scholarly journals Posttraumatic stress disorder (PTSD) and depression severity in sexually assaulted women: hypothalamic-pituitary-adrenal (HPA) axis alterations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ana Teresa D. D’Elia ◽  
Mario F. Juruena ◽  
Bruno M. Coimbra ◽  
Marcelo F. Mello ◽  
Andrea F. Mello
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Depressive Symptoms ◽  
Sexual Assault ◽  
Posttraumatic Stress ◽  
Hpa Axis ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Control Group ◽  
Cortisol Levels ◽  
Ptsd Group

Abstract Background Sexual assault is implicated in several adverse psychological and physical health outcomes, including posttraumatic stress disorder (PTSD) and depression. Neurobiological research has shown variations related to the hypothalamic-pituitary-adrenal (HPA) axis, immune alterations, metabolic function, and brain circuitry. Although these mechanisms have been extensively studied, the results have demonstrated different outcomes in PTSD. Methods We compared the plasma adrenocorticotropin (ACTH) and salivary cortisol levels of fifty-eight women with PTSD developed after sexual assault to those of forty-four female controls with no history of trauma. We also evaluated the psychiatric diagnosis and symptom severity of PTSD and depression. The participants’ clinical conditions were associated with their hormonal levels to assess whether symptom severity was related to hormonal imbalance. Results A large percentage of sexually assaulted women had PTSD and comorbid depression. The ACTH levels were higher in the PTSD group than the control group and increased as PTSD severity increased, considering depressive symptoms, measured by the Beck Depression Inventory (BDI) (p < 0.0001), as well as PTSD symptoms, measured by subscale D of the Clinician-Administered PTSD Scale (CAPS-5) (p = 0.045) and the CAPS-5 total scale (p = 0.026). Cortisol levels measured at 10 pm were higher for the PTSD group than the control group (p = 0.045, p = 0.037, respectively), and the cortisol awakening response showed elevated cortisol levels for the PTSD group. Conclusions These results show a correlation between symptom severity and HPA axis imbalance in patients with PTSD. Elevated ACTH and an elevated cortisol response in patients with comorbid depressive symptoms were the opposite of the expected response for patients with PTSD only. This association leads to the hypothesis that the neurobiological alterations of PTSD are related to the type of symptoms presented and their severity. These manifestations likely influence the disease course, prognosis and response to treatment. These outcomes highlight the need to discuss particular neurobiological alterations in patients with PTSD developed after sexual assault, mainly those with severe depressive symptoms.

Effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders Among Veterans With Posttraumatic Stress Disorder: A Pilot Study

2017 ◽  
Vol 42 (2) ◽  
pp. 210-230 ◽  
Author(s):  
Ruth L. Varkovitzky ◽  
Andrew M. Sherrill ◽  
Greg M. Reger
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Emotion Regulation ◽  
Depressive Symptoms ◽  
Pilot Study ◽  
Posttraumatic Stress ◽  
Emotional Disorders ◽  
Symptom Severity ◽  
Stress Disorder ◽  
Transdiagnostic Treatment ◽  
Unified Protocol

Effective treatment options are needed for veterans who do not participate in trauma-focused psychotherapy. Research has yet to examine the effectiveness of transdiagnostic psychotherapy in veterans with posttraumatic stress disorder (PTSD) and co-occurring psychological disorders. This pilot study examined the effectiveness of the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) delivered in a 16-week group format. We examined treatment outcomes in male and female veterans ( n = 52) in an outpatient specialty PTSD clinic at a large Veterans Affairs (VA) medical center. We hypothesized significant decreases in emotion regulation difficulty (Difficulties in Emotion Regulation Scale), PTSD symptom severity (PTSD Checklist for DSM-5), and depressive symptom severity (Patient Health Questionnaire–9). In addition, we hypothesized that reductions in emotion regulation difficulty across treatment would negatively predict PTSD and depressive symptoms at posttreatment. PTSD symptoms, depressive symptoms, and emotion regulation difficulty all evidenced significant improvements at the end of treatment relative to baseline ( ps < .001). In addition, reductions in emotion regulation across treatment were associated with lower PTSD and depressive symptoms at posttreatment ( ps < .001). This pilot study provides preliminary evidence supporting use of UP among veterans with PTSD and co-occurring disorders. Well-designed clinical trials evaluating efficacy of UP among veterans are needed.

Patients with Posttraumatic Stress Disorder Show Decreased Cognitive Control: Evidence from Dichotic Listening

2011 ◽  
Vol 17 (2) ◽  
pp. 344-353 ◽  
Author(s):  
Grethe E. Johnsen ◽  
Pushpa Kanagaratnam ◽  
Arve E. Asbjørnsen
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Cognitive Control ◽  
Posttraumatic Stress ◽  
Dichotic Listening ◽  
Stress Disorder ◽  
Control Group ◽  
Control Functions ◽  
Ear Advantage ◽  
Right Ear Advantage ◽  
Ptsd Group

AbstractThe influence of posttraumatic stress disorder (PTSD) on cognitive control and auditory attention modulation was examined with the use of a dichotic-listening (DL) task. The participants were 45 war-exposed refugees. The PTSD group comprised 22 participants meeting the DSM-IV criteria for PTSD, and the Control group comprised 23 war-exposed participants without PTSD. Both groups were tested with a consonant–vowel syllables DL task under three different attentional instructions. The two groups did not differ in the non-forced and forced-right conditions and showed, as expected, right-ear advantages. The Control group showed, as expected, a left-ear advantage in the forced-left (FL) condition. However, the PTSD group continued to show a right-ear advantage - and only minor modulation of the performance during the FL condition. This finding suggests that PTSD is associated with a reduced capacity for top-down attentional control of a bottom-up or stimulus-driven effect. The result shows that participants with PTSD have impaired cognitive control functions when tested on information processing of neutral stimuli. (JINS, 2011, 17, 344–353)

Metabolic Syndrome and Mental Health in Posttraumatic Stress Disorder Patients

2020 ◽  
Author(s):  
Hassan SHAHMIRI ◽  
Arsia TAGHVA ◽  
Mohammad-Reza EBRAHIMI ◽  
Seyyed Behnam HASHEMI URIMI ◽  
Amir-Mohsen RAHNEJAT
Keyword(s):  
Mental Health ◽  
Metabolic Syndrome ◽  
Posttraumatic Stress Disorder ◽  
Psychiatric Disorders ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Control Group ◽  
Traumatic History ◽  
Psychological Reaction ◽  
Ptsd Group

Abstract Background: Posttraumatic stress disorder (PTSD) is an abnormal physiologic and psychological reaction in person with severe traumatic history. In recent studies, the relationship between PTSD and some other disease apparently unrelated to psychological situations such as cardiovascular diseases, diabetes, and metabolic syndrome has been revealed. Thus, the aim of this study was to survey the prevalence of metabolic syndrome and mental health in PTSD patients. Methods: The research design was retrospective cohort study. Subjects were consisted of 142 Iran-Iraq war veterans with PTSD (age: 40-60 years) and the control group was consisted of 153 veterans without PTSD. Data was collected using questionnaires, physical exams and laboratory tests.Results: Prevalence of metabolic syndrome was 45.1%in PTSD group and 17% in control group. In addition blood pressure, triglyceride and fasting blood sugar in PTSD group were significantly higher than control group (p<0.05). Also, PTSD patients had significant high rates of psychiatric disorders.Conclusion: PTSD patients are more prone to metabolic syndrome and psychiatric disorders than control group.

scholarly journals Diverging roles of the anterior insula in trauma-exposed individuals vulnerable or resilient to posttraumatic stress disorder

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Hyeonseok Jeong ◽  
Yong-An Chung ◽  
Jiyoung Ma ◽  
Jungyoon Kim ◽  
Gahae Hong ◽  
...  
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Underlying Mechanism ◽  
Anterior Insula ◽  
Control Group ◽  
Positron Emission ◽  
Recovery Group ◽  
Current Ptsd ◽  
Ptsd Group

Abstract Distinct brain alterations in response to traumatic events may render trauma-exposed individuals either resilient or vulnerable to posttraumatic stress disorder (PTSD). This study compared regional cerebral metabolic rate of glucose (rCMRglu) among trauma-exposed individuals with current PTSD (PTSD group, n = 61), those without current PTSD (Resilience/Recovery group, n = 26), and trauma-unexposed controls (Control group, n = 54). All participants underwent brain [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans. Voxel-wise group differences in rCMRglu among the three groups were evaluated. Associations between rCMRglu and both PTSD severity and resilience were examined. The rCMRglu in the right anterior insula and adjacent prefrontal and striatal areas was lower in the PTSD group, while higher in the Resilience/Recovery group, compared to the Control group. In addition, the lower glucose metabolism of these areas was associated with higher severity and less improvement in PTSD symptoms in the PTSD group, while the higher levels of rCMRglu were correlated with stronger resilience in the Resilience/Recovery group. This study suggests distinct roles of the anterior insula in response to trauma between the PTSD and Resilience/Recovery groups. Heightened rCMRglu in the anterior insular regions may reflect an underlying mechanism of resilience against traumatic stress, while reduced rCMRglu may indicate vulnerability to PTSD.

Reduced left ventricular diastolic function in women with posttraumatic stress disorder

2019 ◽  
Vol 317 (1) ◽  
pp. R108-R112 ◽  
Author(s):  
Michinari Hieda ◽  
Jeung-Ki Yoo ◽  
Mark B. Badrov ◽  
Rosemary S. Parker ◽  
Elizabeth H. Anderson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Posttraumatic Stress Disorder ◽  
Diastolic Function ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Left Ventricular ◽  
Control Group ◽  
Increased Risk ◽  
Lv Diastolic Function ◽  
Ptsd Group

Women are two to three times more likely to develop posttraumatic stress disorder (PTSD) compared with men after exposure to a major trauma, and PTSD is associated with increased risk for cardiovascular disease in later life. The underlying mechanisms are unclear, but alterations in cardiac function may be involved. We hypothesized that women with PTSD have reduced left ventricular (LV) diastolic function. We studied 14 women with PTSD (PTSD group) and 14 women without PTSD (controls) using echocardiography Doppler to evaluate LV diastolic function, including peak velocities (E and A waves) in transmitral flow; diastolic, atrial kick, and systolic waveform velocities (e′, a′, and s′) in tissue Doppler; the ratio between early mitral inflow velocity and mitral annular early diastolic velocity (E/e′); and velocity of propagation ( Vp) . Baseline characteristics including age, body size, blood pressure, and heart rate were not significantly different between the two groups. Compared with the control group, women with PTSD showed greater E/e′ (controls vs. PTSD group: 7.0 ± 1.3 vs. 9.1 ± 1.3, P = 0.002) and smaller Vp (controls vs. PTSD group: 63.7 ± 11.3 vs. 47.5 ± 6.9 cm/s, P = 0.003). These results suggest that women with PTSD have reduced LV diastolic function, which may contribute, at least in part, to the increased risk of cardiovascular disease later in life.

Factors Associated With Posttraumatic Stress Disorder Symptomology Among Women Who Have Experienced Sexual Assault in Canada

2019 ◽  
pp. 088626051986008
Author(s):  
Janice Du Mont ◽  
Holly Johnson ◽  
Cassandra Hill
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Sexual Assault ◽  
Posttraumatic Stress ◽  
Dating Violence ◽  
Sexual Victimization ◽  
Stress Disorder ◽  
General Social Survey ◽  
Future Research ◽  
Ptsd Symptoms ◽  
Sexually Assaulted

There is a dearth of information about the association of victim-related and assailant-related characteristics and posttraumatic stress disorder (PTSD) among sexually assaulted women. Recently, Statistics Canada included items measuring the possible presence of PTSD symptoms in their 2014 nationally representative General Social Survey on Victimization (GSS-V), for the purpose of improving the understanding of mental health impacts associated with sexual victimization. The present study used the GSS-V to examine the association of sociodemographic, health, and assailant characteristics and prior traumatic experiences in the form of physical or sexual dating violence, physical assault, stalking, childhood abuse, and witnessing of violence between parents with PTSD symptomology among sexually assaulted women. Among 319 women who reported experiencing at least one incident of sexual assault in the 12 months prior to the survey, 68.6% had experienced at least one negative emotional impact as a result, among whom, 43.6% reported past-month PTSD symptoms. Logistic regression modeling revealed that prior traumatic events in the form of physical or sexual dating violence, stalking, and having witnessed violence between parents were associated with higher odds of experiencing PTSD symptoms, as was having been sexually assaulted by a known assailant. In contrast, the odds of experiencing PTSD symptoms was lower for Aboriginal or visible minority women. The results suggest that PTSD symptoms in the near aftermath of sexual victimization are common, and there are a range of factors that contribute to the likelihood of developing these symptoms. Implications for future research are discussed.

scholarly journals A Preliminary Experimental Examination of the Effect of Emotion Dysregulation and Impulsivity on Risky Behaviors Among Women With Sexual Assault–Related Posttraumatic Stress Disorder

2014 ◽  
Vol 38 (6) ◽  
pp. 914-939 ◽  
Author(s):  
Nicole H. Weiss ◽  
Matthew T. Tull ◽  
Kim L. Gratz
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Sexual Assault ◽  
Posttraumatic Stress ◽  
Sexual Behaviors ◽  
Emotion Dysregulation ◽  
Stress Disorder ◽  
Risky Behaviors ◽  
Wide Range ◽  
To Receive

Posttraumatic stress disorder (PTSD) is associated with a wide range of risky behaviors (e.g., substance use and risky sexual behaviors); however, few studies have examined mechanisms that may underlie risky behaviors in this population. The present study utilized a prospective experimental design to examine the effects of emotion dysregulation and impulsivity on risky behaviors across time. Thirty women with sexual assault–related PTSD were randomly assigned to receive emotion modulation (EM), impulsivity reduction (IR), or healthy living (HL; comparison condition) skills trainings. Participants completed measures of emotion dysregulation, impulsivity, and risky behaviors pre-manipulation and 1-month post-manipulation. Participants in the EM and IR conditions reported a significant reduction in risky behaviors from pre- to post-manipulation relative to the HL condition. Changes in emotion dysregulation from pre- to post-manipulation fully accounted for reductions in risky behaviors over time. Results provide preliminary experimental support for the role of emotion dysregulation in risky behaviors.

scholarly journals Posttraumatic Stress Disorder and Autobiographical Memories in Everyday Life

2017 ◽  
Vol 5 (2) ◽  
pp. 325-340 ◽  
Author(s):  
Sabine Schönfeld ◽  
Anke Ehlers
Keyword(s):  
Posttraumatic Stress Disorder ◽  
Autobiographical Memory ◽  
Everyday Life ◽  
Posttraumatic Stress ◽  
Stress Disorder ◽  
Trauma Survivors ◽  
Autobiographical Memories ◽  
Self Reports ◽  
Distinct Features ◽  
Ptsd Group

Evidence from self-reports and laboratory studies suggests that recall of nontrauma autobiographical memories may be disturbed in posttraumatic stress disorder (PTSD), but investigations in everyday life are sparse. This study investigated unintentional nontrauma and trauma memories in trauma survivors with and without PTSD ( N = 52), who kept an autobiographical memory diary for a week. We investigated whether unintentional nontrauma memories show an overgeneral memory bias and further memory abnormalities in people with PTSD, and whether unintentional trauma memories show distinct features. Compared to the no-PTSD group, the PTSD group recorded fewer nontrauma memories, which were more overgeneral, more often from before the trauma or related to the trauma, were perceived as distant, and led to greater dwelling. Trauma memories were more vivid, recurrent, and present and led to greater suppression and dwelling. Within the PTSD group, the same features distinguished trauma and nontrauma memories. Results are discussed regarding theories of autobiographical memory and PTSD.

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