Post-traumatic stress disorder, emotional processing and Inappropriate Implantable Cardioverter-Defibrillator Shocks: clinical consideration by a single case report

Introduction. Even though an overwhelming amount of evidence supports the clinical efficacy and safety of the implantable cardioverter defibrillator (ICD), inappropriate shocks for atrial arrhythmias with rapid ventricular conduction or for abnormal sensing results in multiple adverse effects Presentation. In this study we present the case of a 59- year-old woman who was admitted to hospital for ICD implantation with a past medical history that was positive for non-ischemic dilated cardiomyopathy, congestive heart failure (NYHA class III), atrial fibrillation, essential hypertension and a recent episode of syncope. Since in the 18 months follow-up the patient suffered many inappropriate shocks, we investigated the association of the presence of a PTSD (Post- Traumatic-Stress-Disorder) prior to implantation and a specific profile of cognitive processing emotions, with the effectiveness of the ICD. Emotional distress states and cognitive thoughts preceding ICD shock inappropriate episode were recorded by structured mobile diary (eMotional-ICDiary©). We outlined how the presence of a highly traumatic event which had occurred 6 years previously was related to a recurrence of a combination of moderate distress and cognitive thoughts, associated with episodes of Inappropriate Shock. A psycho-diagnostic examination and the administration of the Emotional Processing Scale (EPS-25) and Emotional Regulation Questionnaire (ERQ) outlined that the patient presented a profile of cognitive processing of emotions characterized by elevated levels of unprocessed emotions, low appraisal and high suppression emotional regulation strategy. Conclusion. The observations gathered in this single case are a good starting point for further research in order to check if the post-traumatic stress disorder and a specific cognitive profile connected to the processing of emotions are associated with the presence of inappropriate ICD shocks. Further larger sample studies are required in this area.

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Study of the links between emotional regulation strategies and sense of place in the expression of symptoms of post-traumatic stress disorder in flood victims

Journal of Environmental Psychology ◽

10.1016/j.jenvp.2021.101656 ◽

2021 ◽

pp. 101656

Author(s):

Puechlong Cécile ◽

Charbonnier Elodie ◽

Weiss Karine

Keyword(s):

Sense Of Place ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Emotional Regulation ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Post Traumatic ◽

Regulation Strategies

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Veterans with post-traumatic stress disorder exhibit altered emotional processing and attentional control during an emotional Stroop task

Psychological Medicine ◽

10.1017/s0033291717000460 ◽

2017 ◽

Vol 47 (11) ◽

pp. 2017-2027 ◽

Cited By ~ 18

Author(s):

M. M. Khanna ◽

A. S. Badura-Brack ◽

T. J. McDermott ◽

C. M. Embury ◽

A. I. Wiesman ◽

...

Keyword(s):

Stroop Task ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Emotional Regulation ◽

Stress Disorder ◽

Attention Allocation ◽

Emotional Stroop ◽

Post Traumatic Stress ◽

Emotional Stroop Task ◽

Post Traumatic

BackgroundPost-traumatic stress disorder (PTSD) is often associated with attention allocation and emotional regulation difficulties, but the brain dynamics underlying these deficits are unknown. The emotional Stroop task (EST) is an ideal means to monitor these difficulties, because participants are asked to attend to non-emotional aspects of the stimuli. In this study, we used magnetoencephalography (MEG) and the EST to monitor attention allocation and emotional regulation during the processing of emotionally charged stimuli in combat veterans with and without PTSD.MethodA total of 31 veterans with PTSD and 20 without PTSD performed the EST during MEG. Three categories of stimuli were used, including combat-related, generally threatening and neutral words. MEG data were imaged in the time-frequency domain and the network dynamics were probed for differences in processing threatening and non-threatening words.ResultsBehaviorally, veterans with PTSD were significantly slower in responding to combat-related relative to neutral and generally threatening words. Veterans without PTSD exhibited no significant differences in responding to the three different word types. Neurophysiologically, we found a significant three-way interaction between group, word type and time period across multiple brain regions. Follow-up testing indicated stronger theta-frequency (4–8 Hz) responses in the right ventral prefrontal (0.4–0.8 s) and superior temporal cortices (0.6–0.8 s) of veterans without PTSD compared with those with PTSD during the processing of combat-related words.ConclusionsOur data indicated that veterans with PTSD exhibited deficits in attention allocation and emotional regulation when processing trauma cues, while those without PTSD were able to regulate emotion by directing attention away from threat.

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Predictors of Quality of Life Following Cognitive Processing Therapy Among Women and Men With Post-Traumatic Stress Disorder

Military Medicine ◽

10.1093/milmed/usz474 ◽

2020 ◽

Vol 185 (5-6) ◽

pp. e579-e585 ◽

Cited By ~ 1

Author(s):

Lisa H Glassman ◽

Margaret-Anne Mackintosh ◽

Stephanie Y Wells ◽

Induni Wickramasinghe ◽

Kristen H Walter ◽

...

Keyword(s):

Cognitive Processing ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Post Treatment ◽

Cognitive Processing Therapy ◽

Evidence Based ◽

Post Traumatic Stress ◽

Post Traumatic

Abstract Introduction The effect of evidence-based post-traumatic stress disorder (PTSD) treatments on quality of life (QOL) is not well understood. In light of mixed findings on QOL after PTSD interventions, little is known about why some individuals experience functional and QOL improvements while others do not. This study examined treatment-related changes in depression, anger, and PTSD following cognitive processing therapy (CPT) as potential predictors of QOL change. Materials and Methods Data from two randomized controlled trials, one examining CPT among female civilians and veterans (women’s study NCT02362477; n = 126) and the other on CPT delivered to male veterans (men’s study NCT00879255; n = 125), were used to test study aims. Linear mixed modeling examined changes in depression, anger, and PTSD as predictors of post-treatment QOL while controlling for baseline QOL. The VA Pacific Island Health Care System’s Institutional Review Board approved all study procedures. Results Among women, reductions in depression from pre- to post-treatment had the strongest predictive value of post-treatment QOL (B = −1.15, 95% confidence interval (−1.71, −0.60), t = −4.07, P < .001). For men, reductions in trait anger from pre- to post-treatment predicted post-treatment QOL (B = −0.55, 95% confidence interval (−0.90, −0.19), t = −3.00, P = .003). Conclusions Improvements in QOL may be predicted by different symptoms for men and women following evidence-based PTSD treatment. Our findings suggest that change in depression symptoms is an important predictor of post-treatment QOL among women, while anger symptoms are more influential for men. QOL and functioning is underresearched within the context of PTSD treatment, and this study suggests that these domains should be examined within the context of gender.

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Childhood Emotional Maltreatment and Post-Traumatic Stress Disorder in the Context of Centrality of the Event and Intrusive Rumination

Rehabilitation Counseling Bulletin ◽

10.1177/0034355220925889 ◽

2020 ◽

Vol 64 (2) ◽

pp. 108-117 ◽

Cited By ~ 1

Author(s):

Justin Watts ◽

Michael Leeman ◽

Deirdre O’Sullivan ◽

Joshua Castleberry ◽

Ganesh Baniya

Keyword(s):

Cognitive Processing ◽

Cognitive Processes ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Contributing Factors ◽

Emotional Maltreatment ◽

Mediation Analyses ◽

Post Traumatic

Psychiatric disorders, such as post-traumatic stress disorder (PTSD), are significantly more likely among those exposed to child maltreatment. Not all who are exposed to maltreatment develop PTSD; while many contributing factors are understood, more research is needed to understand why some develop this disorder. The purpose of this study was to examine relationships among an understudied form of maltreatment: childhood emotional maltreatment (CEM) and cognitive processes that may directly or indirectly explain development of PTSD among CEM survivors. A sample of college students ( N = 396) completed surveys related to childhood trauma history, cognitive processing, and PTSD. Mediation analyses revealed that CEM had a significant direct effect on PTSD, and that centrality of the event and intrusive rumination significantly mediated this relationship. Recommendations are provided for identifying maladaptive cognitive processes with the aim of facilitating adaptive cognitive processing related to prior trauma exposure and current PTSD symptoms.

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Cognitive processing therapy for post-traumatic stress disorder in a University Counselling Center: an outcome study

The Cognitive Behaviour Therapist ◽

10.1017/s1754470x17000216 ◽

2017 ◽

Vol 10 ◽

Author(s):

Charity Wilkinson ◽

Meghan von Linden ◽

Annmarie Wacha-Montes ◽

Craig Bryan ◽

Katherine O'Leary

Keyword(s):

College Students ◽

Cognitive Processing ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Fixed Effects ◽

Stress Disorder ◽

Cognitive Processing Therapy ◽

Post Traumatic Stress ◽

Therapist Experience ◽

Post Traumatic

AbstractMore than half of college students endorse experiencing at least one traumatic event. Consistent with other populations, the rate of post-traumatic stress disorder (PTSD) for college students has been reported at around 12%. Despite this, empirically supported treatments for PTSD have not been widely disseminated in University Counselling Centers (UCCs). This study examines outcomes using cognitive processing therapy (CPT) with a sample of n = 26 college students in a UCC setting. This study also examines therapist experience, length of degree and symptom severity on outcome. After completing training, n = 8 therapists completed CPT consultation and certification. Students who participated in individual CPT during this process were administered the PCL-5 and PHQ-9 at weekly sessions. A retrospective chart review was completed. PCL-5 and PHQ-9 scores were separately examined as outcome variables using linear mixed models where session, therapist experience, length of therapist degree, and severity of symptoms were included as fixed effects, and subjects were assumed to have a random effect. Significant reductions in PCL-5 and PHQ-9 scores were observed across treatment. In this sample, 84.6% of students were treatment responders. Results were unchanged when adjusting for therapist level of experience or training. CPT shows strong potential for UCC settings. CPT can be successfully implemented with novice therapists.

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Post-traumatic stress disorder and chronic hyperconnectivity in emotional processing

NeuroImage Clinical ◽

10.1016/j.nicl.2018.07.007 ◽

2018 ◽

Vol 20 ◽

pp. 197-204 ◽

Cited By ~ 7

Author(s):

Benjamin T. Dunkley ◽

Simeon M. Wong ◽

Rakesh Jetly ◽

Jimmy K. Wong ◽

Margot J. Taylor

Keyword(s):

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Emotional Processing ◽

Stress Disorder ◽

Post Traumatic Stress ◽

Post Traumatic

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Trauma, Dissociation, and Post-traumatic Stress Disorder

The Oxford Handbook of Clinical Psychology ◽

10.1093/oxfordhb/9780199328710.013.040 ◽

2014 ◽

pp. 363-391

Author(s):

Terence M. Keane ◽

Brian P. Marx ◽

Denise M. Sloan ◽

Anne DePrince

Keyword(s):

Cognitive Processing ◽

Post Traumatic Stress Disorder ◽

Traumatic Stress ◽

Stress Disorder ◽

Cognitive Processing Therapy ◽

Post Traumatic Stress ◽

Assessment And Treatment ◽

Post Traumatic ◽

Future Work ◽

The Impact

Worldwide, post-traumatic stress disorder (PTSD) is among the most common psychological disorders; over the past three decades researchers have made considerable progress in understanding the prevalence of PTSD and its psychological and biological underpinnings, while developing methods for its assessment and treatment. Only included in the diagnostic nomenclature since 1980, the history of PTSD extends as far back as the oldest literature in Western civilization. Homer’s Iliad and Odyssey capture the impact of war on combatants and civilians, as do many of the works of writers and artists across the centuries. The focus of this chapter is on the integration of contemporary work on traumatic stress exposure, psychological dissociation, and the development of PTSD, a disorder characterized by concurrent high levels of anxiety and depression and, in many instances, considerable chronicity and disability. More than 50 randomized controlled treatment outcome studies suggest that cognitive- behavioral treatments are especially effective, and support the use of exposure therapy, stress management therapy, cognitive therapy, cognitive processing therapy, and eye movement desensitization and reprocessing in treating PTSD. All these approaches constitute key evidence-based psychological treatments for PTSD. Future work will determine which treatments used by which therapists are best for patients with specific symptoms and concomitant conditions.

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