scholarly journals Latent cause inference during extinction learning in trauma-exposed individuals with and without PTSD

2020 ◽  
Author(s):  
Agnes Norbury ◽  
Hannah Brinkman ◽  
Mary Kowalchyk ◽  
Elisa Monti ◽  
Robert H Pietrzak ◽  
...  
Keyword(s):  
Causal Inference ◽  
Causal Structure ◽  
Negative Relationship ◽  
Traumatic Experiences ◽  
Depression Symptom ◽  
Post Traumatic Stress ◽  
Extinction Learning ◽  
Symptom Dimensions ◽  
Primary Deficit ◽  
Cognitive Therapies

Problems in learning that sights, sounds, or situations that were once associated with danger have become safe (extinction learning) may explain why some individuals suffer prolonged psychological distress following traumatic experiences. Although simple associative learning models have been unable to provide a convincing account of how and why this learning fails, it has recently been proposed that this may be explained by individual differences in beliefs about the causal structure of the environment. Here, we tested two competing hypotheses as to how differences in causal inference might be related to trauma-related psychopathology, using extinction learning data collected from clinically well-characterized individuals with varying degrees of post-traumatic stress (N=56). Latent cause modelling revealed that individuals with more severe PTSD were more likely to assign observations from conditioning and extinction stages to a single underlying cause. Specifically, multivariate analysis incorporating multiple PTSD and depression symptom dimensions revealed a negative relationship between tendency to infer multiple causes were active in the environment and re-experiencing symptom severity. We interpret these results as providing evidence of a primary deficit in discriminative learning in participants with more severe PTSD re-experiencing symptoms. Specifically, in these individuals, a greater tendency to attribute all stimulus configurations to the same underlying cause resulted in greater uncertainty about stimulus-outcome associations, and impeded learning both that certain stimuli were safe, and that certain stimuli were no longer dangerous. Better understanding of the role of causal inference in trauma-related psychopathology may have relevance for the refinement of cognitive therapies for these disorders.

scholarly journals Latent cause inference during extinction learning in trauma-exposed individuals with and without PTSD

2021 ◽  
pp. 1-12
Author(s):  
Agnes Norbury ◽  
Hannah Brinkman ◽  
Mary Kowalchyk ◽  
Elisa Monti ◽  
Robert H. Pietrzak ◽  
...  
Keyword(s):  
Individual Differences ◽  
Causal Inference ◽  
Traumatic Stress ◽  
Causal Structure ◽  
Traumatic Experiences ◽  
Model Parameters ◽  
Depression Symptom ◽  
Post Traumatic Stress ◽  
Extinction Learning ◽  
Post Traumatic

Abstract Background Problems in learning that sights, sounds, or situations that were once associated with danger have become safe (extinction learning) may explain why some individuals suffer prolonged psychological distress following traumatic experiences. Although simple learning models have been unable to provide a convincing account of why this learning fails, it has recently been proposed that this may be explained by individual differences in beliefs about the causal structure of the environment. Methods Here, we tested two competing hypotheses as to how differences in causal inference might be related to trauma-related psychopathology, using extinction learning data collected from clinically well-characterised individuals with varying degrees of post-traumatic stress (N = 56). Model parameters describing individual differences in causal inference were related to multiple post-traumatic stress disorder (PTSD) and depression symptom dimensions via network analysis. Results Individuals with more severe PTSD were more likely to assign observations from conditioning and extinction stages to a single underlying cause. Specifically, greater re-experiencing symptom severity was associated with a lower likelihood of inferring that multiple causes were active in the environment. Conclusions We interpret these results as providing evidence of a primary deficit in discriminative learning in participants with more severe PTSD. Specifically, a tendency to attribute a greater diversity of stimulus configurations to the same underlying cause resulted in greater uncertainty about stimulus-outcome associations, impeding learning both that certain stimuli were safe, and that certain stimuli were no longer dangerous. In the future, better understanding of the role of causal inference in trauma-related psychopathology may help refine cognitive therapies for these disorders.

scholarly journals Heterogeneous Mediation Analysis for Causal Inference

2020 ◽  
Author(s):  
Fei Xue ◽  
Xiwei Tang ◽  
Grace Kim ◽  
Allison Aiello ◽  
Karestan Koenen ◽  
...  
Keyword(s):  
Causal Inference ◽  
Mediation Analysis ◽  
Homogeneous Model ◽  
Heterogeneous Data ◽  
Health Study ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Model Framework ◽  
Mediation Effects ◽  
Mediating Mechanisms

AbstractMediation analysis is widely used to understand mediating mechanisms of variables in causal inference. However, existing approaches do not consider heterogeneity in mediation effects. Mediators in different sub-populations could have opposite effects on the outcome, and could be difficult to identify under the homogeneous model framework. In this paper, we propose a new mediator selection method, which can identify sub-populations and select mediators in each sub-population for heterogeneous data simultaneously. We perform a multi-directional clustering analysis to determine sub-group mediators and the corresponding subjects. Specifically, to select mediators, we propose a new joint penalty which penalizes the effect of independent variable on a mediator and the effect of a mediator on the response jointly. The proposed algorithm is implemented through the convex-smooth gradient descent. Our numerical studies show that the proposed method outperforms the existing methods for heterogeneous data. We also apply the proposed mediation method to estimate mediation effects of DNA methylation variations in glucocorticoid receptor regulatory network genes for post-traumatic stress disorder (PTSD) among African-Americans. Based on data from the Detroit Neighborhood Health Study, we have found heterogeneous mediators, which are indeed associated with PTSD or traumatic experiences according to literature but were not selected by existing homogeneous mediation selection methods.

Trauma Focused Psychodynamic Psychotherapy

2021 ◽  
Author(s):  
Frederic Busch ◽  
Barbara Milrod ◽  
Cory Chen ◽  
Meriamne Singer
Keyword(s):  
Traumatic Stress ◽  
Psychodynamic Psychotherapy ◽  
Symptomatic Relief ◽  
Traumatic Experiences ◽  
Veterans Administration ◽  
Post Traumatic Stress ◽  
Interpersonal Engagement ◽  
Post Traumatic ◽  
The Impact ◽  
Insight Into

This book, which operationalizes and articulates in detail a unique, brief, tested psychodynamic psychotherapy for Post-Traumatic Stress Disorder, Trauma Focused Psychodynamic Psychotherapy [TFPP], describes how to perform this helpful treatment. The book provides tailored psychodynamic background that underpins these approaches, and explains the different phases of treatment. Additionally, it articulates common underlying dynamics of PTSD that the treatment commonly addresses in patients to bring about symptomatic relief. TFPP is being tested in two diverse populations: military Veterans with PTSD who are receiving care at three Veterans Administration Hospitals, and also among LGBTQ patients with PTSD. The book is focused on the authors’ experiences treating Veterans and many clinical examples are provided demonstrating how to work with these principles and approaches. In general, patients and therapists have found the treatment to be an extremely useful tool. Veterans have gained insight into the impact of traumatic experiences on various aspects of their lives and had improvements in dissociation, interpersonal engagement, anxiety, and anger/hostility. TFPP appears to be particularly effective for patients with prominent avoidance symptoms and those who are unwilling or unable to recount the details of their trauma directly. Patients have been found to be more affectively engaged and better connected to others (including the therapist) following treatment.

scholarly journals Evaluation of the effects of L-Theanine on neurobehavior in an adult male Sprague-Dawley Rat Model of PTSD

2019 ◽  
Vol 6 (3) ◽  
pp. 299-308
Author(s):  
John E Buonora ◽  
Patrick M Krum ◽  
Tomás Eduardo Ceremuga
Keyword(s):  
Spatial Memory ◽  
Traumatic Event ◽  
Forced Swim Test ◽  
The United States ◽  
Traumatic Experiences ◽  
Stress Model ◽  
Sprague Dawley ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Shock Stress

Post-traumatic stress disorder (PTSD) continues to be one of the most common mental health disorders in the United States and may occur in response to traumatic experiences. Currently, there are no interventions that prevent the development of PTSD. L-Theanine (L-Th), a major compound in green tea has been found to decrease anxiety and prevent memory impairment and may have potential effects in the prevention of PTSD. Sixty rats were divided into six experimental groups: control vehicle, control L-Th, control naïve, PTSD vehicle, PTSD Pre-L-Th (prophylactic), PTSD Post-L-Th (non-prophylactic). PTSD was induced by a 3-day restraint/tail shock stress model. The effects of L-Th on neurobehavior were evaluated by Elevated Plus-Maze (EPM), Morris Water Maze (MWM), and Forced Swim Test (FST). Our study found that the total food intake weight of PTSD Pre-L-Th (prophylactic) rats were significantly increased compared to that of PTSD vehicle rats (p = .04). Administration of L-Th 24 hours before the initial PTSD event or for 10 days following the last PTSD stress event did not statistically improve mean open arm exploration on the EPM, spatial memory, and learning in the MWM or behavioral despair measured by the FST (p > 0.05). Although the 3-day restraint/tail shock stress model caused stress in the rodents, it did not produce reported PTSD-like anxiety and depression or spatial memory loss. The effect of Pre-L-Th or Post-L-Th treatment, on the neurobehavioral functions could not be effectively evaluated. However, this study provides a foundation for future studies to try different rodent PTSD models to induce PTSD-like neurobehavioral impairments to explore dosage, frequency, as well as the duration of L-Th administration before and/or after the post-traumatic event. The 3-day restraint/tail shock stress model caused stress in the rodents, Pre-L-Theanine treatment preconditioned the PTSD rats to endure stress.

scholarly journals Attention controls multisensory perception via 2 distinct mechanisms at different levels of the cortical hierarchy

PLoS Biology ◽  
2021 ◽  
Vol 19 (11) ◽  
pp. e3001465
Author(s):  
Ambra Ferrari ◽  
Uta Noppeney
Keyword(s):  
Causal Inference ◽  
Causal Structure ◽  
Multisensory Perception ◽  
Spatial Representations ◽  
Perceptual Inference ◽  
Sensory Signals ◽  
Cortical Hierarchy ◽  
Parietal Cortices ◽  
The Brain ◽  
Different Levels

To form a percept of the multisensory world, the brain needs to integrate signals from common sources weighted by their reliabilities and segregate those from independent sources. Previously, we have shown that anterior parietal cortices combine sensory signals into representations that take into account the signals’ causal structure (i.e., common versus independent sources) and their sensory reliabilities as predicted by Bayesian causal inference. The current study asks to what extent and how attentional mechanisms can actively control how sensory signals are combined for perceptual inference. In a pre- and postcueing paradigm, we presented observers with audiovisual signals at variable spatial disparities. Observers were precued to attend to auditory or visual modalities prior to stimulus presentation and postcued to report their perceived auditory or visual location. Combining psychophysics, functional magnetic resonance imaging (fMRI), and Bayesian modelling, we demonstrate that the brain moulds multisensory inference via 2 distinct mechanisms. Prestimulus attention to vision enhances the reliability and influence of visual inputs on spatial representations in visual and posterior parietal cortices. Poststimulus report determines how parietal cortices flexibly combine sensory estimates into spatial representations consistent with Bayesian causal inference. Our results show that distinct neural mechanisms control how signals are combined for perceptual inference at different levels of the cortical hierarchy.

scholarly journals Sexual Assault and White Matter Hyperintensities Among Midlife Women

2021 ◽  
Author(s):  
Rebecca Thurston ◽  
Karen Jakubowski ◽  
Minjie Wu ◽  
Howard Aizenstein ◽  
Yuefang Chang ◽  
...  
Keyword(s):  
White Matter ◽  
Sexual Assault ◽  
Traumatic Stress ◽  
White Matter Hyperintensities ◽  
Small Vessel Disease ◽  
Midlife Women ◽  
Traumatic Experiences ◽  
Linear Regression Models ◽  
Post Traumatic Stress ◽  
Post Traumatic

Abstract Background Traumatic experiences have been linked to poor mental and physical health. However, there has been little examination of their relationship to neuroimaging markers of cerebrovascular risk. White matter hyperintensities (WMHs) are markers of brain small vessel disease. WMHs can be detected decades before the onset of dementia and other disorders and can serve as early markers for these brain disorders. We tested whether traumatic experiences were associated with brain WMH volume among midlife women. Methods In the MsBrain study, 145 women (mean age = 59 years) without cardiovascular disease, stroke, or dementia were recruited. Women completed questionnaires [trauma checklist, depression, post-traumatic stress measures]; physical measures [body mass index (BMI), blood pressure (BP)]; phlebotomy; actigraphy sleep measurement, and 3 Tesla magnetic resonance brain imaging for WMHs. Cross-sectional associations between traumatic experiences and WMH volume were assessed in linear regression models. Covariates were age, race/ethnicity, education, BMI, BP, lipids, preeclampsia, sleep, and additionally depressive and post-traumatic stress disorder symptoms. Results 68% of women endorsed at least one of the traumas assessed. The most common trauma was sexual assault (23% of women). Women with trauma exposure had greater WMH volume than women without trauma [B(SE) = .24 (.09), p = .01, multivariable]. The single trauma most associated with WMH was sexual assault [B(SE) = .25 (.11), p = .02, multivariable]. Results persisted adjusting for depressive or post-traumatic stress symptoms. Conclusions A trauma history, particularly sexual assault, was associated with greater WMH volume controlling for covariates, including depressive and post-traumatic symptoms. Sexual assault may place women at risk for poor brain health.

scholarly journals Efficacy of eye movement desensitization and reprocessing (EMDR) therapy for children and adolescents with post-traumatic stress disorder

2021 ◽  
Vol 2 (1) ◽  
pp. 1-12
Author(s):  
Esra Teke ◽  
Selahattin Avşaroğlu
Keyword(s):  
Children And Adolescents ◽  
Eye Movement ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Positive Results ◽  
Emdr Therapy

The purpose of the present study is to examine the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for children and adolescents with post-traumatic stress disorder (PTSD). For this purpose, a framework was determined by using findings of the research and explanations at the conceptual level. PTSD is a mental disorder that is experienced after traumatic events, affects individuals cognitively, emotionally, and behaviorally and threatens the integrity of an individual's life. EMDR therapy is a therapy that imaginatively reveals the past or traumatic experiences of the client through eye movements and other bilateral stimuli (two-way sound or tactile stimulus), facilitates information processing processes. Whereas EMDR was initially an approach developed for adults, it was later used for children and adolescents. The fact that it gives positive results in a short time and these positive results continue in follow-up studies has increased the interest in using EMDR for children and adolescents with PTSD. The use of EMDR for children and adolescents has allowed their problems to be resolved in a timely manner and reduced PTSD symptoms. This situation has drawn attention to the importance of using EMDR in the practice of psychological counselors working in school environments, leading places where they work with children and adolescents, and where the first preventive and interventional studies are carried out. Therefore, it is considered that the use of EMDR will be functional in overcoming these negative life experiences of many students who have been directly or indirectly exposed to traumatic experiences during the COVID-19 epidemic period.

scholarly journals Depression, resilience and post traumatic stress disorder (PTSD) in asylum-seeker war refugees

2020 ◽  
Author(s):  
Maria Malliarou ◽  
Dimitra Tsapakidi ◽  
Mairi Gouva ◽  
Evaggelia Kotrotsiou ◽  
Athanasios Nikolentzos ◽  
...  
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Asylum Seeker ◽  
Stress Disorder ◽  
Severe Depression ◽  
Cross Sectional Study ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Cross Sectional ◽  
Post Traumatic

Abstract Background The number of refugees and displaced people who have been forced to migrate due to war, mass violence and political instability has reached unprecedented levels. The objective of this study was to assess the degree of depression, resilience and post-traumatic stress disorder (PTSD) in asylum-seeker war refugees, temporally stationed in Larisa, Central Greece, through self-administered questionnaire. Simple regression, Pearson’s correlation coefficient and one-way Anova was used.Methods A cross-sectional study carried out with asylum-seeker war refugees residing in Larisa at a number of apartments rented and ran by the UNHCR and the municipality of Larisa. For the data collection PHQ-9 questionnaire, CD-RISC questionnaire and Harvard Trauma questionnaire (HTQ) were used. Descriptive statistics were applied, as well as Cronbach’s alpha coefficient.Results A total of 64 immigrants (40 males and 23 females, 1-mssing value) agreed to participate in the research. The mean age was 35.72 (SD 7.45), 35 respondents were classified as increased PTSD (scores > 2.5). The results showed a physically and exhausted sample, with marginal mental strength (Mean = 59.38%), fluctuating between moderate (N% = 28.10%) and severe depression (N% = 28.10%). About one in two participants (N% = 54.70%) showed signs of post-traumatic stress disorder PTSD, reporting traumatic experiences that mainly involved immediate events of violence, i.e. beating, while there were very few cases of sexual abuse or violence. A key factor in the formulation of PTSD, depression and Mental Stress Indicators was found to be age but limited to 43 years.Conclusion This study revealed that the refugees of the sample are tired, after being absent and idle for about 2 years from their homeland, in a marginal state of collapse. The most important event-hope that sustains its moderate resilience is the grant of asylum and the hope of arrival in the country of destination.

Psychotherapy and refugees

2021 ◽  
pp. 493-502
Author(s):  
Francesca Brady ◽  
Cornelius Katona ◽  
Eileen Walsh ◽  
Katy Robjant
Keyword(s):  
Psychological Treatment ◽  
Behavioural Therapy ◽  
Traumatic Experiences ◽  
Post Traumatic Stress ◽  
Model Of Care ◽  
Narrative Exposure Therapy ◽  
Psychotherapeutic Interventions ◽  
Appropriate Treatment ◽  
Cognitive Behavioural ◽  
Post Traumatic

This chapter explores effective psychotherapeutic interventions for treating post-traumatic stress disorder in adult vulnerable migrants, including cognitive behavioural therapy (CBT), eye movement desensitization and reprocessing, and narrative exposure therapy. An overview of the evidence for these treatments is discussed, as well as how these can be implemented effectively for vulnerable migrants who face ongoing instability and uncertainty, as well as multiple barriers to accessing appropriate treatment. The additional needs of vulnerable migrants are therefore also highlighted. The chapter proposes that to assist individuals effectively in recovering from their traumatic experiences, support must be offered to address these needs, alongside any psychological treatment. A service case example is presented to highlight how an integrated model of care can most effectively meet the needs of vulnerable migrants.

A Systematic Review of Controlled-Trials for PTSD in Maltreated Children and Adolescents

2020 ◽  
pp. 107755952096117
Author(s):  
Rhiannon S. Bennett ◽  
Megan Denne ◽  
Rosie McGuire ◽  
Rachel M. Hiller
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Child Maltreatment ◽  
Children And Adolescents ◽  
Treatment Decision ◽  
Evidence Base ◽  
Traumatic Experiences ◽  
Controlled Trials ◽  
Post Traumatic Stress ◽  
Randomized Controlled

Child maltreatment is associated with elevated risk of post-traumatic stress disorder (PTSD), which can often present alongside comorbidities. While evidence-based treatments for PTSD in young people already exist, there remains ongoing clinical and academic debate about the suitability of these approaches, particularly cognitive-behavioral approaches, for young people who have been exposed to more complex traumatic experiences, such as maltreatment. We conducted an updated systematic review of the evidence-base for psychological treatments for PTSD, specifically for maltreated young people. Fifteen randomized controlled trials and five non-randomized controlled clinical trials satisfied the inclusion criteria. Trials included treatments ranging from trauma-focused CBT to creative-based therapies. Trauma-focused CBT remained the best supported treatment for children and adolescents following child maltreatment, with new evidence that symptom improvements are maintained at longer-term follow up. The evidence for other therapies remained limited, and there were concerns regarding methodological quality. Implications for treatment decision-making are discussed.

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