Ptsd Symptomatology
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Michelle L. Miller ◽  
Natalie R. Stevens ◽  
Gina S. Lowell ◽  
Stevan E. Hobfoll

Minlan Yuan ◽  
Hongru Zhu ◽  
Yuchen Li ◽  
Fenfen Ge ◽  
Su Lui ◽  

Abstract Rationale and objectives The hippocampus, especially the CA1, CA3, and dentate gyrus (DG) subfields, is reported to be associated with post-traumatic stress disorder (PTSD) after trauma. However, neuroimaging studies of the associations between PTSD and hippocampal subfield volumes have failed to yield consistent findings. The aim of this study is to examine whether the dopamine D2 receptor (DRD2) Taq1A polymorphism, which is associated with both hippocampal function and PTSD, moderated the association between PTSD severity and hippocampal CA1, CA3 and DG volumes. Methods T1-weighted images were acquired from 142 trauma survivors from the 2008 Wenchuan earthquake using a 3.0-T magnetic resonance imaging system. Hippocampal subfield segmentations were performed with FreeSurfer v6.0. We used the simple moderation model from the PROCESS v3.4 tool for SPSS 23.0 to examine the association between the rs1800497 polymorphism, PTSD severity, and hippocampal CA3 and DG volumes. Results A significant genotype × PTSD symptom severity interaction was found for the left CA3 volume (ΔF = 5.01, p = 0.008, ΔR2 = 0.05). Post hoc, exploratory analyses deconstructing the interaction revealed that severe PTSD symptomatology were associated with reduced left CA3 volume among TC heterozygotes (t =  − 2.86, p = 0.005). Conclusions This study suggests that DRD2 Taq1A polymorphism moderates the association between PTSD symptomatology and left CA3 volume, which promotes an etiological understanding of the hippocampal atrophy at the subfield level. This highlights the complex effect of environmental stress, and provides possible mechanism for the relationship between the dopaminergic system and hippocampal function in PTSD.

2021 ◽  
Vol 11 (1) ◽  
Andrew J. Westphal ◽  
Michael E. Ballard ◽  
Nicholas Rodriguez ◽  
Taylor A. Vega ◽  
Mark D’Esposito ◽  

AbstractPost-traumatic stress disorder (PTSD) leads to impairments in both cognitive and affective functioning. Animal work suggests that chronic stress reduces dopamine tone, and both animal and human studies argue that changes in dopamine tone influence working memory, a core executive function. These findings give rise to the hypothesis that increasing cortical dopamine tone in individuals with greater PTSD symptomatology should improve working memory performance. In this pharmacological functional magnetic resonance imaging (fMRI) study, 30 US military veterans exhibiting a range of PTSD severity completed an emotional working memory task. Each subject received both placebo and the catechol-O-methyl transferase inhibitor tolcapone, which increases cortical dopamine tone, in randomized, double-blind, counterbalanced fashion. Mnemonic discriminability (calculated with d′, an index of the detectability of working memory signals) and response bias were evaluated in the context of task-related brain activations. Subjects with more severe PTSD showed both greater tolcapone-mediated improvements in d′ and larger tolcapone-mediated reductions in liberally-biased responding for fearful stimuli. FMRI revealed that tolcapone augmented activity within bilateral frontoparietal control regions during the decision phase of the task. Specifically, tolcapone increased cortical responses to fearful relative to neutral stimuli in higher severity PTSD subjects, and reduced cortical responses to fearful stimuli for lower severity PTSD subjects. Moreover, tolcapone modulated prefrontal connectivity with areas overlapping the default mode network. These findings suggest that enhancing cortical dopamine tone may represent an approach to remediating cognitive and affective dysfunction in individuals with more severe PTSD symptoms.

2021 ◽  
pp. 014544552110168
Antoine Lebeaut ◽  
Samuel J. Leonard ◽  
Nathaniel Healy ◽  
Amanda M. Raines ◽  
Sam J. Buser ◽  

Firefighters are chronically exposed to potentially traumatic events, augmenting their risk of developing posttraumatic stress disorder (PTSD). The current study aimed to examine the incremental associations of lower-order dimensions of anxiety sensitivity (AS), examined concurrently, and PTSD symptom severity among a sample of trauma-exposed firefighters. We hypothesized that AS physical and cognitive concerns would be strongly associated with all PTSD symptom clusters and overall symptom severity, after controlling for theoretically relevant covariates (trauma load; years in fire service; alcohol use severity; depressive symptom severity). Participants were comprised of firefighters ( N = 657) who completed an online questionnaire battery and endorsed PTSD Criterion A trauma exposure. Results revealed that the AS cognitive concerns, but not AS physical concerns, was significantly and robustly associated with overall PTSD symptom severity, intrusion symptoms, and negative alterations in cognitions and mood ( ∆R2’s = .028–.042; p’s < .01); AS social concerns was incrementally associated with PTSD avoidance ( ∆R2 = .03, p < .01). Implications for firefighter-informed, evidence-based interventions are discussed.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A637-A637
Jessica Diller Kovler ◽  
Daniel Prevedello

Abstract The emotional symptomatology accompanying pituitary adenomas has long been recognized, though research has been scant, varied, and more focused on studies related to quality of life. The present study sought to better codify the psychological presentation of pituitary adenoma patients through the lens of trauma and PTSD symptomatology. 128 patients who were successfully treated for pituitary adenoma were recruited from the Wexner School of Medicine at Ohio State University. Ranging in age from 23 to 74, the participants’ mental health functioning was assessed by the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Brief Symptom Inventory (BSI), and the Dissociative Experiences Scale (DES). The findings of this pilot study showed that the rate of traumatization (PTSD) for pituitary adenoma patients was significantly higher than that of the general population. With regard to comorbid trauma-related mental health impairment, our results demonstrated that when moderated by sex, pituitary adenoma patients had significantly higher psychopathology than the non-clinical population. Replicating the existing research, there was a significant positive correlation between trauma symptoms and trauma-related psychopathology in patients successfully treated for pituitary adenoma. Overall, the results of this study demonstrate the traumatic nature of this disease and the need for applied clinical intervention. Further research is needed to replicate these findings, in light of potential selection bias and sample size.

2021 ◽  
Vol 9 (1) ◽  
Mary Jeffrey ◽  
Fanny Collado ◽  
Jeffrey Kibler ◽  
Christian DeLucia ◽  
Steven Messer ◽  

Abstract Background Gulf War Illness (GWI) is a chronic, multi-symptomatic disorder affecting an estimated 25–32% of the returning military veterans of the 1990–1991 Persian Gulf War. GWI presents with a wide range of symptoms including fatigue, muscle pain, cognitive problems, insomnia, rashes and gastrointestinal issues and continues to be a poorly understood illness. This heterogeneity of GWI symptom presentation complicates diagnosis as well as the identification of effective treatments. Defining subgroups of the illness may help alleviate these complications. Our aim is to determine if GWI can be divided into distinct subgroups based on PTSD symptom presentation. Methods Veterans diagnosed with GWI (n = 47) and healthy sedentary veteran controls (n = 52) were recruited through the Miami Affairs (VA) Medical Health Center. Symptoms were assessed via the RAND short form health survey (36), the multidimensional fatigue inventory, and the Davidson trauma scale. Hierarchal regression modeling was performed on measures of health and fatigue with PTSD symptoms as a covariate. This was followed by univariate analyses conducted with two separate GWI groups based on a cut-point of 70 for their total Davidson Trauma Scale value and performing heteroscedastic t-tests across all measures. Results Overall analyses returned two symptom-based subgroups differing significantly across all health and trauma symptoms. These subgroups supported PTSD symptomatology as a means to subgroup veterans. Hierarchical models showed that GWI and levels of PTSD symptoms both impact measures of physical, social, and emotional consequences of poor health (ΔR2 = 0.055–0.316). However, GWI appeared to contribute more to fatigue measures. Cut-point analysis retained worse health outcomes across all measures for GWI with PTSD symptoms compared to those without PTSD symptoms, and healthy controls. Significant differences were observed in mental and emotional measures. Conclusions Therefore, this research supports the idea that comorbid GWI and PTSD symptoms lead to worse health outcomes, while demonstrating how GWI and PTSD symptoms may uniquely contribute to clinical presentation.

2021 ◽  
pp. 070674372110118
Herry Patel ◽  
Katherine Holshausen ◽  
Assaf Oshri ◽  
Krysta Andrews ◽  
Stephanie Penta ◽  

Objective: Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) present a complex and often severe clinical presentation within a concurrent disorders context. The objective of this study was to examine associations between PTSD symptoms and SUD outcomes to better understand the clinical phenomenon of comorbid PTSD and SUD. Multivariate statistical methods were used to test the hypothesis that elevated PTSD symptoms, both at the level of global severity and specific PTSD symptom clusters, are associated with greater substance use and related problems. Methods: Data were collected from an intake assessment battery within a specialized concurrent disorders outpatient service in Hamilton, ON. The sample comprised 326 participants (mean age = 37.19, 45.4% female). Structural equation models examined associations between PTSD and alcohol, cannabis, and substance use frequency and problems, controlling for age and sex. Alcohol was ultimately dropped from the model due to non-significant bivariate associations. Results: Higher global PTSD symptomatology was significantly associated with higher cannabis and other substance use frequency and related problems. Analyses using PTSD cluster scores showed higher scores for alterations in arousal were positively associated with cannabis-related problems, drug-related problems, and cannabis and other substance use frequency. Avoidance was significantly associated with cannabis frequency and cannabis-related problems. In general, effect sizes were small in magnitude, accounting for between 9% and 25% of variance. Conclusion: Significant cluster-level associations indicate the importance of specific PTSD symptoms (hyperarousal, avoidance) in relation to substance use when identifying therapeutic targets among individuals presenting with comorbid PTSD-SUD. This multivariate approach provides a higher resolution and potentially more clinically informative representation of the complex clinical presentation of PTSD and SUD in a concurrent disorder population and could guide the development of more effective treatment paths.

2021 ◽  
Vol 12 ◽  
Francesca Favieri ◽  
Giuseppe Forte ◽  
Renata Tambelli ◽  
Maria Casagrande

Background: The COVID-19 pandemic is a worldwide public health emergency that forced the Italian Government to deliberate unprecedented actions, including quarantine, with a relevant impact on the population. The present study is one of the first Italian nationwide survey within the first period of the COVID-19 outbreak aimed to understand the social and psychological impact of the COVID-19 outbreak.Methods: An online survey collected information on sociodemographic data, history of direct or indirect contact with COVID-19, and other information concerning the COVID-19 emergency. The General Psychological Well-Being Index and a modified version of the PTSD Checklist for DSM-5, focused on the COVID-19 experience, assessed the respondents' general psychological condition.Results: Of 1,639 respondents equally distributed in the Italian territory, 5.1% reported PTSD symptomatology, and 48.2% evidenced lower psychological well-being linked to COVID-19 diffusion. Lower psychological well-being was significantly higher in women, younger than 50 years, and with health risk factors. Lower psychological well-being was also detected in individuals who did not know if they were infected, who have had direct exposure or were uncertain about their exposure to COVID-19, or who knew infected people. Regarding the social and behavioral consequences, respondents perceived worsening in demographic, economic, social, and relational conditions. Moreover, they reported increased film viewing, cookhouse time, social media use, and decreased physical activity.Conclusion: The COVID-19 pandemic appears to be a risk factor for psychological diseases in the Italian population, as previously reported in the Chinese people. About half of the respondents reported a significant psychological impact. Moreover, we confirmed the role of restraining measures that led to modify lifestyles, social perception, and confidence in the institutions. These results underline the need for further studies aimed to develop psychological interventions to minimize the consequences of the COVID-19 pandemic.

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