Desynchronization of autonomic response and central autonomic network connectivity in posttraumatic stress disorder

AbstractRandomized controlled trials have shown efficacy of trauma-focused psychotherapies in youth with posttraumatic stress disorder (PTSD). However, response varies considerably among individuals. Currently, no biomarkers are available to assist clinicians in identifying youth who are most likely to benefit from treatment. In this study, we investigated whether resting-state functional magnetic resonance imaging (rs-fMRI) could distinguish between responders and non-responders on the group- and individual patient level.Pre-treatment rs-fMRI was recorded in 40 youth (ages 8-17 years) with (partial) PTSD before trauma-focused psychotherapy. Change in symptom severity from pre- to post-treatment was assessed using the Clinician-Administered PTSD scale for Children and Adolescents to divide participants into responders (≥30% symptom reduction) and non-responders. Functional networks were identified using meta-independent component analysis. Group-differences within- and between-network connectivity between responders and non-responders were tested using permutation testing. Individual predictions were made using multivariate, cross-validated support vector machine classification.A network centered on the bilateral superior temporal gyrus predicted treatment response for individual patients with 76.17% accuracy (pFWE = 0.018, 87.14% sensitivity, 65.20% specificity, area-under-receiver-operator-curve of 0.82). Functional connectivity between the frontoparietal and sensorimotor network was significantly stronger in non-responders (pFWE = 0.012) on the group-level. Within-network connectivity was not significantly different between groups.This study provides proof-of-concept evidence for the feasibility to predict trauma-focused psychotherapy response in youth with PTSD at an individual-level. Future studies are required to test if larger cohorts could increase accuracy and to test further generalizability of the prediction models.

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Abstract 19204: Symptoms of Depression and Posttraumatic Stress Disorder are Associated with Differential Autonomic Influences to Standing

Circulation ◽

10.1161/circ.130.suppl_2.19204 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Amit J Shah ◽

Ayman Alkhoder ◽

Malik Obideen ◽

Ronnie Ramadan ◽

Kobina Wilmot ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Depressive Symptoms ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Beta Blockers ◽

Autonomic Response ◽

Ptsd Symptoms ◽

Symptoms Of Depression ◽

Autonomic Pathways ◽

The Mean

Introduction: Depression and posttraumatic stress disorder (PTSD) are associated with impaired baroreflex sensitivity, a risk factor for sudden death. Unlike depression, PTSD is associated with hyperarousal. We hypothesized that, in patients with CAD, depressive and PTSD symptoms associate with different autonomic responses to standing (baroreflex response). Methods: We examined 178 patients with CAD for autonomic dysfunction with the ANSAR test (ANX 3.0, ANSAR Inc. Philadelphia, PA) in which heart rate variability was measured in both sitting (5 minutes) and standing (5 minutes) positions. Sympathetic (SNS) and parasympathetic (PNS) nervous system activity was measured using continuous wavelet transform and log-transformed. PTSD symptoms were assessed using the PTSD checklist scale (PCL), and depressive symptoms were assessed using the Beck Depression Inventory-II (BDI). Both BDI and PCL were examined in multivariate models simultaneously, adjusting for CAD risk factors, beta blockers, and antidepressants. Results: The mean (SD) age, BDI, and PCL scores were 62.4 (9.1), 7.2 (7.6), and 26.2 (10.2), respectively. For the group as a whole, the mean baseline SNS and PNS tones were -0.49 and -0.60 log beats per minute squared (log BPM 2 ). In multivariable models, PCL score associated with higher baseline SNS tone (β=0.03, p=0.046). With standing, PCL score associated with decrease in the levels of SNS tone (β=-0.02, p=0.02) vs. sitting, and BDI associated with an increased PNS tone (β=0.03, p=0.03) vs. sitting. In both cases, these responses are the opposite of the expected autonomic response to standing, which is an increase in SNS tone and decrease in PNS tone vs. sitting. Conclusion: Depressive and PTSD symptoms have opposite autonomic pathologies in CAD patients. While PTSD symptoms are associated with higher SNS tone at baseline, they are also associated with lower sympathetic activation with standing. Depressive symptoms, on the other hand, are associated with reduced vagal withdrawal with standing. This suggests that both depressive and PTSD symptoms are associated with an abnormal baroreceptor function, but through different autonomic pathways.

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Trauma and Posttraumatic Stress Disorder

10.1017/9781107445130 ◽

2018 ◽

Cited By ~ 4

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder

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Posttraumatic Stress Disorder Exacerbates Emotional Complaints but not Cognitive Impairments in Individuals Suffering from Postconcussional Disorder after Mild Traumatic Brain Injury

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x/a000132 ◽

2015 ◽

Vol 26 (1) ◽

pp. 35-50 ◽

Cited By ~ 1

Author(s):

Sara C. Schroeder ◽

Ronald M. Ruff ◽

Lutz Jäncke

Keyword(s):

Traumatic Brain Injury ◽

Posttraumatic Stress Disorder ◽

Brain Injury ◽

Posttraumatic Stress ◽

Mild Traumatic Brain Injury ◽

Test Performance ◽

Stress Disorder ◽

Negative Impact ◽

Neuropsychological Test ◽

Composite Scale

The aim of this study was to examine the effect of posttraumatic stress disorder (PTSD) on (a) neuropsychological test performance and (b) self-reported emotional complaints within individuals suffering from postconcussional disorder (PCD) after a mild traumatic brain injury (MTBI). A two-group comparative research design was employed. Two MTBI samples with and without PTSD were assessed with a neuropsychological test battery and the Ruff Neurobehavioral Inventory (RNBI). On the neurocognitive test performances no significant between group differences were found, but the MTBI group with PTSD endorsed a significantly greater number of emotional complaints, especially in the RNBI subscales of anxiety and depression. The patients with PTSD also endorsed a significantly greater number of premorbid sequelae in the RNBI emotional composite scale as well as the RNBI premorbid subscales of pain, anxiety and abuse. In sum, PTSD has a negative impact on emotional but not cognitive functioning within individuals suffering from PCD after a mild TBI.

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Stehen kognitive Funktionen im Zusammenhang mit Angst, Depression und Posttraumatischer Belastungsstörung bei Brustkrebspatientinnen nach onkologischer Behandlung?

Zeitschrift für Psychiatrie Psychologie und Psychotherapie ◽

10.1024/1661-4747.57.1.33 ◽

2009 ◽

Vol 57 (1) ◽

pp. 33-42 ◽

Cited By ~ 1

Author(s):

Lena Schirmer ◽

Anja Mehnert ◽

Angela Scherwath ◽

Barbara Schleimer ◽

Frank Schulz-Kindermann ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Kognitive Funktionen

Die in mehreren Studien gefundenen kognitiven Störungen bei Tumorpatienten nach Chemotherapie werden zumeist mit der Zytostatikaneurotoxizität assoziiert. In der vorliegenden Arbeit wird der Zusammenhang von Angst, Depression und Posttraumatischer Belastungsstörung mit der kognitiven Leistungsfähigkeit bei Frauen mit Mammakarzinom untersucht. Insgesamt wurden 76 Brustkrebspatientinnen fünf Jahre nach Abschluss der onkologischen Behandlung mit neuropsychologischen Testverfahren sowie mit der Hospital Anxiety and Depression Scale – Deutsche Version (HADS-D) und der Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C) untersucht: 23 nach Standard- und 24 nach Hochdosistherapie sowie 29 nach Brustoperation und Strahlentherapie als Vergleichsgruppe. Signifikante Zusammenhänge sind vor allem zwischen kognitiven Funktionen und Intrusionssymptomen einer Posttraumatischen Belastungsstörung (PTBS) festzustellen. Bei Patientinnen nach Standardtherapie weisen Intrusionen der PTBS einen moderaten Zusammenhang mit der globalen kognitiven Beeinträchtigung auf. Die Ergebnisse der Studie deuten auf multidimensionale Einfluss- und moderierende Faktoren bei der Entwicklung kognitiver Defizite bei Brustkrebspatientinnen nach onkologischer Therapie hin.

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Vorhersagbarkeit posttraumatischer Belastung bei Kindern und Jugendlichen nach traumatischen Ereignissen in der Schule

Kindheit und Entwicklung ◽

10.1026/0942-5403.17.4.219 ◽

2008 ◽

Vol 17 (4) ◽

pp. 219-223 ◽

Cited By ~ 4

Author(s):

Barbara Frühe ◽

Hans-Joachim Röthlein ◽

Rita Rosner

Keyword(s):

Posttraumatic Stress Disorder ◽

Los Angeles ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Reaction Index ◽

Traumatische Ereignisse

Traumatische Ereignisse im schulischen Kontext treten vergleichsweise häufig auf. So ist die Bestimmung von Kindern und Jugendlichen, die aktuell und auch zu einem späteren Zeitpunkt einer psychologischen Betreuung bedürfen, im Rahmen der Fürsorgepflicht notwendig. 48 Jugendliche zwischen 12 und 17 Jahren wurden in der Schule zu zwei Messzeitpunkten zur akuten und posttraumatischen Symptomatik sowie zu verschiedenen Risikofaktoren befragt. Verwendet wurde die neu entwickelte Checkliste zur Akuten Belastung (CAB) und die deutsche Version des University of Los Angeles at California Posttraumatic Stress Disorder Reaction Index (UCLA CPTSD-RI). Eine Woche nach dem Ereignis betrug der Anteil klinisch bedeutsamer Belastung 21 % und nach 10 – 15 Wochen 10 %. Ein mittlerer Zusammenhang zwischen akuter und posttraumatischer Belastung konnte nachgewiesen werden. Als bedeutsame Risikofaktoren für die Entwicklung einer posttraumatischen Belastung stellten sich der Konfrontationsgrad, peritraumatisch erlebte Angst sowie akute Beeinträchtigung heraus. Im Kontext der Betreuung betroffener Jugendlicher nach traumatischen Ereignissen sollte den Risikofaktoren mehr Beachtung geschenkt werden.

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Learning and Consolidation of Verbal Declarative Memory in Patients with Posttraumatic Stress Disorder

Zeitschrift für Psychologie / Journal of Psychology ◽

10.1027/0044-3409/a000020 ◽

2010 ◽

Vol 218 (2) ◽

pp. 135-140 ◽

Cited By ~ 1

Author(s):

Slawomira J. Diener ◽

Herta Flor ◽

Michèle Wessa

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Verbal Memory ◽

Stress Disorder ◽

Declarative Memory ◽

Memory Performance ◽

Verbal Learning ◽

Depression Scale ◽

Learning Performance ◽

Ptsd Symptoms

Impairments in declarative memory have been reported in posttraumatic stress disorder (PTSD). Fragmentation of explicit trauma-related memory has been assumed to impede the formation of a coherent memorization of the traumatic event and the integration into autobiographic memory. Together with a strong non-declarative memory that connects trauma reminders with a fear response the impairment in declarative memory is thought to be involved in the maintenance of PTSD symptoms. Fourteen PTSD patients, 14 traumatized subjects without PTSD, and 13 non-traumatized healthy controls (HC) were tested with the California Verbal Learning Test (CVLT) to assess verbal declarative memory. PTSD symptoms were assessed with the Clinician Administered PTSD Scale and depression with the Center of Epidemiological Studies Depression Scale. Several indices of the CVLT pointed to an impairment in declarative memory performance in PTSD, but not in traumatized persons without PTSD or HC. No group differences were observed if recall of memory after a time delay was set in relation to initial learning performance. In the PTSD group verbal memory performance correlated significantly with hyperarousal symptoms, after concentration difficulties were accounted for. The present study confirmed previous reports of declarative verbal memory deficits in PTSD. Extending previous results, we propose that learning rather than memory consolidation is impaired in PTSD patients. Furthermore, arousal symptoms may interfere with successful memory formation in PTSD.

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Social Support, Emotional Intelligence, and Posttraumatic Stress Disorder Symptoms

Journal of Individual Differences ◽

10.1027/1614-0001/a000185 ◽

2016 ◽

Vol 37 (1) ◽

pp. 31-39 ◽

Cited By ~ 8

Author(s):

Nicole L. Hofman ◽

Austin M. Hahn ◽

Christine K. Tirabassi ◽

Raluca M. Gaher

Keyword(s):

Social Support ◽

Posttraumatic Stress Disorder ◽

Emotional Intelligence ◽

Protective Factors ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Traumatic Events ◽

Ptsd Symptoms ◽

The Relationship

Abstract. Exposure to traumatic events and the associated risk of developing Posttraumatic stress disorder (PTSD) symptoms is a significant and overlooked concern in the college population. It is important for current research to identify potential protective factors associated with the development and maintenance of PTSD symptoms unique to this population. Emotional intelligence and perceived social support are two identified protective factors that influence the association between exposure to traumatic events and PTSD symptomology. The current study examined the mediating role of social support in the relationship between emotional intelligence and PTSD symptoms. Participants included 443 trauma-exposed university students who completed online questionnaires. The results of this study indicated that social support mediates the relationship between emotional intelligence and reported PTSD symptoms. Thus, emotional intelligence is significantly associated with PTSD symptoms and social support may play an integral role in the relationship between emotional intelligence and PTSD. The current study is the first to investigate the role of social support in the relationship between emotional intelligence and PTSD symptoms. These findings have important treatment and prevention implications with regard to PTSD.

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