality of life if unclear length of effect. Future research should test this alternative treatment for PTSD more rigorously.
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Affiliation(s)
- Shay Arnon
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Prudence W Fisher
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Alison Pickover
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Ari Lowell
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - J Blake Turner
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Anne Hilburn
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
| | - Jody Jacob-McVey
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
- EquiSense Solutions LLC, 33 West 93rd Street, 3B, New York, NY 10025
| | | | - Debra G Farber
- Bergen Equestrian Center, 40 Fort Lee Road, Leonia, NJ 07605
| | - Jane F Hamilton
- Rancho Bosque Equestrian Center of Excellence, House Hamilton Business Group, PLC, 8649 E Woodland Road, Tucson, AZ 85749
| | - Allan Hamilton
- Department of Surgery, University of Arizona Health Sciences Center, 1501 N. Campbell Avenue, Tucson, AZ 85724
| | - John C Markowitz
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
| | - Yuval Neria
- New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032
- Department of Psychiatry, Columbia University Irving Medical Center, 1051 Riverside Drive, New York, NY 10032
- Department of Epidemiology, Columbia University Irving Medical Center, 722 West 168th Street, New York, NY 10032
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Milrod B, Keefe JR, Choo TH, Arnon S, Such S, Lowell A, Neria Y, Markowitz JC. Separation anxiety in PTSD: A pilot study of mechanisms in patients undergoing IPT. Depress Anxiety 2020; 37:386-395. [PMID: 32097526 PMCID: PMC7207264 DOI: 10.1002/da.23003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 02/02/2020] [Accepted: 02/04/2020] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Separation anxiety disorder (SAD) comprises one aspect of attachment dysregulation or insecurity. Although SAD aggravates posttraumatic stress disorder (PTSD) risk, no clinical research has tracked how many patients with PTSD have SAD, its clinical associations, or its response to PTSD treatment. Our open trial of interpersonal psychotherapy (IPT) for veterans with PTSD assessed these SAD domains. METHODS Twenty-nine veterans diagnosed with chronic PTSD on the Clinician-Administered PTSD Scale were assessed for SAD using the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), and for Symptom-Specific Reflective Function (SSRF), another dysregulated-attachment marker capturing patients' emotional understanding of their symptoms. Patients received 14 IPT sessions for PTSD with assessments at baseline, Week 4 (SCI-SAS and SSRF), and termination for SAD, PTSD, and depression. RESULTS At baseline, 69% of patients met SAD criteria. Separation anxiety did not correlate with baseline PTSD severity, depressive severity, or age when traumatized; patients with and without SAD had comparable PTSD and depression severity. Patients with baseline comorbid SAD who completed IPT (N = 17) reported significantly improved adult separation anxiety (p = .009). Adult SAD improvements predicted depressive improvement (p = .049). Patients with SAD showed a stronger relationship between early SSRF gains and subsequent adult SAD improvement (p = .021) compared with patients without SAD. DISCUSSION This first exploration of dysregulated/insecure attachment features among patients with PTSD found high SAD comorbidity and adult SAD improvement among patients with SAD following IPT. Highly impaired attachment patients normalized attachment posttreatment: 14-session IPT improved attachment dysregulation. This small study requires replication but begins to broaden clinical understanding of separation anxiety, attachment dysregulation, and PTSD.
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Affiliation(s)
- Barbara Milrod
- Department of Psychiatry, Weill Medical College of Cornell University, New York City, New York
| | - John R Keefe
- Department of Psychiatry, Weill Medical College of Cornell University, New York City, New York
| | - Tse-Hwei Choo
- Department of Psychiatry, Vagelos College of Physicians and Surgeons of Columbia University, New York City, New York
| | - Shay Arnon
- Anxiety Disorders Clinic, New York State Psychiatric Institute, New York City, New York
| | - Sara Such
- Anxiety Disorders Clinic, New York State Psychiatric Institute, New York City, New York
| | - Ari Lowell
- Department of Psychiatry, Vagelos College of Physicians and Surgeons of Columbia University, New York City, New York
- Anxiety Disorders Clinic, New York State Psychiatric Institute, New York City, New York
| | - Yuval Neria
- Department of Psychiatry, Vagelos College of Physicians and Surgeons of Columbia University, New York City, New York
- Anxiety Disorders Clinic, New York State Psychiatric Institute, New York City, New York
| | - John C Markowitz
- Department of Psychiatry, Vagelos College of Physicians and Surgeons of Columbia University, New York City, New York
- Anxiety Disorders Clinic, New York State Psychiatric Institute, New York City, New York
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Markowitz JC, Lowell A, Milrod BL, Lopez-Yianilos A, Neria Y. Symptom-Specific Reflective Function as a Potential Mechanism of Interpersonal Psychotherapy Outcome: A Case Report. Am J Psychother 2020; 73:35-40. [PMID: 31902227 DOI: 10.1176/appi.psychotherapy.20190026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- John C Markowitz
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York (Markowitz, Lowell, Neria); New York State Psychiatric Institute, New York (Markowitz, Lowell, Lopez-Yianilos, Neria); Department of Psychiatry, Weill Medical College, Cornell University, New York (Milrod)
| | - Ari Lowell
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York (Markowitz, Lowell, Neria); New York State Psychiatric Institute, New York (Markowitz, Lowell, Lopez-Yianilos, Neria); Department of Psychiatry, Weill Medical College, Cornell University, New York (Milrod)
| | - Barbara L Milrod
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York (Markowitz, Lowell, Neria); New York State Psychiatric Institute, New York (Markowitz, Lowell, Lopez-Yianilos, Neria); Department of Psychiatry, Weill Medical College, Cornell University, New York (Milrod)
| | - Andrea Lopez-Yianilos
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York (Markowitz, Lowell, Neria); New York State Psychiatric Institute, New York (Markowitz, Lowell, Lopez-Yianilos, Neria); Department of Psychiatry, Weill Medical College, Cornell University, New York (Milrod)
| | - Yuval Neria
- Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York (Markowitz, Lowell, Neria); New York State Psychiatric Institute, New York (Markowitz, Lowell, Lopez-Yianilos, Neria); Department of Psychiatry, Weill Medical College, Cornell University, New York (Milrod)
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Kritzer M, Rosario W, Tharayil J, Lai C, Botros P, Lowell A, Cruz D, Rodriguiz R, Wetsel W, Peterchev A, Williamson D. Erratum to ‘Electroconvulsive stimulation increases astrocyte marker GFAP in mouse hippocampus regardless of chronic social defeat stress’ [12 (2) (March–April 2019) 543]. Brain Stimul 2019. [DOI: 10.1016/j.brs.2019.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Kritzer M, Rosario W, Tharayil J, Lai C, Botros P, Lowell A, Cruz D, Rodriguiz R, Wetsel W, Peterchev A, Williamson D. Electroconvulsive Stimulation Increases Astrocytes In Mice Subjected To Chronic Social Defeat Stress. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Lowell A, Lopez-Yianilos A, Ryba M, Arnon S, Suarez-Jimenez B, Lazarov A, Fisher PW, Markowitz JC, Neria Y. A University-Based Mental Health Center for Veterans and Their Families: Challenges and Opportunities. Psychiatr Serv 2019; 70:159-162. [PMID: 30497324 DOI: 10.1176/appi.ps.201800356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
The Military Family Wellness Center at Columbia University Irving Medical Center provides cost-free, confidential mental health services to military service members, veterans, and their families in a nongovernmental setting, with an emphasis on addressing gaps in available care. Partnerships with academic institutions and collaboration with veteran organizations, regional stakeholders, and local Veterans Administration centers facilitate cross-site referrals, enhance knowledge and expertise, and advance shared goals. This article describes the development of these relationships, focusing on key priorities, barriers overcome, and lessons learned. Future directions are discussed.
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Affiliation(s)
- Ari Lowell
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Andrea Lopez-Yianilos
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Matthew Ryba
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Shay Arnon
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Benjamin Suarez-Jimenez
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Amit Lazarov
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Prudence W Fisher
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - John C Markowitz
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
| | - Yuval Neria
- New York State Psychiatric Institute, New York (Lowell, Lopez-Yianilos, Ryba, Arnon, Suarez-Jimenez, Fisher, Markowitz, Neria); Department of Psychiatry, Columbia University Irving Medical Center, New York (Lowell, Suarez-Jimenez, Lazarov, Fisher, Markowitz, Neria); Department of Psychiatry, Weill-Cornell Medical Center, New York (Ryba); School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel (Lazarov)
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Zhu X, Suarez-Jimenez B, Lazarov A, Helpman L, Papini S, Lowell A, Durosky A, Lindquist MA, Markowitz JC, Schneier F, Wager TD, Neria Y. Exposure-based therapy changes amygdala and hippocampus resting-state functional connectivity in patients with posttraumatic stress disorder. Depress Anxiety 2018; 35:974-984. [PMID: 30260530 PMCID: PMC6168398 DOI: 10.1002/da.22816] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 04/19/2018] [Accepted: 05/29/2018] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Recent research suggests that posttraumatic stress disorder (PTSD) is associated with altered amygdala and hippocampal resting-state functional connectivity (rsFC). However, less research has examined whether Prolonged Exposure (PE), a first line exposure-based treatment for PTSD, has the potential to alter resting state neural networks. METHODS A total of 24 patients with PTSD and 26 matched trauma-exposed healthy controls (TEHCs) underwent resting-state functional magnetic resonance imaging (fMRI) at baseline. PTSD patients were scanned a second time after completing 10-session PE in which patients narrated a detailed trauma account (imaginal exposure) and confronted trauma reminders (in vivo exposure) to extinguish trauma-related fear responses. TEHC were scanned again following a 10-week waiting period. Seed regions of interest (ROIs) included centromedial amygdala (CMA), basolateral amygdala (BLA), and the hippocampus. RESULTS Post- versus pretreatment comparisons indicated increased rsFC of the BLA and CMA with the orbitofrontal cortex (OFC), and hippocampus-medial prefrontal cortex (mPFC) among patients with PTSD, but not among TEHC participants. CONCLUSIONS Enhanced amygdala and hippocampus rsFC with prefrontal cortical regions following PE could underlie improved capacity for inhibition and re-evaluation of threat, and heightened memory encoding and retrieval ability, respectively. These findings encourage further investigation of this circuitry as a therapeutic target in PTSD.
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Affiliation(s)
- Xi Zhu
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Benjamin Suarez-Jimenez
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Amit Lazarov
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Liat Helpman
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Santiago Papini
- The University of Texas at Austin, Department of Psychology and Institute for Mental Health Research, TX
| | - Ari Lowell
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | | | | | - John C. Markowitz
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Franklin Schneier
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
| | - Tor D. Wager
- University of Colorado Boulder, Department of Psychology and Neuroscience, CO
| | - Yuval Neria
- Columbia University, Department of Psychiatry, New York, NY,New York State Psychiatric Institute, New York, NY
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Lowell A, Suarez-Jimenez B, Helpman L, Zhu X, Durosky A, Hilburn A, Schneier F, Gross R, Neria Y. 9/11-related PTSD among highly exposed populations: a systematic review 15 years after the attack. Psychol Med 2018; 48:537-553. [PMID: 28805168 PMCID: PMC5805615 DOI: 10.1017/s0033291717002033] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The 11 September 2001 (9/11) attacks were unprecedented in magnitude and mental health impact. While a large body of research has emerged since the attacks, published reviews are few, and are limited by an emphasis on cross-sectional research, short time frame, and exclusion of treatment studies. Additionally, to date, there has been no systematic review of available longitudinal information as a unique data set. Consequently, knowledge regarding long-term trajectories of 9/11-related post-traumatic stress disorder (PTSD) among highly exposed populations, and whether available treatment approaches effectively address PTSD within the context of mass, man-made disaster, remains limited. METHODS The present review aimed to address these gaps using a systematic review of peer-reviewed reports from October 2001 to May 2016. Eligible reports were of longitudinal studies of PTSD among highly exposed populations. We identified 20 reports of 9/11-related PTSD, including 13 longitudinal prevalence studies and seven treatment studies. RESULTS Findings suggest a substantial burden of 9/11-related PTSD among those highly exposed to the attack, associated with a range of sociodemographic and back-ground factors, and characteristics of peri-event exposure. While most longitudinal studies show declining rates of prevalence of PTSD, studies of rescue/recovery workers have documented an increase over time. Treatment studies were few, and generally limited by methodological shortcomings, but support exposure-based therapies. CONCLUSION Future directions for research, treatment, and healthcare policy are discussed.
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Affiliation(s)
- A. Lowell
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - B. Suarez-Jimenez
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - L. Helpman
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - X. Zhu
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - A. Durosky
- New York State Psychiatric Institute, New York, NY, USA
| | - A. Hilburn
- New York State Psychiatric Institute, New York, NY, USA
| | - F. Schneier
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - R. Gross
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
- Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Psychiatry, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Y. Neria
- Department of Psychiatry, Columbia University Medical Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
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DeMasi J, Edwards J, Shahidain S, Desimone P, Tzeng C, Hosein P, Lowell A, Kudrimoti M. Superior Outcomes With Gemcitabine-Based Systemic and Concurrent Administration With Radiation Therapy in Inoperable or Unresectable Cholangiocarcinomas. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Patek AJ, Mankin H, Colcher H, Lowell A, Earle DP. The effects of intravenous injection of concentrated human serum albumin upon blood plasma, ascites and renal functions in three patients with cirrhosis of the liver. J Clin Invest 2008; 27:135-44. [PMID: 16695524 PMCID: PMC439482 DOI: 10.1172/jci101916] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- A J Patek
- Research Services, First and Third Medical Divisions, Goldwater Memorial Hospital, New York City
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Lowell A, Colcher H, Kendall FE, Patek AJ, Seegal D. A COMPARISON OF THE EFFECTS OF HIGH AND LOW VISCOSITY GELATINS AFTER THEIR INTRAVENOUS INJECTION IN MAN. J Clin Invest 2006; 25:226-36. [PMID: 16695311 PMCID: PMC435557 DOI: 10.1172/jci101701] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- A Lowell
- Research Service, First (Columbia) Division, Goldwater Memorial Hospital, New York City
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Affiliation(s)
- H Mankin
- Research Service, First [Columbia] Division, Goldwater Memorial Hospital, New York City
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Allsop J, Lowell A. Why some people just never make it to the surgery. Health Soc Serv J 1984; 94:463-4. [PMID: 10266443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Lowell A. Editorial: Interferon: 1973. South Med J 1974; 67:1-3. [PMID: 4808981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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