Efficacy and Underlying Mechanism of Acupuncture in the Treatment of Posttraumatic Stress Disorder: A Systematic Review of Animal Studies

Acupuncture is a nonpharmacological intervention that can be useful in the clinical management of posttraumatic stress disorder (PTSD), especially in situations with a lack of medical resources, including large-scale PTSD events such as disasters. Some clinical studies have reported the clinical effect of acupuncture in improving PTSD symptoms, but the underlying therapeutic mechanism has yet to be explored. Therefore, this review summarized the underlying therapeutic mechanisms of acupuncture in animal PTSD models. A comprehensive search was conducted in 14 electronic databases, and two independent researchers performed study selection, data extraction, and the methodological quality assessment. Twenty-four relevant studies were included in this review and summarized according to the proposed main mechanisms. In behavioral evaluation, acupuncture, including manual acupuncture and electro-acupuncture, reduced anxiety and fear responses and weakened fear conditioning, improved sleep architecture, reduced depressive symptoms, and alleviated disturbance of spatial learning and memory of PTSD animal models. The therapeutic mechanisms of acupuncture proposed in the included studies could be classified into two categories: (1) regulation of stress responses in the neuroendocrine system and (2) promotion of neuroprotection, neurogenesis, and synaptic plasticity in several brain areas. However, the methodological quality of the included animal studies was not high enough to produce robust evidence. In addition, mechanistic studies on specific aspects of acupuncture that may affect PTSD, including expectancy effects, in human PTSD subjects are also needed.

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Childbirth and Posttraumatic Stress Responses

European Journal of Psychological Assessment ◽

10.1027/1015-5759.22.4.259 ◽

2006 ◽

Vol 22 (4) ◽

pp. 259-267 ◽

Cited By ~ 40

Author(s):

Eelco Olde ◽

Rolf J. Kleber ◽

Onno van der Hart ◽

Victor J.M. Pop

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Responses ◽

Rating Scales ◽

Rating Scale ◽

Stress Disorder ◽

Traumatic Experience ◽

Event Scale ◽

Self Rating ◽

The Impact

Childbirth has been identified as a possible traumatic experience, leading to traumatic stress responses and even to the development of posttraumatic stress disorder (PTSD). The current study investigated the psychometric properties of the Dutch version of the Impact of Event Scale-Revised (IES-R) in a group of women who recently gave birth (N = 435). In addition, a comparison was made between the original IES and the IES-R. The scale showed high internal consistency (α = 0.88). Using confirmatory factor analysis no support was found for a three-factor structure of an intrusion, an avoidance, and a hyperarousal factor. Goodness of fit was only reasonable, even after fitting one intrusion item on the hyperarousal scale. The IES-R correlated significantly with scores on depression and anxiety self-rating scales, as well as with scores on a self-rating scale of posttraumatic stress disorder. Although the IES-R can be used for studying posttraumatic stress reactions in women who recently gave birth, the original IES proved to be a better instrument compared to the IES-R. It is concluded that adding the hyperarousal scale to the IES-R did not make the scale stronger.

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Posttraumatic Stress Disorder and Adjustment Disorder in Lithuanian Healthcare in 2018–2020: A Nation-Wide Cohort Study of the Effects of COVID-19 Pandemic

Healthcare ◽

10.3390/healthcare9111422 ◽

2021 ◽

Vol 9 (11) ◽

pp. 1422

Author(s):

Evaldas Kazlauskas ◽

Odeta Gelezelyte ◽

Auguste Nomeikaite ◽

Paulina Zelviene

Keyword(s):

Mental Health ◽

Posttraumatic Stress Disorder ◽

Mental Disorders ◽

Posttraumatic Stress ◽

Large Scale ◽

Stress Disorder ◽

Negative Impact ◽

Adjustment Disorder ◽

Healthcare Services ◽

National Healthcare

Multiple empirical studies have revealed significant pandemic effects of COVID-19 on mental health in various populations. This study aimed to analyze the incidences of posttraumatic stress disorder (PTSD) and adjustment disorder (AjD) in national healthcare in 2018–2020 in one of the European countries—Lithuania—and estimate the effect of the COVID-19 pandemic on PTSD and AjD incidences in 2020. The national healthcare registry was used for estimations of diagnosis of PTSD, AjD, and major depressive disorder (MD). The study revealed that stress-related disorders PTSD and AjD are diagnosed rarely, resulting in a considerable gap between the expected prevalence and incidences of these diagnoses in healthcare in Lithuania. Moreover, a significant decline in mental disorders incidence in healthcare in 2020, in comparison to 2018 and 2019, was found, revealing that the COVID-19 pandemic had a negative impact on access to healthcare services and increased barriers for mental disorders treatment. The study indicates that major developments in building up knowledge about the effects of trauma and life stressors on mental health are needed in Lithuania and other countries to increase awareness about stress-related disorders and improve care for trauma survivors, in particular in the context of the pandemics or other large-scale disasters.

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The Psychiatric Genomics Consortium Posttraumatic Stress Disorder Workgroup: Posttraumatic Stress Disorder Enters the Age of Large-Scale Genomic Collaboration

Neuropsychopharmacology ◽

10.1038/npp.2015.118 ◽

2015 ◽

Vol 40 (10) ◽

pp. 2287-2297 ◽

Cited By ~ 76

Author(s):

Mark W Logue ◽

Ananda B Amstadter ◽

Dewleen G Baker ◽

Laramie Duncan ◽

Karestan C Koenen ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Large Scale ◽

Stress Disorder

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Modes of Large-Scale Brain Network Organization during Threat Processing and Posttraumatic Stress Disorder Symptom Reduction during TF-CBT among Adolescent Girls

PLoS ONE ◽

10.1371/journal.pone.0159620 ◽

2016 ◽

Vol 11 (8) ◽

pp. e0159620 ◽

Cited By ~ 20

Author(s):

Josh M. Cisler ◽

Benjamin A. Sigel ◽

Teresa L. Kramer ◽

Sonet Smitherman ◽

Karin Vanderzee ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Adolescent Girls ◽

Large Scale ◽

Stress Disorder ◽

Brain Network ◽

Symptom Reduction ◽

Network Organization ◽

Threat Processing ◽

Disorder Symptom

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The Psychometric Properties of the Bangla Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): A Large-scale Validation Study

10.21203/rs.3.rs-210877/v1 ◽

2021 ◽

Author(s):

Md. Saiful Islam ◽

Most. Zannatul Ferdous ◽

Md. Safaet Hossain Sujan ◽

Rafia Tasnim ◽

Jakir Hossain Bhuiyan Masud ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Psychometric Properties ◽

Posttraumatic Stress ◽

Hybrid Model ◽

Large Scale ◽

Screening Tool ◽

Stress Disorder ◽

Depression Scale ◽

Dsm 5 ◽

Confirmatory Factor

Abstract Background: The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5. Methods: A cross-sectional survey was carried out among 10,605 individuals (61.0% male; mean age: 23.6±5.5 [13-71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included Bangla PCL-5 and PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor Hybrid model. Results: Bangla PCL-5 displayed adequate internal consistency (Cronbach’s alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor Hybrid model.Conclusions: The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.

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Epidemiology of Posttraumatic Stress Disorder in Adults

The Oxford Handbook of Traumatic Stress Disorders ◽

10.1093/oxfordhb/9780195399066.013.0007 ◽

2012 ◽

pp. 83-97 ◽

Cited By ~ 3

Author(s):

Naomi Breslau

Keyword(s):

Posttraumatic Stress Disorder ◽

Psychiatric Disorders ◽

Vietnam War ◽

Posttraumatic Stress ◽

Vietnam Veterans ◽

Large Scale ◽

Stress Disorder ◽

Future Research ◽

Specific Response ◽

Epidemiological Surveys

Posttraumatic stress disorder (PTSD) was established in 1980, when it was incorporated in the DSM-III. The PTSD definition brackets a distinct set of stressors—traumatic events—from other stressful experiences and links it causally with a specific response, the PTSD syndrome. Explicit diagnostic criteria in DSM-III made it feasible to conduct large-scale epidemiological surveys on PTSD and other psychiatric disorders, using structured diagnostic interviews administered by nonclinicians. Epidemiologic research has been expanded from Vietnam veterans, who were the center of DSM-III PTSD study, to civilian populations and postwar regions worldwide. This chapter summarizes information on the prevalence estimates of PTSD in U.S. veterans of the Vietnam War, soldiers returning from deployment in Iraq and Afghanistan, and civilian populations. It outlines research findings on the course of PTSD, risk factors, comorbidity with other psychiatric disorders, and the risk for other posttrauma disoders. It concludes with recommendations for future research.

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Role of the dorsal periaqueductal gray in posttraumatic stress disorder: mediation by dopamine and neurokinin

Translational Psychiatry ◽

10.1038/s41398-019-0565-8 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

M. L. Brandão ◽

T. A. Lovick

Keyword(s):

Posttraumatic Stress Disorder ◽

Functional Connectivity ◽

Posttraumatic Stress ◽

Animal Studies ◽

Stress Disorder ◽

Early Stage ◽

Brain Structures ◽

Periaqueductal Gray ◽

Contextual Processing ◽

Learned Fear

Abstract In susceptible individuals, exposure to intensely traumatic life events can lead to the development of posttraumatic stress disorder (PTSD), including long-term dysregulation of the contextual processing of aversive stimuli, the overgeneralization of learned fear, and impairments in the ability to learn or respond to safety signals. The neuropathophysiological changes that underlie PTSD remain incompletely understood. Attention has focused on forebrain structures associated with fear processing. Here we consider evidence from human and animal studies that long-lasting changes in functional connectivity between the midbrain periaqueductal gray (dPAG) and amygdala may be one of the precipitating events that contribute to PTSD. Long-lasting neuroplastic changes in the dPAG can persist after a single aversive stimulation and are pharmacologically labile. The early stage (at least up to 24 h post-stimulation) involves neurokinin-1 receptor-mediated events in the PAG and amygdala and is also regulated by dopamine, both of which are mainly involved in transferring ascending aversive information from the dPAG to higher brain structures, mainly the amygdala. Changes in the functional connectivity within the dPAG-amygdala circuit have been reported in PTSD patients. We suggest that further investigations of plasticity and pharmacology of the PAG-amygdala network provide a promising target for understanding pathophysiological circuitry that underlies PTSD in humans and that dopaminergic and neurokininergic drugs may have a potential for the treatment of psychiatric disorders that are associated with a dysfunctional dPAG.

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Neurobiology of Trauma and Stressor-Related Disorders

10.2310/psych.13025 ◽

2018 ◽

Author(s):

Marissa Elizabeth Maheu ◽

Joseph Hunter Howie ◽

Kerry James Ressler

Keyword(s):

Posttraumatic Stress Disorder ◽

Stress Response ◽

Posttraumatic Stress ◽

Large Scale ◽

Stress Disorder ◽

Acute Stress ◽

Molecular Techniques ◽

Fear Learning ◽

Recent Developments ◽

Genomic Studies

Posttraumatic stress disorder (PTSD) and acute stress disorder are precipitated by exposure to one or more traumatic events, and result in debilitating fear-related symptoms. Advances made over the past several years have greatly improved our understanding of these disorders, as well as the neurobiological and genetic factors that contribute to their emergence and progression. In this review, we provide an overview of this research, with a particular focus on recent developments in understanding the neurocircuitry underlying relevant aspects of fear learning, including acquisition, generalization, and the extinction of fear. Molecular regulators of stress response and candidate genes implicated in PTSD are also discussed. Although there remains a great deal to learn about these disorders, novel approaches, large-scale genomic studies, and new molecular techniques promise to help untangle the neurobiology of trauma- and stressor-related illness over the coming years. This review contains 3 figures, 3 tables and 56 references Key words: Posttraumatic stress disorder, fear, genetics, GWAS, HPA stress response, neurocircuitry models of trauma, generalization, extinction learning.

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Clinical Treatment of Posttraumatic Stress Disorder: Conceptual Challenges Raised by Recent Research

Australian & New Zealand Journal of Psychiatry ◽

10.1080/000486700268 ◽

2000 ◽

Vol 34 (6) ◽

pp. 940-953 ◽

Cited By ~ 37

Author(s):

Alexander C. McFarlane ◽

Rachel Yehuda

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Responses ◽

Stress Disorder ◽

Clinical Treatment ◽

Trauma Survivors ◽

Treatment Plans ◽

Research Findings ◽

Trauma Victims

Objective: This paper highlights some of the recent findings in the field of posttraumatic stress disorder (PTSD) and examines their impact on conceptions of trauma-focused clinical treatment. Method: A series of research findings in the area of epidemiology, phenomenology, neurobiology and treatment are summarised. Results: The findings from these studies present critical challenges for clinicians who wish to treat trauma survivors using specialised trauma treatments. The major challenge is one of avoiding a simplistic view of PTSD as a singular response to trauma, as this perception may result in an underestimation of the complexity and disabling quality of the disorder, and lead to the formulation of treatment plans that are simplistic or incomplete. Conclusions: A more precise characterisation of the nature and range of the stress responses of trauma victims will significantly improve treatments of trauma survivors.

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