scholarly journals Sex-Related Predisposition to Post-Traumatic Stress Disorder Development—The Role of Neuropeptides

Author(s):  
Małgorzata Lehner ◽  
Anna Skórzewska ◽  
Aleksandra Wisłowska-Stanek

Post-traumatic stress disorder (PTSD) is characterized by re-experiencing a traumatic event, avoidance, negative alterations in cognitions and mood, hyperarousal, and severe functional impairment. Women have a two times higher risk of developing PTSD than men. The neurobiological basis for the sex-specific predisposition to PTSD might be related to differences in the functions of stress-responsive systems due to the interaction between gonadal hormones and stress peptides such as corticotropin-releasing factor (CRF), orexin, oxytocin, and neuropeptide Y. Additionally, in phases where estrogens levels are low, the risk of developing or exacerbating PTSD is higher. Most studies have revealed several essential sex differences in CRF function. They include genetic factors, e.g., the CRF promoter contains estrogen response elements. Importantly, sex-related differences are responsible for different predispositions to PTSD and diverse treatment responses. Fear extinction (the process responsible for the effectiveness of behavioral therapy for PTSD) in women during periods of high endogenous estradiol levels (the primary form of estrogens) is reportedly more effective than in periods of low endogenous estradiol. In this review, we present the roles of selected neuropeptides in the sex-related predisposition to PTSD development.

2019 ◽  
pp. 74-80
Author(s):  
Thi Tan Nguyen ◽  
Van Minh Doan ◽  
Nhat Minh Tran ◽  
Van Hung Nguyen

Post-traumatic Stress Disorder (PTSD) is a mental disorder that develops in people who have experienced or witnessed a serious traumatic event, such as natural catastrophes, sexual assaults, war… Some studies showed that acupuncture was effective for PTSD. However, there is no published research on the treatment of PTSD using acupuncture and cognitive behavioral therapy (CBT) in Vietnam. The aim of this study was to evaluate the effectiveness of treating PTSD using acupuncture combined with CBT in Thua Thien Hue province. Method and subject: This study was an interventional study conducted in two districts of Thua Thien Hue province. Thirty patients were diagnosed with PTSD using Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Participants were assessed on PTSD symptoms using PTSD Checklist for DSM-5 (PCL–5); depression, anxiety and stress status using DASS-21; and other health states before and after treatment. Result: The effectiveness rate of treatment was 83.3% by PCL–5 and 86.7% by DASS-21. The improvement of symptoms after 5 weeks of treatment was statistically significant (p <0.05). Side effects were itch (5.0%), pain (4.3%); bleeding (1.3%); and others (0%). Conclusion: Treatment of PTSD using acupuncture and CBT has a high effectiveness rate on PCL - 5 scale and DASS21 scale. Improvement was similar when evaluated by the two scales. Acupuncture was safe and did not cause any significant side effects. Key words: Post-traumatic Stress Disorder, PTSD, acupuncture, cognitive behavior therapy, CBT, Thua Thien Hue


2021 ◽  
Vol 21 (2) ◽  
pp. 143-162
Author(s):  
Anwar Khan ◽  
Faseeh Ullah ◽  
Omer Abid ◽  
Khizra Hafeez Awan

"Post-Traumatic Stress Disorder (PTSD) develops after exposure to or witnessing traumatic events. PTSD is very common among the Spinal Cord Injury (SCI) patients. PTSD can be successfully treated with the Cognitive Behavioral Therapy (CBT). However, CBT is mostly used in the western countries, so its efficacy in the eastern culture is still not fully known. Keeping this in view, the current study has determined the efficacy of CBT in the treatment of PTSD among the SCI patients in Pakistan. Using a Randomized Controlled Pilot Study design, data were collected through the Clinician-Administered PTSD Scale for DSM-5 from thirty patients admitted to the Paraplegic Center. Trauma-focused CBT(TF-CBT) protocol was applied through fourteen sessions. Data were analyzed by descriptive and multivariate statistics. Findings show that the level of PTSD symptoms gradually decreased from high at baseline (CAPS-5 Mean Scores μ= 3.6) to low during follow-up stage (CAPS-5 Mean Scores μ= 0.89). Results obtained from the present study on the efficacy of CBT are in concurrence with the research findings in other countries. This study supports the efficiency CBT intervention among Pakistani patients who had developed PTSD symptoms after suffering from SCI. Therefore, CBT can be widely used in the management of PTSD in Pakistan."


2009 ◽  
Vol 40 (7) ◽  
pp. 1215-1223 ◽  
Author(s):  
A. Liedl ◽  
M. O'Donnell ◽  
M. Creamer ◽  
D. Silove ◽  
A. McFarlane ◽  
...  

BackgroundPain and post-traumatic stress disorder (PTSD) are frequently co-morbid in the aftermath of a traumatic event. Although several models attempt to explain the relationship between these two disorders, the mechanisms underlying the relationship remain unclear. The aim of this study was to investigate the relationship between each PTSD symptom cluster and pain over the course of post-traumatic adjustment.MethodIn a longitudinal study, injury patients (n=824) were assessed within 1 week post-injury, and then at 3 and 12 months. Pain was measured using a 100-mm Visual Analogue Scale (VAS). PTSD symptoms were assessed using the Clinician-Administered PTSD Scale (CAPS). Structural equation modelling (SEM) was used to identify causal relationships between pain and PTSD.ResultsIn a saturated model we found that the relationship between acute pain and 12-month pain was mediated by arousal symptoms at 3 months. We also found that the relationship between baseline arousal and re-experiencing symptoms, and later 12-month arousal and re-experiencing symptoms, was mediated by 3-month pain levels. The final model showed a good fit [χ2=16.97, df=12, p>0.05, Comparative Fit Index (CFI)=0.999, root mean square error of approximation (RMSEA)=0.022].ConclusionsThese findings provide evidence of mutual maintenance between pain and PTSD.


2016 ◽  
Vol 27 (2) ◽  
pp. 226-235 ◽  
Author(s):  
Nancy K. Westerman ◽  
Vanessa E. Cobham ◽  
Brett McDermott

Repeated retelling of trauma narratives within Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) assists participants to habituate to experiences that have precipitated symptoms of post-traumatic stress. In this study, the narratives produced by children and adolescents, who developed post-traumatic stress disorder following a natural disaster, and who were treated with a manualized TF-CBT intervention, were examined. The first author developed a coding system utilizing three major concepts (coherence, elaboration, and evaluation) to identify changes in the narratives as they were retold at each therapeutic session. Analysis using this coding system identified that the internal logic of the stories was maintained as the detail diminished, and that the level of evaluation increased. Compression emerged as a major pattern, alongside the reduction in participant distress over the course of the treatment. Although requiring replication, these trial concepts, developed by the coding system, have potential analyzing trauma narratives and enhancing clinician observations.


Author(s):  
Khalid Astitene ◽  
Hassan Aguenaou ◽  
Laila Lahlou ◽  
Amina Barkat

Aim: After a traumatic event, the person can develop post-traumatic stress disorder (PTSD), the purpose of the study is to assess the prevalence of PTSD in adolescents in public middle schools of the prefecture of Salé in Morocco and study anxiety and depression which are the comorbid disorders of the PTSD. The survey was carried out from March to June 2017. Methods: 523 students were selected by the cross-sectional method from fifteen schools that were randomly selected, the age of the students vary between 12 and 17 years. For the survey, standardized questionnaires (the socio-demographic data, the Life Events Checklist, the CPTS-RI (Children's Post Traumatic Stress Reaction Index), the STAIY (State Trait Inventory Anxiety Form Y) and the CDI (Children Depression Inventory) were used which were filled in by the students. Results: The prevalence of PTSD was 70.4% in the students who have PTSD. We found that the prevalence in boys was 46.74%, while in girls it was 53.26%. In addition to that, 81% of students found to be anxious and 51.8% of students have depression. Conclusion: There is a high prevalence of post traumatic stress disorder among adolescents, there are practical implications for the support and care of these adolescents.


Author(s):  
Onja T. Grad

Emotional turmoil, disruption, shock, post-traumatic stress disorder (PTSD), doubts in own competences as a professional: these are only few of many feelings and reactions that clinicians might experience when faced with the fact that patients they had treated took their lives. The range of reactions can span from none, which is rare, to severe disorders, and can sometimes result in more precautious treatment of future patients, or even in leaving the field of working with suicidal patients. How clinicians respond depends on many factors, such as the length and intensity of the treatment, the understanding of patients’ suicide, the knowledge and past experiences the clinicians have as well as the response of the patients’ family, and the response and support of the colleagues and the institution in which the treatment took place. Some of these factors can help—while others can hinder—the process of overcoming the traumatic event of patients’ suicide.


2014 ◽  
pp. 55-60
Author(s):  
David L Brody

In many contexts, the trauma that caused the concussion can also trigger a strong stress response. Take a focused history from the patient and collateral source for hyperarousal, nightmares, avoidance, emotional numbing, dissociation, and prior diagnosis of post-traumatic stress disorder (PTSD). Assess safety. Severe PTSD can lead to suicide. Refer to a psychologist or counselor with specific expertise in PTSD for prolonged exposure therapy or cognitive behavioral therapy. Optimize sleep. Start an anxiolytic antidepressant. Prescribe prazosin for nightmares. Ideally, use short-acting benzodiazepines only for emergencies. Advise the patient to stop drinking alcohol. Treat chronic pain aggressively if present. Consider a second-line mood stabilizer if necessary. Don’t be afraid to use stimulants if the patient also has impairing attention deficit once the PTSD symptoms are under reasonable control.


2019 ◽  
Vol 176 (21) ◽  
pp. 4119-4135 ◽  
Author(s):  
Andrea Gogos ◽  
Luke J. Ney ◽  
Natasha Seymour ◽  
Tamsyn E. Van Rheenen ◽  
Kim L. Felmingham

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