Posttraumatic Stress Disorder Symptomatology Research Articles

Disclosing Unwanted Pursuit Victimization: Indirect Effects of Negative Reactions on PTSD Symptomatology Among Undergraduate Women.

A growing literature has documented that negative social reactions to disclosures of sexual and intimate partner violence (IPV), such as victim blaming or disbelief, can negatively affect survivors' recovery. However, despite growing recognition of the frequency of unwanted pursuit behaviors (UPBs; for example, stalking, excessive or threatening contact) following romantic relationships and their negative effects on survivors, research to date has not explored disclosures, social reactions, or their impacts among victims of UPBs. The purpose of the present study was to assess the frequency of disclosures of UPB victimization to various sources, social reactions received, and their associations with symptoms of posttraumatic stress disorder (PTSD). Among a sample of 318 undergraduate women (ages 18-24) who reported a breakup within the past 3 years, 59.7% (n =190) reported experiencing UPBs. Nearly all of the women (92.6%; n =176) who experienced UPBs disclosed their victimization to others. Among women who disclosed, the most frequent recipient of disclosure was a female friend (93.2%, n = 164) and women reported receiving higher mean positive than negative social reactions (p < .001). Results supported the hypothesized indirect effect of UPB victimization on PTSD symptoms through increases in negative social reactions (p < .001); these results suggest that negative social reactions to UPB victimization may increase the risk for PTSD symptomatology. By contrast, there was no indirect effect via positive social reactions (p = .205). Implications for research and clinical practice will be discussed.

Challenging child behaviours positively predict symptoms of posttraumatic stress disorder in parents of children with Autism Spectrum Disorder and Rare Diseases

BackgroundThis study investigated the validity of conceptualising elevated stress in parents of children who exhibit challenging behaviour within the framework of posttraumatic stress disorder (PTSD). It was hypothesised that parents of children with autism spectrum disorder (ASD), and parents of children with a rare disease would endorse greater PTSD symptomatology than parents of typically developing (TD) children, and that challenging child behaviours would positively predict PTSD symptomatology. MethodThe Life Events Checklist for DSM-5, Developmental Behaviour Checklist (Parent) and PTSD Checklist for DSM-5 were administered to 395 parents. ResultsSignificantly more PTSD symptomatology was reported by parents of children with ASD and parents of children with a rare disease than parents of TD children, and challenging child behaviours positively predicted PTSD symptomatology in both groups. ConclusionA PTSD framework may validly explain elevated stress among some parents of children with ASD and parents of children with a rare disease, and has important implications for support delivered to parents by healthcare providers.

Angiotensin involvement in trauma processing-exploring candidate neurocognitive mechanisms of preventing post-traumatic stress symptoms.

The angiotensin-II antagonist losartan is a promising candidate that has enhanced extinction in a post-traumatic stress disorder (PTSD) animal model and was related to reducing PTSD symptom development in humans. Here, we investigate the neurocognitive mechanisms underlying these results, testing the effect of losartan on data-driven and contextual processing of traumatic material, mechanisms proposed to be relevant for PTSD development. In a double-blind between-subject design, 40 healthy participants were randomised to a single oral dose of losartan (50 mg) or placebo, 1 h before being exposed to distressing films as a trauma analogue while heart rate (HR) was measured. Peritraumatic processing was investigated using blurry picture stimuli from the films, which transformed into clear images. Data-driven processing was measured by the level of blurriness at which contents were recognised. Contextual processing was measured as the amount of context information retrieved when describing the pictures' contents. Negative-matched control images were used to test perceptual processing of peripheral trauma-cues. Post-traumatic stress symptoms were assessed via self-report questionnaires after analogue trauma and an intrusion diary completed over 4 days following the experiment. Compared to placebo, losartan facilitated contextual processing and enhanced detail perception in the negative-match pictures. During the films, the losartan group recorded lower HR and higher HR variability, reflecting lower autonomic stress responses. We discuss potential mechanisms of losartan in preventing PTSD symptomatology, including the role of reduced arousal and increased contextual processing during trauma exposure, as well as increased threat-safety differentiation when encountering peripheral trauma-cues in the aftermaths of traumatic events.

High physical activity is associated with post-traumatic stress disorder among individuals aged 15 years and older in South Africa.

BackgroundSome research seems to suggest that physical activity (PA) was beneficial for post-traumatic stress disorder (PTSD).AimThis study examined the association between levels of PA and PTSD among individuals 15 years and above in South Africa.SettingCommunity-based survey sample representative of the national population in South Africa.MethodsIn all, 15 201 individuals (mean age 36.9 years) responded to the cross-sectional South African National Health and Nutrition Examination Survey (SANHANES-1) in 2012.ResultsOne in five (20.1%) of participants reported exposure to at least one traumatic event in a lifetime, and 2.1% were classified as having a PTSD, 7.9% fulfilled PTSD re-experiencing criteria, 3.0% PTSD avoidance criteria and 4.3% PTSD hyperarousal criteria. Almost half (48.1%) of respondents had low PA, 17.4% moderate PA and 34.5% high PA. In logistic regression analysis, adjusted for age, sex, population group, employment status, residence status, number of trauma types, problem drinking, current tobacco use, sleep problems and depressive symptoms, high PA was associated with PTSD (odds ratio [OR] = 1.75, confidence interval [CI] = 1.11–2.75), PTSD re-experiencing symptom criteria (OR = 1.43, CI = 1.09–1.86) and PTSD avoidance symptom criteria (OR = 1.74, CI = 1.18–2.59), but high PA was not associated with PTSD hyperarousal symptom criteria. In generalised structural equation modelling, total trauma events had a positive direct and indirect effect on PTSD mediated by high PA, and high PA had a positive indirect effect on PTSD, mediated by psychological distress and problem drinking.ConclusionAfter controlling for relevant covariates, high PA was associated with increased PTSD symptomatology.

Gendered racial microaggressions predict posttraumatic stress disorder symptoms and cognitions among Black women living with HIV.

Gendered racial microaggression (GRM) experienced by Black women living with HIV (BWLWH) is a potentially important variable for posttraumatic stress disorder (PTSD) symptomatology in this population. GRM refers to everyday insults experienced by Black women on the basis of being both Black and female (e.g., comments about Black women's hair and body). We investigated the associations between GRM, race- and HIV-related discrimination, and trauma symptoms among BWLWH and explored whether gendered racial microaggressions contributed uniquely to trauma symptoms above the contribution of race- and HIV-related discrimination. One-hundred BWLWH in the U.S. completed baseline measures on GRM (frequency and appraisal), racial discrimination, HIV-related discrimination, PTSD symptoms, and posttraumatic cognitions. Hierarchical multiple linear regressions controlling for age, education, and income indicated that higher GRM and HIV-related discrimination predicted higher total PTSD symptoms, and higher GRM and racial discrimination predicted higher posttraumatic cognitions. Hierarchical multiple linear regressions with all predictors entered together revealed that only GRM contributed uniquely to both total PTSD symptoms and total posttraumatic cognitions. Analyses between GRM subscales and subscales of PTSD symptoms and posttraumatic cognitions indicated that GRM about beauty/sexual objectification and the strong Black women stereotype contributed uniquely and in interesting ways to PTSD symptoms and posttraumatic cognitions. Our findings highlight the importance of addressing intersectional adversities such as GRM for BWLWH, as well as recognizing the role that GRM may play in mental health symptoms for Black women. Future research and intervention efforts aimed at improving the well-being of BWLWH should address GRM. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

PTSD severity among emergency personnel: An investigation based on the Ehlers and Clark cognitive model.

The relevance of both cognitive and interpersonal processes in predicting adjustment to potentially traumatic events has been highlighted in the literature. The aim of the present study was to investigate whether dysfunctional disclosure mediates the relationship between excessive negative appraisals and posttraumatic stress disorder (PTSD) symptomatology that is proposed in the cognitive PTSD model of Ehlers and Clark (2000). A sample of 134 emergency service workers was interviewed to gain in-depth information regarding their experience of potentially traumatic events, and the following social interactions. Additionally, participants responded to the Disclosure of Trauma Questionnaire, the Posttraumatic Cognitions Inventory, and the Impact of Event Scale-Revised. Bootstrap mediation analyses revealed that the effect of negative trauma related appraisals on PTSD symptoms is partly mediated by dysfunctional disclosure. In particular, the two aspects of dysfunctional disclosure "reluctance to talk" and "excessive emotional reactions during disclosure" were of relevance in this model. The results remained stable even when controlling for potentially relevant sociodemographic and situational characteristics. Our results stress the importance of not only cognitive factors, but also interpersonal behavior in the development and maintenance of PTSD symptoms because we identified interpersonal risk factors (i.e., dysfunctional communicative strategies) to be relevant for PTSD elevation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Applying the Radical Exposure Tapping Protocol in the Treatment of Trauma-Related Emotional Reactivity: A Phenomenological Case Study

This study aimed to investigate the phenomenological experience of an individual engaged in the Radical Exposure Tapping (RET) protocol (MacKinnon, 2014) for trauma-related emotional reactivity. A single case study design was selected to allow for a comprehensive investigation of the participant’s experience following the administration of the RET protocol. Qualitative methods, including interpretive phenomenological analysis (Smith &amp; Osborn, 2009; Smith &amp; Osborn, 2015), were used as the participant’s experience was of primary importance. Data analysis revealed three superordinate themes resulting from the process of the RET protocol—emotional experiences, memory processing, and vulnerability—with each theme comprising various interrelating subordinate themes. Findings suggested the usefulness of the RET protocol in the reduction of trauma-related emotional reactivity for the case study participant, with relevant limitations discussed. More, however, needs to be known about the outcome reliability and mechanism(s) of change for the RET protocol in the treatment of posttraumatic stress disorder (PTSD) symptomatology.

Examination of the effects of impulsivity and risk-taking propensity on alcohol use in OEF/OIF/OND Veterans.

A strong association between posttraumatic stress disorder (PTSD) and problematic alcohol use has been demonstrated among Veteran populations exposed to combat trauma. Several traits, such as higher levels of risk-taking propensity (RTP) and impulsivity (e.g., negative urgency [NU]), are associated with both increased PTSD symptom-atology and greater alcohol use problems. The present study examined the effects of NU and RTP on alcohol use (measured by average weekly alcohol consumption and number of binge drinking days in 1 month), as well as their potential moderating effects on the association between PTSD symptom severity and alcohol use in a sample of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND) US Veterans. We hypothesized that NU and RTP would both significantly predict alcohol use and moderate the relation between PTSD symptom severity and alcohol use, such that the association between PTSD symptoms and alcohol use would be greater among individuals high compared to low in NU and RTP. As hypothesized, the main effects of RTP and NU were significantly positively associated with average weekly alcohol consumption and the number of binge drinking days in the past month. However, neither NU nor RTP moderated the relation between PTSD and either alcohol variable. NU and RTP may represent transdiagnostic risk markers for PTSD and alcohol use problems; however, the current study did not support an exploratory role of NU or RTP in the association between PTSD and alcohol use phenotypes.

Factors associated with high functioning despite distress in post-9/11 veterans.

This study aimed to identify modifiable factors associated with perceived functioning among veterans with high symptoms of posttraumatic stress disorder (PTSD). Two hundred fifty-one post-9/11 veterans completed a survey of psychosocial symptoms and functioning; a subset participated in a follow-up survey (n = 109). Latent profile analysis (LPA) at baseline identified groups that differed by level of functioning (high/low). Items utilized in the LPA analysis were derived from the World Health Organization Quality of Life-Bref self-report measure. Veterans with high PTSD symptoms in both groups were compared and logistic regression was utilized to predict group membership. Veterans with high functioning/high symptoms (n = 45) had significantly lower alcohol use and sleep problems, and higher postdeployment social support, posttraumatic growth, and optimism than veterans with low functioning/high symptoms (n = 100). Fewer sleep difficulties and higher postdeployment social support and optimism were associated with membership in the high functioning/high symptom group. These findings support the importance of identifying factors that can facilitate higher social, occupational, and general functional capacity for those with high levels of PTSD symptomatology. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Understanding the association between posttraumatic stress disorder characteristics and physical health conditions: A population-based study

Posttraumatic stress disorder (PTSD) is commonly comorbid with a range of physical health conditions. The aim of this study was to examine the association between index trauma and PTSD symptom clusters with physical health conditions, among individuals with PTSD in a population-based sample. Data were analyzed from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC-III; N = 36,309). Past-year PTSD (n = 1779) was assessed using a clinical interview in accordance with DSM-5 criteria. Multiple logistic regression models examined the associations between PTSD symptom clusters and index trauma with physical health conditions. Results of the most stringent model, adjusting for sociodemographics, other psychiatric conditions, and other PTSD symptom clusters, indicated re-experiencing symptoms were associated with cardiovascular and endocrine/metabolic conditions (adjusted odds ratio (AOR) range: 1.18–1.33) and negative alterations in mood and cognition symptoms were associated with sleep disorder (AOR = 1.16, 95% confidence interval (CI) [1.04–1.30], p = .009). Results also demonstrated significant associations between life-threatening illness with cancer, digestive, and neurologic conditions (AOR range: 2.10–3.42) and life-threatening injury with musculoskeletal and neurologic conditions (AOR range: 1.76–2.04). Finally, significant associations emerged between psychological trauma with musculoskeletal and neurologic conditions (AOR range: 0.48–0.66), and other trauma with digestive conditions and anemia (AOR range: 0.38–0.47). Results suggest PTSD symptomatology and index trauma play a differential role in their association with variable physical health conditions. Results may inform screening practices and targeted interventions to mitigate risk of PTSD and physical health conditions.

Appraisal-based cognitive bias modification in patients with posttraumatic stress disorder: a randomised clinical trial

ABSTRACT Background: Negative appraisals of the trauma and its sequelae play a crucial role in the development and maintenance of Posttraumatic Stress Disorder (PTSD). Experimental studies have shown promise in reducing negative appraisal through Cognitive Bias Modification (CBM) training. Objective: To determine whether an online CBM training designed to modify dysfunctional appraisals is successful in reducing appraisal bias in PTSD patients. Method: In this double-blinded 2-arm randomised clinical trial, 107 patients with PTSD were randomly allocated to active (n = 49) or control online CBM training (n = 57). Training comprised the completion of four sessions of online CBM training within one week. Change in bias, as measured by a scenario task and questionnaire (i.e. PostTraumatic Cognition Inventory), was the primary outcome. Secondary outcome included change in PTSD symptoms. Assessments took place prior to training, during training sessions, post-training and at 1- and 6-month follow-up. Results: Intent-to-treat analysis indicated that there was no interaction effect of condition by time. Regardless of training condition, participants showed a small to moderate decline in appraisal bias and PTSD symptoms from pre- to post-training. In both conditions, bias change during training sessions was related to decline in PTSD symptomatology following training. No moderators of outcome were found. Conclusions: There was no evidence that active training was more effective than control training in reducing dysfunctional appraisals. In both conditions, participants showed a decline in dysfunctional appraisals and PTSD symptoms following training. Importantly, bias reduction during training was related to PTSD symptom decline following training. Explanations and future research directions are discussed.

The Mediating Effect of Pain Catastrophizing on PTSD Symptoms and Pain Outcome.

Coprevalence of chronic pain and posttraumatic stress disorder (PTSD) negatively impacts the course of both disorders. Patients diagnosed with both conditions report greater pain, affective distress, and disability when compared with those with either chronic pain or PTSD alone. While the prevalence and complexity of the comorbidity is widely acknowledged, there is a dearth of research examining potential mechanism variables that might account for the relationship between chronic pain and PTSD. The current study utilizes a series of mediation analyses to examine if pain catastrophizing mediates the relationship between PTSD symptomatology and chronic pain outcome. A total of 203 treatment-seeking participants admitted to a 3-week interdisciplinary pain rehabilitation program completed a battery of psychometrically validated measures of pain severity, pain interference, pain catastrophizing, depressive symptoms, and PTSD symptoms at program admission. A series of multiple parallel mediation analyses revealed that pain catastrophizing fully mediated the relationships between PTSD symptoms and pain outcome (ie, pain severity and pain interference) above and beyond the influence of depressive symptoms. Results suggest that pain catastrophizing may represent an important cognitive mechanism through which PTSD symptoms influence the experience of chronic pain. Psychosocial treatment approaches that directly target tendency to catastrophize in response to pain may hold the potential to have salutary effects on both chronic pain and PTSD.

Cardiac Arrest and Subsequent Hospitalization-Induced Posttraumatic Stress Is Associated With 1-Year Risk of Major Adverse Cardiovascular Events and All-Cause Mortality.

To compare 1-year all-cause mortality and major adverse cardiovascular events in cardiac arrest survivors with and without posttraumatic stress disorder symptomatology at hospital discharge. Prospective, observational cohort. ICUs at a tertiary-care center. Adults with return of spontaneous circulation after in-hospital or out-of-hospital cardiac arrest between September 2015 and September 2017. A consecutive sample of survivors with sufficient mental status to self-report cardiac arrest and subsequent hospitalization-induced posttraumatic stress disorder symptoms (cardiac arrest-induced posttraumatic stress symptomatology) at hospital discharge were included. None. The combined primary endpoint was all-cause mortality or major adverse cardiovascular event-hospitalization for nonfatal myocardial infarction, unstable angina, congestive heart failure, emergency coronary revascularization, or urgent implantable cardio-defibrillators/permanent pacemaker placements within 12 months of discharge. An in-person posttraumatic stress disorder symptomatology was assessed at hospital discharge via the Posttraumatic Stress Disorder Checklist-Specific scale; a suggested diagnostic cutoff of 36 for specialized medical settings was adopted. Outcomes for patients meeting (vs not meeting) this cutoff were compared using Cox-hazard regression models. Of 114 included patients, 36 (31.6%) screened positive for cardiac arrest-induced posttraumatic stress symptomatology at discharge (median 21 d post cardiac arrest; interquartile range, 11-36). During the follow-up period (median = 12.4 mo; interquartile range, 10.2-13.5 mo), 10 (8.8%) died and 29 (25.4%) experienced a recurrent major adverse cardiovascular event: rehospitalizations due to myocardial infarction (n = 4; 13.8%), unstable angina (n = 8; 27.6%), congestive heart failure exacerbations (n = 4; 13.8%), emergency revascularizations (n = 5, 17.2%), and urgent implantable cardio-defibrillator/permanent pacemaker placements (n = 8; 27.6%). Cardiac arrest-induced posttraumatic stress symptomatology was associated with all-cause mortality/major adverse cardiovascular event in univariate (hazard ratio, 3.19; 95% CI, 1.7-6.0) and in models adjusted for age, sex, comorbidities, preexisting psychiatric condition, and nonshockable initial rhythm (hazard ratio, 3.1; 95% CI, 1.6-6.0). Posttraumatic stress disorder symptomatology is common after cardiac arrest, and cardiac arrest-induced posttraumatic stress symptomatology was associated with significantly higher risk of death and cardiovascular events. Further studies are needed to better understand the underlying mechanisms.

Presence and influence of trauma in inpatient psychiatric care

Background: Previous research indicates traumatic exposure and posttraumatic stress disorder (PTSD) occur at a higher rate in people with severe mental illness (SMI) than in the general population, and co-occurring PTSD symptoms can worsen outcomes for patients with SMI.Objective: This study assessed the presence and influence of PTSD symptoms in individuals with SMI in an inpatient psychiatric setting, and rates of PTSD diagnoses in this population.Methods: Retrospective analysis of demographic information and behavioral health outcomes, using a representative sample of adult and geriatric inpatient psychiatric patients (N = 4,126).Results: This study found elevated PTSD symptoms in over 65% of patients, and significant positive correlations between PTSD symptomatology and behavioral and emotional dysfunction. This study also explored differences in patients with PTSD symptoms who did and did not receive a PTSD diagnosis, finding associations for admission severity, race, and gender.Conclusions: Traumatization and PTSD symptoms were prevalent in psychiatric inpatient settings, and had an impact on behavioral health outcomes. Recommendations include the use of PTSD screening in behavioral healthcare admission processes, and the furtherance of trauma-informed care for inpatient psychiatric patients with SMI, due to the volume of traumatization and PTSD symptoms in the population.

Understanding the Scientific Basis of Post-traumatic Stress Disorder (PTSD): Precision Behavioral Management Overrides Stigmatization.

Post-traumatic stress disorder (PTSD) is a severe polygenic disorder triggered by environmental factors. Many polymorphic genes, particularly the genetic determinants of hypodopaminergia (low dopamine function), associate with a predisposition to PTSD as well as substance use disorder. Support from the National Institutes of Health for neuroimaging research and molecular, genetic applied technologies has improved understanding of brain reward circuitry functions that have inspired the development of new innovative approaches to their early diagnosis and treatment of some PTSD symptomatology and addiction. This review presents psychosocial and genetic evidence that vulnerability or resilience to PTSD can theoretically be impacted by dopamine regulation. From a neuroscience perspective, dopamine is widely accepted as a major neurotransmitter. Questions about how to modulate dopamine clinically in order to treat and prevent PTSD and other types of reward deficiency disorders remain. Identification of genetic variations associated with the relevant genotype-phenotype relationships can be characterized using the Genetic Addiction Risk Score (GARS®) and psychosocial tools. Development of an advanced genetic panel is under study and will be based on a new array of genes linked to PTSD. However, for now, the recommendation is that enlistees for military duty be given the opportunity to voluntarily pre-test for risk of PTSD with GARS, before exposure to environmental triggers or upon return from deployment as part of PTSD management. Dopamine homeostasis may be achieved via customization of neuronutrient supplementation "Precision Behavioral Management" (PBM™) based on GARS test values and other pro-dopamine regulation interventions like exercise, mindfulness, biosensor tracking, and meditation.

The unseen cost of justice: post-traumatic stress symptoms in Canadian lawyers

ABSTRACTLimited research has been conducted on the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5; 2013) exposure criterion: ‘work-related exposure to aversive details of traumatic events’. This study investigated the presence and severity of post-traumatic stress disorder (PTSD) symptomatology among a national cross-sectional sample of practicing Canadian lawyers (N = 476). Participants were categorized into three groups: no, moderate, and high work-related exposure to potentially traumatic material. As hypothesized, lawyers in the moderate and high work-related trauma exposure groups obtained more elevated (severe) mean scores of PTSD symptoms, psychological distress, and reported a poorer quality of life (p < .05) compared to their unexposed colleagues. An important proportion of lawyers scored above the clinical threshold for probable PTSD (9%), psychological distress (23%), and unsatisfactory quality of life (23%). Trauma-exposed lawyers were 2.62 times (95%CI: 1.12–6.12, p = .027) more likely to meet the probable PTSD threshold than the unexposed lawyers. Congruent with the DSM-5 reformulation of trauma exposure, lawyers exposed to aversive details of traumatic events are at increased risk of developing PTSD symptoms requiring an intervention. Future research using random sampling and face-to-face interviews should be conducted to further establish the human cost of this emerging problem.

Repeated ketamine infusions for antidepressant-resistant PTSD: Methods of a multicenter, randomized, placebo-controlled clinical trial

Posttraumatic stress disorder (PTSD) is a debilitating disorder with limited medication treatment options. Recent reports have described the dearth of research on new drug development as a crisis in the pharmacotherapy of PTSD. There are only two PTSD medications approved by the U.S. Food and Drug Administration, and both are serotonergic antidepressants. Therefore, there is a tremendous need to identify more effective and more rapidly acting pharmacotherapies for PTSD that work through novel neural mechanisms. Pilot evidence and case reports provided preliminary evidence supporting the safety and utility of investigating the therapeutic effects of ketamine in PTSD. However, the efficacy of this drug for PTSD has not yet been tested in active duty military or veteran populations. Here, we report the design and methods of a study funded under the Consortium to Alleviate PTSD. The study is a multisite, placebo-controlled, double–blind, randomized clinical trial to examine the dose-related efficacy of ketamine, as compared to placebo, in producing a rapid and sustained reduction in PTSD symptomatology in veterans and active duty military populations with antidepressant-resistant PTSD. Approximately 198 eligible participants who meet criteria for PTSD will be randomized to the study drug (i.e., ketamine 0.5 mg/kg, ketamine 0.2 mg/kg, or placebo). The study drug will be administered intravenously twice per week for 4 weeks, followed by a 4-week follow-up period. This ongoing study is the only trial of therapeutic effects of ketamine for PTSD and the first placebo-controlled trial to determine the dose-related effects of repeated ketamine on PTSD.

Military Veteran Status and Posttraumatic Stress Disorder Symptomatology Among Urban Firefighters: The Moderating Role of Emotion Regulation Difficulties.

A significant portion of firefighters are military veterans, and both populations experience high rates of trauma and posttraumatic stress disorder (PTSD) symptomatology. We investigated main and interactive effects of military veteran status (MVS) and emotion regulation difficulties (ERD) with regard to PTSD symptom severity in firefighters. Covariates included trauma load, number of years in the fire department, and depressive symptom severity. The sample was composed of 839 (93.9% men; mean age = 38.4, SD = 8.5) trauma-exposed firefighters who completed a web-based questionnaire battery. Structural equation modeling was used. ERD were significantly, positively associated with PTSD symptom severity (β = 0.30, confidence interval [CI] = 0.20-0.41, p < 0.001). A significant interactive effect was noted (β = 0.07, CI = 0.01-0.14, p = 0.020); firefighters who endorsed MVS and greater ERD had the highest levels of PTSD symptom severity. It is vital that future work examine associations between MVS and relevant cognitive mechanisms for the purposes of informing effective screening, intervention, and prevention programs.

Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation.

Posttraumatic stress disorder (PTSD) is a prominent mental health problem in veteran and community populations. There is accumulating evidence to suggest that aerobic exercise may serve as an effective treatment option for individuals with PTSD. The purpose of this review is to summarize the existing literature exploring aerobic exercise and PTSD and briefly discuss potential mechanisms of PTSD symptom reduction. A search of electronic databases and reference sections of relevant articles published through October 1, 2018 revealed 19 relevant studies that examined aerobic exercise and PTSD symptomatology. A narrative review of extant studies provides encouraging evidence that aerobic exercise interventions alone or as an adjunct to standard treatment may positively impact PTSD symptoms. Potential mechanisms by which aerobic exercise could exert a positive impact in PTSD include exposure and desensitization to internal arousal cues, enhanced cognitive function, exercise-induced neuroplasticity, normalization of hypothalamic pituitary axis (HPA) function, and reductions in inflammatory markers. Randomized clinical trials and translational neuroscience approaches are required to clarify the efficacy of exercise intervention for PTSD and elucidate potential mechanisms of exercise-induced PTSD symptom reduction.

The Corpus Callosum and PTSD Severity.

Posttraumatic stress disorder (PTSD) is a chronic, debilitating disorder that is associated with neural alterations in multiple brain regions. Neuroimaging studies have largely focused on gray matter abnormalities in PTSD, with less information known about the integrity of white matter tracts. Prior studies of brain white matter in PTSD have produced mixed results, likely due to differences in neuroimaging sequences and clinical variables. This study addressed this gap by examining the microstructural integrity of the corpus callosum, the largest white matter fiber bundle in the brain, using diffusion tensor imaging (DTI). Sixty adult females diagnosed with PTSD with a history of interpersonal violence were compared with 18 trauma-exposed controls. All participants underwent DTI using 1.5 T. MANOVA revealed significantly higher fractional anisotropy (FA; p = .012) in the genu of the corpus callosum (GCC) compared with the trauma-exposed controls. These results suggest the GCC to relate to PTSD symptomatology. Further studies of this mechanism may provide insight into improving treatment and prevention efforts.