scholarly journals Differential Roles of Positive and Negative Valence Systems in the Development of Post-Traumatic Stress Psychopathology

2021 ◽  
Author(s):  
Ziv Ben-Zion ◽  
Ofir Shany ◽  
Roee Admon ◽  
Nimrod Jackob Keynan ◽  
Netanell Avisdris ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Post Traumatic Stress ◽  
Negative Valence ◽  
Risky Choices ◽  
Post Traumatic ◽  
Positive Valence ◽  
Positive And Negative Valence ◽  
Ptsd Severity

Negative and positive valence systems (NVS and PVS) pertain to processing of aversive and rewarding stimuli, respectively. Post-Traumatic Stress Disorder (PTSD) has been typically associated with hyper-responsivity of the NVS, and more recently, with deficient PVS functionality. The respective roles of these systems in early PTSD development have yet to be resolved. Here, we assessed neurobehavioral indicators of PVS and NVS longitudinally among 171 adult civilians at 1-, 6-, and 14-months following trauma exposure (TP1, TP2, and TP3). Using the "Safe or Risky Domino Choice" (SRDC) game during fMRI, NVS and PVS functionality (i.e., activity and connectivity) were indicated by the amygdala and ventral striatum (VS) responses to punishments and rewards, respectively. The complementary functionality of these systems was behaviorally assessed as the percentage of risky choices taken during the game. Results revealed that increased amygdala functionality at TP1 was associated with greater PTSD severity at TP1 and TP3, specifically with hyperarousal and intrusion. Decreased VS functionality at TP1 was associated with greater PTSD severity at TP3, specifically with avoidance. Explainable machine learning revealed the primacy of PVS over NVS functionality at TP1 in predicting PTSD severity at TP3. Behaviorally, fewer risky choices were associated with more severe symptoms at TP1, especially with intrusion and avoidance. Overall, these results suggest a differential and potentially complementary involvement of NVS and PVS in PTSD development following trauma. Early therapeutics for PTSD in the immediate aftermath of trauma may thus target both negative and positive valence processing.

scholarly journals Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach

2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Expressive Writing ◽  
Stress Disorder ◽  
Post Treatment ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Severity

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.

Is plasma GABA level a biomarker of Post-Traumatic Stress Disorder (PTSD) severity? A preliminary study

2016 ◽  
Vol 241 ◽  
pp. 273-279 ◽  
Author(s):  
Marion Trousselard ◽  
Bertrand Lefebvre ◽  
Lionel Caillet ◽  
Yann Andruetan ◽  
Franck de Montleau ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Gaba Level ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Preliminary Study ◽  
Ptsd Severity

Naturalistic Comparison of Models of Programmatic Interventions for Combat-Related Post-Traumatic Stress Disorder

2008 ◽  
Vol 42 (12) ◽  
pp. 1051-1059 ◽  
Author(s):  
David Forbes ◽  
Virginia Lewis ◽  
Ruth Parslow ◽  
Graeme Hawthorne ◽  
Mark Creamer
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
High Intensity ◽  
Stress Disorder ◽  
Moderate Intensity ◽  
Post Traumatic Stress ◽  
Low Intensity ◽  
Post Traumatic ◽  
Over Time ◽  
Ptsd Severity

Objectives: Post-traumatic stress disorder (PTSD) is a difficult-to-treat sequel of combat. Data on effectiveness of alternate treatment structures are important for planning veterans’ psychiatric services. The present study compared clinical presentations and treatment outcomes for Australian veterans with PTSD who participated in a range of models of group-based treatment. Method: Participants consisted of 4339 veterans with combat-related PTSD who participated in one of five types of group-based cognitive behavioural programmes of different intensities and settings. Data were gathered at baseline (intake), as well as at 3 and 9 month follow up, on measures of PTSD, anxiety, depression and alcohol misuse. Analyses of variance and effect size analyses were used to investigate differences at intake and over time by programme type. Results: Small baseline differences by programme intensity were identified. Although significant improvements in symptoms were evident over time for each programme type, no significant differences in outcome were evident between programmes. When PTSD severity was considered, veterans with severe PTSD performed less well in the low-intensity programmes than in the moderate- or high-intensity programmes. Veterans with mild PTSD improved less in high-intensity programmes than in moderate- or low-intensity programmes. Conclusion: Comparable outcomes are evident across programme types. Outcomes may be maximized when veterans participate in programme intensity types that match their level of PTSD severity. When such matching is not feasible, moderate-intensity programmes appear to offer the most consistent outcomes. For regionally based veterans, delivering treatment in their local environment does not detract from, and may even enhance, outcomes. These findings have implications for the planning and purchasing of mental health services for sufferers of PTSD, particularly for veterans of more recent combat or peacekeeping deployments.

Fluoxetine in post-traumatic stress disorder

1999 ◽  
Vol 175 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Kathryn M. Connor ◽  
Suzanne M. Sutherland ◽  
Larry A. Tupler ◽  
Mary L. Malik ◽  
R. Jonathan ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
State Function ◽  
Global Rating ◽  
Post Traumatic Stress ◽  
Global Improvement ◽  
Stress Vulnerability ◽  
Post Traumatic ◽  
Ptsd Severity

BackgroundMost pharmacotherapy trials in post-traumatic stress disorder (PTSD) have been conducted upon male combat veterans. Outcome studies relating to civilians are therefore needed.AimsTo demonstrate that fluoxetine is more effective than placebo in treating PTSD.MethodCivilians with PTSD (n=53) were treated for 12 weeks with fluoxetine (up to 60 mg/day) or placebo. Assessments of PTSD severity, disability, stress vulnerability, and high end-state function were obtained.ResultsFluoxetine was more effective than placebo on most measures at week 12, including global improvement (much or very much improved: fluoxetine 85%, placebo 62%, difference 0.24, 95% CI 0.01–0.47; very much improved: fluoxetine 59%, placebo 19%, difference 0.40, 95% CI 0.16–0.64), and high end-state function (fluoxetine 41%, placebo 4%, difference 0.37, 95% CI 0.17–0.57)ConclusionsFluoxetine was superior for measures of PTSD severity, disability, stress vulnerability, and high end-state function. The placebo-group response was low when viewed as a broad outcome based on a portfolio of ratings, but was higher with a traditional global rating criterion.

scholarly journals Potential Neurocognitive Biomarkers for Post Traumatic Stress Disorder (PTSD) Severity in Recent Trauma Survivors

2019 ◽  
Author(s):  
Ziv Ben-Zion ◽  
Yoav Zeevi ◽  
Nimrod Jackob Keynan ◽  
Roee Admon ◽  
Tal Kozlovski ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Trauma Survivors ◽  
Functional Domain ◽  
Structural Domain ◽  
Post Traumatic Stress ◽  
Cluster Membership ◽  
Post Traumatic ◽  
Ptsd Severity

AbstractContemporary symptom-based diagnosis of Post-traumatic Stress Disorder (PTSD) largely overlooks related neurobehavioral findings and rely entirely on subjective interpersonal reporting. Previous studies associating objective biomarkers with PTSD have mostly used the disorder’s symptom-based diagnosis as main outcome measure, overlooking the actual clustering and richness of phenotypical features associated with PTSD. Here, we aimed to computationally derive potential neurocognitive biomarkers that could efficiently differentiate PTSD subtypes, based on an observational cohort study of recent trauma survivors. A three-staged semi-unsupervised method (“3C”) was used to categorize trauma survivors based on current PTSD diagnostics, derive clusters of PTSD based on features related to symptom load, and to classify participants’ cluster membership using objective features. A total of 256 features were extracted from psychometrics, cognitive, structural and functional neuroimaging data, obtained from 101 adult civilians (age=34.80±11.95, 51 females) evaluated within a month of trauma exposure. Multi-domain features that best differentiated cluster membership were indicated by using importance analysis, classification trees, and ANOVA. Results revealed that entorhinal and rostral anterior cingulate cortices volumes (structural domain), in-task amygdala’s functional connectivity with the insula and thalamus (functional domain), executive function and cognitive flexibility (cognitive domain) best differentiated between two clusters related to PTSD severity. Cross-validation established the results’ robustness and consistency within this sample. Multi-domain biomarkers revealed by the 3C analytics offer objective classifiers of post-traumatic morbidity shortly following trauma. They also map onto previously documented neurobehavioral PTSD features, supporting the future use of standardized and objective measurements to more precisely identify psychopathology subgroups shortly after trauma.

scholarly journals Post-traumatic stress disorder can be predicted in hospitalized blunt trauma patients using a simple screening tool

2021 ◽  
Vol 6 (1) ◽  
pp. e000623
Author(s):  
Saad Rahmat ◽  
Jessica Velez ◽  
Muhammad Farooqi ◽  
Abbas Smiley ◽  
Kartik Prabhakaran ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Multivariate Regression ◽  
Stress Disorder ◽  
Acute Stress ◽  
Post Traumatic Stress ◽  
Ptsd Diagnosis ◽  
Post Traumatic ◽  
Single Question ◽  
Ptsd Severity

BackgroundPost-traumatic stress disorder (PTSD) has debilitating psychiatric and medical consequences. The purpose of this study was to identify whether PTSD diagnosis and PTSD symptom scale score (PTSD severity) could be predicted by assessing peritraumatic experiences using a single question or screening tools at different time points in patients hospitalized after admission to the hospital after significant physical trauma, but with stable vitals (level II trauma).MethodsPatients completed the ‘initial question’ and the National Stressful Events Survey Acute Stress Disorder Scale (NSESSS) at 3 days to 5 days after trauma (NSESSS-1). The same scale was administered 2 weeks to 4 weeks after trauma (NSESSS-2). The Posttraumatic Stress Disorder Symptoms Scale Interview for DSM-5 (PSSI-5) was administered 2 months after trauma. PTSD diagnosis and PTSD severity were extracted from the PSSI-5. Linear multivariate regression analyses were used to establish whether scores for NSESSS-1 or NSESSS-2 predicted PTSD diagnosis/PTSD severity. Non-linear multivariate regression analyses were performed to better understand the relationship between NSESSS-1/NSESSS-2 and PTSD diagnosis/PTSD severity.ResultsA single question assessing the experience of fear, helplessness, or horror was not an effective tool for determining the diagnosis of PTSD (p=0.114) but can be a predictor of PTSD severity (p=0.039). We demonstrate that administering the NSESSS after either 3 days to 5 days (p=0.008, p<0.001) or 2 weeks to 4 weeks (p=0.039; p<0.001) can predict the diagnosis of PTSD and PTSD severity. Scoring an NSESSS above 14/28 (50%) increases the chance of experiencing a higher PTSD severity substantially and linearly.DiscussionOur initial question was not an effective predictor of PTSD diagnosis. However, using the NSESSS at both 3 days to 5 days and 2 weeks to 4 weeks after trauma is an effective method for predicting PTSD diagnosis and PTSD severity. Additionally, we show that patients who score higher than 14 on the NSESSS for acute stress symptoms may need closer follow-up.Level of evidenceLevel III, prognostic.

scholarly journals Post-Traumatic Stress Disorder and Health Problems Among Medically Ill Canadian Peacekeeping Veterans

2009 ◽  
Vol 43 (4) ◽  
pp. 366-372 ◽  
Author(s):  
J. Don Richardson ◽  
Jordan Pekevski ◽  
Jon D. Elhai
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Health Conditions ◽  
Gastrointestinal Disorders ◽  
Post Traumatic Stress ◽  
Musculoskeletal Problems ◽  
Post Traumatic ◽  
Significant Health ◽  
Ptsd Severity

Objective: The aim of the present study was to examine the relationship between post-traumatic stress disorder (PTSD) symptom severity and four significant health conditions (gastrointestinal disorders, musculoskeletal problems, headaches, and cardiovascular problems). Method: Participants included 707 Canadian peacekeeping veterans with service-related disabilities, from a random, national Canadian survey, who had been deployed overseas. Results: PTSD severity was significantly related to gastrointestinal disorders, musculoskeletal problems, and headaches, but not to cardiovascular problems. Controlling for demographic factors did not affect PTSD's relationships with the three significant health conditions. Conclusions: The present study supports previous work in finding consistent relations between PTSD severity and specific types of medical problems.

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